Dentin Margins Research Articles

Adaptability of VisCalor versus bulk-fill composites using scanning electron microscope: an in-vitro study

Purpose To evaluate the marginal integrity of two types of bulk-fill composite resins in Class I box-shaped cavities. Materials and methods Forty extracted human sound molars were selected. The teeth were fixed with sticky wax to the base of plastic cylinder and the cylinder was filled with self-curing acrylic resin so that only root was embedded. Simple Class I box-shaped cavities were prepared using a fissure carbide bur with water spray and finished with fine-grained flame burs. The overall dimensions and depth of the cavities were standardized as follows: 4 mm length mesiodistally and 3 mm width buccolingually and up to 4 mm depth. All prepared cavities were bonded using Futurabond M+ one-step self-etch adhesive system. The teeth were randomly divided into two groups (n = 20 teeth each): group I: specimens were restored with VisCalor composite bulk-fill composite resin, which is heated before insertion using a VisCalor dispenser dental device. Group II: specimens were directly restored with X-tra fill bulk-fill composite resin without preheating. After curing, finishing and polishing were performed. Each group was subdivided into two subgroups a and b (n = 10) according to whether subjecting 500 thermocycling fluctuations or not. Each specimen was sectioned buccolingually through the center of the composite resin restoration in two halves, and then cleaned under running tap water and subjected to thorough ultrasonic cleaning to get rid of both soft and hard surface deposits. All sectional samples were fixated in cylindrical carriers, and a thin layer of gold was applied to the surfaces. The marginal adaptation of composite restorations and ultramorphology of adhesive bonds were analyzed at ×50, ×1000 magnification, with a scanning electron microscope. ×50 magnification was utilized to measure the length of margins free gap in enamel and dentin by Autodesk Auto CAD program and expressed in mm/percent. All data of measurements of the length of nongaped margins in enamel and dentin are collected, tabulated, and statistically analyzed. Results Group Ia (VisCalor bulk-fill not thermocycled), recorded the highest mean value of marginal free-gap with 10.26 ± 0.27 mm (93.31%), while group IIb (X-tra-fill bulk-fill thermocycled) recorded the lowest mean value in 7.90 ± 0.26 mm (73.04%) and the difference was statistically highly significant (P = 0.000). In general, group I recorded higher mean values of marginal free gap and adaptation in mm/percent than group II, and the difference was statistically highly significant at P value of 0.000 (9.86 ± 0.55 and 8.23 ± 0.39 mm and 89.15 ± 5.38 and 74.89 ± 3.69%, respectively). Bulk-fill restorations without thermocycling exhibited a higher mean value of marginal free gap and adaptation in mm/percent than the thermocycled one with a significant difference recorded at P value of 0.005. Conclusion Using preheated VisCalor bulk-fill composites could decrease the marginal gap formation improving the continuity at the tooth–restorative material interface than conventional bulk-fill restorations. On the other hand, thermocycling.

De novo regeneration of dentin pulp complex mediated by Adipose derived stem cells in an immunodeficient albino rat model (Histological, histochemical and scanning electron microscopic Study)

BackgroundDental tissue engineering is an alternative procedure for restoring damaged dental tissues. Adipose-derived stem cells are a new source of cells for regenerative endodontics in combination with scaffold materials. The descriptive data about this regenerative process is still insufficient. ObjectiveTo evaluate the regenerative potential of Adipose-derived stem cells using a self-assembling polypeptide scaffold for the dentin-pulp complex in an emptied root canal space. Material and Methods40 root segments of human single-rooted teeth were transplanted into the albino rats’ dorsal subcutaneous tissue. Root segments were divided into two groups: group I contained only a self-assembling polypeptide scaffold, and group II contained fluorescent-labeled Adipose-derived stem cells embedded in a self-assembling polypeptide scaffold. The newly formed tissues were assessed on the 60th and 90th days post-transplantation using routine histological examination, Masson trichrome staining, and scanning electron microscopy. ResultsGroup I showed granulation tissue without any signs of predentin formation or odontoblast-like cells. Group II revealed the presence of predentin tissue along the dentin margin, with arranged odontoblast-like cells. An organized connective tissue with abundant vasculature and calcific masses was observed in the pulp space. ConclusionAdipose-derived stem cells can be considered as alternative stem cells for regenerating the dentin-pulp complex. Dentin pulp complex regeneration utilizing a self-assembling polypeptide scaffold alone would not yield successful results.

