Influence of cervical margin relocation on marginal integrity of resin composite restoration after thermo mechanical loading.

Introduction: Internal bleaching is a treatment option for wightening endodontically treated discolored teeth. Cervical resorption is one of the side effects of this method. The aim of this study was to compare the sealing ability of resin composite and light-cured resin modified glass ionomer (RMGI) as intra-orifice barriers in internal bleaching. Materials &Methods: In this study, 34 single-canal anterior teeth were used. All samples were endodontically prepared and divided into two experimental groups (n=12) and two control groups (n=5). In the experimental groups, Gutta-percha was removed up to 3 mm below the cemento enamel junction (CEJ). RMGI and composite resin was placed over gutta-percha in the experimental groups up to the level of CEJ. After 24-hours incubation period, the bleaching agent (a mixture of sodium perborate and 30% hydrogen peroxide) was placed in the access cavities. The gnehcaelg agents were replaced every 3 days over 9 days. Then, the access cavity was filled with 2% methylene blue for 48 hours. All samples were longitudinally sectioned and the dye penetration range was evaluated using stereomicroscope. Data was statistically analyzed by using T-student test and variance analysis. Results: The microleakage in RMGI group was 0.945mm and in composite resin group was 0.641mm. Statistically, no significant difference was observed in microleakage between the experimental groups (p=0.121). Conclusion: Both materials can be applied as the intra-orifice barriers for internal bleaching.

Comparison of the shear bond strength in Giomer and resin-modified glass ionomer in class V lesions

Effect of flowable composite liner and glass ionomer liner on class II gingival marginal adaptation of direct composite restorations with different bonding strategies

Objective: to compare the shear bond strength of resin composite using universal adhesive system containing MDP and resin modified glass ionomer cement to cementum and compare the results with those of cervical dentin. Materials and methods: A total of 12 lower premolars were used in this study, they were sectioned just above the cemento-enamel junction, the roots were then sectioned into two halves and divided into two main groups according to the tooth substrate in which group 1) Cervical dentin and group 2) Cementum. They were further subdivided into two subgroups according to the material used where n= 6 subgroup 1) Resin composite (Brilliant Ever-Glow) using universal adhesive (One coat 7 universal), subgroup 2) Resin modified glass ionomer (Fuji II LC). Shear bond strength was then evaluated for all specimens and statistically analyzed. Results: There was statistically significant difference between resin composite using universal adhesive system and resin modified glass ionomer when applied on cementum. While on comparing the resin composite using universal adhesive system and resin modified glass ionomer on cervical dentin it showed no statistically significant difference. Meanwhile no statistically significant difference was found between cervical dentin and cementum when using resin composite with universal adhesive system. Comparing resin modified glass ionomer on dentin and cementum there was also no statistical difference. Conclusion: using universal adhesive containing MDP with resin composite it showed the same bond strength to cervical dentin and cementum. While the resin modified glass ionomer showed higher bond strength to cementum than that of the universal adhesive system.

Self-etch vs etch-and-rinse adhesives: effect of thermo-mechanical fatigue loading on marginal quality of bonded resin composite restorations

To evaluate the effect of dental bleaching with carbamide peroxide at different exposure times on the microleakage of resin composite and resin-modified glass ionomer restorations after placement in extracted human teeth. 120 Class V cavity preparations were placed at the cementoenamel junction (CEJ) of human teeth. Half of the cavities were restored with Filtek P60 resin composite (C) and the other half were restored with Fuji II LC resin-modified glass ionomer (G). Each group was randomly divided into four subgroups (n=15). Groups C1 and G1 were not bleached and stored in artificial saliva at 37 degrees C to serve as control groups, while in Groups C2 and G2, C3 and G3, and C4 and G4 specimens were exposed to a 15% carbamide peroxide gel for one day, one week, and two weeks, respectively, following the placement of restorations. Microleakage was assessed using the dye penetration method. Data were analyzed using the Kruskal-Wallis and Wilcoxon tests (p=0.05). The Kruskal-Wallis test showed no significant difference among all groups of composite or glass ionomer restorations with either enamel or dentinal margins with regard to microleakage (p>0.05). The Wilcoxon test revealed more marginal leakage in the enamel/glass ionomer margins than the enamel/composite margins (p<0.05). In comparisons within each group, the Wilcoxon test showed there was more microleakage in dentinal margins of composite restorations than in the enamel margins in the test groups (p<0.05). The dentinal margins of the glass ionomer in control groups showed more leakage than the enamel margins, but after the bleaching procedure all experimental groups showed statistically similar microleakage in both the enamel and dentinal margins (p>0.05). Postoperative bleaching with carbamide peroxide could increase microleakage in the dentinal margins of composite and the enamel margins of resin-modified glass ionomer restorations. Rebonding of resin composite restorations should be considered following bleaching with 15% carbamide peroxide in order to reseal the margins. Resin-modified glass ionomer is not suitable as a filling material before bleaching because of its susceptibility to increased microleakage.

