Influence of flowable liner and margin location on microleakage of conventional and packable class II resin composites

This in vitro study evaluated gingival wall microleakage in packable and microhybrid conventional composite restorations with and without a flowable composite liner. Each group was evaluated with gingival margins situated in both enamel and cementum/dentin. Two hundred and forty Class II cavities were prepared in extracted third molars, half with gingival margins in enamel and half with margins in dentin/cementum. In groups of 30, restoration was undertaken with packable alone (3M Filtek P60), conventional alone (3M Z250), packable plus flowable liner (3M Filtek Flow) and conventional plus flowable liner. All used 37% phosphoric acid etch and Scotchbond 1 (3M) as the bonding system. After restoration, the teeth were thermocycled (between 5 degrees C, 37 degrees C and 60 degrees C) 1,500 times, soaked in 0.1% methylene blue, sectioned and microleakage from the gingival margin scored. Statistical analysis was performed using Kruskal Wallis and Mann-Whitney U tests. There was no significant difference between systems in terms of leakage scores when gingival margins were situated in enamel (p=0.70). All restorations with margins in cementum/dentin leaked significantly more than those with margins in enamel (p<0.001). There was no significant difference between leakage scores of 3M Z250 and Filtek P60 with cementum/dentin gingival margins (p=0.68). Use of a flowable composite liner (3M Filtek Flow) against cementum/dentin was associated with increased microleakage (p<0.001). In this study, leakage scores suggest that gingival margins should be placed in enamel. The conventional and packable resin composites tested were not associated with differences in microleakage. Leakage data do not support the use of flowable resin composite linings in Class II resin composite restorations.