Evaluation of surface microhardness and gingival marginal adaptation of three different bulk-fill flowable resin composites: A comparative study.

To evaluate surface microhardness and gingival marginal adaptation of three different bulk-fill flowable resin composites (FB-RBCs) in Class V cavities with enamel or dentin margins before and after thermocycling (TMC). Three available FB-RBCs were used; Palfique Bulk Flow (PaBF) (Tokuyama Dental), SDR Flow+ Bulk Fill Flowable (Dentsply Sirona), and I-Flow Bulk Fill (I-Dental). Thirty discs were prepared from each type of FB-RBCs. The discs were subjected to Vickers microhardness tester machine. Class V cavities were prepared on 180 molars. Gingival margins of half the specimens were prepared above CEJ and the other half below CEJ. Cavities were restored with FB-RBCs for gingival marginal adaptation test. Two-way ANOVA was used in microhardness, while three-way ANOVA was used for marginal adaptation. The used materials showed statistically significant differences in microhardness and marginal adaptation. Regarding microhardness, PaBF showed the highest value before TMC and SDR was the highest after TMC. Regarding marginal adaptation, SDR revealed the best marginal adaptation than PaBF and I-flow, either subjected to TMC or not. The longevity of cervical restorations depend on both the location of the cavity margin and the material used. The microfractures in resin composite surface due to low surface microhardness as well as marginal gaps seen in laboratory studies could be considered as an indicative parameter for clinical problem associated with marginal differences.

Comparative Evaluation of the Microleakage of Glass Ionomers as Restorative Materials: A Systematic Review of In Vitro Studies

This study aimed to perform a qualitative synthesis of the available in vitro evidence on the microleakage of commercially available conventional glass ionomer cements (GICs), resin-modified glass ionomer cements (RMGICs), and modified glass ionomer cements with nano-fillers, zirconia, or bioactive glasses. A systematic review was conducted according to the PRISMA 2020 (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement standards. The literature search was performed in Medline (via PubMed), Embase, Web of Science, and Scopus to identify relevant articles. Laboratory studies that evaluated microleakage of GICs, RMGICs, and modified glass ionomer cements with nano-fillers, zirconia, or bioactive glasses were eligible for inclusion. The QUIN risk of bias tool for the assessment of in vitro studies conducted in dentistry was used. After the study selection process, which included duplicate removal, title and abstract screening, and full-text assessment, 15 studies were included. A qualitative synthesis of the evidence is presented, including author data, year of publication, glass ionomer materials used, sample characteristics, microleakage technique and values, and main outcome measures for primary and permanent teeth. Although no statistically significant differences were found in numerous studies, most results showed that RMGICs exhibited less leakage than conventional GICs. All studies agreed that leakage was significantly higher at dentin margins. It was also higher at the gingival margin than at the occlusal margin. Nano-filled RMGICs Ketac N100, Equia Forte, and Zirconomer appear to have less microleakage than conventional GICs and RMGICs. Further investigations using a standardized procedure are needed to confirm the results.

Pre-heating decreases micro-leakage of bulk fill composite resins in dentin margins of class II cavities: an in-vitro study

Pre-heating decreases micro-leakage of bulk fill composite resins in dentin margins of class II cavities: an in-vitro study

Effect of different storage media on elemental analysis and microhardness of cervical cavity margins restored with a bioactive material.

