The clinical performance of a posterior composite resin restorative material, Heliomolar R.O.: 3-year report. A practice-based, randomized, controlled clinical trial of a new resin composite restorative: one-year results. Clinical evaluation of resin composite and resin-modified glass ionomer cement in non-carious cervical lesions. 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. Clinical evaluation of packable and conventional hybrid posterior resin-based composites: results at 3.5 years. One year clinical evaluation of two different types of composite resins in posterior teeth. Resin-dentin interfaces of endodontically-treated restored teeth. Two-year clinical performance of sonic-resin placement system in posterior restorations. 56-month clinical performance of Class I and II resin composite restorations Endodontic complications after plastic restorations in general practice. Three-year clinical evaluation of a self-cured posterior composite resin. Clinical evaluation of polyacid-modified resin composite posterior restorations: one-year results. A thirty months clinical evaluation of a posterior composite resin in primary molars. Retention of microfilled and hybrid resin-based composite in noncarious Class 5 lesions: a double-blind, randomized clinical trial. Clinical evaluation of two packable resin-based composite restorations: a three-year report. Four-year clinical evaluation of posterior resin-based composite restorations placed using the total-etch technique.
A  posterior composite resin restorative material  was evaluated over a 3-year period by means of a controlled clinical trial . A total of 52 composite resin restorations and 52 amalgam alloy restorations were included in this trial , and were examined with regard to marginal integrity , surface texture , anatomical form and proximal contact with adjacent teeth . There were no significant differences in clinical performance between test and control material s , which both gave good service over the period of evaluation . Only five restorations ( one of amalgam and four of composite resin )  failed during the trial . Plastic replica dies were used to support the clinical examinations of the restorations , and such dies were found to be helpful This study evaluated the performance of a low-shrinking resin composite compared with an amalgam for restoration of Class I and II cavities of moderate size in posterior teeth in a general practice setting . Fifty-two pairs of test and control restorations were placed in 49 patients . Clinical evaluations and assessment s of replica models were carried out at baseline , six months and one year . Patients recorded their level of satisfaction with the restorations by means of  visual analog scales . Apart from one control restoration that failed due to a fractured cusp , all of the restorations review ed at six months and one year were intact with no unacceptable scores for any of the evaluation criteria . It was concluded that the resin composite evaluated , when used in conjunction with the recommended adhesive system , may be an appropriate alternative to amalgam in the restoration of posterior teeth over one year in clinical service 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 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 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 AIM The aim of this study was to assess the clinical performance of two adhesive restorative systems ( Single Bond/Filtek P-60 and Single Bond/Filtek Z-250 ) in posterior teeth using a modified United States Public Health Service ( USPHS ) system . METHODS AND MATERIAL S A total of 70 restorations were placed in molars and premolars in 30 patients ( 14 females and 16 males ; 18 - 40 years ) by one operator . All restorations were directly evaluated by two examiners at baseline , six months , and 12 months using the following modified USPHS rating criteria : marginal integrity , marginal discoloration , surface texture , contour , postoperative sensitivity , and recurrent caries . RESULTS At six and 12 months all restorations were available for evaluation of marginal discoloration , surface texture , contour , postoperative sensitivity , and recurrent caries that remained with 100 % Alpha-ratings at recalls for both restorative systems . Marginal integrity for P-60 was scored as 94.3 % and 91.4 % Alpha at six and 12 months , respectively , and rates for Z-250 were 100 % and 97.1 % Alpha at six and 12 months , respectively . Statistical analysis was completed with Fisher 's exact and McNemar Chi-square tests at a significance level of 5 % ( P<0.05 ) . CONCLUSION All restorations were clinical ly satisfactory and no significant differences were found among them . CLINICAL SIGNIFICANCE Posterior resin composite restorations placed under appropriate conditions provide