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
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DOI: 10.12659/MSM.951980
Med Sci Monit 2026; 32:e951980
Table 7 Evidence mapping matrix: operative techniques vs clinical outcomes.
| Operative technique | Longevity | Marginal adaptation | Postop sensitivity | Secondary caries |
|---|---|---|---|---|
| Multi-step adhesive protocol | Strong↑ | Strong↑ | Moderate↑ | Moderate↑ |
| Self-etch adhesive (deep boxes) | Moderate↑ | Moderate↑ | Strong↑ | ↔ Limited |
| Incremental layering | Strong↑ | Moderate↑ | Strong↑ | Weak↑ |
| Bulk-fill (unsupported) | ↓ Weak | ↓ Moderate | ↓ Weak | ↓ Weak |
| Bulk-fill (with control) | ↔ Mixed | ↔ Mixed | ↔ Mixed | ↓ Weak |
| Sectional matrix | Moderate↑ | Strong↑ | Moderate↑ | Weak↑ |
| Circumferential matrix | ↓ Weak | ↓ Moderate | ↔ Neutral | ↓ Weak |
| Soft-start curing | Moderate↑ | Strong↑ | Moderate↑ | ↔ Limited |
| Aggressive curing | ↓ Moderate | ↓ Moderate | ↓ Weak | ↓ Weak |
| ↑ – positive association; ↑↑ – strong association; ↓ – negative association; ↔ – mixed/neutral evidence. | ||||