Dentin Margins Research Articles

Influence of filler existence on microleakage of a self-etch adhesive system.

Aim:This study evaluated the effect of filler existence in self-etch adhesive resin on the marginal leakage of a class V restoration.Materials and Methods:Class V cavities were prepared and restored with a resin composite on the buccal surfaces of 48 premolars lined with unfilled or filled adhesives (n = 24). After thermo cycling, teeth in each group were divided to two subgroups (n = 12), specimens of the first subgroup were incubated for 24 h in distilled water at 37°C, and for the second group three months in the same condition. Specimens were placed in 50% silver nitrate for 24 h at 37°C, and then were cut buccolingually 1 mm thick. Dye penetration was measured using a stereomicroscope and scaled from 0 to 5 in a blind method. SEM images were made to evaluate the dentin-adhesive interfaces. Collected data were analyzed using the nonparametric Kruskal-Wallis and Mann-Whitney U-tests at a significant level of P<0.05.Results:There was no significant difference between microleakage of filled and unfilled adhesive at 24 h and 3 months (P<0.05). There was a significant difference in cervical microleakage between 24 h and 3 months, which was independ on filler load of the adhesive (P<0.001). In contrast, there was no significant difference in occlusal microleakage between 24 h and 3 months and the cervical microleakage was significantly higher than occlusal microleakage after 3 months. SEM images reveald that unfilled adhesive infiltrate slightly better than filled adhesive.Conclusion:The application of filler particles in a self etch adhesive system had no influence on marginal leakage at both the enamel and dentin margins. While the unfilled adhesive infiltrate better than the filled adhesive, its long term performance is not promising.

Microleakage at enamel and dentin margins with a bulk fills flowable resin.

Objective:The aim of this in vitro study was to evaluate the marginal sealing ability of a bulk fill flowable resin composite on both enamel and dentin substrates.Materials and Methods:48 non-carious molars were selected and four Class-V cavities were prepared at the CEJ of each sample. Cavities were filled with Venus Diamond (Heraeus Kulzer); Venus Diamond Flow (Heraeus Kulzer) and Surefil SDR (Dentsply). Samples were divided into two groups: First group samples were immersed in a methylene blue solution for 30 min at 25°C. Second group samples were artificially aged and then treated with methylene blue. Samples were sectioned in the center of the restoration and observed with a 40x stereomicroscope, and the percentage of cavity infiltration was calculated.Results:Results were analyzed statistically by ANOVA (P < 0.05). The amount of infiltration was significantly lower for the enamel substrate compared with dentin (P = 0.0001) and in samples immediately immersed in methylene blue compared with those that were artificially aged (P = 0.011). The interaction between the composite material and the marginal substrate significantly affected dye penetration (P = 0.006).Conclusions:Bulk fill flowable resins provided significantly better marginal seal in dentin, both before and after artificial ageing. Nanohybrid resin composites and bulk fill flowable resins showed similar microleakage values at enamel margins. Bulk fills flowable resins provided significantly better marginal seal in dentin, both before and after artificial ageing. Nanohybrid resin composites and bulk fill flowable resins showed similar microleakage values at enamel margins.

An in-vitro evaluation of microleakage among nano ceramics and nano hybrid composite resins in Class V cavities

Background: Prevention of micro-leakage plays an important role in the success of composite restorations. This has led scientists to find newer composite restorative materials. Materials and Methods: Twenty-four human freshly extracted molar was randomly selected for this study. The teeth were stored in 0.1% thymol solution diluted in 0.4% saline. Class V cavities were prepared at the cemento-enamel junction on the buccal surfaces of each tooth. One coat of seventh generation bonding agent G-bond (GC Japan) was applied to all the samples. The samples were randomly divided into two groups of 12 samples each. All the samples were restored with composite resin using single increment technique as per the grouping. The teeth were then stored at 370°C water, except when they were removed from storage and subjected to thermo cycling for 1000 cycles in water between 50°C and 550°C for 30 s in each bath and 15 s transfer between bath. After thermo cycling, the samples were dried superficially, and two coats of nail varnish applied to the entire sample surface, leaving a 1 mm window around the restored cavity margins. All teeth were immersed in 2% methylene blue solution for 24 h at room temperature. The teeth were sectioned in the bucco – lingual direction across the center of the restoration using a slow speed saw (Isomet 1000, Buchler, USA). The sectioned teeth were examined by two calibrated inspectors for dye penetration levels. Results: Mann–Whitney U-test showed that there was no significant difference in dye leakage between Group I and Group II. However, at experimental level, when observing the enamel and dentinal margin, Group II showed a greater degree of leakage than Group I. Conclusion: In the present study, it was observed that self-etch adhesive systems and single increment technique are beneficial as they help in reducing the application time and technique related sensitivity.

