Effect of flowable composite lining on microleakage and internal voids in Class II composite restorations

PURPOSE: The aim of this study was to determine the influence of four flowable composite linings on marginal microleakage and internal voids in Class II composite restorations with the margins above the cementoenamel junction (CEJ). MATERIALS AND METHODS: Class II cavities were randomly divided into 8 groups (n = 10). Group 1: One Step Plus/Aelite LS Packable; group 2: One Step Plus/Aelite Flow/Aelite LS Packable; group 3: Comfort Bond/Solitaire 2; group 4: Comfort Bond/Flowline/Solitaire 2; group 5: Solobond M/Grandio; group 6: Solobond M/Grandio Flow/Grandio; group 7: Admira Bond/Admira; Group 8: Admira bond/Admira Flow/Admira. After restoration, all teeth were stored for 24 h, thermocycled (at 5 degrees C to 55 degrees C) 500 times, and soaked in 0.5% basic fuchsin dye for 24 h. After soaking, the teeth were sectioned and observed under a stereomicroscope. Gingival marginal microleakage and internal voids (at the gingival wall interface and in the cervical and the occlusal parts) were recorded. Data were analyzed with the Mann-Whitney U- and Kruskal-Wallis tests (p < 0.05). RESULTS: Statistical analyses indicated that the use of flowable resin composites provided a reduction in microleakage in groups 6 and 8. Groups 2 and 4 showed fewer voids in the cervical area than without flowable composites. CONCLUSION: It was concluded that none of the materials tested was able to eliminate the marginal microleakage on the cervical wall. Flowable resin composites under nanohybrid (group 6) and ormocer (group 8) composites provided a significantly different reduction in microleakage compared to restorations without flowable liners. Fewer cervia voids were observed in packable composites with flowable liner (groups 2 and 4) than without flowable liner (groups 1 and 3s).     

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.     

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.     

Microleakage of different resin composite types.

OBJECTIVE: The purpose of this study was to evaluate the microleakage of Class V cavity preparations restored with three different types of resin composite and an ormocer. METHOD AND MATERIALS: Forty Class V cavities were prepared in buccal and lingual surfaces of 20 recently extracted molar teeth. The occlusal margin of each restoration was on enamel and the gingival margin on dentin. Teeth were randomly assigned to four groups of 5 teeth each and restored as follows: Group I, flowable resin composite (Tetric Flow); Group II, hybrid resin composite (Z100); Group III, packable resin composite (Solitaire 2); Group IV, organically modified ceramics-ormocer (Admira). In all groups, the manufacturers' instructions were strictly followed. All restorative resin composite materials were placed in one increment. All teeth were then immersed in 0.5% basic fuchsin solution for 24 hours after thermocycling (200 cycles; between 4 degrees C to 60 degrees C). The teeth then were longitudinally sectioned and observed under a stereomicroscope. The degree of dye penetration was recorded and analyzed with the Kruskal-Wallis and Mann-Whitney tests. RESULTS: No statistically significant differences in microleakage were observed between groups either on enamel or dentin. CONCLUSION: All restorative materials demonstrated equal effectiveness in reducing microleakage.     

The effect of different types of flowable restorative resins on microleakage of Class V cavities

This study evaluated the microleakage of Class V cavities restored with three different types of flowable resin restorative material and compared the effects of using their respective manufacturer's dentin adhesive or a different brand. Class V cavities with the occlusal margin in enamel and the gingival margin in dentin were prepared on the buccal and lingual surfaces of 48 non-carious human molars. The teeth were randomly assigned to three equal groups of 16. The first eight teeth in each group were restored with one of the flowable restorative materials (Filtek Flow, Dyract Flow, Admira Flow) using the manufacturer's recommended dentin adhesive (Single Bond, Prime & Bond NT, Admira Bond), and the remaining eight molars were restored using a different brand of dentin adhesive (Gluma Comfort Bond). The samples were thermocycled 200 times (5 degrees C-55 degrees C) with a one-minute dwell time. They were then immersed in a 2% basic fuchsin solution for 24 hours, sectioned and analyzed by stereomicroscopy. There was no statistically significant difference at the occlusal margins for either restoration used with its respective dentin adhesive. At the gingival margins, there was a significant difference among all groups. Flowable ormocer (Admira Flow/Admira Bond) displayed the least leakage at the gingival margins. When these flowable restoratives were used with a different brand of dentin adhesive, statistically significant differences were observed both on enamel and dentin. None of the restoratives tested fully prevented leakage at the gingival margins. No significant differences in microleakage were observed among the restorative materials used with respect to the manufacturer's dentin adhesive or a different brand except for Admira Flow restorative at the gingival margins. The gingival margins had significantly more microleakage than the occlusal margins (p < 0.05) except in the Admira Flow group, where microleakage at the occlusal and gingival margins was almost equal.     

