Saturday, July 26, 2025
The study assessed the surface texture, color stability, and marginal discoloration of sonic-activated bulk-fill resin composite (BFRC) compared to non-sonic-activated BFRC over 24 months, using two evaluation criteria. Sixty restorations each in the Sonicfill 3 and X-tra fill groups were evaluated at baseline, 3, 6, 12, and 24 months. Clinical outcomes were non-significant between the two groups, with all restorations considered clinically successful by USPHS or FDI criteria. The surface texture, color stability, and marginal discoloration of both tested BFRCs were considered clinically successful, either with or without sonic energy. The criteria used were reliable, comparable, and suitable for evaluating RC restorations. The study registered at www.clinicaltrials.gov and has a unique identification number NCT04926883. The current use of resin composites as dental restorations is increasing, with adhesive restorative materials offering minimal invasiveness and preserving tissues. Evidence supports the success of direct and light-polymerized RC restorations in posterior teeth [1]. Their advantages include affordability, longevity, and aesthetic and mechanical properties, which meet patients' increasing aesthetic expectations [2, 3]. Manufacturers improve physical and optical properties of RCs to mimic natural teeth and make handling easier [4]. Despite these improvements, polymerization shrinkage remains a challenge. While there are ideas to reduce this, placing RC materials with a 2-mm layering technique is recommended [1, 5, 6]. However, deep cavity restoration with incremental technique requires time, and postoperative sensitivity may occur [7]. The BFRC was designed to handle a single increment of 4–5 mm for efficiency. Shorter curing times and deeper cure depth can result from optimizing the light-curing composite’s photo-initiator system, reducing layers and minimizing polymerization shrinkage [7, 8]. Sonicfill RC, introduced with a sonically activated handpiece, reduces its viscosity, allowing for thicker restorations. Although less translucent than conventional BFRCs, depth of polymerization does not depend solely on translucency [9]. One drawback is color change due to intrinsic or extrinsic factors, making shade selection and color stability crucial for long-term restorability [4]. The Ryge or USPHS criteria and their modifications play important roles in evaluating clinical performance and applicability of restorations [10, 11, 12, 13, 14, 15, 16]. The success rate of restorations according to these criteria depends on their clinical acceptability. The USPHS and FDI guidelines are the most commonly used criteria for evaluating RC restorations [10, 11, 12, 17, 18, 19]. Criteria such as color matching, marginal discoloration, surface structure, retention, marginal integrity, anatomic form, secondary caries, and postoperative sensitivity are clinically significant for dental restorations. The defined properties according to modified USPHS criteria are evaluated with Alpha, Bravo, Charlie, and Delta scores, where Alpha indicates the best score and Delta the worst [12].
Reference: 24-month randomized controlled clinical trial assessment of surface texture, color stability, and marginal discoloration of sonic activated bulk-fill resin composite according to USPHS and FDI criteriaLabels: BMC Oral Health
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