Cervical Interfacial Bonding Effectiveness of Class II Bulk Versus Incremental Fill Resin Composite Restorations

2015 ◽  
Vol 40 (6) ◽  
pp. 622-635 ◽  
Author(s):  
F Al-Harbi ◽  
D Kaisarly ◽  
A Michna ◽  
A ArRejaie ◽  
D Bader ◽  
...  

SUMMARY Cervical interfacial bonding quality has been a matter of deep concern. The purpose of this study was to analyze microtensile bond strength (MTBS) and cervical interfacial gap distance (IGD) of bulk-fill vs incremental-fill Class II composite restorations. Box-only Class II cavities were prepared in 91 maxillary premolars (n = 7) with gingival margin placement 1 mm above the cementoenamel junction at one side and 1 mm below it on the other side. Eighty-four maxillary premolars were divided into self-etch and total-etch groups and further subdivided into six restorative material subgroups used incrementally and with an open-sandwich technique: group 1, Tetric Ceram HB (TC) as a control; group 2, Tetric EvoFlow (EF); group 3, SDR Smart Dentin Replacement (SDR); group 4, SonicFill (SF); group 5, Tetric N-Ceram Bulk Fill (TN); and group 6, Tetric EvoCeram Bulk Fill (TE). Groups 2-6 were bulk-fill restoratives. Tetric N-Bond Self-Etch (se) and Tetric N-Bond total-etch (te) adhesive were used in subgroups 1–5, whereas AdheSE (se) and ExciTE F (te) were used in subgroup 6. In an additional group, Filtek P90 Low Shrink Restorative (P90) was used only with its corresponding self-etch bond. The materials were manipulated, light-cured (1600 mW/cm2), artificially aged (thermal and occlusal load-cycling), and sectioned. Two microrods/restoration (n = 14/group) were tested for MTBS at a crosshead-speed of 0.5 mm/min (Instron testing machine). Fracture loads were recorded (Newtons), and MTSBs were calculated (Megapascals). Means were statistically analyzed by the Kruskal-Wallis test, Conover-Inman post hoc analysis for MTBS (multiple comparisons), and Mann-Whitney U test for IGD. The ends of the fractures were examined for failure mode. One microrod/restoration (n = 7/group) was investigated by scanning electron microscopy (×1200) for IGD. MTBS values for SF/te, P90 in enamel, and TC+SDR/te in enamel and cementum were significantly higher compared with those for the control TC/te and TC/se in cementum. Most of the failures were mixed. IGDs were generally smaller at enamel margins, and the smallest IGDs were found in P90 at both enamel and cementum margins. Bulk-fill and silorane-based composites might provide better cervical interfacial quality than incremental-fill restorations.

2016 ◽  
Vol 41 (2) ◽  
pp. 146-156 ◽  
Author(s):  
F Al-Harbi ◽  
D Kaisarly ◽  
D Bader ◽  
M El Gezawi

SUMMARY Bulk-fill composites have been introduced to facilitate the placement of deep direct resin composite restorations. This study aimed at analyzing the cervical marginal integrity of bulk-fill vs incremental and open-sandwich class II resin composite restorations after thermomechanical cycling using replica scanning electron microscopy (SEM) and ranking according to the World Dental Federation (FDI) criteria. Box-only class II cavities were prepared in 91 maxillary premolars with the gingival margin placed 1 mm above and below the cemento-enamel junction. Eighty-four premolars were divided into self-etch and total-etch groups, then subdivided into six restorative subgroups (n=7): 1-Tetric Ceram HB (TC) was used incrementally and in the open-sandwich technique with 2-Tetric EvoFlow (EF) and 3-Smart Dentin Replacement (SD). Bulk-fill restoratives were 4-SonicFill (SF), 5-Tetric N-Ceram Bulk Fill (TN), and 6-Tetric EvoCeram Bulk Fill (TE). In subgroups 1-5, Tetric N-Bond self-etch and Tetric N-Bond total-etch adhesives were used, whereas in subgroup 6, AdheSE self-etch and ExciTE F total etch were used. One more group (n=7) was restored with Filtek P90 Low Shrink Posterior Restorative (P9) only in combination with its self-etch P90 System Adhesive. Materials were manipulated and light cured (20 seconds, 1600 mW/cm2), and restorations were artificially aged by thermo-occlusal load cycling. Polyvinyl-siloxane impressions were taken and poured with epoxy resin. Resin replicas were examined by SEM (200×) for marginal sealing, and percentages of perfect margins were analyzed. Moreover, samples were examined using loupes (3.5×) and explorers and categorized according to the FDI criteria. Results were statistically analyzed (SEM by Kruskal-Wallis test and FDI by chi-square test) without significant differences in either the replica SEM groups (p=0.848) or the FDI criteria groups (p>0.05). The best SEM results at the enamel margin were in TC+EF/total-etch and SF/total-etch and at the cementum margins were in SF/total-etch and TE/self-etch, while the worst were in TC/self-etch at both margins. According to FDI criteria, the best was TE/total-etch at the enamel margin, and the poorest was P9/self-etch at the cementum margin. Groups did not differ significantly, and there was a strong correlation in results between replica SEM and FDI ranking.


