Influence of Cavity Lining on the 3-Year Clinical Outcome of Posterior Composite Restorations: A Randomized Controlled Clinical Trial

• Published in: Dentistry journal 2024-05, Vol.12 (5), p.128
• Main Authors: Nguyen, Anh Duc, Pütz, Natalie, Michaelis, Mary, Bitter, Kerstin, Gernhardt, Christian Ralf
• Format: Article
• Language: English
• Subjects: Adhesives; Ceramic materials; Ceramics; Clinical outcomes; clinical study; Clinical trials; Composite materials; Dentistry; Dentists; direct restoration; Discoloration; flowable composite materials; Molars; nanohybrid composite; Oral hygiene; Parameters; Premolars; randomized clinical trial; Statistical analysis; Teeth; Viscosity
• ISSN: 2304-6767; 2304-6767
• DOI: 10.3390/dj12050128

The purpose of this randomized, split-mouth-designed controlled and single-blinded clinical study was to evaluate the 3-year clinical performance of Class I and Class II resin composite restorations placed with or without cavity lining with a flowable composite. Fifty patients with treatment needs in two premolars or molars were included. One of the teeth was restored using the nanohybrid composite (Grandio SO, control group), in the test group a high viscosity flowable composite was additionally applied as a first layer. In both groups, the same self-etch adhesive system was applied. Clinical evaluation after 3 years was carried out using the modified USPHS/Ryge criteria. At the 3-year follow-up the recall rate was 92%. Four restorations failed in the test group (8.7%), three due to the loss of vitality and one after fracture. The control group exhibited a cumulative success rate of 100%, while the test group achieved a success rate of 91.3%. This led to significant differences in the annual failure rate (AFR) between the two groups, with rates of 0% and 2.9% ( < 0.05; Mann-Whitney U-test). After 3 years the cumulative survival rate including all restorations was 95.7%. Statistical analysis revealed significant differences for the parameters: tooth vitality, marginal discoloration, success rate, and AFR. The other parameters exhibited no significant differences. Consequently, the nanohybrid composite demonstrated excellent performance over a 3-year period, whereas the utilization of a flowable composite for the cavity lining did not appear to exert a beneficial influence on clinical outcomes.