26 April 2026 : Meta-Analysis
Influence of Operative Techniques on Clinical and Laboratory Outcomes in Class II Resin-Based Composite Restorations: A Systematic Review
Bassam Zidane
ABCDEF 1*
DOI: 10.12659/MSM.951980
Med Sci Monit 2026; 32:e951980
Table 3 Summary characteristics of the included randomized controlled trials and clinical studies.
| Author (year) | Population/tooth | Intervention | Comparator | Relevant outcomes |
|---|---|---|---|---|
| 34 premolars (mesial/distal cavities) | Directed shrinkage technique | Incremental horizontal layering | Better interfacial adaptation with directed shrinkage | |
| 35 children, Class II in primary molars | Compoglass (polyacid-modified composite) | TPH-Spectrum (hybrid composite) | Survival (79.5% at 3 years); marginal adaptation (Ryge) | |
| 120 Class II cavities (extracted after 1 month) | Sandwich technique with RMGIC base | Base or total bond technique | Superior marginal adaptation in sandwich group | |
| 58 restorations in permanent teeth | Flowable composite liner + hybrid composite | Hybrid composite alone | Improved marginal adaptation; similar survival | |
| 11 patients, 44 Class II restorations (split-mouth) | Direct composite (incremental, light-cured) | Semi-direct inlay technique | High clinical performance and marginal integrity | |
| 50 posterior restorations, permanent molars | Ormocer-based composite | Hybrid composite | Similar survival and marginal adaptation | |
| 40 Class II restorations (extracted after 1 month) | Diagonal layering + transparent matrix | Horizontal layering + metal matrix | Improved adaptation with diagonal layering | |
| 13 patients, 29 restorations | Beveled cavity margins | Butt-joint margins | Improved marginal adaptation | |
| 30 patients, indirect Class II restorations | Self-etch luting protocol | Total-etch luting protocol | Marginal adaptation slightly better in total-etch | |
| 53 patients, 159 Class II cavities | Bulk-fill composite | Nano-hybrid composite | Similar survival; mild sensitivity resolved | |
| 53 patients, 159 restorations (split-mouth) | Bulk-fill flowable + hybrid layering | Conventional incremental layering | Comparable 4-year survival; good marginal adaptation | |
| RMGIC – resin-modified glass ionomer cement; Ryge – Ryge criteria for clinical evaluation. | ||||