2019 ◽  
Vol 10 (4) ◽  
pp. 275-282
Author(s):  
Niusha Golbar ◽  
Shahin Kasraei ◽  
Anahit Afrasiabi ◽  
Elahe Mostajir ◽  
Seyed Masoud Mojahedi

Introduction: Some studies have shown that laser irradiation on unpolymerized adhesives can improve composite-dentin adhesion. The aim of the present study was to evaluate the effect of the diode laser (810 nm) on the microleakage of multi-mode adhesive systems at enamel and dentin margins of composite restorations. Methods: Classic class V boxes were prepared on 48 sound premolar teeth and randomly divided into 6 groups (n=16). In the control groups, Scotchbond Universal (SBC), G-Premio (GBC), and Ambar U (AMC) were used by a self-etch mode. In the test groups (SBL, GBL, ABL), the 810 nm diode laser was irradiated (1 W) for 10 seconds before the polymerization of the adhesive. The boxes were restored by the resin composite. After finishing and polishing, the samples were thermocycled (5°C to 55°C) for 1000 cycles and then immersed in 0.1% methylene blue dye (48 hours). Dye penetration through the gingival and occlusal margins was measured by Stereomicroscope. The data were analyzed at the 5% significance level using Kruskal-Wallis and Mann-Whitney U tests. Results: Significant differences were found between the control and test groups (P<0.05). The occlusal margins of the SBL and GBL groups and the cervical margin of the SBL group exhibited the lowest microleakage (P<0.05). The AM control group showed maximum microleakage at cervical and occlusal margins. Conclusion: The irradiation of the 810 nm diode laser on the unpolymerized universal adhesive systems in a self-etch mode caused a significant reduction in enamel and dentin marginal microleakage of composite restorations.


2015 ◽  
Vol 09 (02) ◽  
pp. 218-223 ◽  
Author(s):  
Ebru Kucukyilmaz ◽  
Bilal Yasa ◽  
Merve Akcay ◽  
Selcuk Savas ◽  
Fevzi Kavrik

ABSTRACT Objective: The aim of this study was to investigate the effect of cavity design and the type of pulp capping materials on the fracture resistance of Class II composite restorations. Materials and Methods: Sixty freshly extracted, sound molar teeth were selected for the study. A dovetail cavity on the mesio-occlusal and a slot cavity on disto-occlusal surfaces of each tooth were prepared, and the teeth were divided 4 groups which one of them as a control group. The pulp capping materials (TheraCal LC, Calcimol LC, Dycal) applied on pulpo-axial wall of each cavity, and the restoration was completed with composite resin. The teeth were subjected to a compressive load in a universal mechanical testing machine. The surfaces of the tooth and restoration were examined under a stereomicroscope. The data were analyzed using factorial analysis of variance and Tukey's test. Results: For pulp capping materials, the highest fracture load (931.15 ± 203.81 N) and the lowest fracture load (832.28 ± 245.75 N) were calculated for Control and Dycal group, respectively. However, there were no statistically significant differences among all groups (P > 0.05). The fracture load of the dovetail groups was significantly higher than those of the slot cavity groups (P < 0.05). Conclusion: Dovetail cavity design shows better fracture resistance in Class II composite restorations, independent of used or not used pulp capping materials.