Effect of Thermocycling on Microleakage of New Adhesive Systems on Primary Teeth: An In-Vitro Study

Introduction: This study investigated the sealing ability of three different adhesives in primary bovine teeth. Methods: Facial and lingual class V cavities were prepared half in enamel and half in cementum, in 48 bovine primary mandibular incisors and randomly divided into three groups and each group divided to two subgroups. The tested adhesives were XPBond (XP), ClearfilS3 Bond (S3), and Xeno III (XE). All cavities were restored with composite and light cured. After 24 hours storage in 37 ° C distilled water and polishing, teeth were thermocycled and sealed with nail varnish. Then, they were stored in 2% methylene blue and dye penetration was evaluated under a stereomicroscope. Results: No significant differences were recorded in the microleakage value between three adhesives in enamel and dentin margins (p>0.0.5) before and after thermocycling. The lowest microleakage value was obtained in XE followed by XP and S3. Conclusion: There were not any differences between adhesives in enamel and dentin margins of class V cavities on primary bovine teeth.

Effect of saliva contamination on shear bond strength and microleakage of one-bottle etch-and-rinse and self-etch adhesives: scanning electron and confocal laser microscopic analyses

Purpose: To evaluate the effect of saliva contamination on shear bond strength, microleakage, and microstructure of the adhesive interface in two different adhesive systems by using scanning electron microscopy (SEM) and confocal laser microscopy (CLSM). Materials and methods: Randomly, 228 third molars were allocated to six groups for an etch-and-rinse adhesive One-Step Plus (Bisco Inc.) and a self-etch adhesive G Bond (GC Corp.): Group 1 – manufacturer’s instructions were followed; Group 2 – involved contamination and drying before adhesive application; Group 3 – involved contamination, washing, and blot drying before adhesive application; Group 4 – involved contamination, etching, washing, and blot drying before adhesive application; Group 5 – involved contamination and drying after adhesive application, followed by adhesive reapplication; Group 6 – involved contamination and washing after adhesive application, followed by adhesive reapplication. Shear bond strength was tested after specimens were stored in distilled water at 37 °C for 24 h. Specimens were evaluated under a stereomicroscope for microleakage. Dentin–resin interfaces were evaluated by SEM and CLSM. Results: Group 2 for One-Step Plus and Group 3 for G Bond showed significantly lower bond strengths than control groups. Microleakage values were significantly greater at dentin than at enamel margins for all groups. In Group 2, for both adhesive systems, the highest microleakage was observed at dentin margins. Further, dentin–adhesive interfaces were not uniform and gaps were found by SEM and CLSM. Conclusions: The SEM and CLSM images demonstrated high variability of dentin–resin interfaces among saliva-contaminated groups. Rinsing the saliva and re-applying adhesive might be the best way to reduce the effect of saliva contamination on bond strength and microleakage.

The effect of thermocycling on microleakage analysis of bulk filled base composite in comparison to incrementally placed nanohybrid composite in class II MOD restorations (An in vitro study)

Background: The study aim was to evaluate thermocycling effect on microleakage of occlusal and cervical margins of MOD cavity filled with bulk filled composites in comparison to incrementally placed nanohybrid composite and to evaluate the difference in microleakage between enamel and dentin margins for the three materials groups. Materials and method: Forty eight maxillary first premolars were prepared with MOD cavities. Samples were divided into three groups of sixteen teeth according to material used: Grandio: Grandio. SDR: SDR +Grandio. X-tra: X-tra base + Grandio. Each group was subdivided into two according to be thermocycled or not. After 24 hrs immersion in 2% methylene blue, samples weresectioned and microleakage was estimated. Results: Thermocycling significantly increased microleakage at occlusal margin in Grandio group compared to other groups. SDR composite use before and after thermocycling significantly reduced microleakage at occlusal and cervical enamel margins compared to other groups. Grandio group had non significant difference to X-tra group in microleakage before thermocycling at occlusal and cervical enamel margins while it had a significant increase after thermocycling. No material had significantly reduced dentin margin microleakage before or after thermocycling. Only SDR group before thermocycling, significantly reduced microleakage in enamel margin compared to dentin margin. Conclusion: Thermocycling did not increase microleakage in all the groups except for Grandio group in occlusal margin. SDR group showed reduced microleakage in occlusal and enamel margins in comparison to other groups.None of the materials reduced microleakage in dentin margin.

