White Paper Bio-tribo corrosion study of Filtek ™ Supreme Universal Restorative and Z100 ™ Restorative in vitro and in vivo Professor Paul Lambrechts and colleagues Katholieke University of Leuven, Belgium
White Paper Bio-tribo corrosion study of Filtek™ Supreme Universal Restorative and Z100™ Restorative
in vitro and in vivo
Professor Paul Lambrechts and colleaguesKatholieke University of Leuven, Belgium
Five-year clinical data on Filtek Supreme Universal Restorative and Z100 Restorative
This study is of special interest because Filtek
Supreme restorative and Z100 restorative were
evaluated both qualitatively (USPHS criteria) and
quantitatively (3D laser-scanned images) for
clinical performance over a significant time period.
Fillings were placed in 37 molar teeth in 16 adult
patients. All restorations were placed under
rubber dam using Adper™ Single Bond (Adper™
Scotchbond™ 1) Dental Adhesive. Baseline data
were recorded and recalls were carried out
at six months and annually for five years. The
restorations were evaluated by two calibrated
examiners using modified USPHS criteria.
At baseline and at each recall, the study
restorations were photographed and
impressions were taken using individualized
custom trays for replica models. The replicas
were scanned three-dimensionally using laser
profilometry with an accuracy of 5 micrometers.
The resulting images were superimposed and
each recall image was digitally subtracted from
baseline using specially developed software.
Based on the blue articulation marks
photographed at baseline and each recall, the
wear facets could be identified on the different
images. The volume loss across the occlusal
surface of the restoration and the occlusal
enamel; the vertical height loss for each
study tooth and restoration surface; and the
differential wear relative to enamel, were
all measured.
The microwear features of the restorations were
also evaluated using SEM.
IntroductionProfessor Paul Lambrechts and coworkers have completed a five-year clinical study on
Filtek™ Supreme Universal Restorative and Z100™ Restorative. The study evaluated both the clinical
performance of Filtek Supreme and Z100 restoratives in Class I and II restorations, and compared the
bio-tribo wear rates of the restorations with that of enamel. Bio-tribo wear is a combination of corrosive
wear (erosion) and mechanical wear (attrition, abrasion, abfraction and fatigue).
2.
Results—Clinical evaluation
Table 1 shows the percent Alpha clinical
evaluation scores over the five-year time frame.
One restoration (Filtek™ Supreme Universal
Restorative) was lost to the study as the patient
decided to have a crown; otherwise, there was
100% recall throughout the study period.
No restorations fractured during the study,
however, some occasional minor chipping at
the marginal ridge area was seen for both
Filtek Supreme restorative and Z100 restorative.
There was no statistically significant difference
between Filtek Supreme restorative and Z100
restorative for anatomic form, secondary
caries, color match, margin adaptation, surface
staining, proximal contact or post-operative
sensitivity (p>0.05) throughout the study
duration. From baseline onwards, however,
Filtek Supreme restorative was statistically
significantly better than Z100 restorative for
polish retention (p<0.05).
Apart from the one request for a crown, no
restorations needed replacing during the study.
One restoration was repaired after endodontic
treatment, and one restoration had a chipping
defect repaired. Both these restorations were
kept in the study.
3.
White Paper Bio-tribo corrosion study of Filtek™ Supreme Universal Restorative and Z100™ Restorative
Table 1. Percent Alpha scores over time.
Baseline 1 year 2 years 3 years 5 years Filtek Filtek Filtek Filtek Filtek Supreme Z100 Supreme Z100 Supreme Z100 Supreme Z100 Supreme Z100
Anatomic form 100% 100% 94% 95% 94% 100% 100% 100% 94% 100%
Color match 83% 79% 83% 74% 78% 68% 76% 68% 82% 74%
Polish retention 56% 11% 56% 11% 72% 11% 82% 47% 88% 42%
Surface stain 94% 89% 100% 100% 89% 89% 88% 89% 88% 95%
Margin adaptation 94% 100% 78% 79% 50% 68% 53% 68% 71% 68%
Proximal contact 94% 89% 94% 89% 94% 89% 94% 89% 94% 89%
Secondary caries 100% 100% 100% 100% 100% 100% 100% 100% 94% 95%
Results -Material loss
The mean volume loss across the occlusal
surface of the restoration and the occlusal
enamel gave an indication of the overall wear
value or contact-free area bio-tribo corrosion
wear (Table 2). There was no statistically
significant difference in volume loss
between Filtek Supreme restorative and
Z100 restorative up to four years of the
study. At five years, Z100 restorative showed
a notably greater volume loss than Filtek
Supreme restorative, however there was no
statistically significant difference between
volume loss of Filtek Supreme restorative
and enamel at four and five years (p<0.05).
