Clinical Evaluation of Dentin Replacement Materials in Posterior Composite Restorations

Experimental: Biodentine

Participants will receive posterior Class I composite restorations incorporating Biodentine as the dentin replacement material according to the standardized clinical protocol and manufacturer's instructions.

Otro: Biodentine

Biodentine will be used as a dentin replacement material in standardized posterior Class I cavities before placement of the definitive composite restoration. The material will be applied according to the manufacturer's instructions

Experimental: ACTIVA BioACTIVE

Participants will receive posterior Class I composite restorations incorporating ACTIVA BioACTIVE as the dentin replacement material according to the standardized clinical protocol and manufacturer's instructions.

Otro: ACTIVA BioACTIVE

ACTIVA BioACTIVE will be used as a dentin replacement material in standardized posterior Class I cavities before placement of the definitive composite restoration. The material will be applied according to the manufacturer's instructions.

Experimental: Glass Ionomer Cement

Participants will receive posterior Class I composite restorations incorporating conventional glass ionomer cement as the dentin replacement material according to the standardized clinical protocol and manufacturer's instructions.

Otro: glass ionomer cement

Glass ionomer cement will be used as a dentin replacement material in standardized posterior Class I cavities before placement of the definitive composite restoration. The material will be applied according to the manufacturer's instructions.

Experimental: everX Posterior

Participants will receive posterior Class I composite restorations incorporating everX Posterior as the dentin replacement material according to the standardized clinical protocol and manufacturer's instructions.

Otro: everX Posterior

everX Posterior will be used as a dentin replacement material in standardized posterior Class I cavities before placement of the definitive composite restoration. The material will be applied according to the manufacturer's instructions.

Experimental: Flowable Resin

Participants will receive posterior Class I composite restorations incorporating flowable resin composite as the dentin replacement material according to the standardized clinical protocol and manufacturer's instructions

Otro: Flowable Resin Composite

Flowable resin composite will be used as a dentin replacement material in standardized posterior Class I cavities before placement of the definitive composite restoration. The material will be applied according to the manufacturer's instructions.

marginal adaptation

Clinical evaluation of marginal adaptation was conducted in accordance with the World Dental Federation (FDI) criteria by two calibrated examiners at baseline and after 6, 12, and 18 months. Each restoration was assessed and categorized according to the degree of conformity with the established criteria as follows: score 1, clinically excellent; scores 2 and 3, clinically satisfactory; and scores 4 and 5, clinically inadequate. Scores of 1-3 were considered indicative of clinical success, whereas scores of 4 or 5 were considered indicative of failure. Visual assessment was performed under adequate illumination using a high-intensity light source and a dental magnifying loupe to facilitate accurate evaluation. For statistical analysis, the Friedman test was used to assess within-group changes in restoration outcomes across the different follow-up periods. The Kruskal-Wallis test was applied to compare restoration outcomes among the different groups at each corresponding follow-up.