This study aimed to investigate the elemental analysis and microhardness of a bioactive material (Activa) and marginal tooth structure after storage in different media. Fifteen teeth received cervical restorations with occlusal enamel and gingival dentin margins using the tested material bonded with a universal adhesive, 5 of them on the 4 axial surfaces and the other 10 on only the 2 proximal surfaces. The first 5 teeth were sectioned into 4 restorations each, then stored in 4 different media; deionized water, Dulbecco's phosphate buffered saline (DPBS), Tris buffer, and saliva. The storage period for deionized water was 24 hours while it was 3 months for the other media. Each part was analyzed by scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) analysis for different substrates/distances and the wt% of calcium, phosphorus, silica, and fluoride were calculated. The other 10 teeth were sectioned across the restoration, stored in either Tris buffer or saliva for 24 hours or 3 months, and were evaluated for microhardness of different substrates/areas. Data were analyzed using analysis of variance and Tukey's post hoc test. Enamel and dentin interfaces in the DPBS group exhibited a significant increase in calcium and phosphorus wt%. Both silica and fluoride significantly increased in tooth structure up to a distance of 75 μm in the 3-month-media groups than the immediate group. Storage media did not affect the microhardness values. SEM-EDS analysis suggests an ion movement between Activa and tooth structure through a universal adhesive while stored in DPBS.

Evaluation of the microleakage of class V composite restoration after cavity treatment with Erbium, CO2 lasers, Papain, and Bromelain enzymes.

Different surface preparation and treatment methods may have dissimilar effects on the microleakage of composite resin. This study was conducted to determine the deproteinizing effect of 10% bromelain enzyme, 10% papain enzyme, CO2 , and erbium-YAG laser in regard to decrease in the microleakage of composite restorations. Thirty teeth were selected and 60 class V cavities were prepared on the lingual and buccal sides. They were divided into six groups (n = 10): Group 1, phosphoric acid gel; Group 2, bromelain enzyme 10%; Group 3, papain enzyme 10%; Group 4, mixed papain and bromelain enzymes 10%; Group 5, CO2 laser; and Group 6, erbium-YAG laser. They were stored in basic fuchsine and dye penetration was evaluated. Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis, p < 0.05 RESULTS: In both occlusal and gingival margins, comparison of microleakage between groups 1, 2, 3, 4, and 5 showed no significant differences (p = 1) and group 6 had a significant difference with other groups (p ˂ 0.001). Microleakage of composite resin in the dentin surface was not affected significantly using either bromelain or papain 10% enzymes or erbium laser. However, CO2 laser had a negative effect on the enamel and dentin margins and increased the microleakage. Erbium laser showed a better effect than enzymes on microleakage.

Cuspal Deflection and Marginal Integrity of Class II Cavities Restored with Bulk-fill Resin Composites

Objective: This laboratory study aims to assess the cuspal deflection, adaptation, and marginal sealing of premolars restored with bulk-fill resin composites. Methods: Fourty-four premolars received class II preparations (distal and mesial boxes located 1 mm above and 1 mm below the cementoenamel junction, respectively). The teeth were distributed into four groups according to the resin composite used for restoration (n=11): G1 (control): Filtek Z250 XT; G2: Filtek Bulk-Fill; G3: Tetric N-Ceram Bulk-Fill; G4: Aura Bulk-Fill. A digital micrometer was used to measure the cuspal deflection before and after the restorative procedures. Replicas in epoxy resin of the restored teeth were achieved before and after thermal cycles. The cervical margins were observed by SEM at 200x magnification to obtain the percentage of continuous margins (%CM). After thermal cycles, the samples were immersed in a silver nitrate solution, and the microleakage was analyzed in the cervical margins. Results: ANOVA showed no significant differences in the cuspal deflection and %CM among the resin composites. Student’s t-test showed a significant decrease in the %CM after thermal cycles for all resin composites at the cervical margin in dentin. There was higher microleakage at the dentin margin for all the resin composites. Conclusion: Bulk-fill resin composites had comparable behavior to a conventional composite in regard to the cuspal deflection, adaptation, and marginal sealing parameters.

