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The effect of etching on bacterial microleakage of an adhesive composite restoration.

OBJECTIVES: The incidence of bacterial microleakage, pulp inflammation and necrosis associated with dentine etching treatments prior to restoration are not known. Consequently, to resolve some of the controversy surrounding the effects and importance of vital dentine etching, the authors investigated these factors. METHODS: 110 standardised class V cavities were cut into buccal dentine, without exposing the pulp of teeth scheduled for extraction for orthodontic reasons. Cavities were either left unetched, or etched with the non-equivalent treatments of phosphoric acid gel for 60s or Ethylenediaminetetraacetic acid (EDTA) for 30s, prior to placement of composite resin. Teeth were collected and pulp responses were evaluated according to ISO guidelines, using pathohistomorphometric analysis and ANOVA statistics. RESULTS: Etching was found to be correlated to bacterial microleakage (p=0.0001) and tertiary dentine formation (p=0.0023). Bacterial microleakage was correlated to inflammatory activity (p=0.0001). The frequency of bacterial microleakage was: no etching (65%), EDTA (51%) and phosphoric acid (PA) (20%). SIGNIFICANCE: Vital dentine etching treatment is of extreme importance for the placement of RC to minimise bacterial microleakage. PA etching proved to be more effective at preventing bacterial microleakage than non-etching, and etching with EDTA.

Acid Etching, Dental↗

Fluoride release, microbial inhibition and microleakage pattern of two orthodontic band cements.

OBJECTIVES: To compare, in vitro, the fluoride release, microbial inhibition and microleakage pattern of a conventional glass ionomer cement (Ketac-Cem) and an acid-modified composite (Ultra Band-Lok) for band cementation. METHODS: Fluoride release was measured from cement discs (3.0 mm diameter and 1.5 mm thick) at regular intervals over 40 days using a potentiometric method. Microbial inhibition was determined for each cement using an agar diffusion test against one of four different strains of Streptococcus mutans. Thirty pairs of banded third molars (15 banded pairs for each cement) were thermocycled and microleakage determined by a dye penetration method. The depth of microleakage was assessed by an index applied by two examiners independently to photographic records taken of the mid-buccal aspect of each tooth. RESULTS: The cumulative and daily fluoride release for days 5, 15 and 40 were significantly greater for Ketac-Cem than for Ultra Band-Lok (all p < 0.05). After the initial set, the anti-microbial activity was significantly greater for Ketac-Cem than for Ultra Band-Lok over the following 24 h period for all four strains of S. mutans (all p < 0.05). There was no significant difference between the two cement groups for microleakage at the cement/enamel interface (p = 0.66) but a borderline significance was detected for microleakage at the cement/band interface (p = 0.051). CONCLUSIONS: The fluoride release and anti-microbial activity of Ketac-Cem were greater than that of Ultra Band-Lok. There was no significant difference in microleakage between the cements at the cement/enamel interface but a borderline difference existed between the cements at the cement/band interface.

Composite Resins↗

Microleakage of three sealants following conventional, bur, and air-abrasion preparation of pits and fissures.

