الفهرس 
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Abstract
Objective: This trial aimed to evaluate and compare the 3-year clinical performance of three recently developed glass ionomer restorative materials with that of a microhybrid resin composite placed in Class I and II cavities. Materials and methods: Forty patients, each with four Class I and II restorations under occlusion, were enrolled in this trial. A total of 160 restorations were placed, 25% for each material, as follows: three encapsulated bulk-fill conventional glass ionomer restorative systems (Ketac Universal Aplicap, EQUIA Forte and Riva Self Cure HV) and a microhybrid resin composite system (Filtek Z250 Universal Restorative). All restorations were placed according to the manufacturers’ instructions. Clinical evaluation was performed at baseline and after one, two, and three years by two independent blinded examiners using the FDI World Dental Federation criteria. Epoxy resin replicas from randomly selected patients were observed at each recall under scanning electron microscope (SEM) to examine surface characteristics. Kruskal-Wallis and Mann-whitney U tests were used to analyze the differences between the four restorative materials for every criterion in each evaluation period, while differences in all criteria throughout the evaluation periods were analyzed with Friedman and Wilcoxon signed-rank tests. The level of significance was set at P<0.05. Results: After three years, the recall rate of patients was 97.5%. The success rates were 100% for Filtek Z250, 97.4% for Ketac Universal and 94.9% for both EQUIA Forte and Riva HV. Five Class II glass ionomer restorations failed throughout the trial. Statistically significant differences were observed between the clinical performance of these materials in terms of surface luster and color match criteria (P<0.05). Whilst, no statistically significant differences were found for other criteria (P>0.05). When comparing baseline with the different recalls, statistically significant changes were observed for all criteria except for postoperative hypersensitivity, recurrence of caries, tooth integrity, periodontal response and adjacent mucosa criteria. On the other hand, SEM evaluations were in accordance with the clinical findings. Conclusions: Although drawbacks in surface luster and color match appeared over the 3-year evaluation period, the three glass ionomer restorative materials provided acceptable clinical performance in Class I and II cavities compared to microhybrid resin composite. The enhancement in their strength properties and wear resistance was remarkable. Clinical Significance: Ketac Universal, EQUIA Forte and Riva HV glass ionomer restorations exhibited clinical performance similar to that of Filtek Z250 microhybrid resin composite restorations in Class I and II cavities subsequent to three-year evaluation.
Key words
clinical trial; clinical performance; glass ionomer; resin composite; posterior restorations.