Esthetics of Dental Composite and Adhesive System

NCT ID: NCT03716349

Last Updated: 2025-06-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

37 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-01

Study Completion Date

2026-04-30

Brief Summary

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To compare a newly developed filling composite to a current filling composite system. Two restorations will be placed in each subject, one using system A and one using system B. The first system listed in the randomization pair will be placed on first tooth (#4-#13), and the second system on 2nd tooth (#4-#13). The same three researchers will be responsible for placement of all the restorations.

Detailed Description

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The aim of this (12-month; 36-month; 60-month) randomized controlled clinical trial is to evaluate and compare the esthetic outcomes and patient satisfaction of a simplified newly developed dental composite system (system A)for the esthetic region to a nanohybrid composite system (Filtek Supreme Ultra-system B) placed in class III, IV and V lesions. Even though dental composite systems have been used extensively for the anterior region, clinicians face challenges with shade selection and longevity of the material over the years. This new system has been developed to improve the esthetic outcomes and patient satisfaction by enhancing the blending capability of the material.

Dental composite systems have been used for 50 years as state of art materials to restore the anterior region. Significant development has occurred regarding the composition and structure of dental composites, improving the longevity of these restorations; however, clinicians are faced with the challenge of selecting the most adequate shade and restorative technique to reproduce missing tooth structure.

Depending on the size of the cavity preparation, a single layer of material or multiple layers might be needed to reproduce dentin and enamel. Different dental composite systems offer multiple body, dentin, and enamel shades. Therefore, clinicians are faced with the challenge of recreating nature using this material. Different devices, such as spectrophotometers have been introduced on the market for shade selection. However, one of the most important aspects when placing anterior composites is the esthetic outcome based on the patient's assessment. Therefore, this study will evaluate the esthetic outcomes of a simplified and a conventional dental composite system based on the provider's and patient's assessment.

Conditions

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Cavities of Teeth

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Simple randomization will be used for assignment of the treatment groups. Randomization: Two restorations will be placed in each subject, one using system A and one using system B.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
The statistician will prepare a randomization list of A-B and B-A pairs to be applied sequentially as subjects receive restorations. The first system listed in the randomization pair will be placed on first tooth (#4-#13), and the second system on 2nd tooth (#4-#13). The random sequence will be individually placed in opaque, consecutively numbered and sealed envelopes, which should be opened by the operator immediately before the intervention.

Study Groups

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System A

Tokuyama Universal Bond (TUB) single component self-etching 1-step adhesive system w/Tokyuama supra-nanofilled dental composite (ECM) (Tokuyama Dental Corp., Japan), informed consent signed, release of medical information signed, oral exam, health Questionnaire completed and/or updated, xray obtained if needed, pulp vitality testing, Tooth shade determination, photos of teeth, local and/or topical anesthetic applied as necessary, rubber dam isolation, tooth surface cleaned, cavity preparation performed as usual for caries removal, Enamel margins beveled, infinite invisible margins created, adhesive systems applied, dental composite placed, shade selection using Easy Shade 5. Light curing, restoration will be contoured and polished. teeth assessment, clinical assessment

Group Type EXPERIMENTAL

Pulp vitality testing

Intervention Type DIAGNOSTIC_TEST

each tooth will be tested to determine if the pulp of the tooth responds to cold

Photos

Intervention Type OTHER

Photos of teeth (Photos will be taken with a DSLR camera settings will be determined with optimal settings) and captured periodically throughout the study. Photographs will be made of the cavity preparation. Photographs will be made post-operatively

local and/or topical anesthetic

Intervention Type DRUG

Local and/or topical anesthetic will be applied as necessary to the teeth or gingiva

rubber dam

Intervention Type DEVICE

The area will be isolated with rubber dam isolation

tooth surface cleaned

Intervention Type OTHER

The tooth surface will be cleaned with flour of pumice on a prophy cup only, cavity preparation will be performed as usual for caries removal.

enamel margins

Intervention Type PROCEDURE

Enamel margins will be beveled with a long flame diamond bur (8863.314.012 Komet) at 45 degrees to the external tooth surface to achieve the desired bevel length. Along with the use of the diamond bur, infinite invisible margins will be created by contouring and smoothing with a dark orange Sof-LexTM extra-thin contouring and polishing disc (3M).

