Microleakage of posterior packable resin composites with and without flowable liners

The use of flowable composites as liners in Class II packable composites has been suggested by some manufacturers. However, the contributions of this technique are unproven. This study evaluated marginal microleakage in Class II packable composite restorations with and without the use of a flowable composite liner. A conventional microhybrid composite was used as a control. Microleakage at occlusal and gingival margins of Class II cavities was evaluated using 45Ca and autoradiographs. Fifty non-carious, restoration-free human molar teeth were used. Separate mesio-occlusal and disto-occlusal Class II cavity preparations were made in each tooth. Gingival margins of all cavities were placed 1 mm apical to the cementoenamel junction (CEJ). Four Packable composites (Alert, Surefil, Pyramid and Solitaire) and one conventional microhybrid composite (Renew) with their respective manufacturer's bonding agents were used to restore the cavities. One side of each tooth was restored with composite alone, while the other side was restored with the composite lined with that manufacturer's flowable liner. The restored teeth were thermally stressed and 45Ca was used to evaluate microleakage. Two independent evaluators scored leakage based on the autoradiographs. The results showed flowable composites helped reduce microleakage at gingival margins of Class II restorations (p < 0.05). Gingival margins had higher microleakage than occlusal margins (p < 0.05). Without flowable liners, three packable composites (Alert, Pyramid and Surefil) showed higher leakage (p < 0.05) than the microhybrid control. Only Solitaire packable composite without liner showed no significant difference in microleakage to the control (p > 0.05). Although the flowable liners help reduce microleakage, Alert and Pyramid packable composites with liners still showed higher leakage than the control (p < 0.05). Surefil and Solitaire packable composites with flowable liners showed no significant difference in microleakage (p > 0.05) to the control.     

Leakage pathway of Class V cavities restored with different flowable resin composite restorations

This study investigated the leakage pathway of facial and lingual Class V cavities restored with different flowable resin composites bonded with one bonding agent by examining the resin/dentin interface. Forty Class V cavities were etched with 37% phosphoric acid gel; Single Bond dental adhesive was applied, then the cavities were randomly divided into four groups (n=10). Three groups were restored with one of three flowable resin composites (Grandio Flow, Filtek Flow and Admira Flow). The fourth group was restored with Z250 (hybrid resin composite) to serve as a control. The specimens were then placed in 50% w/v silver nitrate solution for 24 hours and immersed in a photodeveloping solution for eight hours. Thereafter, the specimens were sectioned bucco-lingually, polished, mounted on stubs, gold sputter coated and examined by scanning electron microscope. Silver particle penetration length with and without gap formation was measured directly on the scanning electron microscope monitor and calculated as a percentage of the total length of the cut dentin surface that was penetrated by silver nitrate. The data were analyzed with one-way ANOVA and Tukey HSD test. The groups restored with Filtek Flow and Admira Flow showed a microleakage pattern where silver nitrate penetration was observed with gap formation at the tooth/restoration interface and Filtek Flow recorded significantly higher leakage than Admira Flow. Grandio Flow showed similar marginal adaptation to Z250 resin composite with no gap formation at the interface. However, silver ions had penetrated beneath the resin-impregnated layer in cavities restored with Grandio Flow and Z250, indicating nanoleakage occurred. This study suggests that volumetric shrinkage in resin composites remains a problem. Although some new technologies are trying to solve the problem of composite shrinkage, the bonding system used in this study did not achieve perfect sealing at the restoration/dentin interface. This might affect durability of the bond to dentin.     

Marginal adaptation of class II cavities restored with bulk-fill composites

Objectives

To determine the marginal adaptation of bulk-fill composites in class II MO cavities.

Methods

Standardized class II MO cavities with bevelled enamel margins were prepared in 40 extracted human molars. The teeth were randomly assigned to one of the five experimental groups (n = 8). The teeth were restored with two horizontal increments of composite (4 mm and 2 mm thickness). The experimental groups were (1st/2nd increment): Gr. A – Venus Bulk-Fill/Venus Diamond; Gr. B – Tetric EvoCeram BulkFill/Tetric EvoCeram; Gr. C – Surefil SDR/Ceram-X; Gr. D – SonicFill; Gr. E – Ceram-X/Ceram-X (control). After finishing procedures, impressions were made using a polyvinyl siloxane and epoxy resin replicas were obtained. Thermo-mechanical stressing was carried out 24 h after the restorative procedure. All specimens were submitted to 240,000 occlusal loading and simultaneous 600 thermal cycles in water at 5 °C and 50 °C. After loading, a new set of epoxy resin replicas was obtained. Scanning electron microscopy was carried out at 200× magnification. Results for the marginal adaptation were expressed as percentages of continuity relative to the exposed interface and analyzed by ANOVA and Duncan post hoc test (p < 0.05).

