Composite ResinsNCT07415317
Influence of Composite Placement Techniques on the Clinical Performance of Posterior Restorations in Vital Teeth
A study testing nanohybrid composite resin in people with Composite Resins and Posterior Teeth, run by Tanta University at 3 sites in Egypt.
Trial summary
The purpose of this 12-month randomized clinical investigation was to compare the clinical performance of posterior composite resin restorations implanted in vital teeth using various placement techniques. Read more about this study
- Who is it for?
- Ages 20 to 35 yearsHealthy volunteers can take part
- Conditions the study is for
- Composite Resins, Posterior Teeth
- What is being tested?
- nanohybrid composite resin
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 3 sitesEgypt
- Study dates
- 1 Jan 2024to 17 Jan 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 35 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Good general and oral health
- Vital posterior teeth with primary occlusal caries
- Class I cavities with depth ranging from 3 to 4 mm
Who cannot join
- Non-vital or restored teeth
- Parafunctional habits (e.g., bruxism)
Trial locations and contacts
3 sites in 1 country.
Egypt3 sites
Restorative Department, Faculty of Dentistry, Tanta University
Tanta, Tanta, 31527
Restorative Department, Faculty of Dentistry, Tanta University
Tanta, Tanta
Faculty of Dentistry
Tanta
About this study
The purpose of this 12-month randomized clinical investigation was to compare the clinical performance of posterior composite resin restorations implanted in vital teeth using various placement techniques.
Read the detailed description
Because of their conservative nature, aesthetic qualities, and consistently improved mechanical performance and handling features, resin-based composites have become the restorative material of choice for posterior teeth. Nevertheless, significant obstacles influencing the stability of the marginal area, sensitivity following the procedure, and the durability and effectiveness of composite restorations in the long run are polymerization shrinkage and stress associated with shrinkage.
To reduce polymerization stress and maximize adaptability to hollow walls, various placement procedures have been suggested. While older incremental layering methods sought to lessen the configuration factor (C-factor) and increase light penetration, more recent methods like the Stamp and Snowplow approaches sought to replicate the occlusal architecture and enhance marginal sealing. Conversely, bulk-fill techniques were first developed to streamline clinical processes by enabling the use of bigger composite layers with the promise of lower shrinkage stress.
Despite a plethora of in vitro studies, there is a dearth of high-quality clinical data that compares these placement methods under controlled settings. Due to the fact that laboratory studies cannot completely replicate the oral environment, clinical trials continue to be the best way to assess the real-world efficacy of restorative procedures.
Consequently, this randomized clinical trial set out to assess the clinical efficacy of posterior composite restorations placed in vital teeth utilizing four distinct procedures over the course of a year
- Conditions
- Composite Resins, Posterior Teeth
- Being tested
- nanohybrid composite resin
- Keywords
- Clinical, Placement techniques, Stamp, bulk-fill, Snowplow
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
nanohybrid composite resinOther
Fifty patients received a total of 200 Class I composite restorations, which were placed using the same nanohybrid composite resin and randomly allocated into four groups (n = 50) according to placement technique: Group I-Stamp technique; Group II-Snowplow technique; Group III-Modified incremental "Pizza" technique; and Group IV-Bulk-fill technique
| Study group | Role | What they receive |
|---|---|---|
| incremental nanohybrid composite | Experimental | Stamp technique Receives: Other: nanohybrid composite resin |
| Flowable and nanohybrid composite | Experimental | Snowplow technique Receives: Other: nanohybrid composite resin |
| incremental layering technique | Experimental | Modified incremental "Pizza" technique Receives: Other: nanohybrid composite resin |
| bulk fill composite resin | Experimental | Bulk-fill technique Receives: Other: nanohybrid composite resin |
What is being measured
The primary outcome is the main question the study is designed to answer.
The primary outcome was marginal adaptation
Clinical evaluation of marginal adaptation was performed according to the World Dental Federation (FDI) by two calibrated evaluators at baseline and at 6, 12, and 24 months. All of the restorations were ranked according to how well they met the criteria: score 1 (clinically excellent), score 2 (clinically satisfactory), score 3 (clinically satisfactory), or scores 4 and 5 (clinically inadequate). Clinical success was defined as a score of 1, 2, or 3, and failure was indicated by scores of 4 or 5. A powerful light source was used to conduct the visual inspection of the parameters. A magnifying dental loupe was utilized for this purpose. The Friedman test was conducted to evaluate intragroup comparisons of the same restoration outcomes through different follow-up periods. The Kruskal-Wallis test was utilized to assess intergroup comparisons between different restorations during the same follow-up period.
Time Frame: 24 months
Measured: 24 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Feb 2026
- Study start1 Jan 2024
- Primary completion6 Jan 2026
- Study completion17 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Composite ResinsStudies of the same condition, open and under way.
