Three-year clinical evaluation of a silorane composite resin. A randomized controlled three year evaluation of "bulk-filled" posterior resin restorations based on stress decreasing resin technology. Clinical performance of posterior composite resin restorations. One-year clinical evaluation of two resin composites, two polymerization methods, and a resin-modified glass ionomer in non-carious cervical lesions. Three-year randomized clinical evaluation of a low-shrinkage silorane-based resin composite in non-carious cervical lesions Clinical evaluation of packable and conventional hybrid posterior resin-based composites: results at 3.5 years. Two-year clinical evaluation of packable and nanostructured resin-based composites placed with two techniques. Retention of microfilled and hybrid resin-based composite in noncarious Class 5 lesions: a double-blind, randomized clinical trial. A prospective, randomized, double-blind clinical trial of one nano-hybrid and one high-viscosity bulk-fill composite restorative systems in class II cavities: 12 months results Clinical evaluation of two posterior composite resins: two-year results. Two-year clinical comparison of a microfilled and a hybrid resin-based composite in non-carious Class V lesions. Bulk‐filled posterior resin restorations based on stress‐decreasing resin technology: a randomized, controlled 6‐year evaluation Randomized 3-year clinical evaluation of Class I and II posterior resin restorations placed with a bulk-fill resin composite and a one-step self-etching adhesive. Comparative clinical evaluation of different treatment approaches using a microfilled resin composite and a compomer in Class III cavities: two-year results. A five year study of the clinical performance of a posterior composite resin restorative material. Clinical evaluation of packable composite resins in Class-II restorations Clinical evaluation of resin composite and resin-modified glass ionomer cement in non-carious cervical lesions.
STATEMENT OF PROBLEM Composite resins are still outperformed by amalgams in the clinical practice with secondary caries and fractures being their most common failures . A material that suffers less polymerization shrinkage might improve the clinical performance of composite resins . PURPOSE To evaluate the clinical performance of a low-shrink silorane-based composite resin ( Filtek LS Low Shrink Posterior Restorative , 3 M ESPE , St. Paul , MN , USA ) in comparison with a methacrylate-based composite resin ( Tetric EvoCeram , Ivoclar Vivadent , Schaan , Principality of Liechtenstein ) over time . MATERIAL S AND METHODS C and i date s in need of Class II composite resin restorations participated in this r and omized controlled clinical trial . Those were 25 female and six male subjects with average age of 44.3 ± 12.7 years . Participants received 82 restorations , being 54 in premolars and 28 in molars . Procedures , which included the restoration of primary caries lesions or replacement of failing restorations , were done using modified preparations with no bevels or additional retention . Restorations were placed using Filtek LS ( and dedicated self-etch adhesive ) or Tetric EvoCeram ( with AdheSE , Ivoclar Vivadent ) , following manufacturers ' instructions . Incremental placement technique was applied and the restorations were immediately finished . Follow-up evaluations occurred at six , 12 , 24 , and 36 months and were done using the Fédération Dentaire Internationale criteria . Statistical analysis was performed using generalized estimating equations . RESULTS The recall rate at 36 months was 89 % . All interaction terms were not significant . CONCLUSIONS Filtek LS performs as well  as Tetric EvoCeram performs in the clinical setting at 36 months . CLINICAL SIGNIFICANCE The silorane-based composite resin Filtek LS and the conventional methacrylate-based composite resin Tetric EvoCeram performed similarly well in posterior restorations over at least 36 months of clinical service OBJECTIVE The objective of this r and omized controlled prospect i ve clinical trial was to evaluate the efficacy of a flowable resin composite ( SDR ) bulk fill technique in posterior restorations and to compare it intraindividually with a conventional 2 mm resin composite curing technique in a 3-year follow up . MATERIAL S AND METHODS Thirty-eight pairs Class II and 15 pairs Class I restorations were placed in 38 patients with a mean age of 55.3 years ( range 32 - 87 ) . Each patient received at r and om at least two , as similar as possible , Class II or Class I restorations of two restorative techniques . In all cavities a single step self-etch adhesive ( Xeno V ) was applied . In one of the cavities of each pair , a flowable resin composite ( SDR ) was placed , in bulk increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface . The occlusal part was completed with a nano-hybrid resin composite ( Ceram X mono ) layer . In the second cavity , the hybrid resin composite was placed