2013 ◽  
Vol 38 (4) ◽  
pp. 439-446 ◽  
Author(s):  
AA Ali ◽  
HA El Deeb ◽  
O Badran ◽  
EH Mobarak

SUMMARY Objective To evaluate the bond strength durability of a single-step self-etch adhesive to dentin pretreated with either ethanol-based chlorhexidine (ECHX) or water-based chlorhexidine (WCHX) after storage in artificial saliva and under intrapulpal pressure simulation (IPPS). Methods The occlusal enamel of 30 freshly extracted premolars was trimmed to expose midcoronal dentin. Roots were sectioned to expose the pulp chamber. Specimens were distributed over three groups (n=10) according to the dentin pretreatment used. In the first group, Adper Easy One (3M ESPE) was applied to the dentin surfaces according to the manufacturer's instructions (control group). In the second group, dentin was pretreated before bonding with 1 mL of 2% CHX diacetate dissolved in 100% ethanol (ECHX). The third group received the same pretreatment; however, CHX was dissolved in distilled water (WCHX). Pretreatment and bonding were carried out while the specimens were subjected to IPPS. Resin composite (Valux Plus, 3MESPE) buildups were made. After curing, specimens were stored in artificial saliva and under IPPS at 37°C in a specially constructed incubator (n=5/group) either for 24 hours or six months prior to testing. Thereafter, bonded specimens were sectioned into sticks with a cross section of 0.9 ± 0.01 mm2 and subjected to microtensile bond strength (μTBS) testing (n=25/subgroup) using a universal testing machine. Data were statistically analyzed using two-way analysis of variance (ANOVA) with repeated measures, one-way ANOVA , and Bonferroni post hoc tests (p≤0.05). Failure modes were determined using a scanning electron microscope. Results After 24 hours of storage, control and WCHX groups revealed significantly higher μTBS than the ECHX group. After six-month storage in artificial saliva and IPPS, only the WCHX group maintained its μTBS value. The predominant mode of failure was the mixed type, except for the ECHX group, which was mostly adhesive. Conclusion Pretreatment of the dentin with ECHX had a negative effect on bonding of the tested single-step self-etch adhesive; however, WCHX showed bond stability under IPPS.


2020 ◽  
Vol 45 (5) ◽  
pp. E227-E236
Author(s):  
N Scotti ◽  
A Baldi ◽  
EA Vergano ◽  
R Michelotto Tempesta ◽  
M Alovisi ◽  
...  

Clinical Relevance Using a material that optimizes marginal seal when using a margin elevation technique to manage deep class II cavities should enhance clinical outcomes. SUMMARY Objectives: The purpose of this laboratory study was to perform a tridimensional interfacial gap evaluation of class II cavities with enamel and dentin cervical margins, before and after cyclic fatigue, restored with different nanohybrid resin composites. Methods and Materials: Standardized class II cavities were performed on 48 intact maxillary premolars, placing the mesial cervical margin 1 mm above the cement–enamel junction (CEJ) and the distal cervical margin 1 mm below the CEJ. Specimens were treated with two-step self-etch adhesive (Clearfil SE Bond2) and divided into six groups according to the restoration technique. Microcomputed Tomography imaging was executed before and after 1,000,000 cycles of chewing simulation at 50 N. Tridimensional interfacial gaps, expressed as cubic millimeters, were analyzed through a standardized software flowchart (Mimics). Data were analyzed with a two-way analysis of variance and Tukey post hoc tests (α=0.05). Results: Restoration technique (p=0.001) and chewing simulation (p=0.00001) significantly influenced interfacial gap on dentin but not on enamel. The post hoc test showed that, on dentin margins, flowable resins had a lower gap at baseline but a higher gap after chewing simulation, especially when a 2-mm-thick layer was applied, compared with nanohybrid and bulk-fill composites. Conclusions: Based on the obtained results, no differences in interfacial gap volume were found on enamel margins. On dentin margins, flowable resins showed better marginal seal at baseline, but they seem to be more prone to interfacial degradation during chewing simulation than traditional composites.


2014 ◽  
Vol 38 (3) ◽  
pp. 223-228 ◽  
Author(s):  
H C Güngör ◽  
E Canoğlu ◽  
Z C Çehreli

