EFCD Expert Non-Consensus on Material and Technique Use for Direct Class II Composites With Guidance on Restoring Complex Cavities.

PURPOSE: There is confusion over the indications, techniques, and material choices for placing direct class II composite restorations among general dentists. This paper synthesizes new data on the general frequency of use of materials and techniques by experts, with a previous related paper that explored if and how experts restored specific class II cavities with varying complexities. It aimed to see if consensus on technique and material use when restoring class II cavities with composite could be pursued. These findings are used to inform an overview of various techniques and provide guidance on the management of more complex class II cavities. METHODS: An international expert group (n = 9) developed an e-questionnaire. The first part of the questionnaire, reported here, covered the general frequency of material and technique use during cavity preparation, control of the operating field, soft tissue management, matrix selection, stabilization and peripheral seal, tooth separation, composite materials, application techniques, light curing, finishing, and polishing. It was distributed to 67 international clinicians with expertise in placing direct composite restorations (September 2024). RESULTS: Response rate was 82%, with 95% of responders completing the first part of the survey. There was a wide variation in frequency of use of a broad variety of materials and techniques. CONCLUSIONS: International experts used a wide variety of materials and techniques for restoration of class II cavities with direct composite. Consensus was therefore not pursued. There are many potential techniques which can offer pragmatic solutions to directly restore complex class II cavities that are not beyond general practitioners.