This in vitro study evaluated the marginal quality of Lava Ultimate inlays in deep proximal cavities with and without proximal box elevation (PBE) before and after thermomechanical loading (TML). Mesio-occluso-distal cavities with proximal boxes beneath the cementoenamel junction (CEJ) were prepared in 24 human molars. Then, one of the proximal boxes was elevated with Filtek Supreme above the CEJ. The specimens were divided into three groups (n=8). The inlays of group A were adhesively luted to the cavities with Scotchbond Universal and Rely X Ultimate, the inlays of group B with Monobond Plus, Syntac, and Variolink II, and the inlays of group C with Clearfil Ceramic Primer and Panavia SA Cement. Epoxy resin replicas were taken before and after thermomechanical loading (1,200,000cycles, 55°C/5°C, max. load 50N). Marginal integrity at the different interfaces tooth/PBE, tooth/dentine, inlay/PBE, inlay/dentine was evaluated with scanning electron microscopy (×200). The percentage of continuous margin (% of total proximal margin length) was compared between the groups before and after TML. Mann-Whitney U test (p=0.05). No significant differences (p>0.05) before and after TML were found between the three groups for bonding the inlay to dentine or to PBE composite. The marginal integrities of bonding inlays directly to dentine are not different from bonding inlays to a proximal box, which has been elevated by a composite filling material. For deep proximal cavities, the PBE technique could be an alternative technique to conventional methods. Clinical research is needed to confirm.

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.

Objective:The aim of this study was to comparatively investigate the neutralizing effect of antioxidant treatment and delayed bonding after bleaching with hydrogen peroxide on the shear bond strength of a composite resin (CR) and resin-modified glass ionomer (RmGI) to enamel.Materials and Methods:Ninety-six freshly extracted human 3rd molars with flat enamel surfaces were divided into six experimental groups (n=12/group) and two control groups (n=12/group). After initial preparation, specimens in Groups 1 and 5 (control groups) were not bleached and the buccal enamel surface of specimens were bonded immediately with CR and RmGI. The samples of the remaining groups were all bleached six hours a day for seven days consecutively. Immediately after bleaching, groups two and six specimens were bonded with CR and RmGI. Groups 3 and 7 specimens were immersed in distilled water at 37°C for 7 days and the specimens in Groups 4 and 8 were treated with 10% sodium ascorbate as an antioxidant agent after bleaching. Specimens in Groups 3 and 4 were bonded with CR and Groups 7 and 8 specimens were bonded with RmGI immediately. After specimens were bonded, the shear bond strength (SBS) was measured. The SBS data analyses were subjected to one-way analysis of variance (ANOVA) followed by Tukey test for comparison of specific mean values.Results:The mean SBS value in Group 2 (immediately bonded with CR after bleaching) was significantly lower than other CR groups (P=0.045). RmGI did not bond to buccal enamel surface of specimens in group 6. There was no significant difference between other groups bonded with RmGI (P>0.05).Conclusions:Applying 10% sodium ascorbate hydrogel and one week delay before bonding resulted in reversal of reduced bond strength of CR and RmGI to bleached enamel.

Aim: To compare the microleakage of Cention N, a subgroup of composite resins with a resin-modified glass ionomer (RMGI) and a composite resin. Methods: Class V cavities were prepared on the buccal and lingual surfaces of 46 extracted human molars. The teeth were randomly assigned to four groups. Group A: Tetric N-Bond etch-and-rinse adhesive and Tetric N-Ceram nanohybrid composite resin, group B: Cention N without adhesive, group C: Cention N with adhesive, and group D: Fuji II LC RMGI. The teeth were thermocycled between 5°-55°C (×10,000). The teeth were coated with two layers of nail vanish except for 1 mm around the restoration margins, and immersed in 2% methylene blue (37°C, 24 h) before buccolingual sectioning to evaluate dye penetration under a stereomicroscope (×20). The data were analyzed by the Kruskal-Wallis and Wilcoxon tests (α=0.05). Results: Type of material and restoration margin had significant effects on the microleakage (p&lt;0.05). Dentin margins showed a higher leakage score in all groups. Cention N and RMGI groups showed significant differences at the enamel margin (p=0.025, p=0.011), and for the latter group the scores were higher. No significant difference was found at the dentin margins between the materials except between Cention N with adhesive and RMGI (p=0.031). Conclusion: Microleakage was evident in all three restorative materials. Cention N groups showed similar microleakage scores to the composite resin and displayed lower microleakage scores compared with RMGI.

