Elisa Gomes Albuquerque

This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months. A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson's Chi-square test were used (α=0.05) for statistical analysis. After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p<0.05). BCa and BSy groups showed fewer marginal discrepancies compared to In (p<0.05). Restorations performed with BCa showed less color mismatch than BSy or In (p<0.05). Although all restorations exhibited satisfactory clinical performance after 24 months of clinical service, the clinical behavior of class I and II restorations' improved when performed with a bulk-fill composite in capsules, mainly when associated with a universal adhesive applied with SEE.

The objective of this study was to evaluate the alteration of the optical properties of bulk Fill resin-based composites after 2 years of simulated toothbrushing. Three high-viscosity bulk fill resin composites and one conventional sculptable resin composite (control) were analyzed. Five specimens of each resin composite were prepared, and roughness, color, translucency and gloss were evaluated initially and after one and two years of simulated toothbrushing. The specimens were submitted to electric simulated toothbrushing (14600 strokes/100g) using a commercially available toothbrush with soft fibers and toothpaste slurry in a proportion of 1:2 by weight. The brushing scheme was of 40 cycles per day (2 cycles per second / 280 cycles in a week). The optical properties and the roughness data were analyzed by a multifactor analysis of variance (MANOVA) and a Tukey post hoc test. The baseline and final values of Ra and Sa were submitted to linear regression analyses, all of which were performed at a significance level of p=0.05. Gloss and roughness presented statistical differences between the resin-time interactions in all composite resins. The gloss (72.5%) and roughness (89.4%) worsened significantly after brushing, but the authors didn’t find statistically significant differences when evaluating translucency and color. Based in the results, it could be concluded that the simulated brushing degraded the brightness and roughness of the used high-viscosity bulk fill composites.

The objectives of this double-blind randomized clinical trial were to compare (a) the clinical times and (b) the occurrence and severity of postoperative sensitivity, of posterior restoration that used a universal adhesive, in a self-etch or selective enamel-etching technique, along with incremental or bulk-fill composites (presented in syringes or capsules). A total of 295 posterior restorations were placed according to the following groups: SETB – self-etch/bulk-fill in syringe; SETC – self-etch/bulk-fill in capsules; SETI – self-etch/incremental; SEEB – selective enamel-etching/bulk-fill in syringe; SEEC – selective enamel-etching/bulk-fill in capsules; and SEEI – selective enamel-etching/incremental. Clinical time was assessed by a reason (s/mm³) between the total volume of resin inserted and the total time required to perform the restorations. Postoperative sensitivity was evaluated using two scales (Numeric Rating Scale and Visual Analogue Scale). Mean clinical time results, analyzed by Wald’s Chi-square, showed significant statistical differences among all groups (p<0.001), indicating that the restorative strategy affected the time required for the restoration. A generalized estimating equation model statistical analysis, performed to compare postoperative sensitivity, showed that neither the restorative technique, the adhesive strategy nor the presentation mode of the bulk-fill composite affected the overall risk of postoperative sensitivity (4.06 [2.22–6.81]). The use of bulk-fill composite, presented in capsules or syringes, is less time consuming and does not increase the risk or intensity of postoperative sensitivity relative to the traditional incremental technique.

Objetivo: o objetivo deste ensaio clínico randomizado, duplo-cego e multicêntrico foi avaliar o desempenho clínico de um novo sistema adesivo universal (Futurabond U, Voco GbmH, Alemanha) quando aplicado com diferentes estratégias de aplicação durante um período de seis meses. Material e Métodos: para isso, foram realizadas 200 restaurações em lesões cervicais não cariosas, utilizando o adesivo Futurabond U de acordo com quatro estratégias adesivas (n = 50 por grupo): autocondicionante sem condicionador prévio (SEE); autocondicionante associado ao condicionamento seletivo do esmalte (SET); etch-and-enxaguar com dentina seca (ERDry) e; etch-and-enxaguar com dentina úmida (ERWet). Após a hibridização, as cavidades foram restauradas usando resina composta Admira Fusion (Voco GmbH). Após 6 meses de desempenho clínico, essas restaurações foram avaliadas de acordo com os critérios do IDE nos seguintes itens: retenção / fratura, adaptação marginal, coloração marginal, sensibilidade pós-operatória e recorrência de cárie. Resultados: sete restaurações foram perdidas / fraturadas após seis meses de avaliação clínica (2 no grupo SEE, 1 no grupo SET, 1 no grupo ERDry e 3 no grupo ERWet). As taxas de retenção por seis meses (intervalo de confiança de 95%) foram 96% (86% -98%) para o grupo SEE, 98% (89% -99%) para o grupo SET, 98% (89% -99%) para o grupo ERDry e 94% (83% -97%) para o grupo ERWet, sem diferença estatística identificada entre qualquer par de grupos (p> 0,05). Vinte e quatro restaurações apresentaram pequenos defeitos de adaptação marginal no recordatório de avaliação de seis meses, e todas foram consideradas clinicamente aceitáveis. Conclusão: o desempenho clínico do adesivo universal Futurabond U associado ao composto de resina unidoses Admira Fusion foi promissor após 6 meses de avaliação clínica quando aplicado em lesões cervicais não cariosas e não dependeu da estratégia de colagem empregada.