Two-year clinical performance of a packable posterior composite with and without a flowable composite liner

The aim of the study was to evaluate the clinical performance of a packable fine hybrid dental composite (Prodigy Condensable) and the influence of the additional application of a flowable resin composite (Revolution, SDS Kerr) layer on marginal integrity after 2 years in stress-bearing posterior cavities according to the Ryge criteria. In 50 patients (40.5+/-17.5 years of age), 116 class II fillings (metal matrix system, glass ionomer-cement-base in 36%, rubberdam isolation in 70%) were placed, with at least two restorations per patient. The adhesive Optibond Solo Plus was used for all the restorations. In one of the two fillings in each patient, an additional layer of the flowable composite Revolution was applied in the entire cavity and separately light-cured. Baseline scores have been rated Alfa in > or =95% and Bravo in <5%. After 2 years, the results [%] of the Ryge evaluation for the two groups with/without the additional use of Revolution were: (1) Marginal Adaptation: Alfa:78/70, Bravo:16/27, Charlie:0/0, Delta:6/4; (2) Anatomic Form: Alfa:89/95, Bravo:6/2, Charlie:6/4; (3) Secondary Caries: Alfa:98/100, Bravo:2/0; (4) Marginal Discoloration: Alfa:76/68, Bravo:24/32, Charlie:0/0; (5) Surface: Alfa:90/91, Bravo:4/5, Charlie:0/0, Delta:6/4; (6) Color Match: Oscar:56/57, Alfa:44/39, Bravo:0/4, Charlie:0/0. Within the observation period (recall rate: 95%), three restorations out of 116 at baseline fractured, one restoration showed a secondary caries, one tooth received endodontic treatment, and all other restored teeth remained vital. After 2 years, no statistically significant difference (Chi-square test) in the overall survival rate between the group with the additional use of Revolution (92.8%) and that without Revolution (94.6%) was found. The combined survival rate for both groups together was 93.7% of clinically acceptable restorations.