Influence of Curing Mode and Layering Technique on the 3D Interfacial Gap of Bulk-fill Resin Composites in Deep Class-I Restorations: A Micro-CT Volumetric Study.

Abstract

To three-dimensionally evaluate the interfacial gap of bulk-fill resin composites applied in deep Class-I restorations with different layering techniques and curing modes. Ninety-six (n = 96) samples were prepared with standardized deep Class-I cavities and adhesive procedures. Four materials were tested: SDR (SDR), SonicFill2 (SF), Admira Fusion X-Tra (AFXT), Filtek Supreme XTE (FS). Four subgroups (n = 6) were created according to layering and curing techniques: 2+2mm increments with soft start curing (SG1), 2+2 mm with conventional curing (SG2), a 4-mm increment with soft start curing (SG3), a 4-mm increment with conventional curing (SG4). All samples underwent micro-CT scans; afterwards, voids surrounding the restorations automatically underwent a thresholding procedure (Mimics, Materialise; Geomagic Studio 12, 3D Systems) to analyze the 3D interfacial gap. Statistical analysis was performed using three-way ANOVA with Tukey's test (significance p < 0.05). Statistically significant differences were reported between materials, layering techniques and their interaction. No statistically significant differences were reported for polymerisation mode. Bulk-fill materials showed average interfacial gap volumes ranging from 0.031 mm3 to 0.200 mm3, while FS showed volumes ranging from 0.416 mm3 to 1200 mm3. All bulk-fill materials performed statistically significantly better than did FS (p < 0.05), with no statistically significant differences between them. Curing mode did not influence interfacial gap volume in any group (p > 0.05), while bulk-filling vs layering influenced the volume of interfacial gaps only in the FS group, which performied better when incrementally applied. Regarding gap localisation, the floor of the cavity was the area with the highest likelihood of gaps in all samples.