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The present study investigated the effect of three high-viscosity bulk-fill resin-based composite materials on cuspal deflection in natural teeth. Thirty-two sound maxillary premolar teeth with large slot mesio-occlusal-distal cavities were distributed into four groups (n=8). Three groups were restored with bulk-fill resin composite materials (Tetric EvoCeram Bulk Fill, Ivoclar Vivadent, Schaan, Liechtenstein; x-tra fil, VOCO, Cuxhaven, Germany; and SonicFill, Kerr, Orange, CA, USA) in a single 4-mm increment. The conventional composite group, Filtek Z100 (3M ESPE, St Paul, MN, USA), was used to restore the cavities in 2-mm increments. Cusp deflection was recorded postirradiation using a Nikon measurescope UM-2 (Nikon, Tokyo, Japan) by measuring the changes in the bucco-palatal widths of the teeth at five minutes, 24 hours, and 48 hours after completion of the restorations. Cuspal deflection was significantly higher in the conventional composite than in the Tetric EvoCeram Bulk Fill ( p=0.0031), x-tra fil ( p=0.0029), and SonicFill Bulk ( p=0.0002) groups. There were no significant differences in cuspal deflection among the three bulk-fill materials (all p<0.05). In conclusion, all the investigated bulk-fill resin composites exhibited cuspal deflection values that were smaller than those associated with a conventional incrementally placed resin composite.

Background: A new restorative called a "giomer composite" has been introduced. The authors conducted a study to determine retention, anatomical form, caries, staining, marginal discoloration, marginal adaptation, surface roughness and sensitivity of giomer compared with those of a microfilled composite., Methods: The authors placed 40 sets of restorations randomly in canines and premolars in vivo. They used a giomer composite and a microfilled composite in erosion/abrasion/abfraction Class V lesions that were not altered with rotary instruments. They placed the restorations according to manufacturer's recommendations, and two calibrated examiners evaluated the restorations independently using modified U.S. Public Health Service criteria at baseline and at six, 18 and 36 months. The lesions receiving the restorations did not differ from each other in the amount of circumferential enamel present, the percentage of the surface area of dentin or lesion type., Results: There were no differences in the restorations at baseline, an evaluation made two weeks after placement. At 36 months, the giomer and microfilled composite restorations were not significantly different from one another in any of the eight criteria evaluated. The percentage agreement between examiners was at least 83 percent for each criterion in each evaluation period., Conclusions: Both the giomer and the microfilled composite used in this study meet the clinical portion of the Acceptance Program Guidelines for Dentin and Enamel Adhesives Materials established by the American Dental Association., Clinical Implications: Both the giomer and the microfilled composite used in this study can be used with confidence in Class V lesions.

This paper describes a technique of placing a semi-rigid cervical matrix slightly past the cervical border of a lesion that extends below (apical to) the gingival crest and inserting the glass ionomer cement through an opening cut in the matrix above the soft tissue level.

At least four cervical erosion/abrasion lesions were restored with glass ionomer materials in 30 patients. Some restorations were finished in 15 minutes, and some were finished 24 hours after placement. No significant differences were found after five years.