Adhesive Systems

Intervention Type PROCEDURE

Adhesive systems will be applied according to manufacturer's instructions and selective etching of the enamel will be performed. The dental composite will be incrementally placed using a two- layer or one-layer technique based on the cavity size and light-cured (detailed adhesive instruction sheet will be chairside for reference)

cavity preparation

Intervention Type PROCEDURE

The technique to be used will be determined by the size of the final cavity preparation. For small preparations a one-layer technique will be used. No backing material is necessary for the Tokuyama system, Filtek Supreme Ultra will be determined by manufacturer's wheel. A two-layer technique will be used for a large cavity preparation. Large cavity preparation is defined as being 4mm in length or more and/or at least 2mm in depth.

Shade selection using Easy Shade 5

Intervention Type OTHER

A1 (shade determined by Easy Shade 5), ECM-001/Backing material, A1E/A2D (shade will be selected by shade wheel) A4 (shade determined by Easy shade5), ECM-001/Backing material, A3E/A6D (shade will be selected by shade wheel

Light Curing

Intervention Type PROCEDURE

A Valo Grand curing unit (Ultradent) with an exitant irradiance with no less than 500 and no greater than 1500 mW/cm2 as measured with MARC Light Collector will be used in standard mode to deliver the required radiant exposure J/cm2 for adhesive and dental composite increments.

Contoured and polished

Intervention Type PROCEDURE

The restoration will be contoured and polished with - Long flame diamond bur (8863.314.012 Komet), Sof-Lex Medium (orange) Contouring and Polishing Discs (3M), Green Jiffy cup pre-polisher (Ultradent Products, Inc.), Blue and grey silicone points composite polisher gloss plus finisher (Kerr Hawe)

Consent

Intervention Type OTHER

The consent form will be signed, copy will be provided to the patient

Health Questionnaire

Intervention Type OTHER

The health questionnaire will be completed at initial visit and updated at each follow-up visit

xray

Intervention Type RADIATION

When necessary a radiograph (xray) will be obtained

Release of medical information signed

Intervention Type OTHER

The release of medical information form will be signed

Oral Exam

Intervention Type OTHER

An Oral Exam will be completed

Teeth Assessment

Intervention Type OTHER

The teeth assessment by subject will be completed using the Visual Analog Scale (VAS) and Verbal Rating Scale (VRS) at the follow-up visits 1 month after restoration, 1 year, 2 years and 3 years post restoration.

Clinical Assessment

Intervention Type OTHER

A clinical assessment will be completed by the evaluators

Tokuyama Universal Bond

Intervention Type DEVICE

Tokuyama Universal Bond (TUB) single component self-etching 1-step adhesive system with Tokyuama supra-nanofilled dental composite (ECM) (Tokuyama Dental Corp., Japan)

System B

ScotchBond Universal one-step adhesive system with Filtek Supreme Ultra™, nanofilled dental composite (3M) will randomly be applied to the other tooth informed consent signed, release of medical information signed, oral exam, health Questionnaire completed and/or updated, xray obtained if needed, pulp vitality testing, Tooth shade determination, photos of teeth, local and/or topical anesthetic applied as necessary, rubber dam isolation, tooth surface cleaned, cavity preparation performed as usual for caries removal, Enamel margins beveled, infinite invisible margins created, adhesive systems applied, dental composite placed, shade selection using Easy Shade 5. Light curing, restoration will be contoured and polished. teeth assessment and clinical assessment at periodic timepoints.

Group Type ACTIVE_COMPARATOR

Pulp vitality testing

Intervention Type DIAGNOSTIC_TEST

each tooth will be tested to determine if the pulp of the tooth responds to cold

Photos

Intervention Type OTHER

Photos of teeth (Photos will be taken with a DSLR camera settings will be determined with optimal settings) and captured periodically throughout the study. Photographs will be made of the cavity preparation. Photographs will be made post-operatively

local and/or topical anesthetic

Intervention Type DRUG

Local and/or topical anesthetic will be applied as necessary to the teeth or gingiva

rubber dam

Intervention Type DEVICE

The area will be isolated with rubber dam isolation

tooth surface cleaned

Intervention Type OTHER

The tooth surface will be cleaned with flour of pumice on a prophy cup only, cavity preparation will be performed as usual for caries removal.

enamel margins

Intervention Type PROCEDURE

Enamel margins will be beveled with a long flame diamond bur (8863.314.012 Komet) at 45 degrees to the external tooth surface to achieve the desired bevel length. Along with the use of the diamond bur, infinite invisible margins will be created by contouring and smoothing with a dark orange Sof-LexTM extra-thin contouring and polishing disc (3M).