Results

In enamel, no significant differences were detected before and after thermo-mechanical loading between groups. In dentine, the worst results were observed in Gr. A.

Conclusion

By applying simple layering techniques, bulk-fill materials do not allow better marginal adaptation than a standard composite.

Clinical significance

A new class of resin-base composite (bulk-fill) was recently launched on the market. The bulk-fill composites exhibited adequate marginal adaptation and similar to the results of the standard composite.     

The leakage of Class II cavities restored with packable resin-based composites

Recently, new resin-based composites, called "packable" or "condensable" resin composites, are being promoted as amalgam alternatives. The purpose of this study was to evaluate leakage in Class II cavities restored with the five packable resin-based composites. On 45 freshly extracted human molars, cavities were prepared following a standardized pattern in which the Class II cavity had a length of 3.0 mm, width of 2.0 mm, and depth of 1.5 mm occlusally. The proximal box had an axial depth of 1.5 mm and a buccolingual width of 4.0 mm. The cervical margin was located 1.0 mm below the cement enamel junction (CEJ). The teeth were randomly divided into five groups of 8 each. The cavity surface was conditioned with 36% phosphoric acid, rinsed, excess water removed, and a dental bonding adhesive (Prime&Bond NT) was used for all the cavities. The teeth were then restored according to the manufacturer's instructions: Group 1, Surefil; Group 2, Solitaire; Group 3, Alert; Group 4, Filtek P60; and Group 5, Prodigy Condensable. After the restorations were completed, the specimens were finished and polished with an aluminum-oxide-coated disc, thermocycled, stained, sectioned, and viewed under a stereomicroscope for leakage at occlusal/enamel and gingival/dentin margins. All test groups showed that leakage of gingival/dentin margins were greater when compared with leakage of occlusal/enamel margins. At the occlusal/enamel margins, there were no significant differences between the materials; however, at gingival/dentin margins, Filtek P60 and Prodigy Condensable demonstrated less leakage, while Solitaire demonstrated greater leakage.     

Microleakage study of flowable composite resin systems

The purpose of this in vitro microleakage study was to evaluate four low-viscosity composite resin systems. Each resin system included the corresponding bonding agent for each respective flowable composite. A hybrid material was used as a control. A total of 75 noncarious, freshly extracted human teeth were prepared with a Class 5 occlusal preparation and a gingival preparation at the cementoenamel junction. The materials were inserted according to the manufacturers' recommendations using the single-component bonding agent for each system. Teeth were thermocycled 800 times between 5 degrees C and 55 degrees C with 30-second dwell times. The teeth were then coated with nail polish 1 mm short of the restoration, placed in a basic fuchsin dye for 24 hours, and sectioned with a diamond wheel. Enamel and dentin/cementum margins were analyzed for microleakage on a scale of 0 (no leakage) to 3 (axial wall). Results were evaluated with the Fisher's exact test. The results of the study indicate that there was no leakage at the enamel margin of any restorations. No statistically significant differences in microleakage were found in dentin/cementum margins among the samples in the experimental group or between the experimental group and control group. The results indicate flowable composites demonstrate resistance to microleakage in both enamel and cementum/dentin margins similar to TPH hybrid composite.     

Microleakage at the cervical margin of composite Class II cavities with different restorative techniques

This study evaluated the microleakage at the cervical margins of Class II composite resin restorations restored with different techniques. Slot cavities were prepared on both proximals of 40 unerupted third molars with one cervical margin located above and the other below the cementoenamel junction. The prepared teeth were randomly assigned to four groups and restored using the following techniques: (I) 3-Sited, (II) Directed-Shrinkage, (III) Resin-Modified Glass-Ionomer Cement or a (IV) Flowable Composite as the gingival increment. All restorations were placed with the same bonding agent and composite resin. The difference among the groups was on the first increment and on its insertion and polymerization techniques. After restoration, the teeth were thermocycled and exposed to a dye. Results showed that all the techniques worked well for enamel, with almost no leakage. However, on cementum, all techniques demonstrated moderate to severe leakage.     

