Clinical performance of two ion-releasing bulk-fill composites in class I and class II restorations: A two-year evaluation

OBJECTIVES

This randomized clinical trial evaluated and compared the 2-year clinical performance of two ion-releasing bulk-fill composites (Cention N and Surefil One) with that of a conventional bulk-fill resin composite (Powerfil) in Class I and II cavities.

METHODS

Thirty-two patients, each with 3 Class I and/or Class II cavities under occlusion, were enrolled in this trial. A total of 96 restorations were placed, 32 for each material, as follows: a self-adhesive composite; Surefil-one, alkasite; Cention N, and a bulk-fill resin composite; Powerfil. The restorations were placed by a single operator. Clinical evaluation was performed at baseline (1-week), 6-months, 1-year, and 2-years by two independent examiners using the FDI criteria. Intergroup and intragroup comparisons were analyzed using the Kruskal-Wallis and Friedman Tests. Multiple comparisons between groups were analyzed using the Mann-Whitney and Wilcoxon-rank tests. The level of significance was set at α = 0.05.

RESULTS

Twenty-seven patients with a total of 81 restorations were evaluated at the end of the 2-years with 84.35% recall rates. Clinical success rates were 100%, 100%, and 96.3% for Powerfil, Surefil-one, and Cention N, respectively. Cention N showed a statistically significant (p < 0.05) decreased marginal integrity in comparison with resin composite at the 2-year evaluation. No recurrent decay was detected in any restoration.

CONCLUSIONS

Both ion-releasing bulk-fill composites provided acceptable clinical performance similar to bulk-fill composite in Class I and II restorations over a 2-year period.

CLINICAL RELEVANCE

The results of this trial suggests that there is a promising evidence supporting the use of ion-releasing composites.

Comparative clinical evaluation between self-adhesive and conventional bulk-fill composites in class II cavities: A 1-year randomized controlled clinical study

OBJECTIVE

This randomized controlled clinical trial compared the clinical efficacy of self-adhesive bulk-fill Surefil One with a traditional bulk-fill composite in class II restorations.

MATERIALS AND METHODS

Sixty-four direct class II composite restorations were categorized into two groups. Group I, control group (n = 32): cavities were restored by Filtek One bulk-fill composite with Scotchbond Universal (SBU) adhesive in self-etch mode, Group II, test group (n = 32): cavities were restored by Surefil One self-adhesive bulk-fill composite. The study involved a follow-up period of 1 year, during which restorations were assessed at baseline (BL), 6 months, and 12 months using Federation Dentaire Internationale (FDI) criteria. Data analysis was performed using nonparametric tests. A comparison of restoration characteristics was performed utilizing the chi-square test (X2). The significance level was set at 0.05.

RESULTS

Filtek One and Surefil One bulk-fill composites revealed clinically acceptable FDI scores over 12-month recalls. Thirty-two patients (64 restorations) were available for all follow-up visits; 100% of the restorations survived. For esthetic properties, Filtek One was far better than Surefil One at all time points. However, in terms of functional and biological properties, both restorations demonstrated comparable performances.

CONCLUSIONS

Filtek One bulk-fill restorations were superior in terms of surface luster, surface staining, color match, and translucency, but Surefil One restorations performed well and were similar to Filtek One restorations; however, additional advancements and research are needed to obtain better esthetics. Furthermore, longitudinal studies with extended follow-up periods are needed to assess the clinical potential of both materials.

CLINICAL SIGNIFICANCE

Both Filtek One and Surefil One met the FDI criteria, with Filtek One demonstrating superior esthetic and functional qualities and similar performance regarding biological criteria. Both innovative restorative materials show potential for clinical use. Trial registered on ClinicalTrials.gov under registration number; NCT06120868:07/11/2023.

A 4D Printed Adhesive, Thermo-Contractile, and Degradable Hydrogel for Diabetic Wound Healing

Chronic wound healing remains a substantial clinical challenge. Current treatments are often either prohibitively expensive or insufficient in meeting the various requirements needed for effective diabetic wound healing. A 4D printing multifunctional hydrogel dressing is reported here, which aligns perfectly with wounds owning various complex shapes and depths, promoting both wound closure and tissue regeneration. The hydrogel is prepared via digital light process (DLP) 3D printing of the mixture containing N-isopropylacrylamide (NIPAm), curcumin-loaded Pluronic F127 micelles (Cur-PF127), and poly(ethylene glycol) diacrylate-dopamine (PEGDA575-Do), a degradable crosslinker. The use of PEGDA575-Do ensures tissue adhesion and degradability, and cur-PF127 serves as an antibacterial agent. Moreover, the thermo-responsive mainchains (i.e., polymerized NIPAm) enables the activation of wound contraction by body temperature. The features of the prepared hydrogel, including robust tissue adhesion, temperature-responsive contraction, effective hemostasis, spectral antibacterial, biocompatibility, biodegradability, and inflammation regulation, contribute to accelerating diabetic wound healing in Methicillin-resistant Staphylococcus aureus (MRSA)-infected full-thickness skin defect diabetic rat models and liver injury mouse models, highlighting the potential of this customizable, mechanobiological, and inflammation-regulatory dressing to expedite wound healing in various clinical settings.

A self-adhesive microneedle patch with drug loading capability through swelling effect

Microneedles (MNs) offer a rapid method of transdermal drug delivery through penetration of the stratum corneum. However, commercial translation has been limited by fabrication techniques unique to each drug. Herein, a broadly applicable platform is explored by drug-loading via swelling effect of a hydrogel MN patch. A range of small molecule hydrophilic, hydrophobic, and biomacromolecule therapeutics demonstrate successful loading and burst release from hydrogel MNs fabricated from methacrylated hyaluronic acid (MeHA). The post-fabrication drug loading process allows MeHA MN patches with drug loadings of 10 μg cm-2. Additional post-fabrication processes are explored with dendrimer bioadhesives that increase work of adhesion, ensuring stable fixation on skin, and allow for additional drug loading strategies.