- More trials run by Tanta UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 50 participants (actual)
Sponsor and investigators
- Lead sponsor
- Tanta University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mohammed Abd El Ghany Mohammed, Tanta University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07415317
- Sponsor's protocol ID
- Composite Placement Techniques
- Status last verified
- Jan 2026
- First submitted
- 18 Jan 2026
- Last updated
- 17 Feb 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Karunakar P, Ranga Reddy MS, Kumar BS, Namratha R. Direct and indirect stamp techniques for composite restorations - Sealing the uniqueness of a tooth: A case series. J Conserv Dent. 2022 May-Jun;25(3):327-331. doi: 10.4103/jcd.jcd_616_21. Epub 2022 Jun 13.
PubMed 35836552Paolone G, Coccoluto L, Cortili S, Collivasone G, Cantatore G, Gherlone EF. Copolymerizing flowable and high-viscosity composite resins in class II restorations: The "Snowplow" technique. A scoping review. J Prosthet Dent. 2026 May;135(5):e1-e11. doi: 10.1016/j.prosdent.2025.10.058. Epub 2025 Nov 14.
PubMed 41241559Zhu J, Fu C, Deng X, Ma L, Song F, Huang C. Effects of stamp material and restoration depth on the accuracy of direct composite resin restorations using stamp technique. J Dent. 2024 Nov;150:105369. doi: 10.1016/j.jdent.2024.105369. Epub 2024 Sep 26.
PubMed 39341448Vertuan M, Mosquim V, Guimaraes GMF, Obeid AT, Bombonatti JFS, Ishikiriama SK, Furuse AY. The stamp technique for direct restoration in a ICDAS 4 carious lesion: A 4-year follow-up. J Esthet Restor Dent. 2023 Apr;35(3):442-448. doi: 10.1111/jerd.12963. Epub 2022 Sep 26.
PubMed 36161755Desai D. "Stamp" Technique to Recreate Accurate Occlusal Topography for Direct Composite Posterior Restorations. Compend Contin Educ Dent. 2025 May;46(5):236-239.
PubMed 40479542Zotti F, Vincenzi S, Zangani A, Bernardi P, Sbarbati A. Stamp Technique: An Explorative SEM Analysis. Dent J (Basel). 2023 Mar 8;11(3):77. doi: 10.3390/dj11030077.
PubMed 36975574Mohammed MAEG, Naser AS, Abozaid D. Clinical Performance of Bulk-Fill Versus Incremental Composite Placement Approaches in Vital Posterior Teeth: A 24 Months Randomized Controlled Trial. J Esthet Restor Dent. 2026 Jun 10. doi: 10.1111/jerd.70202. Online ahead of print.
PubMed 42272133
Study at a glance
From the registry record, last updated by the sponsor on 17 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Influence of Composite Placement Techniques on the Clinical Performance of Posterior Restorations in Vital Teeth
- ClinicalTrials.gov ID
- NCT07415317
- Acronym / sponsor ID
- Composite Placement Techniques
- Conditions
- Composite Resins, Posterior Teeth
- Keywords
- Clinical, Placement techniques, Stamp, bulk-fill, Snowplow
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 50 participants (actual)
- Lead sponsor
- Tanta UniversityUniversity, hospital or other
- Study start
- 1 Jan 2024 (actual)
- Primary completion
- 6 Jan 2026 (actual)
- Study completion
- 17 Jan 2026 (actual)
- First posted
- 17 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this 12-month randomized clinical investigation was to compare the clinical performance of posterior composite resin restorations implanted in vital teeth using various placement techniques.
Detailed description
Because of their conservative nature, aesthetic qualities, and consistently improved mechanical performance and handling features, resin-based composites have become the restorative material of choice for posterior teeth. Nevertheless, significant obstacles influencing the stability of the marginal area, sensitivity following the procedure, and the durability and effectiveness of composite restorations in the long run are polymerization shrinkage and stress associated with shrinkage.
To reduce polymerization stress and maximize adaptability to hollow walls, various placement procedures have been suggested. While older incremental layering methods sought to lessen the configuration factor (C-factor) and increase light penetration, more recent methods like the Stamp and Snowplow approaches sought to replicate the occlusal architecture and enhance marginal sealing. Conversely, bulk-fill techniques were first developed to streamline clinical processes by enabling the use of bigger composite layers with the promise of lower shrinkage stress.
Despite a plethora of in vitro studies, there is a dearth of high-quality clinical data that compares these placement methods under controlled settings. Due to the fact that laboratory studies cannot completely replicate the oral environment, clinical trials continue to be the best way to assess the real-world efficacy of restorative procedures.