a satisfactory clinical performance PURPOSE To compare by confocal and scanning electron microscopy the post-resin-dentin interfaces of endodontically-treated teeth which had been restored with dentin-bonding systems and composite and needed to be extracted after 6 months to 6 years of clinical service . MATERIAL S AND METHODS Sixteen single rooted teeth showing proximal lesions penetrating the pulp chamber were included in the investigation and divided into two groups . Group 1 teeth were endodontically-treated , restored with carbon fiber posts and resin-based composite . Group 2 teeth were treated in the same way and covered with porcelain fused-to-metal crowns . RESULTS Two thirds of the observed interfaces showed resin penetration of the root dentin in the middle and coronal third of the post space preparation , while only one third of the interface showed resin infiltration in the apical third of the post space preparation . Debonding of the adhesive from the resin infiltrated dentin area and debonding of the composite cement from the adhesive were the most frequently observed failure modes and were observed in one third of the observed interfaces . There was no difference between the post-resin-dentin interfaces of teeth covered and teeth not covered with porcelain-fused to metal crowns . Teeth extracted after longer periods of clinical service showed more abundant areas of debonding of the adhesive from the resin-dentin interdiffusion zone . The presence of bacteria in resin infiltrated dentin tubules was observed in two specimens OBJECTIVE The objective of this split-mouth r and omized controlled study was to compare the 2-year clinical performance of two restorative techniques and material s for posterior permanent carious teeth . METHOD AND MATERIAL S After signing informed consent , 30 patients aged between 7 and 16 received two Class 1 restorations on cavities on permanent first or second molar teeth performed with one of two systems : incrementally placed conventional posterior composite resin ( Herculite Ultra , Kerr ) , and sonic-resin placement system ( SonicFill , Kerr ) with single-component self-etch adhesive system ( Kerr ) according to the manufacturers ' directions . Two blinded observers evaluated the restorations at three times ( baseline , and after 1 and 2 years ) according to the US Public Health Service modified criteria . Kruskal-Wallis test and Mann-Whitney U-test were used to compare the clinical performance of the restorative systems . RESULTS The restorative systems showed similar clinical performance at 2 years . At the end of 2 years in both groups , one restoration 's marginal staining Alpha ratings decreased . In the same period , two restorations in the conventional group and one in the SonicFill group received Bravo ratings for color match and surface roughness scorings . CONCLUSION The sonic-resin placement system demonstrated similar results to incrementally placed conventional composite resin in terms of clinical success . Considering the advantages of providing up to 5 mm in a single layer , and the adjustability of the viscosity , bulk-fill composite restorations seem to be a good alternative to posterior Class 1 composite restorations . CLINICAL RELEVANCE This study suggests that a new dental material for bulk-fill technology exhibits similar clinical success to incrementally placed composite resin Objective This study evaluated the 56-month clinical performance of Class I and II resin composite restorations .  Filtek P60 was compared with Filtek Z250 , which are both indicated for posterior restorations but differ in terms of h and ling characteristics . The null hypothesis tested was that there is no difference in the clinical performance of the two resin composites in posterior teeth . Material and Methods Thirty-three patients were treated by the same operator , who prepared 48 Class I and 42 Class II cavities , which were restored with Single Bond/Filtek Z250 or Single Bond/Filtek P60 restorative systems .  Restorations were evaluated by two independent examiners at baseline and after 56 months , using the modified USPHS criteria . Data were analyzed statistically using Chi-square and Fisher 's Exact tests ( a=0.05 ) . Results After 56 months , 25 patients ( 31 Class I and 36 Class II ) were analyzed . A 3 % failure rate occurred due to secondary caries and excessive loss of anatomic form for P60 . For both restorative systems , there were no significant differences in secondary caries and postoperative sensitivity . However , significant changes were observed with respect to anatomic form , marginal discoloration , and marginal adaptation . Significant decreases in surface texture were observed exclusively for the Z250 restorations . Conclusions Both restorative systems can be used for posterior restorations