Clinical Evaluation of Bioactive Injectable Resin Composite vs Conventional Nanohybrid Composite in Posterior Restorations: An 18-Month Randomized Controlled Clinical Trial
Hazem M Elderiny, Yomna S Khallaf, Mai M Akah, Olfat E Hassanein
Aim: To evaluate the clinical performance of bioactive injectable resin composite vs nanohybrid resin composite in restoring carious posterior teeth.
Materials and methods: A total of 18 patients with 26 class I and II carious cavities were recruited. Teeth were divided into two groups (n = 13): group I: Bioactive injectable resin composite (Beautifil Flow Plus X F00) while group II: Nanohybrid resin composite (Tetric N-Ceram) and were restored according to the manufacturer's instructions. The restorations were evaluated using the modified USPHS criteria at baseline, 6, 12, and 18 months. Data were tabulated and statistically analyzed with a significant level set at (p ≤ 0.05). Using the Chi-squared test and Cochran's Q test. The survival rate was analyzed using the Kaplan–Meier and Log-rank tests.
Results: Inter- and intra-group comparisons showed no statistically significant difference between bioactive injectable resin composite and nanohybrid resin composite at different time intervals in terms of anatomical form, marginal adaptation, secondary caries, marginal staining, postoperative sensitivity. Moreover, there was no statistically significant difference between both materials regarding the overall survival rate after 18 months.
Conclusions: The clinical performance of bioactive injectable resin composite and nanohybrid resin composite was similar and found to be clinically acceptable after 18 months of clinical use.
Clinical significance: Bioactive injectable resin composite can be used to restore occlusal anatomy as a nanohybrid resin composite in restoring posterior cavities with acceptable clinical performance.
Trial registration: It was registered in (www.clinicaltrials.gov) database in June 2022, with identification number NCT05499494.
Bayraktar Y, Ercan E, Hamidi MM, et al. One-year clinical evaluation of different types of bulk-fill composites. J Investig Clin Dent. 2017;8(2). DOI: 10.1111/jicd.12210.
Krämer N, Reinelt C, Frankenberger R. Ten-year clinical performance of posterior resin composite restorations. J Adhes Dent 2015;17(5):433–441. DOI: 10.3290/j.jad.a35010.
Kitasako Y, Sadr A, Burrow MF, Tagami J. Thirty-six month clinical evaluation of a highly filled flowable composite for direct posterior restorations. Aust Dent J 2016;61(3):366–373. DOI: 10.1111/adj.12387.
Badr C, Spagnuolo G, Amenta F, et al. A two-year comparative evaluation of clinical performance of a nanohybrid composite resin to a flowable composite resin. J Funct Biomater 2021;12(3). DOI: 10.3390/jfb12030051.
Ozer F, Patel R, Yip J, Yakymiv O, et al. Five-year clinical performance of two fluoride-releasing giomer resin materials in occlusal restorations. J Esthet Restor Dent 2022;34(8):1213–1220. DOI: 10.1111/jerd. 12948.
Mostafa A, El Baz M, Taher H, Shabka A. Flowable GIOMER vs conventional flowable composite for retention and prevention of caries recurrence when used as sealants for initially demineralized fissures. A randomized clinical trial. J Pharm Negat Results 2022; 3257–3263. DOI: 10.47750/pnr.2022.13.S09.407.
Manhart J, Chen HY, Neuerer P, et al. Clinical performance of the posterior composite QuiXfil after 3, 6, and 18 months in Class 1 and 2 cavities. Quintessence Int (Berl). 2008;39(9). PMID: 1909 3049.
Bayne SC, Schmalz G. Reprinting the classic article on USPHS evaluation methods for measuring the clinical research performance of restorative materials. Springer; 2005.
Pflaum T, Kranz S, Montag R, et al. Clinical long-term success of contemporary nano-filled resin composites in class I and II restorations cured by LED or halogen light. Clin Oral Investig 2018;22(4):1651–1662. DOI: 10.1007/s00784-017-2226-8.
