Consultants’ Comments
- “The success of a posterior composite is related.”
- “Exceptional posterior esthetics at placement.”
- “The wear of the composite was consistent with that of natural dentition.”
Description
CLEARFIL MAJESTY Posterior is a nano-hybrid, light-cured, radiopaque composite that is filled 92% by weight. Anterior and posterior class I-V restorations are indicated with its properties of high strength and low polymerization shrinkage. The material is available in 4.9 g syringes and 0.25 g unit-dose pre-loaded tips in six shades: A1, A2, A3, B2, E2 and E3. This product received a 99% rating.
Clinical Evaluation Protocol
• 605 CLEARFIL MAJESTY Posterior restorations were placed using CLEARFIL S3 BOND, a 7th-generation bonding agent.
• Class I, Class II and Class V posterior restorations were placed on molars and premolars (Figure 1).
• 327 restorations in 62 patients were available for evaluation of clinical performance up to 24 months after placement (Figure 2).
• Restorations were evaluated on a 1-5 rating scale: 1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent.
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.
Clinical Observations at Recall
Resistance to Fracture
Ninety-nine percent of CLEARFIL MAJESTY Posterior restorations were in excellent condition after two years in service. Only three restorations exhibited minor fractures and one required replacement. There were no debonds during the two years since placement (Figure 4).
Esthetics
CLEARFIL MAJESTY Posterior exhibited excellent posterior esthetics at placement. It blended well with the surrounding tooth structure and displayed adequate opacity to mask most amalgam stains. After two years, these restorations continue to exhibit excellent esthetics both in luster and shade stability (Figure 4).
Resistance to Marginal Discoloration
The 7th-generation, self-etching bonding agent, CLEARFIL S3 BOND, was used bond the CLEARFIL MAJESTY Posterior restorations. The majority of the restorations were resistant to staining after two years. (Figure 4).
Wear Resistance
All posterior composites undergo considerable stress during function. As a high-strength, low-shrinkage material, CLEARFIL MAJESTY Posterior restorations showed minimal evidence of wear (Figure 4).
Sensitivity
Minimal postoperative sensitivity was reported following initial placement and there were no instances of tooth sensitivity reported during the two-year recall evaluation (Figure 4).
Summary
Three hundred twenty-seven CLEARFIL MAJESTY Posterior restorations were recalled at two years in 62 patients. At two-year recall, the majority of restorations exhibited excellent esthetics equivalent to that at initial placement. All restorations remain intact with almost no fracture, marginal discoloration or wear. No sensitivity was reported at recall.
