Clinical Performance of Nanofilled and Microhybrid Direct Composite Restorations on Endodontically Treated Teeth

European Journal of Prosthodontics and Restorative Dentistry (2019) 27, 39–47

Adhesion Aging Clinical Trial Esthetics Endodontics Resin composite USPHS Aged Restorations Endodontically Treated Tooth

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This study evaluated the clinical performance of direct restorations made of nanofilled
and microhybrid resin composites in endodontically treated teeth. Twenty patients (11
males, 9 females; mean age: 34.2±10) that met the inclusion criteria received a total
of 48 restorations. After employing etch-and-rinse adhesive system, one dentist placed
all restorations using either a nanofilled (Filtek Ultimate) or microhybrid (Filtek Z250)
resin composite. The restorations were clinically reviewed at baseline, 6 months, and
up to 2 years using the modified United States Public Health Service (USPHS) criteria.
The changes were analyzed using the McNemar test and marginal homogeneity tests
(p<0.05). The mean observation period was 17.4 months. With respect to color match,
marginal adaptation, secondary caries, and surface texture, no significant differences
were found between the two restorative materials (p>0.05). Most restorations yielded
alpha or bravo scores with respect to the evaluation criteria. Five restorations failed due
to chipping up to 2 years (1 microhybrid at 6 m, and 3 at 2 years; 1 nanofilled at 2 y) and
were repaired. One complete replacement and one extraction due to endodontic complications were needed for 2 microhybrid resin group at 2 years.

Dr. Tugba Toz Akalın *
(DDS, PhD)

Dr. Funda Öztürk Bozkurt *
(DDS, PhD)

Dr. Aysun Kara Tuncer ^

Ba

(DDS, PhD)

Dr. Harika Gözükara Bağ †
(PhD)

Prof. Dr. Mutlu Özcan Δ

Address for Correspondence

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Dr. Tugba Toz Akalın *

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(DDS, Dr.Med.Dent, PhD)

Email: ttoz@medipol.edu.tr

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* Istanbul Medipol University, Department of Restorative Dentistry, School of Dentistry, Istanbul, Turkey

^ Bezmialem University, School Of Dentistry, Department of Endodontics, Istanbul, Turkey Inonu University, School of Medicine, Department of Biostatistics, Malatya, Turkey

†

University of Zurich, Dental Materials Unit, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Zurich, Switzerland

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Clinical Performance of Nanofilled and Microhybrid Direct Composite Restorations on Endodontically Treated Teeth

Received: 02.01.2019 Accepted: 11.01.2019

The selection of direct versus indirect restorations involves aesthetic, economic, mechanical, and anatomical considerations with respect to the restorative materials and the amount of remaining tooth structure.1 The process of choosing the most suitable restoration for endodontically treated teeth is important as such teeth are highly susceptible to fractures.2 Endodontically treated teeth are weak due to loss of structure and as a consequence of restorative and endodontic procedures and/or caries.3 Helfer et al. reported that endodontic treatment causes biological changes, rendering treated teeth more susceptible to failure.4 However, other studies found no significant difference in moisture content and claimed that endodontic procedures do not impair tooth strength.5,6 Current adhesive technologies enable restorations without posts in many clinical situations that do not further weaken endodontically treated teeth.2 The loss of tooth vitality and structure after endodontic treatment has been viewed as an issue for crown placement.7,8 Today, direct restorations are preferred as a basic treatment protocol for the replacement of lost tooth structure.

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