Effect of open-sandwich vs. adhesive restorative techniques on enamel and dentine demineralization: An in situ study

ObjectivesTo assess in situ the effect of different restorative techniques used with fluoride-releasing materials on enamel and dentine demineralization in the presence of a cariogenic challenge. MethodsThirty human molars were prepared for 60 Class V cavities, with enamel and dentine margins. The teeth were divided into four groups (n=15): L1 – open sandwich technique with a conventional glass ionomer cement (GIC), L2 – open sandwich technique with a resin-modified GIC, A1 – total-etch bonding with a fluoride-containing adhesive, A2 – total-etch bonding with a nonfluoride-containing adhesive. All the cavities were restored with a nanofilled composite. Fifteen volunteers used appliances containing one specimen from each group. The cariogenic challenge was carried out with a 20% sucrose solution 8×/day for 7 days. The specimens were sectioned for microhardness test and EDS analysis at different depths below the enamel and dentine margins (25, 50 and 100μm) and distances from the tooth-restoration interfaces (25 and 75μm). The data were analyzed by ANOVA and Games–Howell test (α=5%). ResultsBoth GICs produced higher hardness in enamel at all depth-and-distance combinations, but only L1 produced higher hardness in dentine (p<0.05). L2 and A1 exhibited similar dentine hardness at 25μm distance for all depths (p>0.05). L1 demonstrated significantly higher amounts of calcium in dentine than the other groups, but had similar amounts in enamel to L2 and A1. ConclusionsThe open sandwich technique using conventional GIC proved more effective in reducing enamel and dentine demineralization at depths of up to 100μm under a cariogenic challenge. Clinical significanceConventional GICs should be considered the materials of choice for lining of cavities not having all margins in enamel, particularly using the open sandwich technique.

Detection of Marginal Leakage of Class V Restorations In Vitro by Micro–Computed Tomography

This in vitro study evaluated the efficacy of micro-computed tomography (CT) in marginal leakage detection of Class V restorations. Standardized Class V preparations with cervical margins in dentin and occlusal margins in enamel were made in 20 extracted human molars and restored with dental bonding agents and resin composite. All teeth were then immersed in 50% ammoniacal silver nitrate solution for 12 hours, followed by a developing solution for eight hours. Each restoration was scanned by micro-CT, the depth of marginal silver leakage in the central scanning section was measured, and the three-dimensional images of the silver leakage around each restoration were reconstructed. Afterward, all restorations were cut through the center and examined for leakage depth using a microscope. The silver leakage depth of each restoration obtained by the micro-CT and the microscope were compared for equivalency. The silver leakage depth in cervical walls observed by micro-CT and microscope showed no significant difference; however, in certain cases the judgment of leakage depth in the occlusal wall in micro-CT image was affected by adjacent enamel structure, providing less leakage depth than was observed with the microscope (p<0.01). Micro-CT displayed the three-dimensional image of the leakage around the Class V restorations with clear borders only in the dentin region. It can be concluded that micro-CT can detect nondestructively the leakage around a resin composite restoration in two and three dimensions, with accuracy comparable to that of the conventional microscope method in the dentin region but with inferior accuracy in the enamel region.

