Nanohybrid vs. fine hybrid composite in Class II cavities: Clinical results and margin analysis after four years

Krämer, Norbert; Reinelt, Christian; Richter, Gert; Petschelt, Anselm; Frankenberger, Roland

doi:10.1016/j.dental.2008.12.003

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Volume 25, Issue 6 , Pages 750-759, June 2009

Nanohybrid vs. fine hybrid composite in Class II cavities: Clinical results and margin analysis after four years

Norbert Krämer
- Department of Pediatric Dentistry, University Medical Center Carl Gustav Carus, Technical University Dresden, Germany
Christian Reinelt
- Private Practice, Nuremberg, Germany
Gert Richter
- Department of Prosthetic Dentistry, University Medical Center Carl Gustav Carus, Technical University Dresden, Germany
Anselm Petschelt
- Dental Clinic 1 - Operative Dentistry and Periodontology, University Medical Center Erlangen, University of Erlangen-Nuremberg, Glückstrasse 11, D-91054 Erlangen, Germany
Roland Frankenberger
- Dental Clinic 1 - Operative Dentistry and Periodontology, University Medical Center Erlangen, University of Erlangen-Nuremberg, Glückstrasse 11, D-91054 Erlangen, Germany
- Corresponding author. Tel.: +49 9131 8533693 fax: +49 9131 8533603.

Received 2 July 2008; received in revised form 20 November 2008; accepted 17 December 2008.

Abstract

Objectives

This controlled prospective split-mouth study evaluated the clinical behavior of two different resin composites in extended Class II cavities over a period of four years.

Methods

Thirty patients received 68 direct resin composite restorations (Grandio bonded with Solobond M: n=36, Tetric Ceram bonded with Syntac: n=32) by one dentist in a private practice. All restorations were replacement fillings, 24 cavities (35%) revealed no enamel at the bottom of the proximal box, in 33 cavities (48%) the proximal enamel width was less than 0.5mm. The restorations were examined according to modified USPHS criteria at baseline, and after six months, one, two, and four years. At each recall, impressions were taken for replica preparation. Replicas of 44 select subjects were assessed for marginal quality under a stereo light microscope (SLM) at 130× and 22 replicas were assessed under a scanning electron microscope (SEM) at 200×.

Results

Both recall rate and survival rate were 100% after four years of clinical service. No significant difference was found between the restorative materials (p>0.05; Mann–Whitney U-test). Hypersensitivities were significantly reduced over time (p<0.05; Friedman test). A significant deterioration over time was found for the criteria marginal integrity (66% bravo after four years), tooth integrity (15% bravo), filling integrity (73% bravo) and proximal contact (p<0.05; Friedman test). SLM and SEM analysis of restoration margins revealed differences in the amount of perfect margins, in favor of Tetric Ceram (p<0.05).

Significances

Both materials performed satisfactorily over the four-year observation period. Due to the extension of the restorations, wear was clearly visible after four years of clinical service with 50% bravo ratings.

Keywords: Resin composites, Nanofiller, Marginal integrity, Etch and rinse