Effect of Aging on Coronal Microleakage in Access Cavities through Metal Ceramic Crowns Restored with Resin Composites

Purpose: The purpose of this in vitro study was to determine if packable resin composite with/without flowable resin composite has the ability to prevent coronal leakage in restored endodontic access openings following aging. Materials and Methods: Eighty simulated standardized access cavities of metal‐ceramic crowns were fabricated and fixed on Vitrebond cavities filled with an epoxy resin. The specimens were randomly divided into two main groups: (1) Group A—Access cavities filled with only packable composite (Filtek P60); (2) Group B—Access cavities filled with Filtek P60 and a flowable composite (Filtek Z350) as liner. Each main group was further subdivided randomly into four subgroups according to water storage and thermocycling periods. All specimens were immersed in blue ink solution for 24 hours and then sectioned into quadrants. The extension of blue ink along the metal‐ceramic crown/composite resin interface was measured linearly using image analyzer and then analyzed by three‐way ANOVA and independent t‐test with a Mann‐Whitney test. The level of significance was set at p < 0.05. Results: All tested subgroups demonstrated different levels of microleakage. There was no significant difference related to restorative technique; however, there was a significant difference related to water storage and thermocycling. Conclusions: All tested techniques and materials in this study showed microleakage. Packable composite while a flowable liner showed a marginally better result than packable composite alone. Excessive thermocycling resulted in significant differences among the test groups.     

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.     

In vitro microleakage study of a condensable and flowable composite resin

The aim of this study was to evaluate the in vitro microleakage of a condensable composite resin recommended for Class II restorations with and without a flowable composite resin as a liner. There were statistically significant differences between all groups and between individual groups (p < 0.05). The results showed significantly less microleakage in teeth restored with flowable composite resin underneath a condensable composite resin.     

The effect of flowable resin composites as gingival increments on the microleakage of posterior resin composites

Microleakage has been a major concern in restorative dentistry. The curing contraction of composites still presents a problem with controlling microleakage and postoperative sensitivity. This study investigated the effect of flowable materials on gingival microleakage of microhybrid and packable resin composite restorations. Ninety Class II cavities with cervical margins 1 mm below the CEJ were prepared in 45 extracted human premolars. The teeth were randomly divided into three groups (n=15). In each group, one side of each tooth was restored incrementally with respective composites-SureFil, Filtek P60 and Tetric Ceram; whereas, on the other side, flowable materials-Dyract Flow, Filtek Flow or Tetric Flow-were placed respectively as a 1-mm thick gingival increment before the resin composite restoration. The restored teeth were stored for one week in distilled water at 37 degrees C, thermocycled between 5 degrees C and 55 degrees C and immersed in 0.5% basic fuchsin for 24 hours. Dye penetration was evaluated using a stereomicroscope at 10x magnification. The data were analyzed statistically by Kruskal-Wallis analysis of variance and Mann-Whitney U-tests. The effect of flowable increments on reducing the gingival microleakage was found to be statistically significant for all restorative materials tested (p<0.05).     

