{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:24:42Z","timestamp":1783347882649,"version":"3.54.6"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Polymerization shrinkage and postoperative sensitivity remain significant concerns in posterior composite restorations. Although bulk-fill composites simplify clinical procedures, their long-term clinical performance compared with incremental techniques remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the clinical performance of Smart Dentin Replacement Plus (SDR+) and Tetric N-Ceram composites when placed using incremental and bulk-fill techniques in Class I pit and fissure cavities over a 6- and 12-month follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      This prospective randomized split-mouth clinical trial included 44 patients (18\u201335 years) with Class I pit and fissure caries. Teeth were randomly allocated into four groups (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11): SDR+ bulk-fill, SDR+ incremental, Tetric N-Ceram bulk-fill, and Tetric N-Ceram incremental. Restorations were evaluated at 6 and 12 months for postoperative sensitivity and secondary caries using clinical examination, caries detector dye under \u00d76, and bitewing radiographs. Data were analyzed using the Chi-square test (\u03b1 = 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      At 6 and 12 months, the incremental technique groups demonstrated significantly higher clinical success (90.91%) compared with the bulk-fill groups (SDR+ \u2013 45.45% and Tetric N-Ceram \u2013 54.55%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). No statistically significant difference was observed between SDR+ and Tetric N-Ceram when identical placement techniques were used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance:<\/jats:title>\n                    <jats:p>Placement technique plays a more decisive role than composite material selection in the long-term success of posterior restorations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Incremental placement technique showed superior clinical performance compared to the bulk-fill technique in Class I restorations, irrespective of the composite material used.<\/jats:p>\n                  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