&gt;Purpose: To compare the occlusal and gingival microleakage of Class-II composite restorations utilizing etch-and-rinse and self-etch adhesives and different liner materials in primary and permanent teeth. Study design: Standardized class-II cavities were prepared in freshly-extracted sound primary and permanent molars (n=80/each), with all cavosurface margins involving enamel. The main experimental groups were; A. Single Bond 2/primary teeth; B. Adper SE Plus/primary teeth; C. Single Bond 2/permanent teeth; and D. Adper SE Plus/permanent teeth. Each group comprised 4 subgroups (n=10/each) with respect to the liner material employed (n=10/subgroup): 1. Fuji VII; 2. Fuji Triage; 3. Filtek Supreme XT Flowable Composite, and 4. No liner. All teeth were restored with Filtek Supreme XT Universal Nanofilled Composite. Following thermocycling and immersion in basic fuchsin, the extent of microleakage was measured on crown sections using image analysis. The data were analyzed with Wilcoxon Signed Ranks Test, Mann-Whitney U-Test and Kruskal-Wallis One-Way ANOVA at ?=0.05. Results: In both primary and permanent teeth the use of etch-and-rinse adhesive resulted in similar occlusal and gingival microleakage values (p&gt;0.05). As for the self-etch adhesive, similar results were observed (p&gt;0.05) with the exception of significantly less occlusal leakage in the Fuji Triage VII and Fuji Triage subgroups of primary teeth than those of permanent teeth (pÃ0.05). When the effects of liner material and the type of adhesive were disregarded, significantly more gingival microleakage was observed in primary teeth than in permanent teeth (pÃ0.01), while the occlusal microleakage values were similar (p&gt;0.05). Irrespective of the tooth type and adhesive material, comparison of subgroups containing a liner material with those without one revealed no significant differences for both occlusal and gingival microleakage values (p&gt;0.05). Conclusions: Occlusal microleakage was similar in both primary and permanent teeth, while a lesser extent of gingival seal was observed in primary teeth. Overall, placement of a liner material did not improve resistance to microleakage.


2017 ◽  
Vol 42 (3) ◽  
pp. 273-283 ◽  
Author(s):  
C Shahidi ◽  
I Krejci ◽  
D Dietschi

SUMMARY The present study evaluated the influence of various low-shrinkage restorative systems in class II direct composite restorations following simulated occlusal loading. Forty MOD class II cavities were prepared on freshly extracted human lower third molars with proximal margins located mesially 1.0 mm coronal to and distally 1 mm apical to the cementoenamel junction. The samples were randomly distributed into five experimental groups corresponding to the following restorative systems: a conventional resin composite (Tetric) as active control group, a low-shrinkage composite (Extra Low Shrinkage [ELS]) alone or combined with its corresponding flowable version (ELSflow) used as a 1- to 1.5-mm liner, a bulk-filling flowable composite (Surefil SDR) covered by a 1-mm layer of restorative composite (Ceram-X), and a restorative bulk-filling composite (SonicFill). All specimens were submitted to 1,000,000 cycles with a 100N eccentric load into saline. Tooth restoration margins were analyzed semiquantitatively by scanning electron microscopy before and after loading. The percentage of perfect adaptation to enamel varied from 94.15% (SonicFill) to 100% (ELS) before loading and from 69.22% (SonicFill) to 93.61% (ELS and ELSflow) after loading. Continuous adaptation to cervical dentin varied from 22.9% (Tetric) to 79.48% (SDR/Ceram-X) before loading and from 18.66% (Tetric) to 56.84% (SDR/Ceram-X) after loading. SDR/CeramX and SonicFill showed the best cervical dentin adaptation.


2020 ◽  
Vol 23 (2) ◽  
Author(s):  
Amr Mohsen Mohamed ◽  
Sameh Mahoud Nabih ◽  
Mohamed Ahmed Wakwak

Objective: The purpose of this study was to evaluate the effect of chitosan nanoparticles on microtensile bond strength of resin composite to dentin using self etch adhesive after aging. Material and Methods: A total number of 90 freshly extracted, sound human molar teeth. Flat tooth surface was gained after cut of the occlusal surface. Three main groups according to pretreatment of dentin before adhesive application; 0.2 % chitosan, 2.5 % chitosan and no treatment control group. Universal self etch adhesive were applied according to manufacture instruction and 4 mm of Feltik Z250 xt composite. Storage of specimens for 1 day, 3 months and 6 months in 37O C distilled water. After that, the tooth was sectioned to beams of 1 mm x8 mm sticks for microtensile bond strength test using universal testing machine. Scanning electron microscope (SEM) was used to evalute the effect of chitosan nanoparticles on dentin and smear layer. Kruskal-Wallis test was used to compare between the three groups as well as the three aging periods. Dunn’s test was used for pair-wise comparisons. The significance level was set at P ≤ 0.05. Results: chitosan 0.2% is statistically significant increase in bond strength than chitosan 2.5% and control in one day group. Three months chitosan 0.2 % groups have statistically significant increase in bond strength than chitosan 2.5%. It was found in 6 months that control and chitosan 0.2 % have statistically significant increase in bond strength than chitosan 2.5%. There was statistically significant difference found between the three studied groups regarding bond strength at different storage times . Conclusion: Microtensile bond strength was influenced by different chitosan concentration. Different aging periods had no effect on the microtensile bond strength without application of chitosan and with application of 2.5% chitosan concentration.KEYWORDSChitosan nanoparticles; Microtensile bond strength; MMPs.


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