Adhesive Systems

Intervention Type PROCEDURE

Adhesive systems will be applied according to manufacturer's instructions and selective etching of the enamel will be performed. The dental composite will be incrementally placed using a two- layer or one-layer technique based on the cavity size and light-cured (detailed adhesive instruction sheet will be chairside for reference)

cavity preparation

Intervention Type PROCEDURE

The technique to be used will be determined by the size of the final cavity preparation. For small preparations a one-layer technique will be used. No backing material is necessary for the Tokuyama system, Filtek Supreme Ultra will be determined by manufacturer's wheel. A two-layer technique will be used for a large cavity preparation. Large cavity preparation is defined as being 4mm in length or more and/or at least 2mm in depth.

Shade selection using Easy Shade 5

Intervention Type OTHER

A1 (shade determined by Easy Shade 5), ECM-001/Backing material, A1E/A2D (shade will be selected by shade wheel) A4 (shade determined by Easy shade5), ECM-001/Backing material, A3E/A6D (shade will be selected by shade wheel

Light Curing

Intervention Type PROCEDURE

A Valo Grand curing unit (Ultradent) with an exitant irradiance with no less than 500 and no greater than 1500 mW/cm2 as measured with MARC Light Collector will be used in standard mode to deliver the required radiant exposure J/cm2 for adhesive and dental composite increments.

Contoured and polished

Intervention Type PROCEDURE

The restoration will be contoured and polished with - Long flame diamond bur (8863.314.012 Komet), Sof-Lex Medium (orange) Contouring and Polishing Discs (3M), Green Jiffy cup pre-polisher (Ultradent Products, Inc.), Blue and grey silicone points composite polisher gloss plus finisher (Kerr Hawe)

Consent

Intervention Type OTHER

The consent form will be signed, copy will be provided to the patient

Health Questionnaire

Intervention Type OTHER

The health questionnaire will be completed at initial visit and updated at each follow-up visit

xray

Intervention Type RADIATION

When necessary a radiograph (xray) will be obtained

Release of medical information signed

Intervention Type OTHER

The release of medical information form will be signed

Oral Exam

Intervention Type OTHER

An Oral Exam will be completed

Teeth Assessment

Intervention Type OTHER

The teeth assessment by subject will be completed using the Visual Analog Scale (VAS) and Verbal Rating Scale (VRS) at the follow-up visits 1 month after restoration, 1 year, 2 years and 3 years post restoration.

Clinical Assessment

Intervention Type OTHER

A clinical assessment will be completed by the evaluators

ScotchBond

Intervention Type DEVICE

Scotch Bond Universal one-step adhesive system with Filtek Supreme Ultra™, nanofilled dental composite (3M)

Interventions

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Pulp vitality testing

each tooth will be tested to determine if the pulp of the tooth responds to cold

Intervention Type DIAGNOSTIC_TEST

Photos

Photos of teeth (Photos will be taken with a DSLR camera settings will be determined with optimal settings) and captured periodically throughout the study. Photographs will be made of the cavity preparation. Photographs will be made post-operatively

Intervention Type OTHER

local and/or topical anesthetic

Local and/or topical anesthetic will be applied as necessary to the teeth or gingiva

Intervention Type DRUG

rubber dam

The area will be isolated with rubber dam isolation

Intervention Type DEVICE

tooth surface cleaned

The tooth surface will be cleaned with flour of pumice on a prophy cup only, cavity preparation will be performed as usual for caries removal.

Intervention Type OTHER

enamel margins

Enamel margins will be beveled with a long flame diamond bur (8863.314.012 Komet) at 45 degrees to the external tooth surface to achieve the desired bevel length. Along with the use of the diamond bur, infinite invisible margins will be created by contouring and smoothing with a dark orange Sof-LexTM extra-thin contouring and polishing disc (3M).