Carvalho AA, Leite MM, Zago JKM, et al. Influence of different application protocols of universal adhesive system on the clinical behavior of Class I and II restorations of composite resin – A randomized and double-blind controlled clinical trial. BMC Oral Health 2019;19(1). DOI: 10.1186/s12903-019-0913-3.
Baroudi K, Rodrigues JC. Flowable resin composites: A systematic review and clinical considerations. Vol. 9, Journal of Clinical and Diagnostic Research. J Clin Diagn Res 2015:ZE18–24. DOI: 10.7860/JCDR/2015/12294.6129.
Saku S, Kotake H, Scougall-Vilchis RJ, Ohashi S, et al. Antibacterial activity of composite resin with glass-ionomer filler particles. Dent Mater J 2010;29(2):193–198. DOI: 10.4012/dmj.2009-050.
Rusnac ME, Prodan D, Cuc S, et al. Water sorption and solubility of flowable giomers. Materials 2021;14(9):2399. DOI: 10.3390/ma14092399.
Efes BG, Dörter C, Goemec Y. Clinical evaluation of an ormocer, a nanofill composite and a hybrid composite at 2 years. Am J Dent 2006;19(4):236–240. PMID: 16939030.
Batista AUD, montenegro RV. Longevity of bulk fill and ormocer composites in permanent posterior teeth: Systematic review and meta-analysis. Am J Dent 2022;35(2). PMID: 35506964.
Josic U, Mazzitelli C, Maravic T, et al. The influence of selective enamel etch and self-etch mode of universal adhesives’ application on clinical behavior of composite restorations placed on non-carious cervical lesions: A systematic review and meta-analysis. Dental Materials 2022;38(3):472–488. DOI: 10.1016/j.dental.2022.01.002.
Marquillier T, Doméjean S, Le Clerc J, et al. The use of FDI criteria in clinical trials on direct dental restorations: A scoping review. J Dent 2018;68:1–9. DOI: 10.1016/j.jdent.2017.10.007.
Dennison JB, Sarrett DC. Prediction and diagnosis of clinical outcomes affecting restoration margins. J Oral Rehabil 2012;39(4):301–318. DOI: 10.1111/j.1365-2842.2011.02267.x.
Perdigão J, Kose C, Mena-Serrano AP, et al. A new universal simplified adhesive: 18-month clinical evaluation. Oper Dent 2014;39(2):113–127. DOI: 10.2341/13-045-C. Epub 2013 Jun 26.
Torres CRG, Rêgo HMC, Perote LCCC, et al. A split-mouth randomized clinical trial of conventional and heavy flowable composites in class II restorations. J Dent 2014;42(7):793–799. DOI: 10.1016/j.jdent.2014.04.009.
Abdel-karim UM, El-Eraky M, Etman WM. Three-year clinical evaluation of two nano-hybrid giomer restorative composites. Tanta Dental Journal 2014;11(3):213–222. DOI: 10.1016/j.tdj.2014.10.004.
Lawson NC, Radhakrishnan R, Givan DA, et al. Two-year randomized, controlled clinical trial of a flowable and conventional composite in Class I restorations. Oper Dent 2015;40(6):594–602. DOI: 10.2341/15-038-C.
Hirata-Tsuchiya S, Yoshii S, Ichimaru-Suematsu M, et al. Two-year clinical comparison of a flowable-type nano-hybrid composite and a paste-type composite in posterior restoration. J Investig Clin Dent 2017;8(3). DOI: 10.1111/jicd.12227.
Abdelwahed AG, Abdelaziz MM, Fahim SE. Clinical evaluation of flowable versus packable bulk-fill giomer restorative materials: A two-year randomized clinical trial. Egypt Dent J 2024;70(2):2093–2105. DOI: 10.21608/edj.2024.267906.2924.