in 2 mm increments . The restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 3 years . Caries risk and parafunctional habits of the participants were estimated . RESULTS After three years , 76 Class II and 28 Class I restorations could be observed . One molar resin composite-only tooth showed post-operative sensitivity during 3 weeks for temperature changes and occlusal forces . Two failed Class II molar restorations in the resin composite-only group were observed during the first year , one cusp fracture and one resin composite fracture . An annual failure rate of 1.3 % was found for the resin composite only restorations and of 0 % in the bulk-filled restorations ( n.s . ) . Ten participants were estimated as having high caries risk and eleven showed active bruxing habits . SIGNIFICANCE The 4 mm bulk-fill technique with the flowable resin composite SDR showed highly clinical effectiveness , which was comparable during the 3-year follow-up with the 2 mm resin composite layering technique Two formulations of posterior composite resin ( P-30 and Bisfil-P ) were evaluated and compared to a high-copper , dispersed-phase amalgam ( Dispersalloy ) .  One hundred twenty-eight restorations were placed in 27 patients so that each patient received at least one of each material . After 3 years of clinical service , all three restorative material s produced clinical ly acceptable restorations , according to US Public Health Service and Leinfelder criteria . The amalgam restorations , however , underwent less wear ( 44 microns ) than did the posterior composite resin restorations ( 60 to 74 microns ) . Stratification of data by type of tooth , class of restoration , and size of restoration produced the same ranking of wear from lowest to highest : Dispersalloy , Bisfil-P , and P-30 . Resin restorations showed 45 % more wear in molars than in premolars , and more wear was associated with moderately sized restorations than with conservative restorations . The surface texture of restorations of composite resin with porous strontium glass filler was nearly as smooth as that of enamel and was significantly smoother than that of the restorations of composite resin with zinc glass filler or of unpolished amalgam AIM The aim of this study was to examine clinical ly relevant data on four restorative procedures for non-carious cervical lesions using United States Public Health Service (USPHS)-compatible clinical and photographic criteria and to compare different methods of analyzing clinical data . METHODS AND MATERIAL S Fourteen patients with at least one or two pairs of non-carious lesions under occlusion and a mean age of 50 were enrolled in this study . A total of 56 restorations ( 14 with each material ) were placed by three experienced , calibrated dental practitioners . Two other experienced and calibrated practitioners , under single-blind conditions , followed up on all restorations for a period of one year . Three material s were r and omly placed : a micro-hybrid composite with two polymerization methods ( G1 and G2 ) , a flowable micro-hydrid composite ( G3 ) , and a resin-modified glass ionomer ( G4 ) . Statistical analysis was performed using the Kruskall-Wallis test ( p<0.05 ) and a Mann-Whitney U modified test with a corrected significance level . RESULTS At the one year evaluation time , there were no restorations with secondary caries and the retention rates in G1 ( IntenS with a hard polymerization ) , G2 ( IntenS with a soft polymerization ) , G3 ( Filtek flow ) , and G4 ( Fuji II LC ) were 85.7 % ( two losses ) , 92.8 % ( one loss ) , 100 % , and 100 % , respectively . The total visual comparison of the results at baseline ( 15 days later ) showed significant differences only with the clinical acceptance criterion : G1 was different from G2 , with a soft polymerization device ( p<0.05 ) . In terms of surface quality at one year , G1 , G2 , and G3 exhibited a statistically significant difference from G4 , p<0.05 . The digital analysis at baseline showed significant differences only with the clinical acceptance criterion : G1=G2 was different from G3=G4 , p<0.05 . At one year , only the microporosity criterion showed any statistical differences : G1=G2=G3 was different from G4 , p<0.05 . CONCLUSIONS The resin-modified glass ionomer was easier to use and had a high retention rate , but it failed in terms of surface quality ( visual mode ) and porosity ( digital mode ) criteria compared to the others groups . Overall results showed no difference between groups G1 ( hard-polymerized ) and G2 ( soft-polymerized ) , and only G1 was affected by the marginal edge ( p<0.03 ) and integrity criteria ( p<0.02 ) at one year Objective The clinical suitability of low-shrinkage resin composites for class V cavities has not been investigated in vivo . The purpose of this double-blind r and omized clinical trial was to compare the clinical performances of low-shrinkage resin composite Filtek silorane and nanoceramic resin composite