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A randomized clinical trial of class II composite restorations using direct and semidirect techniques

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Abstract

Objective

This prospective study evaluated the clinical performance of large class II restorations made with different techniques over 24 months.

Materials and methods

Thirty patients received two class II restorations (n = 60) using a nanohybrid composite and different restorative techniques (direct (DT), semidirect (SDT)), in a split-mouth randomized design. The same adhesive system was applied for all restorations. For DT, the restorative material was applied directly inside the tooth preparation. For SDT, a tooth preparation impression was obtained using alginate and a silicone flexible die was prepared. The restoration was made chairside on the model and additionally light cured. After that, it was cemented in preparation using resinous cement. All restorations were evaluated using the FDI criteria after 7 days, 6, 12, and 24 months postoperatively.

Results

After 24 months, 24 patients attended the recall and 48 restorations were evaluated. Fisher’s statistical analysis (5%) showed no difference between the techniques. Nevertheless, Friedman’s test showed significant differences for some criteria after 12 months of evaluation for both techniques. Postoperative sensitivity was reported in one DT restoration. Also, after 24 months, one SDT restoration presented marginal fracture, which was deemed unsatisfactory.

Conclusions

After a 24-month follow-up, no significant difference between the tested techniques was detected. The restorations performed with both techniques produced clinically acceptable restorations.

Clinical relevance

This study demonstrated the viability of applying two different operatory techniques (direct and semidirect) for class II resin composite restorations.

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References

  1. Villarroel M, Fahl N, De Sousa AM, De Oliveira OB (2011) Direct esthetic restorations based on translucency and opacity of composite resins. J Esthet Restor Dent 23:73–87. https://doi.org/10.1111/j.1708-8240.2010.00392.x

    Article  PubMed  Google Scholar 

  2. Sunnegårdh-Grönberg K, van Dijken JW, Funegård U, Lindberg A, NilssonM (2009) Selection of dental materials and longevity of replaced restorations in public dental health clinics in northern Sweden. J Dent 37:673–678. https://doi.org/10.1016/j.jdent.2009.04.010

    Article  PubMed  Google Scholar 

  3. Torres CRG, Rêgo HM, Perote LC, Santos LF, Kamozaki MB, Gutierrez NC, Di Nicoló R, Borges AB (2014) A split-mouth randomized clinical trial of conventional and heavy flowable composites in class II restorations. J Dent 42:793–799. https://doi.org/10.1016/j.jdent.2014.04.009

    Article  Google Scholar 

  4. Magne P, Dietschi D, Holz J (1996) Esthetic restoration for posterior teeth: practical and clinical considerations. Int J Periodont Rest Dent 16:105–119

    Google Scholar 

  5. Dietschi D, Spreafico R (1997) Adhesive metal-free restorations: current concepts for the esthethic treatment of posterior teeth. Quintenssence Publishing Co, Germany

    Google Scholar 

  6. Ozakar-Ilday N, Zorba YO, Yildiz M, Erdem V, Seven N, Demirbuga S (2013) Three-year clinical performance of two indirect composite inlays compared to direct composite restorations. Med Oral Patol Oral Cir Bucal 18(3):e521–e528

    Article  PubMed  Google Scholar 

  7. Siéssere S, Vitti M, de Sousa LG, Semprini M, Regalo SCH (2004) Educational material of dental anatomy applied to study the morphology of permanent teeth. Braz Dent J 15(3):238–242

    Article  PubMed  Google Scholar 

  8. Alharbi A, Rocca GT, Dietschi D, Krejci I (2014) Semidirect composite onlay with cavity sealing: a review of clinical procedures. J Esthet Restor Dent 26(2):97–106. https://doi.org/10.1111/jerd.12067

    Article  PubMed  Google Scholar 

  9. Gerrow JD, Price RB (1998) Comparison of the surface detail reproduction of flexible die material systems. J Prosthet Dent 80(4):485–489

    Article  PubMed  Google Scholar 

  10. Antonelli JR, Gulker I (2000) A modified indirect working die technique for fabricating provisional restorations for multiple teeth. Quintessence Int 31(6):392–396

    PubMed  Google Scholar 

  11. Yoshikawa T, Burrow MF, Tagami J (2001) A light curing method for improving marginal sealing and cavity wall adaptation of resin composite restorations. Dent Mater 17(4):359–366