Intervention Type PROCEDURE

Adhesive Systems

Adhesive systems will be applied according to manufacturer's instructions and selective etching of the enamel will be performed. The dental composite will be incrementally placed using a two- layer or one-layer technique based on the cavity size and light-cured (detailed adhesive instruction sheet will be chairside for reference)

Intervention Type PROCEDURE

cavity preparation

The technique to be used will be determined by the size of the final cavity preparation. For small preparations a one-layer technique will be used. No backing material is necessary for the Tokuyama system, Filtek Supreme Ultra will be determined by manufacturer's wheel. A two-layer technique will be used for a large cavity preparation. Large cavity preparation is defined as being 4mm in length or more and/or at least 2mm in depth.

Intervention Type PROCEDURE

Shade selection using Easy Shade 5

A1 (shade determined by Easy Shade 5), ECM-001/Backing material, A1E/A2D (shade will be selected by shade wheel) A4 (shade determined by Easy shade5), ECM-001/Backing material, A3E/A6D (shade will be selected by shade wheel

Intervention Type OTHER

Light Curing

A Valo Grand curing unit (Ultradent) with an exitant irradiance with no less than 500 and no greater than 1500 mW/cm2 as measured with MARC Light Collector will be used in standard mode to deliver the required radiant exposure J/cm2 for adhesive and dental composite increments.

Intervention Type PROCEDURE

Contoured and polished

The restoration will be contoured and polished with - Long flame diamond bur (8863.314.012 Komet), Sof-Lex Medium (orange) Contouring and Polishing Discs (3M), Green Jiffy cup pre-polisher (Ultradent Products, Inc.), Blue and grey silicone points composite polisher gloss plus finisher (Kerr Hawe)

Intervention Type PROCEDURE

Consent

The consent form will be signed, copy will be provided to the patient

Intervention Type OTHER

Health Questionnaire

The health questionnaire will be completed at initial visit and updated at each follow-up visit

Intervention Type OTHER

xray

When necessary a radiograph (xray) will be obtained

Intervention Type RADIATION

Release of medical information signed

The release of medical information form will be signed

Intervention Type OTHER

Oral Exam

An Oral Exam will be completed

Intervention Type OTHER

Teeth Assessment

The teeth assessment by subject will be completed using the Visual Analog Scale (VAS) and Verbal Rating Scale (VRS) at the follow-up visits 1 month after restoration, 1 year, 2 years and 3 years post restoration.

Intervention Type OTHER

Clinical Assessment

A clinical assessment will be completed by the evaluators

Intervention Type OTHER

Tokuyama Universal Bond

Tokuyama Universal Bond (TUB) single component self-etching 1-step adhesive system with Tokyuama supra-nanofilled dental composite (ECM) (Tokuyama Dental Corp., Japan)

Intervention Type DEVICE

ScotchBond

Scotch Bond Universal one-step adhesive system with Filtek Supreme Ultra™, nanofilled dental composite (3M)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Sensible tooth -responds to cold or electric pulp testing (done at screening)
* Patient 18years of age or old
* Current radiograph available (done at screening as needed)
* A pair of the same type of restorations needed in the anterior esthetic/facial region (tooth #4-#13).

Exclusion Criteria

* Fewer than 20 teeth
* Advanced untreated periodontal disease or recent periodontal surgery
* Rampant uncontrolled caries activity
* Bruxism or clenching and visible wear facets on the occlusal surface
* Undergoing or in need of TMJ therapy
* Known allergy to methacrylate-based materials or product ingredients
* History of poor dental visit attendance
* Not available for recall for at least 3 years
* Fractured or visibly cracked tooth
* Poor oral hygiene
* Sensitive tooth or currently using desensitizing treatments, pastes or medicaments
* Pregnant
* Abutment teeth for prostheses
* Teeth considered for restoration are non-vital, have had root canal therapy or been pulp capped
* Teeth or supporting structures with any symptomatic pathology or extensive caries lesion
* Individual supervised by PI or supervised by member of research team
* Individual subordinate to the PI or subordinate to any member of the research team
* Student or trainee under the direction of the PI or under the direction of a member of the research team
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Tokuyama Dental Corporation

UNKNOWN

Sponsor Role collaborator

Erica Teixeira

OTHER

Sponsor Role lead

Responsible Party

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Erica Teixeira

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Erica Teixeira, DDS, MS, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa College of Dentistry

Locations

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University of Iowa

Iowa City, Iowa, United States

Site Status

Countries

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United States

Other Identifiers

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201809844

Identifier Type: -

Identifier Source: org_study_id

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