OBJECTIVES: The aim of this study was to compare the microleakage of a filled sealant with a drying agent (UltraSeal XT plus), a filled sealant (Prismashield) and an unfilled sealant (Delton), after conventional, bur, and air-abrasion tooth preparation techniques. SETTING: The study was completed in a clinical setting at the Simulated Practice Environment Clinic, School of Dentistry, University of Western Ontario, London, Ontario, Canada. SAMPLE AND METHODS: One hundred and eighty extracted teeth were cleaned and divided randomly into three groups. Group 1 was prepared using acid etch only. Group 2 was prepared with a 1/4 round bur in a low-speed handpiece followed by acid etching. Group 3 was prepared with high speed (120PSI) microabrasion using 27 microm alpha-alumina particles in a Midwest Airtouch unit. The teeth in each group were randomly assigned to one of the three subgroups according to the sealant applied. Subgroup A was sealed with a filled sealant with drying agent, B with a filled sealant only, and C with an unfilled sealant. All teeth were stored in artificial saliva for 7 days at 37 degrees C. After this, the teeth were coated with nail varnish 1 mm from the sealant and immersed in 1% methylene blue dye for 48 h at 37 degrees C. Each tooth was sectioned at four locations buccolingually and a total of 665 sections were ranked (0-3) for microleakage. Statistical analysis was completed using the Chi-squared test and Fisher's exact test. RESULTS: UltraSeal XT plus, the filled sealant with drying agent, showed significantly less microleakage than the other two sealants (P < 0.05). Delton, the unfilled sealant, showed significantly less microleakage than Prismashield, the filled sealant (P < 0.05). Air abrasion with acid etch showed significantly less microleakage than either bur with acid etch or acid etch alone. There was however, no significant difference between the bur and acid etch tooth preparations (P < 0.05). CONCLUSIONS: UltraSeal XT plus was the most effective sealant for preventing microleakage in this study. The most successful method of preparation was air abrasion with acid etch.

Acid Etching, Dental↗

Dentin adhesion and microleakage of a resin-based calcium phosphate pulp capping and basing cement.

An experimental resin-based bioactive calcium phosphate cement, intended as a pulp capping and basing material, was evaluated for dentin shear bond strength and microleakage. The interfacial morphology was examined by scanning electron microscopy (SEM). For microleakage, dentin cavities without (Group A) or after (Group B) acid etching were restored with the calcium phosphate cement. A resin-based calcium hydroxide (VLC Dycal; Group C) was used as control material according to the manufacturer's instructions. After water storage and thermocycling, the microleakage was scored using a AgNO(3) staining procedure. For the shear bond strength, flat exposed dentin surfaces were treated as for the microleakage test. Metal irises pressed against the dentin surface were filled with the cements, which were photocured. Both tests were carried out after 1 wk. While acid etching did not result in significantly greater microleakage, it led to higher shear bond strength, and allowed, as shown by SEM, the formation of a hybrid layer and resin tags. Both groups treated with the calcium phosphate cement had significantly lower microleakage scores and higher mean shear bond strength values than the groups treated with the control material.

Acid Etching, Dental↗

Microleakage of IRM used to restore endodontic access preparations.

The effect on microleakage of varying the powder-to-liquid ratio (P/L) of IRM used to restore endodontic access preparations was evaluated. Crowns of noncarious, nonrestored extracted human teeth were used in this study. Microleakage was measured using a fluid filtration technique prior to access preparation to obtain control measurements. After access preparation, IRM restorations were placed using P/L of 2, 3, 4, 5, and 6 g/ml, using the manufacturer's recommended dispensing scoop and dropper, and using 2 P/L in a new capsulated IRM delivery system (IRM CAPS). Microleakage measurements were made after various time intervals and after thermal stress. The results indicated that the lower P/L provided the best seals. All groups demonstrated significant microleakage measurements after thermal stress. Significantly greater microleakage measurements were obtained with the P/L of 6 g/ml and the manufacturer's recommended dispensing scoop and dropper. A P/L of 2 g/ml demonstrated less microleakage than the other groups tested.

Dental Leakage↗

Addition of fresh amalgam to existing amalgam: microleakage study.

The purpose of this in vitro study was to determine whether adhesive lining materials reduce microleakage in amalgam restorations, and to observe the degree of microleakage at the interface between freshly placed (new) and existing (old) amalgam. Forty-eight specimens were used in the experimental groups. The materials used to study microleakage in this investigation were: copal varnish, a dentin bonding agent (Clearfil New Bond), and a 4-META adhesive (Amalgambond). No significant difference in microleakage was found at the interfaces between freshly placed and existing amalgam. Significantly less microleakage was noted in specimens using the 4-META adhesive and the dentin bonding agent as compared to specimens in which no lining material was placed. Significantly less microleakage was noted in specimens using the 4-META adhesive compared to specimens using cavity varnish.