Cuspal deflection and microleakage in premolar teeth restored with resin-based composites with and without an intermediary flowable layer

OBJECTIVES: To assess cuspal deflection and cervical enamel microleakage with and without an intermediary flowable RBC layer for the incremental restoration of mesio-occluso-distal (MOD) cavities with two resin-based composites (RBCs). METHODS: Forty sound upper premolar teeth had standardised MOD cavities prepared. Restoration of the teeth involved the placement of the RBCs (Filtek P60 or Filtek Supreme) in eight increments with the appropriate bonding system with and without an intermediary flowable RBC layer (Filtek Flow). Buccal and palatal cusp deflections were recorded post-irradiation using a twin channel deflection measuring gauge. Following restoration, the teeth were thermocycled, immersed in a 0.2% basic fuchsin dye for 24h, sagittally sectioned and examined for cervical enamel microleakage. RESULTS: A significant reduction in cuspal deflection was evident when both RBC materials were used to restore the cavity by employing an intermediary flowable (P<0.001) compared with when no intermediary flowable was utilised. No statistically significant differences were identified in microleakage between the teeth restored with Filtek P60 or Filtek Supreme when an intermediary flowable (Filtek Flow) was employed. CONCLUSIONS: The results of the current study suggest that there was a benefit to the operator in terms of a reduction in cuspal deflection but not from the maintenance of the synergism of the adhesive bond, namely microleakage at the cervical enamel cavosurface margin, when an intermediate layer of a flowable RBC was used under higher elastic modulus RBCs.     

Er:YAG激光对Constic自粘接流动树脂预防性充填的边缘封闭效果

目的 探讨Er:YAG激光处理早期窝沟龋并用Constic自粘接流动树脂进行预防性充填后的边缘封闭效果.方法 收集患有窝沟龋的前磨牙或磨牙60颗,随机分为4组(n=15).A、B组用传统涡轮手机备洞,C、D组用Er:YAG激光备洞;A、C组酸蚀并涂布粘结剂后,用F03流体树脂充填;B、D组用Constic自粘接流动树脂...     

Microleakage of temporary endodontic restorations in teeth restored with amalgam

Microleakage of seven temporary restorative materials was evaluated in endodontic access preparations made in teeth restored with amalgam. Ten teeth were used for each of the seven materials: Cavit, Cavit-G, TERM, zinc phosphate cement, polycarboxylate cement, glass ionomer cement, and IRM. A class I amalgam was placed in the occlusal surface of each experimental tooth and an endodontic access preparation was made entirely within the amalgam. Then the access preparation was restored with one of the temporary restorative materials, and microleakage was evaluated using a fluid filtration technique. The amount of microleakage was quantitated by measuring the fluid flow at 15 min, 1 h, 24 h, 1 wk, and 2 wk after insertion of the temporary restoration. Cavit, Cavit-G, TERM, IRM, and glass ionomer cement all provided excellent seals while zinc phosphate cement and polycarboxylate cement provided less effective seals.     

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目的探讨Esthet—X Flow光固化流体树脂粘接正畸托槽的效果。方法收集2012年1月至2012年2月在中国医科大学口腔医院颌面外科因正畸需要拔除的上颌第一前磨牙30颗,随机等分为3组：实验Ⅰ组应用Esthet—X Flow光固化流体树脂及Prime＆Bond NT粘接剂粘接托槽;实验Ⅱ组仅应用Esthet—X Flow光固化流体树脂粘接托槽;对照组应用京津釉质粘接剂粘接托槽。测试各组的抗剪切强度,并在光学显微镜下观察粘接剂残留情况。结果实验Ⅰ、Ⅱ组的抗剪切强度均明显低于对照组（P〈0．05）,而实验Ⅰ、Ⅱ组间差异无统计学意义（P〉0．05）,且抗剪切强度均大于9MPa,达到了临床应用标准。各组间粘接剂残留指数差异无统计学意义（P〉0．05）。结论单独应用Esthet—X Flow光固化流体树脂可满足临床粘接托槽的要求。     

Bacterial penetration of restored cavities

The aim of this study was to assess the quality of the marginal seals of 7 restoratives by means of a bacterial penetration test in vitro. Sixty intact premolars and third molars that were scheduled for extraction were used in the test. There were 2 experimental groups of teeth, as follows: (1) A class V conventional cavity and a wedge erosion cavity were prepared on the buccal surface and the lingual surface, respectively, of each tooth. (2) A class V conventional cavity and a wedge erosion cavity were prepared on the buccal surface and the lingual surface, respectively, of each tooth with a completely removed enamel layer. The cavities were then reconstructed with different restorative materials. The quality of the marginal seals was evaluated by submerging the teeth in a bacterial suspension and incubating them in an anaerobic milieu at 37 degrees C for 20 hours. The teeth were subsequently processed for histologic data and bacterial staining. The best marginal sealing in both the wedge erosion and the class V cavities was provided by the Herculite/Optibond system and the Valux Plus/Scotchbond Multipurpose system. Bacterial penetration was slightly greater with the Luxat compomer and the Dyrect compomer, as well as with Vitremer glass ionomer cement and Fuji LC glass ionomer cement. The bacterial penetration test showed that the use of restorative material does not entirely eliminate microleakage.     