Cuspal Deflection and Marginal Integrity of Class II Cavities Restored with Bulk-fill Resin Composites

Objective: This laboratory study aims to assess the cuspal deflection, adaptation, and marginal sealing of premolars restored with bulk-fill resin composites. Methods: Fourty-four premolars received class II preparations (distal and mesial boxes located 1 mm above and 1 mm below the cementoenamel junction, respectively). The teeth were distributed into four groups according to the resin composite used for restoration (n=11): G1 (control): Filtek Z250 XT; G2: Filtek Bulk-Fill; G3: Tetric N-Ceram Bulk-Fill; G4: Aura Bulk-Fill. A digital micrometer was used to measure the cuspal deflection before and after the restorative procedures. Replicas in epoxy resin of the restored teeth were achieved before and after thermal cycles. The cervical margins were observed by SEM at 200x magnification to obtain the percentage of continuous margins (%CM). After thermal cycles, the samples were immersed in a silver nitrate solution, and the microleakage was analyzed in the cervical margins. Results: ANOVA showed no significant differences in the cuspal deflection and %CM among the resin composites. Student’s t-test showed a significant decrease in the %CM after thermal cycles for all resin composites at the cervical margin in dentin. There was higher microleakage at the dentin margin for all the resin composites. Conclusion: Bulk-fill resin composites had comparable behavior to conventional composites in regard to the cuspal deflection, adaptation, and marginal sealing parameters.

Marginal Adaptation of In Vitro Class II Restorations Made Out of Bulk or Conventional Composite Using Single- or Multi-Layered Techniques.

Objective: Testing the influence of various restorative materials (conventional or bulkfill composites) and filling techniques (single- or multi-layered techniques) on the in vitro marginal adaptation of large class II direct composites with supra and sub-gingival margins subjected to thermomechanical loading (TML). Methods: A total of 40 prepared teeth were attributed randomly to five experimental groups. In Group 1, restorations were made of multi-layered high-viscosity conventional composite (Tetric EvoCeram); in Groups 2 and 3, restorations were made of a high viscosity bulkfill composite (Tetric EvoCeram Bulk Fill) applied in one (Group 2) or three layers (Group 3); in Groups 4 and 5, restorations were made of a flowable bulkfill composite (SDR flow) applied in one (Group 4) or two layers (Group 5), covered with a layer of high-viscosity conventional composite (Ceram-X Universal). A single adhesive (OptiBond FL) was used in all groups. All specimens were submitted to a staged TML comprising three phases (2 × 500,000 and 1,000,000 cycles) at 50 N with 3350 thermal cycles (5 to 55 °C) every 500,000 cycles. The tooth-restoration interfaces on proximal surfaces were evaluated quantitatively by scanning electron microscopy, before and after each TML phase, hence at three timepoints (T0, T1, T2 and T3). The following segments were considered for evaluation: proximal, vertical enamel margins (assessed individually on both restoration sides), cervical enamel (restoration side above CEJ) and cervical dentin margin (restoration side below the CEJ). Results: TML induced a significant reduction in continuous adaptation at both enamel and dentin margins in all groups, with percentages of continuous margins ranging from 75.2 to 91.8% at T0, and decreasing to values ranging from 21.3 to 73.9% at T3. Both composite systems and layering protocols had a significant influence on marginal adaptation of the restorations, with statistical associations depending on the restoration group and the timepoint considered. Defective margins in enamel were all of a cohesive nature with micro-fractures, while in dentin, interfacial gaps were the main defect observed. Conclusions/Clinical significance: The present results highlighted significant degradation of marginal adaption after long-term in vitro fatigue test using materials even with high-viscosity conventional resin composites, applied with a proper layering approach in medium-large sub-gingival cavities. While no significant differences were observed at the dentin cervical margins, there was a tendency for better adaptation at the enamel margin when using a higher modulus material with a multi-layered technique.

In vitro microleakage at the enamel and dentin margins of class II cavities of primary molars restored with a bulk-fill and a conventional composite.

This study assessed the enamel and dentin margin microleakage of class II cavities of primary molars restored with a bulk-fill and a conventional composite. In this in vitro, experimental study, standard class II cavities were created in the proximal surfaces of 60 extracted primary molars. The teeth were randomly divided into two groups, and restored with SonicFill bulk-fill and Filtek Z250 conventional composite along with Single Bond 2 adhesive. The teeth were coated with two layers of nail varnish to 1 mm around the restoration margins, and the apices were sealed with wax. The teeth underwent 1500 thermal cycles and incubated at 37°C for 24 h. They were then immersed in 1 M silver nitrate in the dark, rinsed with water, immersed in developing solution for 12 h, and exposed to fluorescent light. Next, they were mesiodistally sectioned, and digitally photographed under a stereomicroscope at ×10 magnification. The dye penetration depth was measured by a blind observer, and analyzed by the Mann-Whitney U test (α = .05). No significant difference existed in microleakage between the two composite groups at the enamel (p = .76) or dentin (p = .16) margins. In both composite groups, microleakage at the dentin margins was significantly greater than that at the enamel margins (p = .000). Considering the absence of a significant difference in microleakage, SonicFill bulk-fill composite can be used as an alternative to Filtek Z250 conventional composite for restoration of primary molars to benefit from its advantages such as simpler and faster application.