Analysis of Variance↗

Effect of stepped exposure on quantitative in vitro marginal microleakage.

PURPOSE: The aim of this in vitro study was to evaluate the effect of a soft-start curing mode on microleakage MATERIALS AND METHODS: Standardized Class V cavities were prepared within all the margins in the buccal enamel or dentin surface of sound, freshly extracted inferior bovine incisors. Forty preparations were filled with a restorative system (Single Bond and Filtek Z250, 3M ESPE, St. Paul, MN, USA). Ten restorations of each group were made on both types of substrates and polymerized with a conventional curing technique (600 mW/cm2/40 s) or with a soft-start technique (150 mW/cm2/10 s + 600 mW/cm2/30 s). All specimens were thermocycled 3000 times and then immersed in methylene blue 2% for 12 hours. The specimen microleakage was quantitatively determined in a spectrophotometer. RESULTS: The soft-start technique resulted in statistically significant less microleakage for each substrate (p < .05). The conventional groups exhibited 6.1 (dentin) to 15.4% (enamel) more leakage compared with the soft-start groups. When compared with the enamel margins, the dentin margins demonstrated greater microleakage: from 15.5% greater with the conventional light-curing mode to 25.6% greater with the soft-start light-curing mode. CONCLUSIONS: The polymerization technique using a very low initial intensity (150 mW/cm2/10 s) decreased the microleakage of composite resin restorations. CLINICAL SIGNIFICANCE: A soft-start light-curing approach to resin composite polymerization resulted in less microleakage at enamel and dentin margins in Class V cavities compared with resin composite restorations polymerized using a conventional light-curing approach.

Analysis of Variance↗

Effect of LED curing on microleakage and microhardness of Class V resin-based composite restorations.

BACKGROUND: Polymerisation shrinkage is a critical limitation of dental composites and may contribute to microleakage, postoperative pain, tooth fracture, and secondary caries. It has been shown that curing methods play a significant role in polymerisation shrinkage of light-cured dental resins. The purpose of this study was to investigate the effect of a LED curing light on microleakage as well as microhardness of a dental composite. METHOD: For the microleakage test 32 Class V cavities were prepared in human premolars, conditioned with 35% phosphoric acid and treated with the bonding agent Prime & Bond NT. They were then incrementally filled with the composite Esthet-X and randomly divided into two groups of 16 each. The first group was cured by means of a Spectrum 800 set at 500 mW/cm2 for 40 seconds and the second group with the GC E-Light in standard mode. The specimens were thermo-cycled in a 0.5% basic fuchsin solution, sectioned and evaluated for dye penetration. For the microhardness test two groups of 6 specimens each were exposed using either the LED- or the Halogen curing unit. Vickers microhardness tests were performed immediately after curing as well as 24 hours later, on the top, and at the bottom surface. RESULTS: At the dentine/cementum interface, significantly less microleakage (p=0.004) was found when the restorations were cured with the LED-unit. At the enamel interface no significant difference (p=0.340) in microleakage was found between curing methods. Immediately after exposure significantly harder surfaces were found at the top (p<0.001) as well as at the bottom (p<0.001), using the halogen unit (p<0.05). CONCLUSION: Although a reduction in microleakage could be demonstrated exposing the composite restoration to an LED LCU, an effective microhardness ratio was not achieved.

Bicuspid↗

Microleakage in class II composite restorations bonded to dentin using thermal and load cycling.