    Article  PubMed  Google Scholar 

  12. Torres CRG, Zanatta RF, Huhtala MFR, Borges AB (2017) Semidirect posterior composite restorations with a flexible die technique. J Am Dent Assoc 148(9):671–676. https://doi.org/10.1016/j.adaj.2017.02.032

    Article  PubMed  Google Scholar 

  13. Dimashkieh MR, Rayyan MR (2016) Chairside technique for expediting indirect interim restorations. J Prosthet Dent 115(4):510–511. https://doi.org/10.1016/j.prosdent.2015.09.025

    Article  PubMed  Google Scholar 

  14. Setembrini L, Gultz G, Scherer W, Kaim J (1998) A 30-minute in-office indirect composite inlay technique. J Am Dent Assoc 129(3):366–367

    Article  Google Scholar 

  15. Angeletaki F, Gkogkos A, Papazoglou E, Kloukos D (2016) Direct versus indirect inlay/onlay composite restorations in posterior teeth. A systematic review and meta-analysis. J Dent 53:12–21. https://doi.org/10.1016/j.jdent.2016.07.011

    Article  PubMed  Google Scholar 

  16. Llena Puy MC, Navarro LF, Faus Llacer VJ, Ferrandez A (1993) Composite resin inlays: a study of marginal adaptation. Quintessence Int 24(6):429–433

    PubMed  Google Scholar 

  17. Donly KJ (1990) Composite resin inlays: a single appointment technique. Am J Dent 3(5):181–184

    PubMed  Google Scholar 

  18. Price RB, Gerrow JD (2000) Margin adaptation of indirect composite inlays fabricated on flexible dies. J Prosthet Dent 83(3):306–313

    Article  PubMed  Google Scholar 

  19. Heintze SD (2007) Systematic reviews: I. The correlation between laboratory tests on marginal quality and bond strength. II. The correlation between marginal quality and clinical outcome. J Adhes Dent 9(Supp1):77–106

    PubMed  Google Scholar 

  20. Peutzfeldt A, Asmussen E (2000) The effect of postcuring on quantity of remaining double bonds, mechanical properties, and in vitro wear of two resin composites. J Dent 28(6):447–452

    Article  PubMed  Google Scholar 

  21. Prabhu K, Subashini BC, Venkatakrishnan B, Ramesh AS (2018) Comparison of dimensional stability of die stone and die silicone: an in vitro comparative study. J Interdiscip Dentistry 8:92–95. https://doi.org/. https://doi.org/10.4103/jid.jid_95_17

    Article  Google Scholar 

  22. El-Safty S, Akhtar R, Silikas N, Watts DC (2012) Nanomechanical properties of dental resin-composites. Dent Mater 28(12):1292–1300. https://doi.org/. https://doi.org/10.1016/j.dental.2012.09.007

    Article  PubMed  Google Scholar 

  23. Schulz KF, Altman DG, Moher D, CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med 152(11):726–732. https://doi.org/10.7326/0003-4819-152-11-201006010-00232

    Article  Google Scholar 

  24. Hickel R, Peschke A, Tyas M, Mjör I, Bayne S, Peters M, Hiller KA, Randall R, Vanherle G, Heintze SD (2010) FDI world dental federation: clinical criteria for the evaluation of direct and indirect restorations-update and clinical examples. Clin Oral Investig 14(4):349–366. https://doi.org/10.1007/s00784-010-0432-8

    Article  PubMed  Google Scholar 

  25. Hickel R, Roulet JF, Bayne S, Heintze SD, Mjör IA, Peters M, Rousson V, Randall R, Schmalz G, Tyas M, Vanherle G (2007) Recommendations for conducting controlled clinical studies of dental restorative materials. Science Committee Project 2/98--FDI World Dental Federation study design (part I) and criteria for evaluation (part II) of direct and indirect restorations including onlays and partial crowns. J Adhes Dent 9(Suppl1):121–147

    PubMed  Google Scholar 

  26. Mahmoud SH, El-Embaby AE, AbdAllah AM, Hamama HH (2008) Two-year clinical evaluation of ormocer, nanohybrid and nanofill composite restorative systems in posterior teeth. J Adhes Dent 10(4):315–322

