Microleakage in Class II composite restorations with margins below the CEJ: In vitro evaluation of different restorative techniques

C Poggio,A Scribante,M Colombo,M Chiesa,J Mekler

doi:10.4317/medoral.18344

C Poggio, A Scribante + Show 3 more

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https://doi.org/10.4317/medoral.18344

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Abstract

Objectives: The purpose of this in vitro study was to evaluate the microleakage in “deep” Class II composite restorations with gingival cavosurface margin below the CEJ (cemento-enamel junction) and restored with different techniques. Study Design: Fifty human teeth were used. In each tooth two standardized Class II slot cavities (on mesial and on distal surfaces) were prepared: the buccolingual extension of the cavities was 4 mm; the gingival wall was located in dentin/cementum (2 mm beyond the CEJ). The prepared teeth were randomly assigned to 5 experimental groups (of 10 specimens and 20 cavities each) and restored. Group 1: Filtek TM Supreme XTE Flowable (3MESPE) + Universal Filtek Supreme XTE (3MESPE), Group 2: GrandioSO Heavy Flow (Voco) + GrandioSo (Voco), Group 3: SDR™ (Dentsply Caulk) + Esthet-X® HD (Dentsply Caulk), Group 4: SonicFill (Kerr), Group 5: Grandio (Voco). After thermocycling, the specimens were immersed in a 0.5% basic fuchsine dye solution and incubated at 37°C for 24 hours. The teeth were subsequently sectioned mesiodistally. All specimens were examined at 25× in a stereomicroscope and standardized digital images were obtained. Dye penetration was measured from gingival margins. Results: The results demonstrated no significant leakage differences between Group 4 and Group 5, that both showed significantly higher frequency distribution of Score 0. Group 2 and Group 3 showed a significant prevalence of Score 1, whereas Group 1 showed significantly higher frequency of Score 2. Conclusions: None of the restorative techniques tested completely eliminated microleakage dye penetration in dentin margins; marginal adaptation in Class II composite restorations with gingival wall below the CEJ varied in both substrates and from different restorative techniques used. Key words:Microleakage, Class II composite restorations, CEJ.

Highlights

Direct Class II composite restorations can be placed at an acceptable standard if the cervical margin is in sound enamel; when the adhesive restorations are located below the CEJ and cervical lesions have no enamel the quality of the marginal integrity is questionable [1]
The cervical marginal microleakage was recorded based on the following criteria [18]: score 0 = no dye penetration, score 1 = dye penetration limited to enamel, score 2 = dye penetration beyond the dentinenamel junction but limited to 2/3rds of the cervical wall length, score 3 = dye penetration beyond 2/3rds of the cervical wall length but not to the pulpal wall, score 4 = dye penetration to the pulpal wall. -Statistical analysis The results of microleakage scores were subjected to statistical analysis using “Stata 7.0” computer software (Stata Corp., Station College, TX)
Significant prevalence of Score 0 was reported both for Groups 4 (SonicFill) and 5 (Grandio), indicating that both composites showed the lowest microleakage values when compared with other groups tested

Summary

Introduction

Direct Class II composite restorations can be placed at an acceptable standard if the cervical margin is in sound enamel; when the adhesive restorations are located below the CEJ (cemento-enamel junction) and cervical lesions have no enamel the quality of the marginal integrity is questionable [1]. Marginal gap formation contributes to microleakage permitting the passage of oral fluids and bacteria from the oral cavity and become a source of post-operative sensitivity, pulpal inflammation and recurrent caries [2,3,4] To reduce these effects have been suggested, as a better option to the conventional resin technique, the Class II open-sandwich restorations: glass-ionomer cement (GIC) or resin-modified glass-ionomer cement (RMGIC) is placed between the dentin cervical margins and occlusal composite restoration [5,6]. SonicFill’s activation significantly reduces the composite’s viscosity to rapidly fill the cavity The purpose of this in vitro study was to evaluate the microleakage in “deep” Class II composite restorations with gingival cavosurface margin below the CEJ and restored with different techniques. The null hypothesis of the study was that there is no significant difference in microleakage of the different evaluated restorative techniques evaluated

Objectives

Results

Conclusion