Evaluating the Clinical Performance of Highly Filled Injectable Composite and Condensable Universal Composite Restorations: A One-Year Randomized Clinical Trial

Year 2025, Volume: 15 Issue: 2, 373 - 379, 30.06.2025

Merve Gürses , Nimet Ünlü

https://doi.org/10.33808/clinexphealthsci.1592696

Abstract

Objective: Composite materials are constantly renewed and developed. Recently, injectable composite materials with filler ratios similar to condensable composites have been made available to clinicians. The purpose of this randomized controlled clinical trial was to evaluate the one-year clinical performance of Class II restorations performed with injectable and condensable universal composite resins.
Methods: The study involved 71 patients (45 female, 26 male) and 140 restorations. It used G-aenial Universal Injectable (GCI; GC, Tokyo, Japan), G-aenial A'CHORD (GCA; GC, Tokyo, Japan), Tetric Prime (TP; İvoclar Vivadent, Lichtenstein), Filtek Ultimate (FU; 3M ESPE, St. Paul, MN, USA) universal composites, and the Clearfil SE Bond (Kuraray Noritake Dental, Japan) self-etch adhesive system. Restorations were evaluated and scored according to modified USPHS criteria at baseline, six months, and one year. Cochran Q and Fisher-Freeman-Halton tests were used for statistical analysis (p< .05).
Results: At the end of the first year, no significant differences over time were observed in any parameter within any material group (p> .05). The study's materials were compared, showing statistically similar results (p> .05).
Conclusion: This study found that all materials, including the injectable universal composite, demonstrated similar and successful clinical performance at the end of the first year.

Keywords

Class II restoration , clinical evaluation , high-fill injectable , universal composite resin

Ethical Statement

The Turkish Republic Ministry of Health, Turkish Pharmaceuticals, and Medical Devices Ethical Committee approved this prospective clinical trial (2022/152).

Supporting Institution

This clinical research was supported by Selcuk University Scientific Research Projects Institution (Project no: 21112010).

