ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title No Statistical Difference Between Class II Nano-Hybrid and Hybrid Resin Composite Restorations Over Six Years
Clinical Question In patients receiving class II resin composite restorations, do nano-hybrid resin composites perform better over six years than hybrid resin composite restorations in terms of modified United States Public Health Service criteria?
Clinical Bottom Line In two separate RCTs performed over six year periods of time, both a nano-filled and a micro-hybird-filled resin composites displayed similar clinical characteristics according to modified USPHS criteria and had no statistically significant difference in overall survival rate.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23063254van Dijken/2012Adults (ages 29 to 82, mean = 52) requiring two to four extensive Class II restorations.Split-Mouth Randomized Controlled Trial (RCT)
Key resultsIn the study using 52 patients with 118 Class II restorations, 96% of the patients were evaluated at the six-year follow-up evaluation. The overall survival success rate in Class II restorations over a six-year period was 88.1%. Using the modified USPHS criteria of six characteristics (anatomical form, marginal adaptation, color match, marginal discoloration, surface roughness, and caries), there was no statically significant difference between the nano-hybrid resin composite (Exite/Tetric EvoCeran) and the micro-hybrid resin composite (Exite/Tetric Ceran). Out of the 11.9% that failed, the primary reasons were due to secondary caries and restoration fracture. 63% of the restorations that failed were in patients with a high caries risk. The six characteristics of the modified USPHS criteria were statistically evaluated using the Friedman test at p-value < 0.05.
#2) 21397316Kramer/2011Adults (ages 24 to 59, mean = 33) needing at least two restorations in different quadrants.Split-Mouth Randomized Controlled Trial (RCT)
Key resultsIn this study with 30 patients and 60 restorations, 100% of the patients were available for the six-year follow-up evaluation. The overall success survival rate in Class II restorations over the six-year period was 100%. Using the modified USPHS criteria on the basis of surface roughness, color match, marginal integrity, integrity of tooth, integrity of filling, proximal contact, changes in sensitivity, hypersensitivity, and radiographic assessment, there was no statistically significant difference between the nano-filled resin composite (Grandio) and the micro-hybrid resin composite (Tetric Ceram. Significant changes were seen in all criteria throughout the experiment regardless of the resin composite used, with a p-value of < 0.05 when using the Friedman test. Both of the resin composites achieved satisfactory results over the six year period, with the majority of restorations falling into the bravo rating for their respective categories. Overall there was no statistically significant difference between Teric Ceram and Grandio resin composites for use in class II restorations.
Evidence Search "Nanohybrid composite class II" OR "Nano-hybrid composite class II"
Comments on
The Evidence
Van Dijen conducted a randomized controlled trial (RCT) comparing a nano-hybrid resin composite with a micro-hybrid resin composite in Class II cavity locations over a six-year period of time. All of the restorations were placed by one, unblinded operator and, therefore, the patients did not all start the same day. The six-year completion rate was excellent (96%). Each of the participants were treated the same, and follow-up occurred at baseline and then annually for six years post-procedure. Evaluation of the restorations was conducted by two well-trained dentists without prior knowledge of previous assessments of the restorations. There were no recall biases that applied to this experiment. The experiment was supported by the County Council of Vasterbotton and the National Board of Welfare. Kramer conducted a randomized controlled trial (RCT) comparing a nano-hybrid resin composite to a micro-hybrid resin composite in Class II cavities over a six year period. All of the restorations were placed by one, unblinded dentist in a private practice, and, therefore the patients did not all start the same day. The completion rate was excellent (100%), and each of the participants was treated the same. Follow-up occurred at baseline, after six month, one, two, four, and six years post-procedure. Evaluation of the restorations was conducted by two independent investigators who did not place the restorations. Any recall biases did not apply in this experiment. The experiment was supported by Voco, which is the manufacturer of Grandio nano-filled resin composite.
Applicability There are no statically significant differences in USPHS clinical criteria between using a nano-filled resin composite compared to a micro-filled resin composite in adult patients in a private practice setting over a six-year period. Both materials performed adequately.
Specialty/Discipline (General Dentistry)
Keywords Nano-hybrid, nanohybrid, resin composite, Class II, nano-filled, survival
ID# 2431
Date of submission: 04/01/2013spacer
E-mail WardRJ@livemail.uthscsa.edu
Author Ryan Ward
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Charles Hermesch, DMD
Faculty mentor/Co-author e-mail hermesch@uthscsa.edu
Basic Science Rationale
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