The vertical loss of enamel and composite
at the wear facets (marked with articulating
paper) was also measured (Table 3, next page).
4.
0.0
Table 2. Mean surface volume loss over time (mm3)
Baseline 6 months 12 months 24 months 36 months 48 months 60 months
Time
0.5
-0.5
-1
-1.5
-2.5
-2
-3
Z100 Filtek Supreme Enamel
Baseline
Case 1
5 Years 5 Years
Baseline
Case 2
5 Years
Baseline
Filtek™ Supreme Universal Restorative—5-Year Study Clinical Photos Case 3
Table 2: Mean surface volume loss over time (mm3)
Clinical photos courtesy of Professor Paul Lambrechts and colleagues
Case 4
5.
The vertical loss indicated the amount of
occlusal contact area wear. The largest amount
of vertical loss in the restorations occurred
between baseline and six months. This reflected
a “running-in” wear period for the composites
while the occlusion was readjusting after
restoration placement. There was no statistically
significant difference in the mean vertical loss
(occlusal contact area wear) between Filtek
Supreme restorative, Z100 restorative and
enamel at five years.
The SEM evaluation of surface microwear
showed a rougher surface for Z100 restorative
compared with Filtek Supreme restorative
(Fig. 1).
The researchers commented on the enamel-
like wear of both Filtek Supreme restorative
and Z100 restorative as being a very desirable
feature in a composite.
Fig. 1: Material specific microwear
Some micro-cracks visible.
Filtek Supreme Z100
Filtek Supre m e
Some micro -cracks visible
Z100
Some filler pluck-out & craters
Fig. 1 Material specific microwear
Filtek™ Supreme Universal Restorative
Some filler pluck-out and craters.
Filtek Supreme Z100
Filtek Supre m e
Some micro -cracks visible
Z100
Some filler pluck-out & craters
Fig. 1 Material specific microwear
Z100™ RestorativeZ100™ RestorativeZ100™ RestorativeZ100™ RestorativeZ100™ Restorative
Case 5
5 Years
Baseline
5 Years
Baseline
Case 6
5 Years
Baseline
Table 3. Mean vertical loss over time (micron)
Baseline 6 months 12 months 24 months 36 months 60 months
Time
0
-20
Z100 Filtek Supreme Enamel
-40
-60
-80
-100
-120Table 3: Mean vertical loss over time (micron)
Z100™ Restorative—5-Year Study Clinical Photos
White Paper Bio-tribo corrosion study of Filtek™ Supreme Universal Restorative and Z100™ Restorative
© 3M ESPE 2009. All rights reserved. 3M, ESPE, Adper, Filtek, Scotchbond and Z100 are trademarks of 3M or 3M ESPE AG. Used under license in Canada.
Conclusions
Filtek™ Supreme Universal Restorative and Z100™ Restorative both showed acceptable clinical
performance over five years in Class I and II restorations in molar teeth. Filtek Supreme restorative
had notably better surface polish retention than Z100 restorative—and Filtek Supreme restorative
showed better color stability and surface texture.
Wear rates measured quantitatively for Filtek Supreme restorative, Z100 restorative and enamel,
showed both composites to be equivalent to enamel for wear at the occlusal contact area at five
years. For generalized occlusal surface wear (mean volume loss) Filtek Supreme restorative
was not statistically different than enamel throughout the five years of the study.
According to these study results both Filtek Supreme restorative and Z100 restorative show
enamel-like wear over the long term.