    PubMed  Google Scholar 

  27. Zhu H, Zhang S, Ahn C (2017) Sample size considerations for split-mouth design. Stat Methods Med Res 26(6):2543–2551. https://doi.org/10.1177/0962280215601137

    Article  PubMed  Google Scholar 

  28. Loguercio AD, de Paula EA, Hass V, Luque-Martinez I, Reis A, Perdigão J (2015) A new universal simplified adhesive: 36-month randomized double-blind clinical trial. J Dent 43(9):1083–1092. https://doi.org/10.1016/j.jdent.2015.07.005

    Article  PubMed  Google Scholar 

  29. Coelho-de-Souza FH, Gonçalves DS, Sales MP, Erhardt MC, Corrêa MB, Opdam NJ, Demarco FF (2015) Direct anterior composite veneers in vital and non-vital teeth: a retrospective clinical evaluation. J Dent 43(11):1330–1336. https://doi.org/10.1016/j.jdent.2015.08.011

    Article  PubMed  Google Scholar 

  30. Mena-Serrano A, Kose C, De Paula EA, Tay LY, Reis A, Loguercio AD, Perdigão J (2013) A new universal simplified adhesive: 6-month clinical evaluation. J Esthet Restor Dent 25(1):55–69. https://doi.org/10.1111/jerd.12005

    Article  PubMed  Google Scholar 

  31. Perdigão J, Kose C, Mena-Serrano AP, De Paula EA, Tay LY, Reis A, Loguercio AD (2014) A new universal simplified adhesive: 18-month clinical evaluation. Oper Dent 39(2):113–127. https://doi.org/10.2341/13-045-C

    Article  PubMed  Google Scholar 

  32. Ástvaldsdóttir Á, Dagerhamn J, van Dijken JW, Naimi-Akbar A, Sandborgh-Englund G, Tranæus S, Nilsson M (2015) Longevity of posterior resin composite restorations in adults – a systematic review. J Dent 43(8):934–954. https://doi.org/10.1016/j.jdent.2015.05.001

    Article  PubMed  Google Scholar 

  33. Brouwer F, Askar H, Paris S, Schwendicke F (2016) Detecting secondary caries lesions: a systematic review and meta-analysis. J Dent Res 95(2):143–151. https://doi.org/10.1177/0022034515611041

    Article  PubMed  Google Scholar 

  34. Nedeljkovic I, Teughels W, De Munck J, Van Meerbeek B, Van Landuyt KL (2015) Is secondary caries with composites a material-based problem? Dent Mater 31(11):e247–e277. https://doi.org/10.1016/j.dental.2015.09.001

    Article  PubMed  Google Scholar 

  35. da Veiga AM, Cunha AC, Ferreira DM, da Silva Fidalgo TK, Chianca TK, Reis KR, Maia LC (2016) Longevity of direct and indirect resin composite restorations in permanent posterior teeth: a systematic review and meta-analysis. J Dent 54:1–12. https://doi.org/. https://doi.org/10.1016/j.jdent.2016.08.003

    Article  PubMed  Google Scholar 

  36. Nadine S (2010) Indirect resin composites. J Conserv Dent 13(4):184–194

    Article  Google Scholar 

  37. Spreafico RC, Krejci I, Dietschi D (2005) Clinical performance and marginal adaptation of class II direct and semidirect composite restorations over 3.5 years in vivo. J Dent 33(6):499–507. https://doi.org/10.1016/j.jdent.2004.11.009

    Article  PubMed  Google Scholar 

  38. Briso AL, Mestrener SR, Delício G, Sundfeld RH, Bedran-Russo AK, de Alexandre RS, Ambrosano GM (2007) Clinical assessment of postoperative sensitivity in posterior composite restorations. Oper Dent 32(5):421–426. https://doi.org/10.2341/06-141

    Article  PubMed  Google Scholar 

  39. van Dijken JW, Lindberg A (2009) Clinical effectiveness of a low-shrinkage resin composite: a five-year evaluation. J Adhes Dent 11(2):143–148

    PubMed  Google Scholar 

  40. van Dijken JW (2013) A 6-year prospective evaluation of a one-step HEMA-free self-etching adhesive in class II restorations. Dent Mater 29(11):1116–1122. https://doi.org/10.1016/j.dental.2013.08.205