The aim of the present study was to evaluate the effect of four different sandwich techniques on gingival microleakage of Class II direct composite resin restorations. Fifty sound human premolars were selected and randomly divided into five groups (n=10). Class II box only cavities were prepared in one of the proximal surfaces of each tooth with a gingival margin located approximately 0.5 mm below the cemento-enamel junction. Group A (control) was restored incrementally with composite resin (Tetric Ceram). Groups B, C, D, and E were restored with the sandwich technique using a compomer (Compoglass F), flowable composite resin (Tetric Flow), self-cure composite resin (Degufill SC), or resin modified glass ionomer (Fuji II LC), respectively. After thermal-load cycling, the specimens were immersed in 0.5% basic fuschin for 24 hours. Dye penetration (10(-1) mm) was detected using a sectioning technique. Data were analyzed with repeated measurements and Duncan test at α=0.05. The least amount of microleakage was detected in the incremental group (1.28 ± 0.98). The sandwich technique using resin modified glass ionomer (7.99 ± 9.57) or compomer (4.36 ± 1.78) resulted in significantly more leakage than did the sandwich technique using flowable (1.50 ± 1.97) or self-cure composite (2.26 ± 1.52). According to the results of this study, none of the four sandwich technique composite resin restorations used in this study could reduce gingival microleakage to a greater degree than the incremental technique.

Background and Aim: The objective of this review was to assess the clinical efficacy of resin-modified glass ionomers (RMGIs) and composite resins for management of non-carious cervical lesions (NCCLs).Materials and Methods: A systematic search was conducted using the Cochrane Oral Health Group Trials Register, MEDLINE via Ovid, EMBASE via Ovid, and PubMed Health, with no restrictions on language up to 2021.The review included randomized controlled trials (RCTs) with a minimum follow-up period of 12 months, comparing RMGI restorations to composite resin restorations in adult populations with NCCLs.The primary outcomes assessed were retention rate, marginal integrity, and marginal discoloration.The search results were rigorously screened, and relevant trial data were extracted.Additionally, the risk of bias for the included studies was evaluated.The results were presented as risk ratios (RRs) with 95% confidence intervals (CIs), and a meta-analysis was performed using Review Manager 5 (RevMan 5).Results: Of 978 retrieved references, 12 trials (15 articles) were included in this systematic review.Nine trials were split-mouth studies involving 414 RMGI restorations and 454 composite restorations.The remaining three trials were parallel group studies involving 83 RMGI restorations and 131 composite restorations.The meta-analysis showed that RMGI restorations had a significantly lower failure rate (RR: 0.35, 95% CI: 0.23 to 0.52) than composite restorations.However, no significant difference was found between the two materials for marginal integrity and marginal discoloration (P>0.05).Conclusion: RMGI restorations exhibited superior clinical performance regarding the retention rate for NCCLs.

This in vitro study examined the margin integrity of sculptable and flowable bulk-fill resin composites in Class II cavities of primary molars. Standardized Class II cavities were prepared in human primary molars and restored with the following resin composite materials after application of a universal adhesive: a sculptable bulk-fill composite (Tetric EvoCeram Bulk Fill (TEC) or Admira Fusion x-tra (AFX)), a flowable bulk-fill composite (Venus Bulk Fill (VBF) or SDR), or a conventional composite (Filtek Supreme XTE (FS)). The bulk-fill materials were applied in 4 mm layers, while the conventional composite was applied in either 2 mm (FS2, positive control) or 4 mm layers (FS4, negative control). The specimens were exposed to thermo-mechanical loading (TML) in a computer-controlled masticator. A quantitative margin analysis was performed both before and after TML using scanning electron microscopy, and the percentage of continuous margins (margin integrity) was statistically analyzed (α = 0.05). All composites showed a significant decline in margin integrity after TML. AFX exhibited the significantly highest margin integrity of all materials after TML (97.5 ± 2.3%), followed by FS2 (79.2 ± 10.8%), TEC (73.0 ± 9.1%), and FS4 (71.3 ± 14.6%). SDR (43.6 ± 22.3%) and VBF (25.0 ± 8.5%) revealed the lowest margin integrity. In conclusion, the tested sculptable bulk-fill materials show similar or better margin integrity in primary molars than the conventional resin composite placed in 2 mm increments.

This study investigated the release and recharge of fluoride by restorative materials. Resin-modified glass ionomers (RGIs), polyacid-modified composite resins (PMCRs) and resin composite containing fluoride were used for comparison of fluoride release. Non-fluoride-releasing resin composite was used as a control. The amounts of fluoride release from RGIs and PMCRs remarkably increased in the citrate-phosphate acid buffer compared with distilled water. The amounts of fluoride recharged in RGIs increased with the concentration of NaF solution, but those of PMCRs exposed to all concentrations of NaF solutions were less than 1.5 ppm. Neither resin composite containing fluoride and non-fluoride-releasing resin composite gave any evidence of recharge. RGIs and PMCRs affected by acid buffer solution could not recharge much fluoride even if they were immersed in the 1000 ppmF NaF solution. The results suggested that the matrix of RGIs and PMCRs functioned as a reservoir of fluoride, but the functions were lost by acid attack.

Effect of low-elastic modulus liner and base as stress-absorbing layer in composite resin restorations