The effectiveness of a dentin-bonding agent (DBA) and a glass-ionomer cement liner (GIC) in reducing the marginal microleakage at the cervical margin of Class II posterior composite restorations was examined. The effect of load cycling on microleakage of this type of restoration was evaluated. The Class II cavities were prepared in extracted human pre-molar teeth, with the cervical margins finished approximately 1 mm below the CEJ. Combinations of DBA, GIC, and control (no liner) were used as mediators between resin and dentin. All restorations were placed incrementally with a 40-second cure per increment and finished with high-speed diamond burs. Half the samples of each treatment group received cyclical axial loading and half did not. All samples were thermocycled at 5 degrees and 55 degrees C for 500 cycles of one min each, stained (four hr) in 50% AgNO3, and sectioned following stain development. Microleakage was scored linearly along the dentin-restoration interface. All restorations exhibited microleakage which was unaffected by load cycling. Both the DBA and the GIC significantly reduced microleakage independently. When GIC was present, the additional presence of the DBA did not provide a statistically significant additional reduction of microleakage.

Adhesives↗

Influence of cavity dimensions, insertion technique and adhesive system on microleakage of Class V restorations.

BACKGROUND: The authors evaluated the influence of cavity dimensions, insertion technique and adhesive system on microleakage of Class composite restorations. METHODS: The authors prepared cylindrical cavities with enamel margins of 3-millimeter diameter by 1-mm depth or 6-mm diameter by 2-mm depth on the labial surface of bovine incisors. They defined experimental groups (n = 15) according to cavity size, insertion technique (bulk or incremental) and adhesive system applied (Single Bond, 3M ESPE, St. Paul, Minn., or Excite, Ivoclar Vivadent, Amherst, N.Y.). They restored preparations with Tetric Ceram (Ivoclar Vivadent). After 36 hours' storage in distilled water at 37 C, specimens were submitted to microleakage using 50 percent silver nitrate as tracer. Teeth were sectioned twice and dye penetration on the axial wall was determined in millimeters. RESULTS: The authors analyzed the data using analysis of variance/Tukey test (a = .05). For large restorations, the use of Single Bond resulted in higher microleakage than Excite (1.56 +/- standard deviation [SD] 0.26 mm and 0.63 +/- SD 0.56 mm, respectively; P < .001), whereas for small restorations there was no statistical difference between adhesives (Excite: 0.47 +/- SD 0.28 mm; Single Bond: 0.46 +/- SD 0.28 mm). CONCLUSION: The choice of adhesive system influenced microleakage only for large restorations. Incremental insertion of the composite did not affect dye penetration. CLINICAL IMPLICATIONS: Microleakage of composite restorations cannot be predicted only on the basis of the restorations' dimensions. In large restorations, it also depends on the choice of adhesive system, whereas in small restorations, the adhesive used does not seem to be an influential factor. Incremental insertion did not seem to reduce restorations' microleakage.

Acid Etching, Dental↗

Microleakage beneath ceramic and metal brackets bonded with a conventional and an antibacterial adhesive system.

OBJECTIVE: To assess microleakage of a tooth-adhesive-bracket complex when metal or ceramic brackets were bonded with a conventional and an antibacterial self-etching adhesive. MATERIALS AND METHODS: Forty freshly extracted human premolars were randomly assigned to four equal groups and received the following treatments: group 1 = Transbond XT + metal bracket, group 2 = Transbond XT + ceramic bracket, group 3 = Clearfil Protect Bond + ceramic bracket, and group 4 = Clearfil Protect Bond + metal bracket. After photopolymerization, the teeth were kept in distilled water for 1 month and thereafter subjected to thermal cycling (500 cycles). Specimens were further sealed with nail varnish, stained with 0.5% basic fuchsin for 24 hours, sectioned and examined under a stereomicroscope, and scored for marginal microleakage for the adhesive-tooth and bracket-adhesive interfaces from incisal and gingival margins. Statistical analysis was accomplished by Kruskal-Wallis test and Mann-Whitney U-test with Bonferroni correction. RESULTS: All groups demonstrated microleakage between the adhesive-enamel and bracket-adhesive interfaces. A significant difference was observed among all groups (P < .05) for the microleakage between the bracket-adhesive interface. Metal brackets exhibited significantly more microleakage than did ceramic brackets between the bracket-adhesive interface with either of the adhesives. Clearfil Protect Bond exhibited results similar to Transbond XT. Clearfil Protect Bond may be a choice of adhesive in bracket bonding because of its antibacterial activity and similar microleakage results with the orthodontic adhesive. CONCLUSIONS: Metal brackets cause more leakage between an adhesive-bracket interface, which may lead to lower clinical shear bond strength and white-spot lesions.