Consequently, this randomized clinical trial set out to assess the clinical efficacy of posterior composite restorations placed in vital teeth utilizing four distinct procedures over the course of a year
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| incremental nanohybrid composite | Experimental | Other: nanohybrid composite resinStamp technique |
| Flowable and nanohybrid composite | Experimental | Other: nanohybrid composite resinSnowplow technique |
| incremental layering technique | Experimental | Other: nanohybrid composite resinModified incremental "Pizza" technique |
| bulk fill composite resin | Experimental | Other: nanohybrid composite resinBulk-fill technique |
Who may qualify
- Ages
- 20 to 35 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Good general and oral health
- Vital posterior teeth with primary occlusal caries
- Class I cavities with depth ranging from 3 to 4 mm
Key exclusion criteria (2 listed)
- Non-vital or restored teeth
- Parafunctional habits (e.g., bruxism)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| nanohybrid composite resinFifty patients received a total of 200 Class I composite restorations, which were placed using the same nanohybrid composite resin and randomly allocated into four groups (n = 50) according to placement technique: Group I-Stamp technique; Group II-Snowplow technique; Group III-Modified incremental "Pizza" technique; and Group IV-Bulk-fill technique | Other | Flowable and nanohybrid composite, bulk fill composite resin, incremental layering technique, incremental nanohybrid composite |
Primary outcome
The primary outcome was marginal adaptation
Time frame: 24 months
Clinical evaluation of marginal adaptation was performed according to the World Dental Federation (FDI) by two calibrated evaluators at baseline and at 6, 12, and 24 months. All of the restorations were ranked according to how well they met the criteria: score 1 (clinically excellent), score 2 (clinically satisfactory), score 3 (clinically satisfactory), or scores 4 and 5 (clinically inadequate). Clinical success was defined as a score of 1, 2, or 3, and failure was indicated by scores of 4 or 5. A powerful light source was used to conduct the visual inspection of the parameters. A magnifying dental loupe was utilized for this purpose. The Friedman test was conducted to evaluate intragroup comparisons of the same restoration outcomes through different follow-up periods. The Kruskal-Wallis test was utilized to assess intergroup comparisons between different restorations during the same follow-up period. Time Frame: 24 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Feb 2026.
- Background: PubMed 35836552Karunakar P, Ranga Reddy MS, Kumar BS, Namratha R. Direct and indirect stamp techniques for composite restorations - Sealing the uniqueness of a tooth: A case series. J Conserv Dent. 2022 May-Jun;25(3):327-331. doi: 10.4103/jcd.jcd_616_21. Epub 2022 Jun 13.
- Results publication: PubMed 41241559Paolone G, Coccoluto L, Cortili S, Collivasone G, Cantatore G, Gherlone EF. Copolymerizing flowable and high-viscosity composite resins in class II restorations: The "Snowplow" technique. A scoping review. J Prosthet Dent. 2026 May;135(5):e1-e11. doi: 10.1016/j.prosdent.2025.10.058. Epub 2025 Nov 14.
- Results publication: PubMed 39341448Zhu J, Fu C, Deng X, Ma L, Song F, Huang C. Effects of stamp material and restoration depth on the accuracy of direct composite resin restorations using stamp technique. J Dent. 2024 Nov;150:105369. doi: 10.1016/j.jdent.2024.105369. Epub 2024 Sep 26.
- Results publication: PubMed 36161755Vertuan M, Mosquim V, Guimaraes GMF, Obeid AT, Bombonatti JFS, Ishikiriama SK, Furuse AY. The stamp technique for direct restoration in a ICDAS 4 carious lesion: A 4-year follow-up. J Esthet Restor Dent. 2023 Apr;35(3):442-448. doi: 10.1111/jerd.12963. Epub 2022 Sep 26.
- Results publication: PubMed 40479542Desai D. "Stamp" Technique to Recreate Accurate Occlusal Topography for Direct Composite Posterior Restorations. Compend Contin Educ Dent. 2025 May;46(5):236-239.
- Results publication: PubMed 36975574Zotti F, Vincenzi S, Zangani A, Bernardi P, Sbarbati A. Stamp Technique: An Explorative SEM Analysis. Dent J (Basel). 2023 Mar 8;11(3):77. doi: 10.3390/dj11030077.
- Derived from this study: PubMed 42272133Mohammed MAEG, Naser AS, Abozaid D. Clinical Performance of Bulk-Fill Versus Incremental Composite Placement Approaches in Vital Posterior Teeth: A 24 Months Randomized Controlled Trial. J Esthet Restor Dent. 2026 Jun 10. doi: 10.1111/jerd.70202. Online ahead of print.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing nanohybrid composite resin in people with Composite Resins and Posterior Teeth, run by Tanta University at 3 sites in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 17 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The primary outcome was marginal adaptation (time frame: 24 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07415317, which also lists 7 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Feb 2026.