Influence of Composite Placement Techniques on the Clinical Performance of Posterior Restorations in Vital Teeth

NCT07415317 | Completed DMC

• 1 other identifier: Composite Placement Techniques
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 3

Brief Summary

The purpose of this 12-month randomized clinical investigation was to compare the clinical performance of posterior composite resin restorations implanted in vital teeth using various placement techniques.

Conditions

Composite Resins; Posterior Teeth

Keywords

Clinical; Placement techniques; Stamp; bulk-fill; Snowplow

Outcome Measures

Primary Outcomes (1)

• The primary outcome was marginal adaptation

  Clinical evaluation of marginal adaptation was performed according to the World Dental Federation (FDI) by two calibrated evaluators at baseline and at 6, 12, and 24 months. All of the restorations were ranked according to how well they met the criteria: score 1 (clinically excellent), score 2 (clinically satisfactory), score 3 (clinically satisfactory), or scores 4 and 5 (clinically inadequate). Clinical success was defined as a score of 1, 2, or 3, and failure was indicated by scores of 4 or 5. A powerful light source was used to conduct the visual inspection of the parameters. A magnifying dental loupe was utilized for this purpose. The Friedman test was conducted to evaluate intragroup comparisons of the same restoration outcomes through different follow-up periods. The Kruskal-Wallis test was utilized to assess intergroup comparisons between different restorations during the same follow-up period. Time Frame: 24 months

  24 months

Study Arms (4)

incremental nanohybrid composite

EXPERIMENTAL

Stamp technique

Other: nanohybrid composite resin

Flowable and nanohybrid composite

EXPERIMENTAL

Snowplow technique

Other: nanohybrid composite resin

incremental layering technique

EXPERIMENTAL

Modified incremental "Pizza" technique

Other: nanohybrid composite resin

bulk fill composite resin

EXPERIMENTAL

Bulk-fill technique

Other: nanohybrid composite resin

Interventions

nanohybrid composite resin OTHER

Fifty patients received a total of 200 Class I composite restorations, which were placed using the same nanohybrid composite resin and randomly allocated into four groups (n = 50) according to placement technique: Group I-Stamp technique; Group II-Snowplow technique; Group III-Modified incremental "Pizza" technique; and Group IV-Bulk-fill technique

Flowable and nanohybrid composite; bulk fill composite resin; incremental layering technique; incremental nanohybrid composite

Eligibility Criteria

• Age: 20 Years - 35 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Good general and oral health
• Vital posterior teeth with primary occlusal caries
• Class I cavities with depth ranging from 3 to 4 mm

You may not qualify if:

• Non-vital or restored teeth
• Parafunctional habits (e.g., bruxism)

Sponsors & Collaborators

• Tanta University: lead

Study Sites (3)

Restorative Department, Faculty of Dentistry, Tanta University

Tanta, Tanta, 31527, Egypt

Location

Restorative Department, Faculty of Dentistry, Tanta University

Tanta, Tanta, Egypt

Location

Faculty of Dentistry

Tanta, Egypt

Location

Related Publications (6)

• Karunakar P, Ranga Reddy MS, Kumar BS, Namratha R. Direct and indirect stamp techniques for composite restorations - Sealing the uniqueness of a tooth: A case series. J Conserv Dent. 2022 May-Jun;25(3):327-331. doi: 10.4103/jcd.jcd_616_21. Epub 2022 Jun 13.

  PMID: 35836552 BACKGROUND

• Paolone G, Coccoluto L, Cortili S, Collivasone G, Cantatore G, Gherlone EF. Copolymerizing flowable and high-viscosity composite resins in class II restorations: The "Snowplow" technique. A scoping review. J Prosthet Dent. 2025 Nov 14:S0022-3913(25)00863-7. doi: 10.1016/j.prosdent.2025.10.058. Online ahead of print.

  PMID: 41241559 RESULT

• Zhu J, Fu C, Deng X, Ma L, Song F, Huang C. Effects of stamp material and restoration depth on the accuracy of direct composite resin restorations using stamp technique. J Dent. 2024 Nov;150:105369. doi: 10.1016/j.jdent.2024.105369. Epub 2024 Sep 26.

  PMID: 39341448 RESULT

• Vertuan M, Mosquim V, Guimaraes GMF, Obeid AT, Bombonatti JFS, Ishikiriama SK, Furuse AY. The stamp technique for direct restoration in a ICDAS 4 carious lesion: A 4-year follow-up. J Esthet Restor Dent. 2023 Apr;35(3):442-448. doi: 10.1111/jerd.12963. Epub 2022 Sep 26.

  PMID: 36161755 RESULT

• Desai D. "Stamp" Technique to Recreate Accurate Occlusal Topography for Direct Composite Posterior Restorations. Compend Contin Educ Dent. 2025 May;46(5):236-239.

  PMID: 40479542 RESULT

• Zotti F, Vincenzi S, Zangani A, Bernardi P, Sbarbati A. Stamp Technique: An Explorative SEM Analysis. Dent J (Basel). 2023 Mar 8;11(3):77. doi: 10.3390/dj11030077.

  PMID: 36975574 RESULT

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor

Study Record Dates

• First Submitted: January 18, 2026
• First Posted: February 17, 2026
• Study Start: January 1, 2024
• Primary Completion: January 6, 2026
• Study Completion: January 17, 2026
• Last Updated: February 17, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

EG (3)