Periodontal Outcomes of Class II Posterior Restorations Performed with Two Ormocer-Based Restorative Approaches: A Five-Year Follow-Up

Background/Objectives: In this prospective clinical follow-up study, we aimed to evaluate the long-term periodontal responses over a five-year follow-up period associated with Class II direct posterior restorations placed using two different restorative approaches. Materials and Methods: Thirty-one Class II posterior restorations in 25 patients were included. Eighteen were performed using a bulk-fill approach with Admira Fusion X-tra® (VOCO, Cuxhaven, Germany), whereas thirteen used the proximal wall approach with Admira Fusion® (VOCO, Cuxhaven, Germany). Periodontal parameters, including plaque control record, gingival bleeding index, probing depth, and clinical attachment loss, were recorded at baseline and five years using standardized periodontal examination procedures. Data were expressed as mean ± standard deviation and analyzed using repeated-measures ANOVA. Given the limited sample size, the statistical analyses were considered exploratory. Results: The plaque control record decreased from baseline to the five-year follow-up, with a significant overall effect of time (F = 4.789, p = 0.037), while the time × restorative approach interaction was not significant (p = 0.694). The gingival bleeding index showed a slight numerical increase over the five-year period (25.52 ± 27.20% at baseline versus 27.00 ± 26.11% at five years); however, neither the effect of time (F = 0.139, p = 0.712) nor the time × restorative approach interaction (F = 0.505, p = 0.483) was statistically significant. Probing depth and clinical attachment loss remained relatively stable throughout the observation period, with no statistically significant time or interaction effects. Overall, no statistically significant time × restorative approach interactions were observed, indicating that longitudinal changes in the evaluated periodontal parameters did not differ significantly between the restorative approaches. Conclusions: Within the limitations of this exploratory clinical study, both ormocer-based restorative protocols were not associated with detectable deterioration in the evaluated periodontal parameters over the five years of follow-up.