The aim of this study was to evaluate the clinical performance of surface sealants associated with a bulk-fill composite in posterior restorations after 4 years. A total of 174 posterior restorations were performed on 57 participants using a self-etch adhesive system and a bulk-fill composite. The groups were then divided into the following categories: 1) without surface sealant (NoS), 2) with surface sealant Biscover (Bisco, SBi), and 3) with surface sealant Permaseal (Ultradent, SPe). Restorations were evaluated using FDI criteria at baseline and after 1 and 4 years. Statistical analysis was conducted using Kaplan-Meier survival analysis and the Chi-square test (α = 0.05). After 4 years, only one restoration was lost (1 in the NoS group). The fracture/retention rate (with 95% confidence interval) was 98% for NoS and 100% for both SBi and SPe (p = 0.76). The majority of secondary outcomes showed minor defects, with no significant differences among the groups (p > 0.05). However, significant differences were observed among the groups in terms of marginal staining and marginal adaptation (p = 0.03). In both items, twelve restorations (nine in NoS, one in SBi, and two in SPe) showed minor marginal discrepancies favoring the sealant groups (SBi and SPe). Regardless of the use of surface sealants, the bulk-fill composite restorations showed excellent clinical performance after 4 years. However, the groups that received sealants showed better marginal adaptation and less marginal discoloration compared to those that did not receive sealants.

中文翻译：

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表面封闭剂对散装填充复合材料后牙修复体质量的影响：一项为期 4 年的随机临床试验

本研究的目的是评估 4 年后与散装填充复合材料相关的表面封闭剂在后牙修复体中的临床性能。使用自蚀刻粘合剂系统和散装填充复合材料，对 57 名参与者总共进行了 174 次后牙修复。然后将各组分为以下几类：1) 不使用表面密封剂 (NoS)，2) 使用表面密封剂 Biscover (Bisco, SBi)，以及 3) 使用表面密封剂 Permaseal (Ultradent, SPe)。使用 FDI 标准在基线以及 1 年后和 4 年后评估恢复情况。使用 Kaplan-Meier 生存分析和卡方检验（α = 0.05）进行统计分析。4 年后，只有 1 个修复体丢失（NoS 组有 1 个）。NoS 的断裂/保留率（置信区间为 95%）为 98%，SBi 和 SPe 均为 100%（p = 0.76）。大多数次要结果显示轻微缺陷，各组之间没有显着差异 (p > 0.05)。然而，各组之间在边缘染色和边缘适应方面观察到显着差异（p = 0.03）。在这两个项目中，十二个修复体（NoS 中九个，SBi 中一个，SPe 中两个）显示出有利于密封剂组（SBi 和 SPe）的微小边缘差异。无论是否使用表面密封剂，散装填充复合修复体在 4 年后都表现出优异的临床性能。然而，与未接受密封剂的组相比，接受密封剂的组表现出更好的边缘适应和更少的边缘变色。