Clinical and Radiographical Evaluation of Smart and Bulk-fill Composite Materials in Class I Restorations of Deciduous Molars: A Parallel-arm Randomised Clinical Study

Abstract Introduction: Restoring primary molars affected by dental caries is a routine challenge in paediatric dentistry. One of the critical factors influencing the success of these restorative procedures is the choice of dental material employed. Recently, bulk fill and bioactive materials have been introduced, combining the strength of composite resins with the advantages of glass ionomer cements. The aim of the study is to evaluate and compare the success rate of smart and bulk fill composite materials restorative materials in Class I cavities of primary molars and to assess the time taken for placement of restoration. Materials and Methods: This study enrolled 65 children aged 4–9 years who required occlusal caries restorations in their first and/or second primary molars. The teeth were randomly assigned to three restorative groups: Activa Kids BioACTIVE, One Bulk Fill Restorative, or Tetric N-Ceram. Clinical evaluations were performed at baseline, 3, 6, and 9 months using the United States Public Health Service (USPHS) criteria. Results: A statistically significant difference was found in marginal adaptation and marginal integrity on intergroup and intragroup comparison, respectively. There were no samples with gross fracture and secondary caries found in any group at the given time duration. The mean time taken for placement of restoration in Group A, Group B and Group C were 4.81 min, 5.98 min, 5.95 min, respectively. Conclusion: Activa bioactive material showed better results for Class I primary molar fillings, offering faster placement and good clinical outcomes. Tetric N-Ceram and One Bulk Fill performed similarly in clinical and radiographic assessments.