One-Year Clinical Aging of Low Stress Bulk-Fill Flowable Composite in Class II Restorations: A Case Report and Literature Review

Louis Hardan,Carlos Enrique Cuevas-Suárez,Maciej Zarow,Rim Bourgi,Monika Lukomska-Szymanska,Natalia Jakubowicz,Krzysztof Sokolowski,Camillo D’Arcangelo

doi:10.3390/coatings11050504

Abstract

Bulk-fill flowable composites provide functional and aesthetic restorations while eliminating incremental composite layering and saving time. The degradation of the adhesive interface with subsequent gap formation is a concern when adhesively luted restorations are placed. Moreover, the number of adhesive interface failures increases when they are exposed to long-term water storage. The aim of the present study was to evaluate the morphological characteristics of the tooth-composite interface in class II cavities restored with a low stress bulk-fill flowable composite after aging in an oral environment. We describe a case of a patient with class II cavities in four premolars restored with a low stress bulk-fill flowable composite Surefil SDR (Dentsply DeTrey GmbH, Konstanz, Germany). The occlusal part was restored with nano-hybrid resin composite Ceram X Mono (Dentsply DeTrey GmbH). After one year of clinical function, the teeth were extracted and examined in a scanning electron microscope (SEM). It can be concluded that the application of bulk-fill covered with conventional composite seems to provide the homogeneous and stable bond to tooth structure after one year of aging in an oral environment. However, some defects within the dentin-resin composite interface were observed.

Highlights

Resin composites have evolved significantly over the last decades and we are witnessing the greatest development of these materials [1,2,3]
The gap formation may occur at the margins in enamel and dentin or even along the adhesive system–tooth interface [9,10,11]
Representative scanning electron microscope (SEM) micrographs of the tooth–composite interfaces are shown in FigRepresentative SEM micrographs of the tooth–composite interfaces are shown in ures 1–3

Summary

Introduction

Resin composites have evolved significantly over the last decades and we are witnessing the greatest development of these materials [1,2,3].Despite numerous advantages, composites exhibit some shortcomings that may adversely influence clinical results. The marginal micro-leakage and polymerization shrinkage still occur, in class II restorations; the adhesive interface becomes the most vulnerable site for the restoration failure [4,5,6,7]. The interface between tooth structure and high viscosity resin composites that was expected to provide the long-term and stable result may reveal many defects with time. The lack of compensation of initial polymerization shrinkage stress occurs prior to the first occlusal loading. The occlusal load results in repeated stress exerted on the resin–tooth interface. The biochemical stress via biofilm accumulation at the restoration margin. These phenomena might cumulate and cause damage to the adhesive bond [12]

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Conclusion