Bulk-Fill Ormocer versus Methacrylate-Based Resin Composite Restorative Systems: The Effect of Flowable Lining on Two-Year Clinical Performance in Class II Cavities

Abstract

Objective The aim of this study was to assess and compare the impact of bulk-fill flowable resin composite liners (BFFL) on the 2-year clinical performance of bulk-fill ormocer (BORC) in comparison to methacrylate-based resin composites (BMRC) in Class II cavities. Materials and Methods Thirty participants, each aged between 18 and 30 years, were included in the study, each presenting four class II cavities. A total of 120 restorations were placed, with participants randomly assigned to one of four restorative systems through a blind drawing: Admira Fusion X-Tra (AFX) alone, AFX after lining with Admira Fusion Xtra-Base (AFB), X-Tra Fill (XF) for complete cavity filling, and XF after lining with Xtra-Base (XB). The universal adhesive system (Futura U bond Voco, Germany) was consistently applied for all restoration techniques using selective enamel etching. A single operator, following the manufacturer's instructions for each material, performed all restorations, and finishing/polishing occurred immediately after placement. Clinical evaluation, based on World Dental Federation (FDI) criteria, was conducted by two blinded examiners at baseline (7 days) and at 6, 12, and 24 months postoperatively. Results The chi-squared test was used to compare the four applied restorative systems within each follow-up period, while the marginal homogeneity test was employed to assess changes over time. No statistically significant differences were observed among the four restorative systems at any evaluation period. Conclusions After 2 years, the clinical performance of BFFL or complete bulk-fill technique remained similar, regardless of the material composition.