الفهرس 
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Abstract
The current in vivo study was carried out to assess the clinical performance of two posterior bulk fill resin composite restorative materials for the management of carious class II lesions in adult patients over an up to 6-month evaluation period: sonic activated bulk fill resin composite (Sonicfill2) and a dual cure zinc oxide containing bulk fill resin composite (Fill Up). A convenient sample of twenty patients with proximal caries in at least three of their posterior teeth were chosen. Twenty patients were chosen, and posterior class II cavities were prepared for them. There were two prepared teeth for each patient, for a total of forty prepared teeth. Subsequently, the teeth in each patient were randomly assigned for restoration using resin composite materials without knowledge of the specific allocation as follow: -
group A1: Twenty teeth were filled with SonicFill2, a Sonic activated bulk fill resin composite, using the Sonic-fill handpiece, and following the manufacturer’s instructions. The unidose tip was affixed to the cavities and administered into the prepared cavity.
group A2: Following the guidelines provided by the manufacturer, twenty teeth were treated with a Dual cure zinc oxide containing bulk fill resin composite called Fill Up. The material was applied directly into the cavity using an automix syringe and then delivered into the prepared cavity with light pressure.
Evaluation of the restorations
The clinical status of the tested restorations was evaluated at baseline (24h) after placement of the restorations, after one, three and six months.
The two types of resin composites were evaluated using Unites State Public Health Service (USPHS) criteria for: -
1. Color matching (CM).
2. Marginal discoloration (MD).
3. Marginal adaptation (MA).
4. Anatomic form (AF).
5. Secondary caries (SC).
The clinical evaluation conducted by two trained operators and the Alpha and Bravo score percentages were considered significant of clinical success.
Evaluation of postoperative sensitivity (POS):
Each restored tooth was evaluated for postoperative sensitivity. and the patients’ responses were assessed by using the VAS (Visual Analog Scale) Score.
The results of the study showed that: -
1- In regard to color match, the results revealed that in SonicFill there was no statistically significant change in color match scores by time. While there was a statistically significant change in color match scores by time in Fill Up.
2- There were no statistically significant differences between the two tested materials as regards to the marginal discoloration by the time.
3- There were no statistically significant differences between the two tested materials as regards to the marginal adaptation by the time.
4- For anatomic form between the two studied materials, no statistically significant differences were found
5- No significant differences between the two tested materials for secondary caries.
6- Regarding postoperative sensitivity, the difference between SonicFill and Fill Up was not statistically significant. At one, three and six months all cases reported no pain in both groups and this result was not significant.
7- The general results of this clinical study showed that the two tested resin composite materials had a satisfactory significant difference in performance during the evaluation period.
Conclusion:
Within the limitations of this current in vivo study, and based on the findings it was concluded that: -
1- Over the six month follow-up period of the study, both bulk-fill techniques demonstrated satisfactory clinical outcomes throughout the evaluation periods.
2- The findings of this study indicate that bulk-fill restorations can effectively address the challenges associated with the multi-layer technique. This approach saves time and effort while still achieving satisfactory clinical results.
3- The two tested bulk-fill resin composite restorative materials exhibited satisfactory clinical performance as a direct restoration for class II cavity preparations.
Recommendations:
- Because six months may not seem like a long enough period to make an appropriate judgement on restorative material, it is advisable to clinically examine the restorations for extended periods of time in order to provide useful information regarding changes in restorative material over time.