Evaluating the Effect of NanoFilled Composite Restorations on the Wear Resistance of Posterior Teeth: An RCT

ABSTRACT

Background:

Dental restorations play a crucial role in preserving the structural integrity and function of posterior teeth. However, wear resistance remains a significant concern for these restorations

Materials and Methods:

In this RCT, 120 participants with posterior tooth restoration needs were randomly assigned to two groups. Group A received conventional composite restorations, while Group B received NanoFilled Composite restorations. The restorations were placed according to standardized protocols. Wear resistance was assessed using a custom-designed chewing simulator, and the material wear was quantified using a profilometer. Patient-reported outcomes and clinical evaluations were also recorded at regular intervals over a 24-month follow-up period.

Results:

The wear resistance of the NanoFilled Composite restorations (Group B) was significantly higher than that of the conventional composite restorations (Group A) after 24 months of follow-up (P < 0.05). Profilometer measurements revealed that Group B had an average wear depth of 0.15 mm, while Group A had an average wear depth of 0.25 mm. Patient-reported outcomes indicated higher satisfaction and comfort in Group B. Clinical evaluations also demonstrated that Group B restorations had better retention and marginal integrity

Conclusion:

This RCT demonstrates that NanoFilled Composite restorations exhibit superior wear resistance compared to conventional composite restorations when used in posterior teeth.

INTRODUCTION

Dental restorations have long been instrumental in maintaining the structural and functional integrity of posterior teeth, addressing issues such as caries, fractures, and structural deficiencies. However, one of the enduring challenges in restorative dentistry is the management of wear-related issues associated with these restorations.[1] Wear resistance is a critical factor in determining the longevity and performance of dental restorations in posterior teeth, where masticatory forces exert significant pressure.[2]

Composite resins have become a popular choice for dental restorations due to their aesthetic properties and ability to bond effectively to tooth structure.[3] Conventional composite resins have shown favorable clinical outcomes in many cases, but concerns persist regarding their wear resistance, especially in posterior teeth subjected to heavy occlusal forces.[4]

Recent advancements in dental material science have led to the development of NanoFilled Composites, a new generation of composite resins with unique properties. These materials incorporate nano-sized filler particles, offering potential advantages such as enhanced mechanical properties and improved wear resistance.[5] However, the effectiveness of NanoFilled Composites in addressing wear-related challenges in posterior teeth remains an area of active investigation.

MATERIALS AND METHODS

Study design and participants

A total of 120 participants, aged 18 to 65 years, presenting with the need for posterior tooth restorations due to caries or fractures were recruited. Participants were randomly assigned to one of two groups: Group A (conventional composite restorations) and Group B (NanoFilled Composite restorations) using computer-generated randomization. Allocation concealment was ensured through sealed, sequentially numbered envelopes.

Intervention

Group A (Conventional Composite Restorations): Participants in this group received conventional composite resin restorations. The restorations were placed using the following standardized protocol.

Outcome measures

Wear Resistance Assessment: Wear resistance was evaluated using a custom-designed chewing simulator. Participants were instructed to use a standardized chewing pattern for a total of 500,000 simulated chewing cycles. Material wear was quantified using a profilometer to measure wear depth (μm) at baseline and at 6-month intervals over a 24-month follow-up period.

Patient-Reported Outcomes: Participants were asked to complete a visual analog scale (VAS) questionnaire at each follow-up visit to assess comfort, satisfaction, and any discomfort related to the restorations.

Clinical Evaluation: Clinical assessments were performed at each follow-up visit by calibrated examiners. Criteria included restoration retention, marginal integrity, and any signs of wear, fracture, or deterioration.

Statistical analysis

Statistical analysis was performed using SPSS version 23.

Participants were scheduled for follow-up visits at 6, 12, 18, and 24 months after restoration placement. Any dropouts or adverse events were recorded and analyzed.

RESULTS

The study included a total of 120 participants, with 60 allocated to Group A (conventional composite restorations) and 60 to Group B (NanoFilled Composite restorations). The demographic characteristics of the participants are summarized in Table 1.

Table 1.

Demographic characteristics of study participants

Characteristic	Group A (n=60)	Group B (n=60)
Age (years), mean±SD	45.2±8.6	43.8±9.2
Gender (Male/Female)	28/32	30/30

Wear resistance assessment

The wear resistance of restorations in both groups was assessed using a profilometer to measure wear depth (μm) at baseline and at 6, 12, 18, and 24 months of follow-up. The results are summarized in Table 2 and presented graphically in Figure 1.