A Comparison of Laser and Mechanical Surface Pretreatment Methods on Shear Bond Strength of Resin Composite to Resin-Modified Glass Ionomer.

Dentin margins have a higher microleakage than enamel in composite restorations due to weaker bond durability. Clinically, most margins are located apical to cementoenamel junction on the dentin or cementum. Different surface preparation methods may have dissimilar effects on the shear bond strength of resin-modified glass ionomer (RMGI) to composite resin, regarding the layering technique employed in restoration of these cavities. This study aimed to investigate the shear bond strength of RMGI to composite resin using different mechanical surface preparation methods. In this in vitro study, 72 RMGI samples were prepared in six groups (n=12): control, acid etching, air abrasion with aluminum oxide (Al2O3), bur, Er: YAG laser, and Er, Cr: YSGG laser groups. Two samples from each group were randomly examined under a scanning electron microscope (SEM). A bonding layer and composite resin were applied and cured. Then the samples were subjected to 5000-cycles thermocycling procedure. The shear bond strength was then evaluated using a universal testing machine. Finally, the failed surface of the samples was evaluated under a light microscope to examine the failure mode. For the statistical analysis, one-way ANOVA and Games-Howell post hoc test was used to compare quantitative variables and chi-squared test to investigate the relationship between the failure mode and the groups. The significant level was set at 0.05. The results showed significant differences between the mean of the strength variable in the groups (p< .001). The acid-etch and air abrasion groups exhibited significantly the lowest and highest values, respectively. The chi-squared test results also showed a significant relationship between the failure mode in the study groups (p= .008). Acid etching before completing RMGI polymerization could adversely affect shear bond strength. The air abrasion and bur methods are among the best methods to increase the shear bond strength between composite resin and RMGI. Using Er, Cr: YSGG and Er: YAG lasers could increase the bond strength results.

Microleakage and Marginal Integrity of Surface-Coated and Laser-Pretreated Class V Composite Restorations in Primary Teeth.

Introduction: Despite the advanced formulations of resin composites, microleakage is still among the commonest causes of clinical failure of these restorations. We evaluated the effect of surface coating and laser pretreatment on the microleakage of Class V resin composite restorations in primary teeth. Methods: Sixty extracted primary molar teeth having intact lingual or facial surfaces were randomly allocated into the control, G-Coat Plus surface coating, and erbium-doped yttrium aluminum garnet (Er:YAG) laser pretreatment groups. Class V cavities were provided with the coronal and gingival margins in the dentin and enamel, respectively. Restoration of the cavities was done with Z250 resin composite and they were thermocycled, followed by immersing in 2% basic Fuchsin dye for 24 hrs. Samples underwent sectioning occlusogingivally and the microleakage was assessed under a stereomicroscope (40×). Statistical analysis was done via SPSS and Kruskal-Wallis test (α=0.05). Results: The control and G-Coat plus groups were significantly different regarding the microleakage (P<0.001), and G-Coat Plus and laser pretreatment groups (P<0.001) at both gingival and occlusal margins. However, it showed no significant difference between the laser and the control group on the enamel (P=0.063) and dentin margins (P=0.757). Microleakage at the gingival margins was significantly greater compared to the occlusal margins in the control and laser groups (P<0.001), but not in the G-Coat Plus group (P=0.051). Conclusion: G-Coat plus coating significantly reduced microleakage at dentin and enamel margins of Class V composite restorations in primary teeth, in comparison with other groups of the study. Also, dentin margins showed more significant amounts of microleakage versus enamel margins in all groups, except for the G-Coat Plus group.