Impact of Quantity of Resin, C-factor, and Geometry on Resin Composite Polymerization Shrinkage Stress in Class V Restorations

This study evaluated the effect of quantity of resin composite, C-factor, and geometry in Class V restorations on shrinkage stress after bulk fill insertion of resin using two-dimensional finite element analysis. An image of a buccolingual longitudinal plane in the middle of an upper first premolar and supporting tissues was used for modeling 10 groups: cylindrical cavity, erosion, and abfraction lesions with the same C-factor (1.57), a second cylindrical cavity and abfraction lesion with the same quantity of resin (QR) as the erosion lesion, and then all repeated with a bevel on the occlusal cavosurface angle. The 10 groups were imported into Ansys 13.0 for two-dimensional finite element analysis. The mesh was built with 30,000 triangle and square elements of 0.1 mm in length for all the models. All materials were considered isotropic, homogeneous, elastic, and linear, and the resin composite shrinkage was simulated by thermal analogy. The maximum principal (MPS) and von Mises stresses (VMS) were analyzed for comparing the behavior of the groups. Different values of angles for the cavosurface margin in enamel and dentin were obtained for all groups and the higher the angle, the lower the stress concentration. When the groups with the same C-factor and QR were compared, the erosion shape cavity showed the highest MPS and VMS values, and abfraction shape, the lowest. A cavosurface bevel decreased the stress values on the occlusal margin. The geometry factor overcame the effects of C-factor and QR in some situations. Within the limitations of the current methodology, it is possible to conclude that the combination of all variables studied influences the stress, but the geometry is the most important factor to be considered by the operator.

Marginal microleakage of class V resin-based composite restorations bonded with six one-step self-etch systems

This study compared the microleakage of class V restorations bonded with various one-step self-etching adhesives. Seventy class V resin-based composite restorations were prepared on the buccal and lingual surfaces of 35 premolars, by using: Clearfil S3 Bond, G-Bond, iBond, One Coat 7.0, OptiBond All-In-One, or Xeno IV. The Adper Single Bond etch-and-rinse two-step adhesive was employed as a control. Specimens were thermocycled for 500 cycles in separate water baths at 5°C and 55°C and loaded under 40 to 70 N for 50,000 cycles. Marginal microleakage was measured based on the penetration of a tracer agent. Although the control showed no microleakage at the enamel margins, there were no differences between groups (p = 0.06). None of the adhesives avoided microleakage at the dentin margins, and they displayed similar performances (p = 0.76). When both margins were compared, iBond® presented higher microleakage (p < 0.05) at the enamel margins (median, 1.00; Q3-Q1, 1.25-0.00) compared to the dentin margins (median, 0.00; Q3-Q1, 0.25-0.00). The study adhesives showed similar abilities to seal the margins of class V restorations, except for iBond®, which presented lower performance at the enamel margin.

Marginal Adaptation of Direct Class II Composite Restorations with Different Cavity Liners

The aim of this study was to evaluate how cavity linings with different elastic modulus can influence the marginal adaptation (MA) of Class II composite restorations before and after thermo-mechanical loading. Forty Class II cavities with margins extending 1 mm below the cement-enamel junction were prepared in extracted human third molars. In each group except the control group, a lining material of 1-mm thickness was applied to the bottom of the cavity and polymerized before placing the resin composite Herculite XRV Ultra (group A: control; group B: Premise Flowable lining; group C: Herculite XRV Ultra lining; and group D: Optibond FL lining). MA was evaluated (with a scanning electron microscope) before and after loading (200,000 loading cycles). Statistical analysis was done using the Shapiro-Wilks test, the analysis of variance test, and Duncan post hoc test at p<0.05. Before loading, the percentages of continuous margins in dentin were superior (p<0.05) for groups C and D (71.1% and 87.2%, respectively) compared to groups A and B (55.7% and 48.3%, respectively). After loading, group D (79.8%) was statistically superior in dentin compared to all of the other groups (43.6%, 35.9%, and 54.4%, respectively). In occlusal enamel, no significant difference was found between groups. The percentage of enamel fractures and the percentage of noncontinuous margins in proximal enamel were high, with no significant difference between liners. It can be concluded that for the materials used in this study, a 1-mm-thick lining with an extremely low elastic modulus (2-3 GPa) could redistribute shrinkage stress. The use of a flowable composite did not significantly improve MA.