Ceram X mono in non-carious cervical lesions ( NCCLs ) over 36 months . Material s and methods Two calibrated operators restored 144 NCCLs in 24 patients by using Filtek silorane with silorane system adhesive ( FS/SSA ) and Ceram X mono with Clearfil SE ( CXM/CSE ) or XP bond ( CXM/XPB ) . Then , two blinded , calibrated evaluators assessed the restorations at the baseline and 6 , 12 , 24 , and 36 months thereafter by using the modified US Public Health Service criteria . Data were analyzed with the Freidman and Wilcoxon signed-rank tests at a significance level of 5 % ( P < 0.05 ) . Results No restoration was associated with postoperative sensitivity or secondary caries . Further , no group showed significant changes until 12 months . The retention rates of the FS/SSA ( 97.5 % ) , CXM/CSE ( 97.5 % ) , and CXM/XPB ( 92.31 % ) restorations did not differ significantly ( P > 0.05 ) . Six ( 4 CXM/XPB , 1 FS/SSA , and 1 CXM/CSE ) of the 121 restorations evaluated at 36 months were completely lost . However , no significant intergroup differences were observed in the other evaluation criteria . Conclusion The 3-year clinical performances of the restorative material s in NCCLs were not significantly different . Clinical relevance Filtek silorane is suitable for restoring NCCLs BACKGROUND The authors evaluated clinical performances of a packable and a conventional hybrid resin-based composite used with a self-etch adhesive system . METHODS Three dentists placed 105 posterior restorations in 65 adults . They placed a packable ( SureFil , Dentsply DeTrey GmbH , Konstanz , Germany ) and a conventional ( Spectrum , Dentsply DeTrey GmbH ) resin-based composite using a self-etch resin adhesive system . The authors evaluated the restorations using Ryge modified criteria , photographs and die stone replicas . RESULTS After 3.5 years , six large SureFil and two Spectrum restorations had failed from bulk fracture and secondary caries , result ing in cumulative survival rates of 81.3 and 92.0 percent , respectively . Failed  SureFil restorations generally were larger than the remaining intact restorations . Other ratings were satisfactory , with no significant differences between the two material s for any restoration parameter . Alfa ratings for both material s were approximately 80 percent or greater for marginal discoloration , anatomical form , surface texture and surface staining . Lower percentages of restorations were rated Alfa for color match , marginal integrity and gingival health . No postoperative sensitivity was reported . Net mean occlusal wear ( + /- st and ard deviation ) was 28.9 ( + /- 32.9 ) micrometers for SureFil and 33.8 ( + /- 29.6 ) microm for Spectrum restorations ; the difference was not statistically significant . CONCLUSIONS When used with a self-etch adhesive , the 3.5-year clinical performances of both composites were similar and satisfactory for the restoration of Class I and moderate-sized Class II cavities . Clinical Implication s. The two composites placed in this study have an increased risk of bulk fracture when placed in large intracoronal Class II molar preparations BACKGROUND The authors conducted a two-year clinical trial to evaluate the effectiveness of two resin-based composite material s for Class II restorations placed according to two filling techniques . METHODS Twenty-six patients received 105 Class II restorations , which the authors distributed r and omly into three groups of 35 each . The resin-based composite restorations in group A were composed of average-density material ( Ceram X mono [ CXM ] , Dentsply DeTrey , Konstanz , Germany ) placed according to the oblique incremental technique ( OIT ) . Restorations in group B were composed of average- and high-density material s ( CXM and SureFil [ SF ] , Dentsply DeTrey ) placed according to the modified incremental technique ( MIT ) . Restorations in group C were composed of the high-density material ( SF ) placed with the OIT . The authors evaluated the restorations according to modified U.S. Public Health Service criteria . RESULTS At the two-year recall visit , 92 ( 88 percent ) of 105 restorations were available for examination . Restorations in groups A , B and C had success rates of 96.7 percent ( 29 of 30 restorations ) , 96.8 percent ( 30 of 31 ) and 100 percent ( 31 of 31 ) , respectively . Esthetic parameters revealed significant ( P<.05 ) cavo-surface marginal discoloration in group B and a rougher surface in group A. With regard to functional parameters , one ( 3.3 percent ) of 30 restorations in group A exhibited reparable changes in marginal integrity . CONCLUSIONS Restorations in group B performed worse ( P<.05 ) in terms of esthetic ( cavosurface marginal discoloration ) and functional ( marginal integrity ) parameters . Clinical effectiveness was highest in group C and lowest in group B. CLINICAL IMPLICATION S The two resin-based composite material s are effective in Class II clinical situations when placed with either