and can be expected to perform well in the oral environment AIM To test the hypothesis that dentine and pulp protection by conditioning- and -sealing is no less effective than using a conventional calcium hydroxide lining . METHODOLOGY A cohort of healthy adults requiring a new or replacement restoration in a posterior tooth was recruited in six general practice s. All procedures received local Ethics Committee approval . Exclusion criteria included signs and symptoms of pulp necrosis or inflammation , and patients unable to commit to a long-term trial . Cavity preparations were r and omized to receive a calcium hydroxide lining or conditioning- and -sealing with a smear-removing bonding system . Choice of bulk restorative material ( composite resin or amalgam ) was at the discretion of the dentist . The key outcome measure was evidence of pulpal breakdown identified at unscheduled ( emergency ) or scheduled recall examinations . Postoperative sensitivity was recorded on 100 mm VAS at 24 h , 4 days and 7 days . Pulp status was assessed at 6 , 12 , 24 and 36 month recall , and at any emergency recall appointment . The relationship between pre-treatment and treatment variables and pulp breakdown was assessed by logistic regression ( P = 0.05 ) . RESULTS A total of 602 teeth were recruited , with comparable numbers of cavities lined ( 288 , 47.8 % ) or conditioned and sealed ( 314 , 52.2 % ) . The majority ( 492 , 81.7 % ) were replacement restorations , and amalgam was the most common bulk restorative material ( 377 , 62.6 % ) . A total of 390 ( 64.8 % ) restored teeth were review ed at 6 months , 307 ( 51 % ) at 12 months , 363 ( 60.3 % ) at 24 months , and 279 ( 46.3 % ) at 36 months post-restoration . Sixteen cases of pulp breakdown were identified within 36 months of restoration placement , 11 presenting as emergencies and five detected at routine recall examination . Logistic regression showed that preoperative pain , cavity treatment by lining or conditioning- and -sealing and the use of rubber dam isolation had no association with pulp breakdown . Pulp breakdown was associated with deep or pulpally exposed cavities ( P < 0.001 , odds ratio 7.8 ) and with composite rather than amalgam restorations ( P = 0.001 , odds ratio 2.13 ) . Re-coding to identify teeth with pulp exposures revealed that pulpal exposure was the key determinant of adverse pulp outcomes ( P < 0.0001 , odds ratio 28.4 ) and that composite resin restorations were again more likely to be associated with pulp breakdown than amalgam ( P = 0.017 , odds ratio 3.92 ) . CONCLUSIONS Considered within the context of routine primary dental care : Dentists can be confident that pulps will be equally well protected from post-restorative breakdown up to 36 months by calcium hydroxide lining and conditioning- and -sealing with adhesive resins .  Residual dentine thickness appears to be a key determinant of pulp responses after restorative dental treatment . In deep and pulpally exposed cavities in posterior teeth , composites were associated with more pulpal breakdown than amalgams A study was conducted to determine whether the wear resistance of a posterior composite could be improved by maximizing filler particle-to-particle contacts . This was expected to reduce stress concentrations on the resin matrix and thus reduce occlusal wear . A self-curing quartz-filled composite with this design , P-10 , was used to restore 90 Class I and II cavity preparations in adult teeth . Restorations were recalled after baseline at six months , one year , two years , and three years to measure wear by direct and indirect evaluation methods . There was no apparent advantage for this material compared with other previously evaluated posterior composites . The average cumulative wear for P-10 after three years was 145 microns . In addition , the restorations were evaluated for color-matching , interfacial staining , secondary caries , marginal adaptation , surface texture , and postoperative sensitivity . This material was not significantly different in those ways from other posterior composite products except in terms of more rapid color change , because it is self-cured OBJECTIVE The aim of this investigation was to evaluate the clinical performance of a new compomer restorative system , Dyract AP , placed in combination with Non-Rinse Conditioner and Prime & Bond NT in permanent posterior teeth . METHOD AND MATERIAL S Fifty Class II and 41 Class I restorations were placed in 39 patients by 1 dentist . The restorations were evaluated directly , with modified US Public Health Service criteria , and indirectly , with color slides and polyvinyl siloxane impressions , at baseline and 6 months and 1 year after placement . Preoperative and 1-year postoperative bitewing radiographs were also taken . RESULTS All 82 restorations