ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title In Class II Restorations, Silorane-Based Composite Resin Had No Advantage Over Methacrylate-Based Composite Resin
Clinical Question In a healthy average adult requiring a class II restoration, would the use of a silorane-based composite resin compared to a methacrylate-based composite resin result in improved clinical performance?
Clinical Bottom Line Based on the results of the two cited studies with 18-36 month follow-up times, silorane-based composite resin performed similarly to methacrylate-based composite resin in all measured criteria except marginal integrity. Both randomized clinical trials tested both materials on class II restorations using very specific techniques; i.e. rubber dam isolation, specific incremental placement with light curing times, wedge placement, and no additional retention on the preparations. After evaluation of both types of composites using the FDI World Dental Federation and USPHS criterias, marginal integrity was found to be the only difference in clinical performance.
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) 24344912Walter/201325 females and 6 male subjects in need of a class II composite resin restoration.Randomized Controlled Trial
Key resultsAt a 36 months follow up, esthetic, functional, and biologic properties were evaluated, and it concluded that silorane-based composite resin (Filtek LS) performed just as well as methacrylate-based composite resin (Tetric Evoceram). With FDI World Dental Federation criteria being used for evaluation, the scores ranged from 1-5; At least 78% of the restorations scored 1 in the three properties stated above. The recall rate at 36 months was 89%.
#2) 24073532Goncalves/201310 male and 23 female subjects in need of a class II composite resin restorationRandomized Controlled Trial
Key resultsEvaluation of 88 restorations (43 methacrylate and 45 silorane-based) took place after an 18-month follow-up. It was concluded that there was no significant differences in the clinical performance of each type of composite using the USPHS criteria except for marginal integrity (P=0.035). The study showed that after 18 months, it was more likely that the difference in adhesive strength instead of polymerization shrinkage determined the end results, as the marginal integrity of silorane-based composite resin and methacrylate-based composite did not differ at baseline.
Evidence Search ("Silorane Composite" [Mesh]) AND ("Methacrylate Composite" [Mesh]) AND (“Class Two Restoration” [Mesh])
Comments on
The Evidence
In the randomized controlled trial by Walter et al., the groups were similar at the start with a completion rate of >80%. In this trial, all groups were treated the same and had adequate 6, 12, 24, and 36 months follow-up times. The compliance for this trial was adequate with recall bias being unlikely. In the randomized controlled trial by Goncalves et al., the groups were similar at start, with a completion rate of >80%. This study had groups treated the same with adequate compliance and follow-up. Lastly, this study had unlikely recall bias.
Applicability In the clinical dental setting, this information can aid the dentist in deciding if the newly manufactured silorane-based composite resin versus the established methacrylate-based composite resin would benefit patients in the treatment of class II lesions. Since the information collected showed that both materials performed equally except for the marginal integrity of silorane-based composites, the dentist should have a high success rate when placing either of these dental restorative materials.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords Silorane based composite resin, Methacrylate based composite resin, Class II restoration
ID# 2687
Date of submission: 03/13/2014spacer
E-mail lewiz@livemail.uthscsa.edu
Author Sylvia S. Lewiz
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Joseph A. Bartoloni, DMD
Faculty mentor/Co-author e-mail Bartoloni@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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