the OIT or MIT This double-blind clinical trial was undertaken to compare the retention rate of restorative material s with contrasting stiffness in noncarious class 5 lesions . All restorations were placed using retraction cord and cotton roll isolation to more closely mimic the general practice setting . Thirty subjects with at least two lesions were recruited to participate in the study . Each subject received one restoration using Silux Plus and one using Z100 . The assignment of material was r and omized , and the subjects were unaware of which tooth had received which material . All restorations were placed with a fourth-generation adhesive liner , Scotchbond Multi- Purpose . Evaluations were performed at baseline , 6 , and 12 months by two independent examiners unaware of the restoration 's group identity . The restorations were evaluated using criteria developed by Cvar and Ryge in a forced-consensus model . Despite the fact that the two material s have widely different elastic modulus values , after 12 months no difference between the retention rates for the two groups was found , and both groups of restorations performed very well Background : Recently , manufacturers have introduced bulk-fill composite resins that reportedly can be placed in increments of 4 mm or greater . Objective : The purpose of this article was to report the results of 12 months prospect i ve r and omized clinical trial that evaluated the clinical performance of one high-viscosity bulk-fill composite resin in Class II cavities of posterior teeth . Material s and Methods : Thirty-four participants had at least two Class II cavities included the study . Class II cavities restored with either a Tetric EvoCeram bulk-fi fill or universal nano-hybrid resin composite ( Tetric EvoCeram ) . A total of 74 restorations ( 37 with each material ) on 34 patients were placed according to the manufacturers ' instructions by one calibrated operator . Results : Seventy restorations were evaluated after 12 months evaluation period . No postoperative sensitivity , anatomic form , retention , and secondary caries were observed after 6 and 12 months . Regarding the items color match , marginal discoloration , and marginal adaptation , the statistical analysis did not detect any statistical significance between two material s ( P > 0.05 ) . Conclusion : After 12 months of clinical service , all restorations evaluated for both material s were classified as ideal , receiving predominantly Alfa scores for all parameters analyzed . Clinical Relevance : This study presents that high-viscosity bulk-fill resin composites ( RCs ) perform just as well as nano-hybrid RCs with the 2 mm RC layering technique , therefore could be alternative to conventional nano-hybrid RCs Two composite resins were evaluated for clinical acceptability as restorative material s in Class I and II cavities over a 2-year-period . In addition , dispersed phase alloy was evaluated for comparison . All restorations were assessed for anatomical form , marginal integrity and marginal leakage using modified United States Public Health Service ( USPHS ) criteria . At the 2-year recall , 96 % of the composites and 100 % of the amalgams were rated ' alpha ' or ' bravo ' , using the parameters of assessment defined in this study . However , a significant number of shifts from the baseline , within the level of acceptability , had occurred . The two composites showed the greatest number of shifts for anatomical form and marginal leakage , while there were no differences between the composites and the amalgam for shifts in marginal integrity . Although a very high level of acceptability was determined for all of the material s , the frequency of rating change within categories for the composites was a cause of concern with regard to their long-term clinical use The purpose of this double-blind clinical trial was to compare the retention rate in noncarious Class V lesions of two resin-based composite restorative material s with contrasting stiffness . Isolation with retraction cord , pressed paper triangles , and cotton rolls was used to closely mimic the procedures generally used in a practice setting . Thirty pairs of restorations were placed , one using Silux Plus and one using Z100 . The assignment of material was r and omized , and the subjects were unaware of the material used . All restorations were placed with a fourth-generation adhesive liner , Scotchbond Multi- Purpose . Evaluations were performed at baseline , 6 , 12 , 18 , and 24 months by two independent examiners using criteria developed by Cvar and Ryge in a forced consensus model . Examiners were unaware of the restoration 's group identity . No difference between the retention rates for the two groups was found after 24 months , bringing into question the role that a material 's stiffness plays in determining retention in a noncarious Class V lesion This r and omized study evaluated a flowable resin composite bulk-fill technique in