    Article  PubMed  Google Scholar 

  41. Cetin AR, Unlu N, Cobanoglu N (2013) A five-year clinical evaluation of direct nanofilled and indirect composite resin restorations in posterior teeth. Oper Dent 38(2):E31–E41. https://doi.org/10.2341/12-160-C

    Article  Google Scholar 

  42. van Dijken JW, Sunnegårdh-Grönberg K (2005) A four-year clinical evaluation of a highly filled hybrid resin composite in posterior cavities. J Adhes Dent 7(4):343–349

    PubMed  Google Scholar 

  43. Burke FJ, Watts DC, Wilson NH, Wilson MA (1991) Current status and rationale for composite inlays and onlays. Br Dent J 170(7):269–273

    Article  PubMed  Google Scholar 

  44. Ramos NC, Luz JN, Valera MC, Melo RM, Saavedra G, Bresciani E (2019) Color stability of resin cements exposed to aging. Oper Dent [Epub ahead of print]. https://doi.org/10.2341/18-064-L

    Article  PubMed  Google Scholar 

  45. Lu H, Powers JM (2004) Color stability of resin cements after accelerated aging. Am J Dent 17(5):354–358

    PubMed  Google Scholar 

  46. Mendonça JS, Neto RG, Santiago SL, Lauris JRP, Navarro MF, de Carvalho RM (2010) Direct resin composite restorations versus indirect composite inlays: one-year results. J Contemp Dent Pract 11(3):25–32

    Article  Google Scholar 

  47. Petrovic LM, Drobac MR, Stojanac IL, Atanackovic TM (2010) A method of improving marginal adaptation by elimination of singular stress point in composite restorations during resin photo-polymerization. Dent Mater 26(5):449–455. https://doi.org/10.1016/j.dental.2009.11.160

    Article  PubMed  Google Scholar 

  48. Türkumen C, Durkan M, Cimilli H, Öksüz M (2010) Tensile bond strength of indirect composites luted with three new self-adhesive resin cements to dentin. J Appl Oral Sci 19(4):363–369

    Article  Google Scholar 

  49. Yamamoto T, Nakamura Y, Nishide A, Kubota Y, Momoi Y (2013) Contraction stresses in direct and indirect composite restorations compared by crack analysis. J Adhes Dent 15(1):47–54. https://doi.org/10.3290/j.jad.a28171

    Article  PubMed  Google Scholar 

  50. Heintze SD, Reichl FX, Hickel R (2019) Wear of dental materials: clinical significance and laboratory wear simulation methods -a review. Dent Mater J 26:1–11. https://doi.org/10.4012/dmj.2018-140

    Article  Google Scholar 

  51. American Dental Association (2001) Council on Scientific Affairs American Dental Association program guidelines: products for dentin and enamel adhesive materials. (www.ada.org)

  52. Lazaridou D, Belli R, Petschelt A, Lohbauer U (2015) Are resin composites suitable replacements for amalgam? A study of two-body wear. Clin Oral Investig 19(6):1485–1492. https://doi.org/10.1007/s00784-014-1373-4

    Article  PubMed  Google Scholar 

  53. Karaman E, Yazici AR, Ozgunaltay G, Dayangac B (2012) Clinical evaluation of a nanohybrid and a flowable resin composite in non-carious cervical lesions: 24-month results. J Adhes Dent 14(5):485–492. https://doi.org/10.3290/j.jad.a27794

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Science and Technology, Department of Restorative Dentistry, São Paulo State University - UNESP, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, SP, 12245-000, Brazil

    Carlos Rocha Gomes Torres, Mariane Cintra Mailart, Érica Crastechini, Fernanda Alves Feitosa, Stella Renato Machado Esteves, Rebeca Di Nicoló & Alessandra Bühler Borges

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  1. Carlos Rocha Gomes Torres
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  2. Mariane Cintra Mailart
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  3. Érica Crastechini
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Correspondence to Carlos Rocha Gomes Torres.

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Torres, C.R.G., Mailart, M.C., Crastechini, É. et al. A randomized clinical trial of class II composite restorations using direct and semidirect techniques. Clin Oral Invest 24, 1053–1063 (2020). https://doi.org/10.1007/s00784-019-02999-6

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