Influence of Adhesive Application Methods and Rebonding Agent Application on Sealing Effectiveness of All‐in‐One Self‐Etching Adhesives

The choice of adhesive application methods could affect the microleakage of self-etch adhesives. To evaluate the effect of acid-etching, doubling adhesive application time, doubling adhesive coating, and rebonding agent application on microleakage of self-etch adhesives in Class V cavities. Seventy human third molars with Class V cavities assigned to five groups according to different adhesive application protocols for the three dentin adhesives (Clearfil S3 Bond, Kuraray Medical, Okayama, Japan; Optibond All-in-One, Kerr Corporation Orange, CA, USA; G-Aenial Bond, GC Corporation, Tokyo, Japan): group 1, manufacturer's recommendations; group 2, prior acid-etching of cavities; group 3, double application time; group 4, two consecutive coats of the adhesives; group 5, rebonding application on restoration margins. After bonding, the cavities were filled with a resin composite (Filtek Supreme XT, 3M ESPE Dental Products, St. Paul, MN, USA). The teeth were thermocycled, and the specimens were examined for microleakage using methylene blue as a marker. For Clearfil S3 Bond and Optibond All-in-One, microleakage in groups 2 and 5 were significantly lower than other groups' enamel margins. In groups 1, 2, 4, and 5, Clearfil S3 Bond exhibited significantly more leakage than the other dentin bonding agents in dentin margins. Microleakage was significantly higher on dentinal margins compared with the enamel margins for Clearfil S3 Bond in all of the groups. Optibond All-in-One showed significantly lower microleakage in dentin margins in all groups except groups 2 and 5. Acid-etching usually promoted the reduction of microleakage in enamel margins. On the other hand, rebonding application usually contributed to the reduction of microleakage more than other methods in enamel and dentin margins. Acid-etching or rebonding application may contribute to reduction of microleakage of all-in-one self-etching adhesives.

Effect of Postoperative Peroxide Bleaching on the Marginal Seal of Composite Restorations Bonded With Self-etch Adhesives

The aim of this study was to determine the effect of peroxide bleaching on the marginal seal of composite restorations bonded with several adhesive systems. Combined cylindrical Class V cavities located half in enamel and half in dentin were prepared on the buccal and lingual surfaces of human molars. The cavities were bonded with the self-etch adhesives Clearfil SE-Bond (CLF), Adper Prompt (ADP), and iBond (IBO) and an etch-and-rinse adhesive Gluma Comfort Bond (GLU) and restored with a microhybrid composite Charisma. Experimental groups were treated 25 times for eight hours per day with a peroxide bleaching gel Opalescence PF 20, while the control groups were stored in distilled water for two months and then subjected to a microleakage test using a dye penetration method. Scanning electron microscopy was used to investigate the etching and penetration abilities of the adhesives and morphology of debonded restoration-enamel interfaces after the microleakage tests. Statistical analyses were performed using nonparametric Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests at p=0.05. The microleakage of all GLU groups was low and not significantly affected by peroxide bleaching. Low microleakage was recorded for CLF control groups, but after bleaching, a small but significant increase in microleakage at the enamel margin indicated its sensitivity to peroxide bleaching. For ADP and IBO control groups, the microleakage at the enamel margins was significantly higher than for GLU and CLF and exceeded that at the dentin margins. Bleaching did not induce any significant changes in the microleakage. Electron microscopy analysis indicated that in our experimental setup, decreased adhesion and mechanical resistance of the ADP- and IBO-enamel interfaces could be more important than the chemical degradation effects induced by the peroxide bleaching gel.

The Effect of Two Bulk Fill Resin Composites on Microleakage in Endodontically Treated Teeth

Purpose: To evaluate the effect of two bulk fill resin composites on microleakage in endodontically treated Class II restorations. Materials and Methods: Twenty-four non-carious molars were selected and randomly divided into three groups (n = 8). The Class II cavity preparations were made with the cervical margin 1 mm below the cementum-enamel junction, and endodontic treatment was performed using a resin-based sealer and gutta-percha points. In Group 1 (Control), resin composite (G-aenial Posterior; GC Corp., Tokyo, Japan) was applied to the interproximal wall, and then restorative material was applied incrementally. In Group 2, resin composite was applied to the interproximal wall, followed by a 4-mm-layer of a bulk fill flowable composite (x-tra base; Voco, GmbH, Cuxhaven, Germany) and the remaining occlusal part of the cavity was filled with resin composite. In Group 3, resin composite was applied to the interproximal wall, followed by a 4mm layer of a bulk fill fiber-reinforced composite (everX Posterior; GC Corp., Tokyo, Japan), and the remaining occlusal part of the cavity was filled with a resin composite. The restorations were then subjected to 500 thermal cycles, each with a dwell time of 20 seconds at 5 and 55 oC. The adaptation at the cervical margin was evaluated by dye penetration, and one tooth was used to evaluate the restorative material interface using SEM. The data were statistically analyzed using the Kruskal Wallis test (p &lt; 0.05). Results: No significant difference in dye penetration was found between the control and the experimental groups. Microleakage was significantly higher on enamel margins compared with the dentin margins for all of the groups. Conclusion: The use of bulk fill restorative materials under resin composites does not affect the sealing ability of restorations.

