Abstract
Background and aims. Nano-ionomer (NI) interacts with tooth structures superficially, and there is a concern about the enamel bonding ability of mild self-etch Ketac primer. This study compared the effect of different adhesive procedures (self-etching and etch-and-rinse approach) on long-term marginal microleakage of nano-filled resin-modified glass-ionomer (NI) cervical restorations.Materials and methods. Class V cavities were prepared on 72 maxillary premolars. The teeth were divided into six groups: G1: No treatment (NC); G2: Ketac primer (K primer); G3: Etchant + Ketac primer (E+K primer); G4: Self-etch adhesive (Bond Force); G5: Etchant + Bond Force (E+Bond Force); G6: Etchant + Adper Single Bond (Etch and rinse adhesive). All the cavities were restored with Ketac N100. The samples were stored in water for 6 months and thermocycled for 2000 cycles. Marginal sealing was assessed using dye penetration technique. Data were analyzed with non-parametric tests (α=0.05).Results. All the adhesive pretreatments resulted in a lower marginal leakage than that of NC (P≤0.01), except for E+Bond Force at the dentin margin. There was no significant difference between K primer and Bond Force. Microleakage differed significantly between K primer pretreatment and E+K primer (P=0.003), E+Bond Force (P=0.002) and etch-and-rinse adhesive (P=0.001) at the enamel margin, but it did not differ at the dentin margin. E+ Bond Force group showed insignificantly lower leakage at the enamel margin and significantly higher leakage at the dentin margin (P=0.02).Conclusion. Etch-and-rinse adhesive and selective enamel etching along with self-etch adhesive/Ketac primer might improve marginal sealing of aged nano-ionomer restoration.
Highlights
Resin-modified glass-ionomers (RMGIs) are a combination of glass-ionomer cement and resinJODDD, Vol 9, No 3 Summer 2015 components.[1,2] These materials have numerous advantages, including dual-curing setting reaction, bonding ability to tooth structures through a two-fold bonding mechanism, increased mechanical and esthetic properties, improved handling and working characteristics and reduced moisture or dehydration sensitivity.[1,2,3,4,5]A novel, highly packed, nano-filled RMGI, Nanoionomer (NI, Ketac N100) has been introduced to the dental market to restore small cavities
Pair-wise multiple comparisons of the six groups revealed that all the groups had significantly lower microleakage than that of NC at both margins (P≤0.01), except for group 5 at the dentin margin (P=0.14)
There were significant differences between group 2 and groups 3, 5 and 6 (P=0.003, P=0.002 and P=0.001, respectively), revealing a positive effect of acid etching on reducing microleakage; there were no significant differences at dentin margins
Summary
Resin-modified glass-ionomers (RMGIs) are a combination of glass-ionomer cement and resin. NI, in contrast to RMGI, has no selfadhesive capacity and the use of Ketac Nano primer before NI is an essential step to its bond to tooth structures. This self-etch primer (pH=3) contains the acrylic/itaconic acid copolymer dissolved in HEMA and water; its low acidity may not allow the primer to totally dissolve/remove the smear layer.[11] NI interacts very superficially with the dentin and enamel without demineralization or hybrid layer formation. The null hypothesis was that prior different adhesive procedures have no effect on the marginal sealing of Class V NI restorations after water aging
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