available for 1-year evaluation were in situ . No postoperative sensitivity or pulpal problems were reported . Four Class II restorations ( 4.9 % ) failed because of partial fracture or recurrent caries . The percentages of Alfa score for each criterion were color match , 95.1 % ; marginal discoloration , 57.3 % ; marginal integrity , 35.4 % ; anatomic form , 98.8 % ; and surface texture , 91.5 % . The average wear rate of Dyract AP was low ( 18.5 + /- 11.7 microns at 6 months and 35.7 + /- 13.6 microns at 12 months ) . CONCLUSION The excellent h and ling characteristics , the good clinical performance , and the improved wear resistance suggest that this compomer will provide reliable direct tooth-colored restorations in stress-bearing areas The purpose of this in vivo study was to evaluate the clinical performance of a posterior composite resin TP.H ( Caulk Dentisply ) in class I restorations in primary molars . A total of 30 children aged 5 to 8 years old with 49 class I dental lesions in primary molars participated in the study . The cavity preparations involved removal of carious lesion only and the enamel margins were beveled . The results showed after 30 months that , 82 % ( 32/39 ) of Alfa ratings and 18 % ( 7/39 ) of Bravo ratings . We concluded that the composite resin TP-H could be used in conservative restorations in primary molars , particularly in the late mixed dentition 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 This r and omized clinical trial sought to evaluate the performance of two packable composites over a period of 36 months . A total of 39 Class I and II restorations were placed in the permanent teeth of 20 patients . Using United States Public Health Services criteria , two investigators evaluated the restorations immediately after placement and again after 12 and 36 months , examining color match , marginal discoloration , marginal integrity , recurrent caries , proximal contact , anatomical shape , surface texture , and postoperative sensitivity . It was concluded that the packable composites evaluated showed satisfactory clinical performance after three years PURPOSE To report the 4-year clinical performance of  posterior resin-based composite restorations placed using the total-etch technique . MATERIAL S AND METHODS Over a period of 1 year , 726 restorations ( 248 molars , 478 premolars ; 260 Class I , 466 Class II ; 540 replacements , 186 primary decay ) were placed on conservative preparations , using the incremental placement technique in a clinical environment . Baseline data were collected , and the restorations were evaluated after 4 years . Z100 and Scotchbond Multi- Purpose ( SBMP ) ( 3 M Dental Products , St. Paul , Minnesota ) were used as the restorative system . The criteria evaluated were color match , marginal adaptation , anatomic form , cavosurface marginal discoloration , axial contour , interproximal contact , secondary caries , postoperative sensitivity , and tooth vitality . RESULTS At baseline , 24 % of the teeth restored presented postoperative sensitivity ; 86 % of the sensitive teeth were from the replacement group . At 4 years , all teeth were vital to cold test . Eighteen restorations ( 2.5 % ) presented clinical ly detectable marginal fracture . The shade was acceptable in all restorations . Cavosurface marginal discoloration was observed in 47 restorations ( 6.5 % bravo scores ) . Axial contour , interproximal contact , and marginal adaptation received 100 % alfa scores . No secondary caries was diagnosed in any of the teeth examined . None of the examined restorations required replacement . CLINICAL SIGNIFICANCE Under controlled clinical conditions , posterior resin-based composite restorations placed with the total-etch technique and restorative Z100/SBMP have the potential to present a high success rate at 4 years . None of the examined restorations required replacement , and there was no clinical ly detectable wear in any of the restorations . Simultaneous etching of enamel and dentin followed by the application of a resin adhesive can be considered an adequate modality of pulp protection in nonexposed tooth preparations
The included studies reported few , if any , endodontic complications .
Little or no differences emerged between teeth restored with  composite resins  and those restored with amalgam .
Composite resin is used extensively for restoration of teeth with vital pulps .
Although cell culture studies have disclosed harmful effects on pulpal cells , any untoward clinical effects , manifest as adverse pulpal responses , have yet to be determined .
This study comprises a systematic review , design ed to address the question of whether the risk of endodontic complications is greater with  composite resin restorations  than with  other restorative material s  , such as  amalgam .