Glass Hybrid Versus Nanocomposite for Restoration of Sclerotic Non-carious Cervical Lesions: 18-Month Results of a Randomized Controlled Trial.

PURPOSE: To compare the clinical performance and treatment times between glass hybrid (GH; EQUIA Forte Fil/EQUIA Forte Coat, GC) and adhesive/nanofilled resin composite restorations (RC; OptiBond FL, Kerr/Filtek Supreme XTE, 3M Oral Care) of sclerotic non-carious cervical lesions (sNCCL). MATERIALS AND METHODS: This is an 18-month interim analysis of a 36-month cluster-randomized trial (ClinicalTrials.gov Identifier: NCT02631161). Eighty-eight patients (50-70 years) with 175 sNCCLs were randomized to receive GH or RC restorations. Restorations were placed without mechanical cavity preparation, and treatment time was recorded. After 18 months, restorations were evaluated using FDI criteria. Factors associated with restoration survival were evaluated using multi-level Cox-regression analysis. Generalized linear mixed modelling was used to analyze factors associated with treatment time. RESULTS: After a mean of 18 months (min/max: 8/25), 78 patients (160 restorations) were assessed. Fifteen restorations (18%) failed in GH, and 11 (12%) in the RC, without a significant difference in survival (p = 0.904/Cox). Retention loss was the most common reason for failure in both groups. Restorations placed in older patients showed lower risk of failure [OR (95% CI): 0.90 (0.81-0.99) per year], while mandibular teeth showed higher risks [2.89 (1.00-8.31)]. Treatment time was significantly shorter for GH (mean ± SD: 8.6 ± 4.3 min) than RC (11.7 ± 5.7 min; p < 0.001). CONCLUSIONS: GH may be a suitable alternative to RC for restoring sNCCLs, without any significant difference in survival between the two materials at this interim analysis. In addition, placing GH restorations required less chairtime than did placing RC restorations.

Glass hybrid versus composite for non-carious cervical lesions: Survival, restoration quality and costs in randomized controlled trial after 3 years.

OBJECTIVE: This study compared survival, restoration quality and costs of glass hybrid (GH; EQUIA Forte Fil/EQUIA Forte Coat) and resin composite restorations (RC; OptiBond FL/Filtek Supreme XTE) of sclerotic non-carious cervical lesions. METHODS: This is a cluster-randomized trial (ClinicalTrials.gov: NCT02631161). 88 patients (50-70 years) with 175 sNCCLs were randomized to receive GH or RC. Restorations were placed without mechanical cavity preparation and followed for a mean 36 (min/max: 31/55) months (variable follow-up due to COVID-19 lockdown). Restoration quality was re-evaluated at 1-, 18- and 36-months using FDI-criteria. Survival was assessed using multi-level Cox-regression analysis. Costs were estimated from a payer's perspective in Germany. Initial costs were determined based on micro-costing using time recordings and hourly costs, and follow-up costs based on statutory insurance fee-item-catalogues. RESULTS: 88 patients (175 restorations) were treated; 43 received GH (83 restorations), 45 RC (92 restorations). 17  GH and 19 RC showed total retention loss, 5  GH were partially lost (p = 0.396/Cox). FDI ratings were not sufficiently different for any domain except surface luster, where RC showed higher score (p < 0.001). Costs were initially lower for GH (32.57; SD 16.36 €) than RC (44.25; SD 21.40 €), while re-treatment costs were similar (GH: 9.15; SD 15.70 €; RC: 7.35; SD 14.51 €), resulting in significantly lower costs for GH (GH: 41.72; SD 25.08 €) than RC (51.60; 26.17 €) (p < 0.001/GLM). CONCLUSIONS: While survival was not significantly different, GH was significantly less costly both initially and long-term than RC for restoring non-carious cervical lesions. CLINICAL SIGNIFICANCE: Within this trial, survival was not significantly different between GH and RC to restore sclerotic NCCLs. As GH was significantly less costly both initially and long-term than RC, using RC was only cost-effective for payers willing to invest high additional expenses per minimal survival gains.