Project Number

Project no: 21112010

References

• Demarco FF, Corrêa MB, Cenci MS, Moraes RR, Opdam NJM. Longevity of posterior composite restorations: not only a matter of materials. Dent Mater. 2012;28(1):87–101. https://doi.org/10.1016/j.dental.2011.09.003
• UN Environment Programme. New Global Treaty Cuts Mercury Emissions and Releases, Sets up Controls on Products, Mines and Industrial Plants. Avaliable at: https://www.unep.org/news-and-stories/press-release/new-global-treaty-cuts-mercury-emissions-and-releases-sets-controls. Accessed 10 October 2013.
• Gurgan S, Kutuk ZB, Yalcin Cakir F, Ergin E. A randomized controlled 10 years follow up of a glass ionomer restorative material in class I and class II cavities. J Dent. 2020;94:103175. https://doi.org/10.1016/j.jdent.2019.07.013
• Laegreid T, Gjerdet NR, Johansson A, Johansson AK. Clinical decision making on extensive molar restorations. Oper Dent. 2014;39(6):E231–240. https://doi.org/10.2341/13-069-C
• Beun S, Glorieux T, Devaux J, Vreven J, Leloup G. Characterization of nanofilled compared to universal and microfilled composites. Dent Mater. 2007;23(1):51–59. https://doi.org/10.1016/j.dental.2005.12.003
• Hwang S, Chung SH, Lee JT, Kim YT, Kim YJ, Oh S, Yeo ISL. Influence of acid, ethanol, and anthocyanin pigment on the optical and mechanical properties of a nanohybrid dental composite resin. Materials 2018;11(7):1234. https://doi.org/10.3390/ma11071234
• Moldovan M, Balazsi R, Soanca A, Roman A, Sarosi C, Prodan D, Vlassa M, Cojocaru I, Saceleanu V, Cristescu I. Evaluation of the degree of conversion, residual monomers and mechanical properties of some light-cured dental resin composites. Materials 2019;12(13):2109. https://doi.org/10.3390/ma12132109
• Sabatini C. Color stability behavior of methacrylate-based resin composites polymerized with light-emitting diodes and quartz-tungsten-halogen. Oper Dent. 2015;40(3):271–281. https://doi.org/10.2341/14-080-L
• Gurgan S, Koc Vural U, Miletic I. Comparison of mechanical and optical properties of a newly marketed universal composite resin with contemporary universal composite resins: An in vitro study. Microsc Res Tech. 2022;85(3):1171–1179. https://doi.org/10.1002/jemt.23985
• Roeters JJM, Shortall ACC, Opdam NJM. Can a single composite resin serve all purposes? Br Dent J. 2005;199(2):73–79; quiz 114. https://doi.org/10.1038/sj.bdj.4812520
• Hickel R, Roulet JF, Bayne S, Heintze SD, Mjör IA, Peters M, et al. Recommendations for conducting controlled clinical studies of dental restorative materials. Int Dent J. 2007;57(5):300–302. https://doi.org/10.1111/j.1875-595X.2007.tb00136.x
• Askar H, Krois J, Göstemeyer G, Bottenberg P, Zero D, Banerjee A, Schwendicke F. Secondary caries: what is it, and how it can be controlled, detected, and managed? Clin Oral Investig. 2020;24(5):1869–1876. https://doi.org/10.1007/s00784-020-03268-7
• Sarrett DC. Clinical challenges and the relevance of materials testing for posterior composite restorations. Dent Mater. 2005;21(1):9–20. https://doi.org/10.1016/j.dental.2004.10.001
• 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. https://doi.org/10.1111/adj.12387
• Sabbagh J, Ryelandt L, Bachérius L, Biebuyck JJ, Vreven J, Lambrechts P, Leloup G. Characterization of the inorganic fraction of resin composites. J Oral Rehabil. 2004;31(11):1090–101. https://doi.org/10.1111/j.1365-2842.2004.01352.x
• Ikeda I, Otsuki M, Sadr A, Nomura T, Kishikawa R, Tagami J. Effect of filler content of flowable composites on resin-cavity interface. Dent Mater J. 2009;28(6):679–685. https://doi.org/10.4012/dmj.28.679
• Yazici AR, Antonson SA, Kutuk ZB, Ergin E. Thirty-six-month clinical comparison of bulk fill and nanofill composite restorations. Oper Dent. 2017;42(5):478–485. https://doi.org/10.2341/16-220-C
• Yazici AR, Kutuk ZB, Ergin E, Karahan S, Antonson SA. Six-year clinical evaluation of bulk-fill and nanofill resin composite restorations. Clin Oral Investig. 2022;26(1):417–426. https://doi.org/10.1007/s00784-021-04015-2
• Tekçe N, Demirci M, Sancak EI, Güder G, Tuncer S, Baydemir C. Clinical performance of direct posterior composite restorations in patients with amelogenesis imperfecta. Oper Dent. 2022;47(6):620–629. https://doi.org/10.2342/21-106-C
• Elsahn NA, El-Damanhoury HM, Shirazi Z, Saleh ARM. Surface properties and wear resistance of injectable and computer-aided design/computer aided manufacturing-milled resin composite thin occlusal veneers. Eur J Dent. 2023;17(3):663–672. https://doi.org/10.1055/s-0042-1750769
• Alp CK, Gündogdu C, Ahısha CD. The effect of gastric acid on the surface properties of different universal composites: A SEM study. Scanning 2022;2022:9217802. https://doi.org/10.1155/2022/9217802
• Jakupović S, Pervan N, Mešić E, Gavranović-Glamoč A, Bajsman A, Muratović E, Kazazić E, Kantardžić-Kovačević A. Assessment of microhardness of conventional and bulk-fill resin composites using different light-curing intensity. Polymers 2023;15(10):2250. https://doi.org/10.3390/polym15102250
• Tuysuz OK, Gurses M. Changes in physical properties of universal composites and CAD/CAM materials after bleaching and antioxidant applications: Scanning electron microscope and atomic force microscope evaluation. Microsc Res Tech 2024;87(5):977-990. https://doi.org/10.1002/jemt.24494
• Cvar JF, Ryge G. Reprint of criteria for the clinical evaluation of dental restorative materials. 1971. Clin Oral Investig. 2005;9(4):215–232. http://dx.doi.org/10.1007/s00784-005-0018-z
• Gurgan S, Kutuk ZB, Ergin E, Oztas SS, Cakir FY. Four-year randomized clinical trial to evaluate the clinical performance of a glass ionomer restorative system. Oper Dent. 2015;40(2):134–143. https://doi.org/10.2341/13-239-C
• Mahmoud SH, El-Embaby AE, AbdAllah AM. Clinical performance of ormocer, nanofilled, and nanoceramic resin composites in Class I and Class II restorations: a three-year evaluation. Oper Dent. 2014;39(1):32–42. https://doi.org/10.2341/12-313-C
• Almutairi MA, Salama FS, Alzeghaibi LY, Albalawi SW, Alhawsawi BZ. Surface treatments on repair bond strength of aged resin composites. J Int Soc Prev Community Dent. 2022;12(4):449–455. https://doi.org/10.4103/jispcd.JISPCD_99_22
• Bayraktar ET, Atali PY, Korkut B, Kesimli EG, Tarcin B, Turkmen C. Effect of modeling resins on microhardness of resin composites. Eur J Dent. 2021;15(3):481–487. https://doi.org/10.1055/s-0041-1725577
• Tekce N, Demirci M, Gokturk SA, Tuncer S, Ozel E, Pala K, et al. The effect of bonding and surface sealant application on postoperative sensitivity from posterior composites. Istanbul Univ Dishekim Fak Derg. 2015;49(3):1–10. https://doi.org/10.17096/jiufd.33921
• Hamza B, Zimmerman M, Attin T, Tauböck TT. Marginal integrity of classical and bulk-fill composite restorations in permanent and primary molars. Sci Rep. 2022;12(1):13670. https://doi.org/10.1038/s41598-022-18126-7
• Canyurt MB. Investigation of the effect of tooth brushing on the surface rougness and microhardness of the new generation flowable composites. Oktay EA, editor. University of Health Sciences, Gülhane Faculty of Dentistry; 2022.