Bicuspid↗

Microleakage after thermocycling of 4 etch and rinse and 3 self-etch adhesives with and without a flowable composite lining.

This study evaluated the microleakage of composite fillings prepared with 4 etch and rinse and 3 self-etch adhesive systems after thermocycling. Also evaluated was the potential improvement of cavity sealing when utilizing a low charged resin lining for cavity preparations. Seventy recently extracted teeth were randomly allocated to 7 experimental adhesive systems: two 3-step etch and rinse adhesive systems, Scotchbond Multipurpose (SBMP) and Optibond Solo Plus (OS); two 2-step etch and rinse adhesive systems, referred to as "one-bottle," Scotchbond 1 (SB1) and Gluma Comfort Bond + Desensitizer (G); and 3 self-etch "all-in-one" adhesives, Adper Prompt-L-Pop (PLP), Xeno III (X-III) and iBond (iB). On each tooth, 2 rectangular cavities were prepared at the cemento-enamel junction: 1 cavity was prepared with adhesive and the hybrid composite and the second was filled with the same adhesive and a thin layer of flowable composite (Filtek Flow) under the resin composite (Z100). All teeth were thermocycled for 800 cycles (5 degrees C-55 degrees C, 30 seconds dwell time). Leakage was evaluated on a 6-point (0-5) severity scale for enamel and dentin on 4 interfaces for each restoration. The results are expressed as means +/- standard deviation (SD). Microleakage scores were analyzed by means of generalized linear mixed models (GLMM), assuming an ordinal logistic link function. Covariates in the model were: (1) adhesives, (2) fluid composite and (3) interface. The model also accounts for repeated measurements on the various teeth. The authors found that the mean score of microleakage per tooth was significantly higher at the enamel rather than at the dentin interfaces (1.21 +/- 0.51 and 0.87 +/- 0.48; p<0.0001). In this study, there was no significant difference among the 4 etch and rinse adhesive systems. On the other hand, these adhesives yielded smaller mean scores of microleakage than the 3 self-etch systems (respectively, 0.85 +/- 0.2 and 1.3 +/- 0.5; p<0.0001). Among the self-etch adhesives, microleakage was significantly greater for PLP (1.74 +/- 0.46) than for the other self-etch products (p<0.0001), while X-III, an intermediary strong self-etch, was found to be as good as the etch and rinse systems, with a mean score of 0.97 +/- 0.27. In addition, results have also shown that an under layer of flowable composite significantly improved the water tightness of the PLP adhesive restorations (p=0.042). This in vitro study concluded that the self-etch adhesives remain less effective than etch and rinse. Nevertheless, X-III, a self-etch adhesive, showed acceptable performance in accordance with this study's 6-point severity scale of microleakage, but this needs to be confirmed in further clinical studies. On the other hand, this study failed to reveal that the addition of a thin layer of fluid composite improved the water tightness of the restoration, except for PLP.

Acid Etching, Dental↗

Microleakage of indirect composite inlays. An in vitro comparison with the direct technique.