Influence of Enamel Preservation on Failures Rates of Porcelain Laminate Veneers

The purpose of this study was to evaluate the failure rates of porcelain laminate veneers (PLVs) and the influence of clinical parameters on these rates in a retrospective survey of up to 12 years. Five hundred eighty laminate veneers were bonded in 66 patients. The following parameters were analyzed: type of preparation (depth and margin), crown lengthening, presence of restoration, diastema, crowding, discoloration, abrasion, and attrition. Survival was analyzed using the Kaplan-Meier method. Cox regression modeling was used to determine which factors would predict PLV failure. Forty-two veneers (7.2%) failed in 23 patients, and an overall cumulative survival rate of 86% was observed. A statistically significant association was noted between failure and the limits of the prepared tooth surface (margin and depth). The most frequent failure type was fracture (n = 20). The results revealed no significant influence of crown lengthening apically, presence of restoration, diastema, discoloration, abrasion, or attrition on failure rates. Multivariable analysis (Cox regression model) also showed that PLVs bonded to dentin and teeth with preparation margins in dentin were approximately 10 times more likely to fail than PLVs bonded to enamel. Moreover, coronal crown lengthening increased the risk of PLV failure by 2.3 times. A survival rate of 99% was observed for veneers with preparations confined to enamel and 94% for veneers with enamel only at the margins. Laminate veneers have high survival rates when bonded to enamel and provide a safe and predictable treatment option that preserves tooth structure.

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

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.

Self-etching aspects of a three-step etch-and-rinse adhesive

The purpose of this study is to assess the marginal adaptation of cavities restored with a three-step etch-and-rinse adhesive, OptiBond FL (OFL) under different application protocols. Twenty-four class V cavities were prepared with half of the margins located in enamel and half in dentin. Cavities were restored with OFL and a microhybrid resin composite (Clearfil AP-X). Three groups (n = 8) that differed in the etching technique were tested with thermomechanical loading, and specimens were subjected to quantitative marginal analysis before and after loading. Micromorphology of etching patters on enamel and dentin were observed with SEM. Data was evaluated with Kruskal-Wallis and Bonferroni post hoc test. Significantly lower percent CM (46.9 ± 19.5) were found after loading on enamel in group 3 compared to group 1 (96.5 ± 5.1) and group 2 (93.1 ± 8.1). However, no significant differences (p = 0.30) were observed on dentin margins. Etching enamel with phosphoric acid but avoiding etching dentin before the application of OFL, optimal marginal adaptation could be obtained, evidencing a self-etching primer effect. A reliable adhesive interface was attained with the application of the three-step etch-and-rinse OFL adhesive with a selective enamel etching, representing an advantage on restoring deep cavities.

Effect of alternative modes of application on microleakage of one-step self-etch adhesives