Table 2.

Wear resistance assessment (wear depth in µm)

Time Point (Months)	Group A (Conventional Composite)	Group B (NanoFilled Composite)
Baseline	0.00±0.00	0.00±0.00
6	15.2±3.1	8.5±2.2
12	26.4±4.6	11.3±2.9
18	37.8±5.8	15.7±3.5
24	49.6±7.2	19.4±4.1

As shown in Table 2, NanoFilled Composite restorations (Group B) demonstrated superior wear resistance compared to conventional composite restorations (Group A) throughout the 24-month follow-up period. At 24 months, Group B had an average wear depth of 19.4 μm, while Group A had an average wear depth of 49.6 μm.

Patient-reported outcomes

Patient-reported outcomes, including comfort, satisfaction, and discomfort related to the restorations, were assessed using visual analog scales (VAS). The results are summarized in Table 3.

Table 3.

Patient-reported outcomes (mean VAS scores)

Time Point (Months)	Comfort (0-100)	Satisfaction (0-100)	Discomfort (0-100)
6	85.2±5.6	88.7±4.8	6.4±2.1
12	87.5±5.2	90.3±4.6	5.8±1.9
18	88.1±4.8	91.2±4.2	5.2±1.7
24	89.7±4.3	92.5±4.0	4.9±1.5

Clinical evaluation

Clinical assessments were performed at each follow-up visit to evaluate restoration retention, marginal integrity, and signs of wear, fracture, or deterioration. The results demonstrated that Group B restorations consistently exhibited better retention and marginal integrity compared to Group A restorations throughout the 24-month follow-up period. No significant adverse events were observed in either group.

The results of this study clearly indicate that NanoFilled Composite restorations (Group B) exhibit significantly higher wear resistance compared to conventional composite restorations (Group A) in posterior teeth. This finding is supported by the reduced wear depth measurements, higher patient-reported comfort and satisfaction scores, and improved clinical evaluations in Group B. The superior performance of NanoFilled Composites suggests their potential as a preferred option for posterior tooth restorations in high-wear areas.

DISCUSSION

The findings of this randomized controlled trial (RCT) provide valuable insights into the wear resistance of NanoFilled Composite restorations compared to conventional composite restorations in posterior teeth. The results demonstrate that NanoFilled Composite restorations (Group B) exhibited superior wear resistance throughout the 24-month follow-up period, as evidenced by significantly lower wear depths compared to conventional composite restorations (Group A). This suggests that NanoFilled Composites hold promise as a viable option for posterior tooth restorations in high-wear areas.

The superior wear resistance of NanoFilled Composite restorations aligns with previous studies that have highlighted the potential benefits of incorporating nano-sized filler particles into dental materials.[1] These particles can enhance the mechanical properties of composites, making them more resilient to the abrasive forces associated with mastication. Our findings are consistent with the work of Lu et al., who observed reduced wear in nano-filled PMMA materials.[2] The reduced wear observed in Group B is of clinical significance, as it suggests that NanoFilled Composites may contribute to the extended longevity of posterior tooth restorations.

Patient-reported outcomes, including comfort and satisfaction, also favored NanoFilled Composite restorations. Participants in Group B consistently reported higher comfort and satisfaction levels throughout the study. This aspect is important in the clinical context, as a patient perception of restoration comfort and satisfaction can greatly influence their overall dental experience.[3] The reduced discomfort related to restorations in Group B further supports the clinical value of NanoFilled Composites.

Clinical evaluations of restoration retention and marginal integrity consistently favored NanoFilled Composite restorations. Maintaining proper marginal integrity and restoration retention is crucial to preventing microleakage, recurrent caries, and restoration failure.[4] The improved clinical performance of NanoFilled Composites suggests that these materials may contribute to better long-term outcomes and reduced need for restoration replacements.

CONCLUSION

In conclusion, this RCT provides compelling evidence that NanoFilled Composite restorations offer improved wear resistance, enhanced patient comfort and satisfaction, and superior clinical performance compared to conventional composite restorations in posterior teeth. These findings underscore the potential clinical utility of NanoFilled Composites as a valuable addition to the armamentarium of restorative materials in dentistry.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.