TEGDMA-Functionalized Dicalcium Phosphate Dihydrate Resin-Based Composites Prevent Secondary Caries in an In Vitro Biofilm Model.

This study evaluated the efficacy of experimental TEGDMA-functionalized dicalcium phosphate dihydrate (T-DCPD) filler-based resin-based composites (RBC) in preventing caries lesions around the restoration margins (secondary caries, SC). Standardized Class-II cavities were made in sound molars with the cervical margin in dentin. Cavities were filled with a commercial resin-modified glass-ionomer cement (RMGIC) or experimental RBCs containing a bisGMA-TEGDMA resin blend and one of the following inorganic fractions: 60 wt.% Ba glass (RBC-0); 40 wt.% Ba glass and 20 wt.% T-DCPD (RBC-20); or 20 wt.% Ba glass and 40 wt.% T-DCPD (RBC-40). An open-system bioreactor produced Streptococcus mutans biofilm-driven SC. Specimens were scanned using micro-CT to evaluate demineralization depths. Scanning electron microscopy and energy-dispersive X-ray spectroscopy characterized the specimen surfaces, and antimicrobial activity, buffering effect, and ion uptake by the biofilms were also evaluated. ANOVA and Tukey's tests were applied at p &lt; 0.05. RBC-0 and RBC-20 showed SC development in dentin, while RBC-40 and RMGIC significantly reduced the lesion depth at the restoration margin (p &lt; 0.0001). Initial enamel demineralization could be observed only around the RBC-0 and RBC-20 restorations. Direct antibiofilm activity can explain SC reduction by RMGIC, whereas a buffering effect on the acidogenicity of biofilm can explain the behavior of RBC-40. Experimental RBC with CaP-releasing functionalized T-DCPD filler could prevent SC with the same efficacy as F-releasing materials.

Microbiological models for accelerated development of secondary caries in vitro

ObjectivesThe current study aimed to compare the efficacy of two in vitro microbiological models based on open and closed systems designed to obtain secondary caries in an accelerated and reproducible way. MethodsA conventional resin-based composite (RBC - Majesty ES-2; Kuraray, Japan) and a resin-modified glass-ionomer cement (RMGIC – Ionolux; VOCO, Germany) were used to restore standardized class II cavities (n = 4/tooth, cervical margin in dentin) in 16 human molars. The ability to produce secondary caries with Streptococcus mutans biofilms was tested using either an open-cycle or closed-cycle bioreactor (n = 8 specimens/model). Specimens were scanned before and after the biofilm exposure using micro-CT (Skyscan 1176, 9 µm resolution, 80 kV, 300 mA). Image reconstruction was performed, and demineralization depths (µm) were evaluated at the restoration margins and a distance of 1.0 mm. ResultsDentin demineralization could be observed in all specimens, and enamel demineralization in 50% of the specimens. The open system bioreactor produced lesions with significantly higher overall demineralization depths (p < .001). However, demineralization depths at a 1.0 mm distance from the restoration margins showed no difference between open and closed systems or materials. In the open system, significantly lower demineralization depths were observed in proximity to RMGIC than RBC (p < .001), which was not significantly different in the closed system (p = .382). ConclusionsBoth systems produced in vitro secondary caries in an accelerated way. However, the open-cycle bioreactor system confirmed the caries-protective activity exerted by the RMGIC material in contrast to the RBC, better simulating materials’ clinical behavior. Clinical significanceThe possibility of obtaining accelerated and reproducible secondary caries development in vitro is fundamental in testing the behavior of conventional and yet-to-come restorative dental materials. Such systems can provide faster outcomes regarding the performance of dental restorative materials compared to clinical studies, notwithstanding the importance of the latter.

Development and Assessment of Bioactive Coatings for the Prevention of Recurrent Caries Around Resin Composite Restorations.

