Clinical Evaluation of Ormocer and Nanofill Composite: flowable liner effect

Objectives: The aim of this clinical study was to determine the clinical performance of ormocer (Admira) and a nanofilled hybrid composite (Grandio), lined or not lined with flowable composites, after 2 years. Methods: Occlusal restorations (n = 251) were placed in 68 patients with two symmetric restorations per patient. In one of the two restorations in each patient, cavities were first lined with the flowable composite material Admira Flow after applying the two-step total-etch one-bottle adhesive (Admira Bond) or self etch adhesive (Futurabond NR). Composite resin was then applied. Restorations were examined using the USPHS modified Ryge criteria for retention, color matching, cavosurface marginal discoloration, anatomic form, marginal adaptation, surface texture, and secondary caries by two previously calibrated dentists. The overall performance of the restorations was evaluated by Wilcoxon signed ranks test. The chi-square test was used to determine differences in the performance of the restorations in which the flowable composite was applied first. Results: There was no secondary caries or postoperative sensitivity in any of the restorations at the 6-month, 1-year, and 2-year follow-up examinations. There were no statistically significant differences among the materials regardless of the prior use of flowable material (p > 0.05). There was no statistically significant difference between the restorations with and without the prior application of flowable materials (p > 0.05). Conclusion: The clinical performance of occlusal restorations using ormocer or nanofill composite did not benefit from the additional use of the flowable composite. Both of the restorative materials exhibited ideal clinical performance.