Background/purposeContemporary one-step self-etch adhesives are certainly the most user-friendly adhesives; however, typically could not compete with the more traditional multi-step adhesives. This in vitro study evaluated the efficacy of two modes of application (double application or placement of a hydrophobic resin coating) for the reduction of microleakage, using three different one-step self-etch adhesives (AdheSE One VivaPen, Ivoclar Vivadent, Schaan, Liechtenstein; Xeno V, Dentsply De Trey, Konstanz, Germany; OptiBond All-In-One, Kerr Italia S.r.l, Scafati, Italy). Materials and methodsWe prepared Class V cavities with the occlusal margin in enamel and gingival margin in dentin on both buccal and lingual surfaces of 108 human molar teeth. Cavities were divided into nine groups according to the combination of adhesives and application modes used (n = 24). For applying adhesives, we followed three types of procedures: (1) according to the manufacturers’ directions; (2) using a double-application method; and (3) with the additional placement of a hydrophobic resin layer after following the manufacturers’ directions. We restored the cavities with a composite resin. After thermocycling (500 cycles at 5°C/55°C) and immersion in 0.5% basic fuchsin, we sectioned the teeth and evaluated them for microleakage using a stereo microscope (20×). Enamel and dentin margins were scored separately, and we analyzed the data using Kruskal–Wallis, Bonferroni-corrected Mann–Whitney U, and Wilcoxon signed-rank tests. ResultsApplication of a hydrophobic resin over the cured Xeno V adhesive decreased the amount of microleakage at the enamel margins, compared with the application according to the manufacturer’s instructions (P = 0.005). Both application modes decreased the amount of microleakage at the dentin margins with AdheSE One VivaPen adhesive, compared with application according to the manufacturer’s instructions (P < 0.001). With the OptiBond All-In-One adhesive, no significant difference between application modes was observed. ConclusionAlternative modes of application did not adversely affect the sealing ability of one-step self-etch adhesives. Depending on the type of adhesive, alternative modes of application may contribute to low microleakage values.

Clinical Effectiveness of a Hydrophobic Coating Used in Conjunction With a One-step Self-etch Adhesive: An 18-month Evaluation

The purpose of this randomized clinical trial was to evaluate the clinical performance of a one-step self-etch adhesive in noncarious cervical lesions with inclusion of a hydrophobic bonding layer not included in the original bonding system as a test of potentially improved bonding. Patients with noncarious cervical lesions received two or four restorations after being randomly assigned to two adhesive technique protocols (n=32): EB, application of Adper Easy Bond (3M ESPE) following manufacturer's instructions; and EB+B, application of Adper Easy Bond, immediately followed by the application of a hydrophobic resin coat (Scotchbond Multi-Purpose Bonding Agent, 3M ESPE). All restorations were restored with a microhybrid composite (Filtek Z250, 3M ESPE). Clinical effectiveness was recorded in terms of retention, marginal discoloration, marginal integrity, postoperative sensitivity, recurrent caries, periodontal health, and pulpal vitality, according to the modified USPHS criteria, for 18 months. Data were analyzed using chi-square, Fisher exact, and McNemar tests at α=0.05. Two restorations of each group were debonded after six months, leading to an overall clinical success rate of 93.8% for both groups. At the 18-month evaluation period, no new restoration was debonded. However, one restoration of the EB group displayed recurrent caries at the dentin margin, decreasing the overall success rate to 90.6% in comparison to 93.8% of EB+B. The success rate between EB and EB+B was not statistically significant (p=0.5). The application of a hydrophobic resin coat over EB did not increase bonding effectiveness in noncarious cervical lesions after 18 months.

Influence of a proximal margin elevation technique on marginal adaptation of ceramic inlays

Purpose.Evaluating the effect of a proximal margin elevation technique on marginal adaptation of ceramic inlays. Methods. Class II MOD-cavities were prepared in 40 human molars and randomly distributed to four groups (n = 10). In group EN (positive control) proximal margins were located in enamel, 1 mm above the cementoenamel junction, while 2 mm below in groups DE-1In, DE-2In and DE. The groups DE-1In, DE-2In and DE simulated subgingival location of the cervical margin. In group DE-1In one 3 mm and in group DE-2In two 1.5 mm composite layers (Tetric) were placed for margin elevation of the proximal cavities using Syntac classic as an adhesive. The proximal cavities of group DE remained untreated and served as a negative control. In all groups, ceramic inlays (Cerec 3D) were adhesively inserted. Replicas were taken before and after thermomechanical loading (1.200.000 cycles, 50/5°C, max. load 49 N). Marginal integrity (tooth-composite, composite-inlay) was evaluated with scanning electron microscopy (200×). Percentage of continuous margin (% of total proximal margin length) was compared between groups before and after cycling using ANOVA and Scheffé post-hoc test. Results. After thermomechanical loading, no significant differences were observed between the different groups with respect to the interface composite-inlay and tooth-composite with margins in dentin. The interface tooth-composite in enamel of group EN was significantly better compared to group DE-2In, which was not different to the negative control group DE and DE-1In. Conclusion. Margin elevation technique by placement of a composite filling in the proximal box before insertion of a ceramic inlay results in marginal integrities not different from margins of ceramic inlays placed in dentin.