title: Randomized 3-year clinical evaluation of Class I and II posterior resin restorations placed with a bulk-fill resin composite and a one-step self-etching adhesive.
abstract: OBJECTIVE
  To evaluate the 3-year clinical durability of the flowable bulk-fill resin composite SDR in Class I and Class II restorations.
  
  
  METHODS
  Thirty-eight pairs of Class I and 62 pairs of Class II restorations were placed in 44 male and 42 female patients (mean age 52.4 years). Each patient received at least two extended Class I or Class II restorations that were as similar as possible. In all cavities, a one-step self-etching adhesive (XenoV+) was applied. One of the cavities of each pair was randomly assigned to receive the flowable bulk-fill resin composite SDR in increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface. The occlusal part was completed with an ormocer-based nanohybrid resin composite (Ceram X mono+). In the other cavity, only the resin composite CeramX mono+ was placed in 2 mm increments. The restorations were evaluated using slightly modified USPHS criteria at baseline and then annually for 3 years. Caries risk and bruxing habits of the participants were estimated.
  
  
  RESULTS
  No post-operative sensitivity was reported. At the 3-year follow-up, 196 restorations - 74 Class I and 122 Class II - were evaluated. Seven restorations failed (3.6%), 4 SDR-CeramX mono+ and 3 CeramX mono+ only restorations, all of which were Class II. The main reason for failure was tooth fracture, followed by resin composite fracture. The annual failure rate (AFR) for all restorations (Class I and II) was 1.2% for the bulkfilled restorations and 1.0% for the resin composite-only restorations (p > 0.05). For the Class II restorations, the AFR was 2.2% and 1.6%, respectively.
  
  
  CONCLUSIONS
  The 4-mm bulk-fill technique showed good clinical effectiveness during the 3-year follow-up.
authors.forename: Jan Wv
authors.initials: JW
authors.lastname: van Dijken
authors.forename: Ulla
authors.initials: U
authors.lastname: Pallesen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003116:Color; D003188:Composite Resins / Q000737:chemistry*; D003731:Dental Caries / Q000209:etiology; D003738:Dental Cements / Q000737:chemistry; D018772:Dental Marginal Adaptation; D003764:Dental Materials / Q000737:chemistry*; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000145:classification*; D017220:Dentin-Bonding Agents / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008689:Methacrylates / Q000737:chemistry; D008875:Middle Aged; D053761:Nanocomposites / Q000737:chemistry; D063225:Organically Modified Ceramics / Q000737:chemistry; D011092:Polyethylene Glycols / Q000737:chemistry; D011109:Polymethacrylic Acids / Q000737:chemistry; D011140:Polyurethanes / Q000737:chemistry; D012008:Recurrence; D013499:Surface Properties; D055815:Young Adult
chemical_list: C520091:CeramX; D003188:Composite Resins; D003738:Dental Cements; D003764:Dental Materials; D017220:Dentin-Bonding Agents; D008689:Methacrylates; D063225:Organically Modified Ceramics; D011109:Polymethacrylic Acids; D011140:Polyurethanes; C575872:Xeno V; C029824:urethane dimethacrylate luting resin; C020946:triethylene glycol dimethacrylate; D011092:Polyethylene Glycols; C074277:ethoxylated bis-phenol A dimethacrylate