To develop hydrophilic resin-based surface coatings containing bioactive agents (proanthocyanidins from Vitis vinifera and calcium silicate) and assess their protective role at the dentin and enamel margins of cervical restorations against demineralization under simulated conditions of high and low caries activity. Suboptimal resin composite restorations were placed on cervical cavity preparations on buccal and lingual surfaces of thirty-two molars after a contamination protocol. Groups were divided according to the resin-based coatings (n=8): resin without bioactive (C), resin containing 2% enriched Vitis Vinifera (VVE), and resin coat containing 10% calcium silicate (CaSi). The control group did not receive a resin (NC). To simulate a hydrolyticenzymatic degradation, specimens were subjected to 2-month storage followed by incubation in esterase at 37°C for 8 days. Afterwards, recurrent caries was induced using a pH-proteolytic model on half of the specimens to simulate high caries activity, and the other half remained in simulated body fluid (SBF). Measurements of cross-section microhardness (KHN) and infiltration with rhodamine-B assessed the micropermeability (MP), the extent of demineralization (ED), and the demineralization area (DA). Data were analyzed using analysis of variance (ANOVA) and post-hoc tests (α=0.05). VVE and CaSi presented higher cross-sectional KHN values for enamel and dentin (p<0.001). The bioactive coatings resulted in lower MP, ED, and DA compared to NC (p<0.005) in enamel and dentin. CaSi coating preserved the enamel from demineralization (p=0.160). The application of bioactive coatings represents a potential strategy to protect the enamel-dentin margins of resin restorations.

Influence of Matrix Type on Marginal Gap Formation of Deep Class II Bulk-Fill Composite Restorations.

Background: To test the hypothesis that transparent matrices result in more continuous margins of bulk-fill composite (BFC) restorations than metal matrices. Methods: Forty standardized MOD cavities in human molars with cervical margins in enamel and dentin were created and randomly assigned to four restorative treatment protocols: conventional nanohybrid composite (NANO) restoration (Tetric EvoCeram, Ivoclar Vivadent, Schaan, Liechtenstein) with a metal matrix (NANO-METAL) versus transparent matrix (NANO-TRANS), and bulk-fill composite restoration (Tetric EvoCeram Bulk Fill, Ivoclar Vivadent, Schaan, Liechtenstein) with a metal matrix (BFC-METAL) versus transparent matrix (BFC-TRANS). After artificial aging (2500 thermal cycles), marginal quality was evaluated by scanning electron microscopy using the replica technique. Statistical analyses were performed using the Mann–Whitney U-test and Wilcoxon test. The level of significance was p < 0.05. Results: Metal matrices yielded significantly (p = 0.0011) more continuous margins (46.211%) than transparent matrices (27.073%). Differences in continuous margins between NANO (34.482%) and BFC (38.802%) were not significant (p = 0.56). Matrix type did not influence marginal gap formation in BFC (p = 0.27) but did in NANO restorations (p = 0.001). Conclusion: Metal matrices positively influence the marginal quality of class II composite restorations, especially in deep cavity areas. The bulk-fill composite seems to be less sensitive to the influence of factors such as light polymerization and matrix type.

Marginal Adaptation of Different Bulk-fill Composites: A Microcomputed Tomography Evaluation.

ObjectivesIn the last decade, bulk-fill materials were introduced to allow resin-based composites (RBC) in one layer (up to 4-5 mm thick) with optimum polymerization. We sought to evaluate the adaptation ability of different bulk-fill composites resin (CRs)and restoration marginal integrity.MethodsA total of 28 caries-free and crack-free human molars underwent mesio-occlusal-distal cavity preparation. Each sample prepared the mesial margins on enamel, and the distal margins were extended into dentin. Teeth were then randomly distributed into four groups (n = 7 per group) according to the CR used to restore the cavity. Three bulk-fill CRs—Smart Dentin Replacement Flow+, 3M™ Filtek™ One Bulk Fill (FBF), and Tetric® N-Ceram Bulk Fill (TBF)—and one conventional CR (CC)—Filtek™ Z350—were used. The teeth were then subjected to aging via thermocycling, followed by cyclic loading. Finally, the volumetric width of the interfacial gap at the tooth-restoration interface was measured using a microcomputed tomography (µ-CT) analysis.ResultsSDR demonstrated the smallest gap volume among all tested CRs, followed by CC in enamel and TBF in dentin after aging. FBF showed the highest gap volume. There was no statistically significant three-way interaction between surface, aging, and material (p > 0.050).ConclusionsIt is safe to suggest using bulk-fill RBC in deep class II cavities instead of conventional layered RBC when dealing with dentin margins. However, further clinical investigation is required.