Microleakage occurring around directly and indirectly made class-II composite restorations was evaluated on extracted human premolars. Before the evaluation was made, the teeth were thermocycled and stained with an organic dye. Direct class-II composite restorations demonstrated extensive microleakage at their dentin cavosurface margins. Indirect class-II composite inlays luted with a dual-curing composite cement displayed much less microleakage than restorations made using the direct technique. The use of glass-ionomer cement rather than composite cement as the luting material resulted in more microleakage. Rather than being a true microleakage, the leakage of glass-ionomer cement might be the result of a diffusion of the water-soluble organic dye in the water-based cement. The results suggest that the indirect composite technique is superior to the direct technique when it comes to reducing microleakage.

Acid Etching, Dental↗

Microleakage of bonded amalgam restorations: effect of thermal cycling.

This study examined the effect of thermal cycling on the microleakage of bonded amalgam restorations. Three dental amalgam alloys and a gallium alloy were tested with two adhesive resin systems and copal varnish as a control. Class V cavity preparations were prepared on 168 freshly extracted premolars or molars. The preparations were placed parallel to and 1.0 mm occlusal to the cementoenamel junction (CEJ). Four groups of 42 teeth each were treated with one of the following adhesive dentin systems: Bond-It, All-Bond 2/Resinomer or a copal varnish (Copalite). The four groups of 42 teeth each were then restored with one of three dental amalgams: Orosphere Plus, Indiloy, Oralloy or a Gallium alloy (Galloy), resulting in 12 test groups of 14 teeth each. The specimens were stored in double distilled water at 37 degrees C for 24 hours. Final contouring and polishing of the restorations were performed under water spray. Half of the restorations in each group were thermocycled for 3000 cycles (5 degrees C-37 degrees C-55 degrees C-37 degrees C) with a dwell time of 15 sec at each temperature. The other half were stored in double distilled water at 37 degrees C for 24 hours. Then all 168 restorations were stained with dye, sectioned and scored for microleakage. Results showed that the adhesive dentin systems reduced microleakage in amalgam restorations compared to copal varnish only in non-thermocycled specimens. Statistical analysis of the results showed that there was an extremely significant difference (p < 0.001) in microleakage between the non-thermocycled and the thermocycled specimens in all test groups, whereas, there was no significant difference (p > 0.05) among thermocycled specimens. The reduction of microleakage was not significantly different between Bond-It and All-Bond 2/Resinomer in non-thermocycled specimens. Oralloy showed the most microleakage in the non-thermocycled groups when compared to the other alloys using the same adhesive liner.

Analysis of Variance↗

Evaluation of dental adhesive systems with amalgam and resin composite restorations: comparison of microleakage and bond strength results.

A variety of laboratory tests have been developed to assist in predicting the clinical performance of dental restorative materials. Additionally, more than one methodology is in use for many types of tests performed in vitro. This project assessed and compared results derived from two specific laboratory testing methods, one for bond strength and one for microleakage. Seven multi-purpose dental adhesives were tested with the two methodologies in both amalgam and resin composite restorations. Bond strength was determined with a punch-out method in sections of human molar dentin. Microleakage was analyzed with a digital imaging system (Image-Pro Plus, Version 1.3) to determine the extent of dye penetration in Class V preparations centered at the CEJ on both the buccal and lingual surfaces of human molar teeth. There were 32 treatment groups (n = 10); seven experimental (dental adhesives) and one control (copal varnish, 37% phosphoric acid) followed by restoration with either amalgam or resin composite. Specimens were thermocycled 500 times in 5 degrees and 55 degrees C water with a one-minute dwell time. Bond strength and microleakage values were determined for each group. ANOVA and Student-Newman-Keuls tests demonstrated an interaction between restorative material and adhesive system with a significant difference among adhesives (p < 0.05). Using a multi-purpose adhesive system resulted in both a statistically significant increase in bond strength and a statistically significant decrease in extent of microleakage (p < 0.05). The effect of the adhesive upon both microleakage and bond strength was greater in the resin composite restorations than in the amalgam restorations. Bond strength testing was more discriminating than microleakage evaluation in identifying differences among materials.

