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Restorations were placed under rubber-dam isolation using selective enamel etching. Clinical evaluations were performed at baseline, 6 months, one year, and two years using periodontal indices and FDI criteria. Data were analyzed using Kruskal\u2013Wallis, Friedman, Mann\u2013Whitney U, and Wilcoxon signed-rank tests (\u03b1\u2009=\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Recall rates were 96.4% at 6 months, 89.3% at 1 year, and 83.5% at 2 years. Periodontal parameters showed no significant differences among groups. No significant differences were observed between restorative systems for any FDI functional, biological, or esthetic criteria at any evaluation point. All restorations remained clinically acceptable, with no loss of retention, fractures, or secondary caries throughout the two-year follow-up. Marginal adaptation scores remained stable and comparable among all groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All four restorative systems demonstrated comparable and favorable clinical performance over two years. The use of fluoride-releasing adhesives or ion-releasing composites did not confer additional clinical benefits under the conditions of this trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>Both the tested bulk-fill resin composite and ion-releasing composite deliver predictable short-term performance in Class V restorations, without additional benefit from fluoride-releasing components.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-06852-5","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T07:47:06Z","timestamp":1775893626000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A two-year randomized clinical trial of bulk-fill and ion-releasing composites with universal adhesives in class V carious lesions"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8369-4041","authenticated-orcid":false,"given":"Hoda Saleh","family":"Ismail","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5950-7015","authenticated-orcid":false,"given":"Hanan Ahmed Nabil","family":"Soliman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7776-2308","authenticated-orcid":false,"given":"Ashraf Ibrahim","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Gamal","family":"Raghip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman H.","family":"Albelasy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,11]]},"reference":[{"key":"6852_CR1","doi-asserted-by":"publisher","first-page":"585","DOI":"10.3290\/j.jad.a33188","volume":"16","author":"JWV Van Dijken","year":"2014","unstructured":"Van Dijken JWV, Pallesen U (2014) A randomized 10-year prospective follow-up of class II nanohybrid and conventional hybrid resin composite restorations. 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