posterior restorations and compared it intraindividually with a conventional 2-mm resin composite layering technique over a 6-yr follow-up period . Thirty-eight pairs of Class II restorations and 15 pairs of Class I restorations were placed in 38 adults . In all cavities a single-step self-etch adhesive ( Xeno V ) was applied . In the first cavity of each pair , the flowable resin composite ( SDR ) was placed , in bulk increments of up to 4 mm . The occlusal part was completed with a layer of nanohybrid resin composite ( Ceram X mono ) . In the second cavity of each pair , the hybrid resin composite was placed in 2-mm increments . The restorations were evaluated using slightly modified US Public Health Service ( USPHS ) criteria at baseline and then annually for a time period of 6 yr . After 6 yr , 72 Class II restorations and 26 Class I restorations could be evaluated . Six failed Class II molar restorations , three in each group , were observed , result ing in a success rate of 93.9 % for all restorations and an annual failure rate ( AFR ) of 1.0 % for both groups . The AFR for Class II and Class I restorations in both groups was 1.4 % and 0 % , respectively . The main reason for failure was resin composite fracture PURPOSE To evaluate the 3-year clinical durability of the flowable bulk-fill resin composite SDR in Class I and Class II restorations . MATERIAL S AND METHODS Thirty-eight pairs of Class I and 62 pairs of Class II restorations were placed in 44 male and 42 female patients ( mean age 52.4 years ) . Each patient received at least two extended Class I or Class II restorations that were as similar as possible . In all cavities , a one-step self-etching adhesive ( XenoV+ ) was applied . One of the cavities of each pair was r and omly assigned to receive the flowable bulk-fill resin composite SDR in increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface . The occlusal part was completed with an ormocer-based nanohybrid resin composite ( Ceram X mono+ ) . In the other cavity , only the resin composite CeramX mono+ was placed in 2 mm increments . The restorations were evaluated using slightly modified USPHS criteria at baseline and then annually for 3 years . Caries risk and bruxing habits of the participants were estimated . RESULTS No post-operative sensitivity was reported . At the 3-year follow-up , 196 restorations - 74 Class I and 122 Class II - were evaluated . Seven restorations failed ( 3.6 % ) , 4 SDR-CeramX mono+ and 3 CeramX mono+ only restorations , all of which were Class II . The main reason for failure was tooth fracture , followed by resin composite fracture . The annual failure rate ( AFR ) for all restorations ( Class I and II ) was 1.2 % for the bulkfilled restorations and 1.0 % for the resin composite-only restorations ( p > 0.05 ) . For the Class II restorations , the AFR was 2.2 % and 1.6 % , respectively . CONCLUSION The 4-mm bulk-fill technique showed good clinical effectiveness during the 3-year follow-up This study evaluated the 24-month clinical performance of a microfilled composite using a one-bottle bonding system and a compomer that uses one-bottle bonding systems , which include a non-rinse conditioner or 36 % phosphoric acid gel in Class III cavities . Each patient received three restorations due to primary caries of the anterior teeth , result ing in a total of 96 restorations . Three types of restoration/adhesive combinations were used : a microfilled resin composite ( Filtek A110 ) with a one-bottle bonding system ( Single Bond ) ; a polyacid-modified resin composite ( compomer ) ( Dyract AP ) with a filled one-bottle bonding system ( Prime & Bond NT ) using 36 % phosphoric acid pretreatment and a polyacid-modified resin composite ( compomer ) ( Dyract AP ) with a filled one-bottle bonding system ( Prime & Bond NT ) using a non-rinse conditioner ( NRC ) and a self-priming pretreatment . At baseline and one- and two-year recalls , color match , marginal discoloration , wear or loss of anatomical form , caries , marginal adaptation and surface texture of the restorations were evaluated by two experienced , calibrated examiners using the modified Ryge criteria . After two years , one restoration from each group had a rating of Charlie ( C ) for both color match and marginal discoloration and needed to be replaced . Therefore , the failure rate was 3.6 % ( success rate : 96.4 % ) for each group at the end of two years . Statistical analysis showed no significant differences among the three groups in color match , marginal discoloration , wear or loss of anatomical form , marginal adaptation and surface texture after two years . Also , no statistically significant differences were determined for each group with respect to color match , marginal discoloration , wear or loss of anatomical form , marginal adaptation and surface texture at the end of two years Five-year results from four centres of the multicentre clinical trial of the posterior composite Occlusin are reported . Data is presented in respect of 256 restorations of Occlusin and 69 restorations of a conventional lathe cut amalgam .  