Consultants’ Comments
- “Produces firm interproximal contacts.”
- “Simple shading system.”
- “Restorations look good at one year.”
Description
CLEARFIL MAJESTY Posterior is a light-cured, nano-hybrid, radiopaque composite for posterior use. The composite is filled 92% by weight, 82% by volume with alumina and glass-ceramic particles. CLEARFIL MAJESTY Posterior is available in four Vita shades (A1, A2, A3 and B2) and two enamel shades (E2 and E3). It is packaged in 2-mL (4.9-g) syringes or 20, 0.25-g unit-dose tips.
Clinical Evaluation Protocol
- 468 CLEARFIL MAJESTY Posterior restorations were placed in 179 patients.
- CLEARFIL S³ BOND was used to bond all restorations.
- Class I and Class II posterior restorations were placed.
- 93 restorations were available for evaluation of clinical performance up to 20 months after placement (Figures 1 and 2).
- At placement and at recall, restorations were evaluated in various categories on a 1-5 rating scale: 1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent.
Figure 1
Figure 2
Clinical Observations at Placement
Ease of Placement, Packability, Carveability
CLEARFIL MAJESTY Posterior has adequate firmness for packing against a matrix band and maintaining its position where placed (Figure 3). While the composite has a fairly high viscosity, it is easy to extrude from the unit-dose capsules. The unit-dose delivery was overwhelmingly preferred by consultants, compared to the bulk syringes. Sculpting and carving occlusal anatomy is easier with an instrument wetted with unfilled resin. The consistency of CLEARFIL MAJESTY Posterior is somewhat waxy, which drags and pulls with a dry instrument.
Shade Match/Esthetics, Vitality
CLEARFIL MAJESTY Posterior exhibits a nice balance of translucency and opacity to block underlying stained dentin yet achieves very good blending with the enamel margins. All restorations were rated very good to excellent for esthetics and vitality regardless of whether a single Vita shade was used or if it was overlaid with an enamel shade (Figure 3).
Finish/Polish
The composite is easy to finish with standard rotary diamonds and finishing instruments (Figure 3). The polish is acceptable for posterior restorations. The final surface was often reported to be slightly grainy.
Figure 3
Clinical Observations at Recall
Fracture Resistance
Ninety-nine percent of CLEARFIL MAJESTY Posterior restorations recalled showed no chips or fractures (Figure 4). One molar restoration fractured at the marginal ridge, requiring replacement.
Esthetics
CLEARFIL MAJESTY Posterior maintained very good esthetics at all stages of recall (Figure 4). The initial comments of slight graininess at placement were not reported at recall. The composite surfaces were actually smoother after some time in function. No loss of anatomy or surface wear was noted. Shades exhibited stability, and restorations blended well with the surrounding tooth structure.
Resistance to Marginal Discoloration
CLEARFIL S³ BOND was used to bond the CLEARFIL MAJESTY Posterior restorations; no additional etching of peripheral enamel was done at the time of placement. Ninety-nine percent of restorations had no visible staining at the margins (Figure 4).
Sensitivity
No post-operative sensitivity to temperature or pressure was reported by patients when they were asked at their recall appointments (Figure 4).
Figure 4
Summary
CLEARFIL MAJESTY Posterior was used with the 7th-generation bonding agent, CLEARFIL S³ BOND, in restoring 438 teeth in 179 patients. The composite was easy to place from the unit-dose capsules. Sculpting/carving was best accomplished with a resin-wetted instrument. The restorations were evaluated as the patients reported for their next scheduled dental appointments, ranging from two months to 20 months after placement. One restoration was replaced during the recall period. This restoration had a fractured marginal ridge after 13 months in function. Marginal staining was minimal, and no sensitivity was reported with the restorations. Overall, CLEARFIL MAJESTY Posterior was highly rated for producing esthetic posterior restorations.