Marginal microleakage and modified microtensile bond strength of Activa Bioactive, in comparison with conventional restorative materials.

This study aimed to assess the enamel and dentin marginal microleakage and dentin microtensile bond strength (μTBS) of ACTIVA BioACTIVE Restorative with and without a bonding agent compared with conventional restorative materials. For enamel and dentin microleakage, Class II boxes were prepared in the mesial (1 mm under the cementoenamel junction) and distal (1 mm above the cementoenamel junction) surfaces of 90 extracted human third molars. The teeth were randomly divided into five groups (n = 18): Group Z (G-Premio Bond + Filtek Z250 XT), Group X (G-Premio Bond + X-tra fil bulk-fill), Group AA (G-Premio Bond + Activa Bioactive restorative), Group A (Activa Bioactive restorative), and Group G (dentin conditioner + Fuji II LC Improve). The teeth were thermocycled, and their microleakage was quantified using the dye penetration test under a stereomicroscope. For dentin μTBS measurement, 12 specimens were fabricated in metal molds (1 × 1 × 12 mm³) for each group mentioned above, and a universal testing machine measured their μTBS. Data were analyzed using one-way analysis of variance (ANOVA), the Kruskal-Wallis test, and multiple comparisons tests. Significant differences were noted among the groups in marginal microleakage and μTBS (p < .001). The highest mean microleakage scores at the enamel and dentin margins were noted in Group A, which had significant differences with other groups (p < .001). The highest μTBS was found in Group X, with significant differences with Group G and Group A (p < .05). The lowest µTBS was noted in Group A, with significant differences with Groups X, Group AA, and Group Z (p < .001). Activa Bioactive without a bonding agent showed significantly lower µTBS to dentin, and higher microleakage at the enamel and dentin margins. Application of adhesive resin with Activa Bioactive provided a dentine bond strength and marginal seal comparable to other restorative materials.

The Effect of Radiotherapy on the Marginal Adaptation of Class II Direct Resin Composite Restorations: A Micro-computed Tomography Analysis.

This laboratory study was designed to evaluate the marginal adaptation of Class II mesio-occlusodistal (MOD) restorations at the cervical region with micro-computed tomography (micro-CT). Two groups of restorations were compared: 1) those that had been exposed to radiotherapy before restoration was performed using a universal adhesive in etch-and-rinse and self-etch modes; and 2) those that had previously been restored using a universal adhesive in etch-and-rinse and self-etch modes and had subsequently undergone radiotherapy. Sixty intact human molars were randomly divided into groups according to irradiation status: no radiotherapy (control group); radiotherapy followed by restoration (radiotherapy-first group); and restoration followed by radiotherapy (restoration-first group). These three groups were then subdivided into two groups each on the basis of adhesive application type (etch-and-rinse and self-etch modes), for a total of six groups (n=10/group). Standardized Class II MOD cavities were prepared. A universal adhesive (Clearfil Universal Bond Quick, Kuraray, Okayama, Japan) was applied. The teeth were restored with resin composite (Estelite Posterior Quick, Tokuyama, Tokyo, Japan). The radiotherapy protocol was conducted with 60 gray (Gy) at 2 Gy/day, five days a week for six weeks. Adhesive defects were analyzed in distal and mesial views and evaluated with micro-CT (SkyScan 1174v2, Kontich, Antwerp, Belgium) on the basis of the volume of black spaces between the cavity walls and the restorative materials (mm3). The data were analyzed using the Kruskal-Wallis, Mann Whitney U and Wilcoxon tests (p<0.05). The radiotherapy protocol did not affect the marginal adaptation of the universal adhesive at the cervical regions. Regarding the application modes, for the radiotherapy-first group, the self-etch mode caused significantly higher adhesive defects than the etch-and-rinse mode at the dentin margin. For the no-radiotherapy group, the adhesive defects at the dentin margin were significantly higher than at the enamel margin with the application of the etch-and-rinse mode.