It is concluded that more than 90 per cent of the restorations under investigation should be rated as clinical ly acceptable after five years in clinical service , that the wear resistance of the restorations of Occlusin , as assessed by the clinicians , was similar in preparations of different sizes and to that of the amalgam controls , and that similar clinical results were obtained irrespective of the technique used to achieve moisture isolation Abstract . This study investigated the clinical performance of two packable composite resins  in Class-II restorations . One hundred and four Class-II restorations were placed in 52 patients by five dentists ( four in dental practice s and one in a university clinic ) in a controlled prospect i ve multicentre clinical trial . Each patient received one Definite/Etch & Prime 3.0 ( D-EP ) and one Solitaire/Solid Bond ( S-SB ) restoration , which were examined clinical ly according to modified USPHS- criteria after 1 week ( baseline ) and after 1 year . Statistical analysis was performed using the Wilcoxon rank sum test and the error rates method . The significance level was set to 0.05 . At baseline both material s performed equally according to the evaluated criteria . After 1 year D-EP showed significantly worse marginal adaptation compared to S-SB . Both material s displayed significant deterioration for the criteria marginal adaptation , marginal discolouration , approximal contact , and fracture of restoration after 1 year compared to baseline . With a failure rate of 9.6 % after 1 year , D-EP did not fulfill ADA acceptance criteria for restorative material s. It is proposed that at least 1-year data of clinical testing should be available before a new material is broadly marketed BACKGROUND The clinical performance of various tooth-coloured material s used to restore Non-Carious Cervical Lesions ( NCCLs ) has been evaluated . However , most of these evaluations were in western societies where soft diets requiring little mastication were common . The present study sets out to evaluate resin composite and RMGIC in the restoration of NCCLs among a Nigerian sub population group with fibrous diet requiring more rigorous mastication . PATIENTS & METHODS The study included all adult patients that presented at the Dental Hospital , Obafemi Awolowo University Teaching Hospitals Complex , Ile-Ife , Nigeria with non-carious cervical lesions over a period of six months . The teeth with non-carious cervical lesions in each patient were allocated into treatment with either resin composite or resin-modified glass ionomer cement by simple r and om sampling using ballots . The depth of the NCCLs was measured using a graduated flat ash periodontal probe . All the treatment was done by the first author according to the manufacturer 's instructions . Patients were recalled and evaluated at 48- hours , 3- months , 6- months and 12- months using the USPHS criteria . Data analysis was done using SPSS version 15 . The level of significance was put at 0.05 . RESULTS At the end of 12 months , 143 resin composite and 144 RMGIC restorations were evaluated , out of which 37 resin composite and 13 RMGIC restorations were dislodged , giving a retention rate of 74.1 % and 91.0 % respectively . The difference was statistically significant ( p<0.05 ) . For marginal discolouration , marginal adaptation , abrasion wear resistance , post operative sensitivity , and secondary caries , there were no statistically significant differences in the performance of resin composite and RMGIC . There was more retention failure of both resin composite and RMGIC restorations in NCCLs in m and ibular teeth than in maxillary teeth . The differences were statistically significant ( p<0.05 ) . CONCLUSION RMGIC demonstrated a higher retention rate in the restoration of non-carious cervical lesions than resin composite over a period of 12 month
The meta- analysis of the data in the included studies demonstrated that only one variable ( marginal adaptation after 12 months ) showed statistically significant outcomes , in which methacrylates-based composites presented significantly better results than resin composites containing modified monomers .
The good level of the scientific evidence as well as the overall low risk of bias of the included studies indicate that composites with silorane , ormocer or bulk-fill type modified monomers have a clinical performance similar to conventional resin composites
Polymerization shrinkage of resin composite can compromise the longevity of restorations .
To minimize this problem , the monomeric composition of composites have been modified .
The objective of this study was to conduct a meta- analysis to assess the clinical behavior of restorations performed with low polymerization shrinkage resin composite  in comparison with traditional methacrylates-based resin composite .