Microleakage resistance of minimally invasive Class I flowable composite restorations

Minimally invasive flowable composite Class I restorations are widely used. However, flowable composites are characterized by low filler contents, modified resin formulations, low moduli of elasticity, low viscosity, generally poor mechanical properties, and decreased long-term stability. The purpose of this study was to compare the microleakage resistance of a wide variety of flowable composites used with their manufacturers' recommended bonding systems to that of a long-used and widely studied microhybrid composite when placed as minimally invasive occlusal restorations. Molar teeth were prepared in a standardized manner, restored, artificially aged, stained, sectioned, evaluated, and analyzed. Microleakage varied substantially, by a whole order of magnitude, among the material groups tested. The control group, a conventional microhybrid composite material, leaked significantly less than all the flowable composite groups. Microleakage varied very slightly among measurement site locations. Tiny microscopic bubbles were seen within many of the flowable composite specimens, as were a few voids.     

Microleakage of several tooth-colored restorative materials in cervical cavities. A comparative study in vitro

Two standardized V-shaped cavities were prepared at the cementoenamel junction of buccal and lingual surfaces of each of 45 extracted premolars (total 90 cavities). Nine combinations of bonding agents (Bondlite, Cervident, Clearfil, Heliobond, Pyrofil, Scotchbond, Concise) with restorative materials (Command, Ultrafine, Cervident, Silux, Heliosit, Pyrofil, Ketac-fil, Concise) were randomly assigned to the cavities. After thermocycling, dye penetration and sectioning of the teeth, the degree of penetration in the cavity walls was assessed. All combinations showed some degree of leakage. In all cases significantly more leakage was found in gingival (dentin or cementum) walls than in occlusal (enamel) walls. For enamel walls combinations of Bondlite with Command ultrafine and Pyrofil newbond with Pyrofil were superior; for dentin or cementum walls the combination of Clearfil newbond with Silux gave the least leakage.     

Marginal gap repair with flowable resin-based composites

This study was designed to test the hypothesis that the flowable/dentin interface has the weakest bond and highest frequency of failure when a resin-based composite is repaired using a flowable composite. Comparing three specific groups--dentin, flowable composite, and hybrid composite-under the Kruskal-Wallis test showed that the mean bond strength values at the flowable/dentin interface and within the dentin were significantly lower than those at the hybrid/flowable interface and within the flowable resin. Dentin near the pulp chamber yielded consistently lower bond strength values than dentin located at the dentino-enamel junction. Bonding at the flowable resin/dentin interface showed the weakest bond and highest frequency of failure.     

Microleakage in overflared root canals restored with different fiber reinforced dowels

This study evaluated microleakage in overflared root canals restored with four different types of adhesively-luted fiber-reinforced dowels: DT Light Post (LP), Glassix (GL), Ribbond (RB) and StickTech Post (ST). Forty non-carious, single-rooted mandibular human premolars with straight root canals were prepared using a step-back technique and obturated with gutta-percha using lateral condensation. The restored roots were randomly divided into four groups (n=10). The root canals were overprepared, creating an overflared dowel space, and each dowel was adhesively luted using a total-etched adhesive (Single Bond) and dual-polymerizing luting agent (RelyX ARC). All specimens were thermal cycled 1000 times between 5 degrees C and 55 degrees C and stored in 2% methylene-blue solution for one week. The teeth were cut horizontally into three consecutive sections: apical (A), middle (M) and coronal (C). Each section was digitally photographed from the occlusal direction under a stereomicroscope. The images were transferred to a PC and stored in TIFF format. For each image, dye penetration was estimated as the ratio of methylene-blue-infiltrated surface divided by total dentin surfaces. The data were compared and statistically analyzed using the Kruskal-Wallis test (p<.05). The Mann-Whitney U test was used to compute multiple pairwise comparisons to determine differences between the experimental groups (p=.083). Dentin-luting agent fiber-reinforced dowel (FRD) interfaces were evaluated under a scanning electron microscope. Scanning electron microscopy (SEM) showed detachment of the luting resin from the dentin surface in varying degrees in all specimens evaluated. All groups showed considerable leakage at the sections evaluated. Significant differences were demonstrated between LP-RB for the apical and middle sections and between GL-RB, LP-RB and ST-RB for the coronal sections (p<.0083). Among the FRDs evaluated, the individually shaped polyethylene-reinforced dowel (Ribbond) showed the least overall leakage.