Analysis of Variance↗

Effect of air abrasion and resin composite on microleakage of Class V restorations bonded with self-etching primers.

PURPOSE: The purpose of this in vitro study was to determine the effect of air-abrasion pretreatment on microleakage of Class V resin composite restorations bonded with self-etching primers. MATERIALS AND METHODS: A total of 54 Class V cavities prepared either with diamond burs or air abrasion (KCP 1000) was restored with resin composites using adhesive systems with self-etching priming agents (Clearfil Liner Bond 2 or Resulcin AquaPrime + Monobond) and thermocycled 2,500 times. The degree of dye penetration (0.5% methylene blue solution) was scored on an ordinal scale at 25X magnification on longitudinally cut sections of the specimens. Wall adaptation at the tooth-restoration interfaces was evaluated under a SEM using replicas of the sectioned teeth. RESULTS: Severe microleakage occurred at the gingival dentinal margins, and less microleakage was detected at the enamel cavity margins. Nonparametrical statistical analysis (H-test) demonstrated no significant differences in microleakage among the different groups. Comparison of dye penetration data and SEM findings showed that with both self-etching priming agents, microleakage occurred in the absence of gaps. CONCLUSION: Use of air abrasion in combination with self-etching priming agents cannot prevent microleakage at the dentin-resin interface of Class V resin composite restorations.

Air Abrasion, Dental↗

Microleakage of packable composites used in post spaces condensed using different methods.

The aim of this in vitro study was to evaluate the apical and coronal microleakage of a packable composite material compacted by either hand or ultrasonic condensers when placed in post spaces. Forty-two extracted anterior teeth were used. After conventional obturation of the root canals, parallel post spaces 5 mm in depth and 2 mm in diameter were prepared using Gates Glidden and diamond burs. A primer and a dentin bonding agent (Prime & Bond NT) was applied to the etched surface for 30 seconds and light polymerized for 40 seconds. Surefil packable composite resin was inserted in four equal increments and each polymerized for 40 seconds. Half of the specimens were compacted with an ultrasonic tip and the other half with a mechanical hand compactor. After immersion in the dye, the teeth were sectioned longitudinally and dye penetration was evaluated using a stereomicroscope and microleakage recorded in mm. A One-Way Analysis of Variance indicated the two condensing methods were not statistically different (p>0.05). When microleakage was compared within groups, there was also no statistical difference between coronal or apical microleakage (p>0.05). In an in vitro environment, ultrasonic condensers do not offer any advantage over hand condensers. Both the coronal and apical portions of the root had microleakage indicating that regardless of the condensation method and the use of a packable composite, there is still microleakage that could potentially create further clinical problems.

Analysis of Variance↗

Composite restorations: influence of flowable and self-curing resin composite linings on microleakage in vitro.

This in vitro study evaluated the microleakage at enamel (occlusal) and dentin (gingival) margins of MOD resin composite restorations made with different incremental insertion techniques. MOD cavities were prepared on 60 extracted human molars with the proximal margins placed 1 mm below the cemento-enamel junction. All teeth were acid-etched and treated with One-Step adhesive, then restored with a hybrid resin composite (Renew) with and without a flowable composite (AEliteflo) or a self-curing composite (Bisfil 2B) as the first increment in the proximal boxes. The time of placement of the second increment in relation to curing of the first increment was also varied. After polishing, the teeth were soaked in 0.5% basic fuchsin for 24 hours, sectioned and evaluated for dye penetration. None of the restorative techniques prevented microleakage at the enamel and dentin margins. However, microleakage at dentin margins were significantly reduced by the use of a flowable composite as the first increment in the proximal boxes. Time of placement in relation to curing had no influence on microleakage. Microleakage was lower at enamel margins than at dentin margins; however, besides microleakage at the enamel-restoration interface, 37 of the 60 restored teeth (62%) displayed at least one white line in enamel adjacent to the composite restoration.

Barium Compounds↗