The effect of flowable resin composite on microleakage in class V cavities

This in vitro study investigated the microleakage of flowable resin composite as a restorative material and as a liner (either light cured separately or co-cured with hybrid resin composite) in Class V cavities. A light-cured hybrid resin composite was used as a control. Twenty extracted human premolars were prepared with standardized Class V cavity outlines on the buccal and lingual surfaces. The occlusal margin of the cavities was on enamel and the gingival margin was on dentin. One bottle adhesive system (Single Bond) was used after etching enamel and dentin with 34.5% phosphoric acid for 15 seconds. The cavities were randomly divided into four groups of 10 each and restored according to the manufacturers' instructions: Group I-Hybrid resin composite (Z100); Group II-Flowable resin composite (Filtek Flow); Group III-Flowable resin composite (Filtek Flow)+Hybrid resin composite (Z100); light cured separately; Group IV-Flowable resin composite (Filtek Flow)+Hybrid resin composite (Z100); co-cured. The samples were thermocycled 200 times with a 30-second dwell time. They were then immersed in a 0.5% basic fuchsin solution for 24 hours, sectioned and analyzed by stereomicroscopy. The degree of dye penetration was recorded and analyzed with the Kruskal-Wallis and Mann-Whitney U tests. The results of this study indicate that there was no leakage at the occlusal margin for either restoration. Statistically significant differences were found among the groups at the gingival margin. No statistically significant difference was observed between the occlusal and gingival margins except in Group IV. The combination of flowable resin composite and hybrid composite light cured separately yielded the best result in this study. The most leakage was observed when this combination was co-cured. The resistance to microleakage of flowable resin composite as a restorative material is similar to that of hybrid resin composite.     

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.     

The effect of flowable resin composite on microleakage and internal voids in class II composite restorations

This in vitro study evaluated the influence of two flowable resin composites on marginal microleakage and internal voids in Class II composite restorations with the margins below the cementoenamel junction (CEJ). Class II cavities randomly divided into four groups: Group I-Filtek with Filtek Flow lining; Group II-Filtek; Group III-Tetric Ceram with Tetric Flow lining; Group IV-Tetric Ceram. After thermocycling tests (5-60 x 1500) and dye soaking, the teeth were sectioned in a mesiodistal direction along their longitudinal axis. Gingival-marginal microleakage and internal voids in three separate portions of the restoration (interface, cervical and occlusal voids) were observed with a microscope. Statistical analyses indicated that the use of flowable resin composites (Groups I and III) provided a reduction in marginal microleakage and a reduction in some parts of the internal voids or total voids (p<0.05). The condensable material (Filtek) in combination with the flowable liner showed fewer voids (interface, occlusal, total) than the hybrid resin (Tetric) (p<0.05). There was a correlation between the number of internal voids or total voids and the marginal microleakage (p<0.05). It was concluded that a composite lining in a Class II resin composite with margins below the cementoenamel junction may reduce marginal microleakage and voids in the interface and the total number of voids in the restoration.     

Fracture resistance of class II packable composite restorations with and without flowable liners

This study evaluated fracture resistance in class II slot packable composite restorations with and without the use of a flowable composite liner. A conventional microhybrid composite was used as a control. Thirty-six sound, caries-free human mandibulary molar teeth were used. Separate mesio-occlusal and disto-occlusal class II slot cavity preparations were made in each tooth. The prepared teeth were randomly divided into three groups of 12 teeth. Two packable composites (Surefil, Filtek P60) and one microhybrid composite (Filtek Z250) 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 marginal ridges of the restorations were loaded at an angle of 13.5 degrees to the long-axis of the tooth in an Instron Testing Machine until failure. The data were analysed using a one-way anova. There was no significant difference in fracture resistance between composite restorations with and without flowable liners.     

Microleakage of Ormocer-based restorative material in primary teeth: an in vivo study

This in vivo study aimed to compare, by means of dye penetration, the microleakage values of an Ormocer-based material (Admira) and a commonly-used composite resin (Restorative Z-100) and to assess the differences in the degree of microleakage according to the cavity wall location for both tested materials. No statistically significant differences were found in the degree of microleakage between the 2 materials or the location of cavity walls. Additional preventive measures should be considered to minimize leakage since none of the restorative systems used, eliminated microleakage.     

Polymerization shrinkage and microleakage in Class II cavities of various resin composites

This study investigated the polymerization shrinkage of restorative materials and microleakage in the proximal box of Class II restorations. Twenty caries free extracted human molars were prepared on the mesial and distal, making 40 slot cavities. Groups (n=10) were classified as: Group 1: Single bond/Filtek Z-250; Group 2: Single Bond/Filtek Flow/Filtek Z-250; Group 3: Admira Bond/Admira; Group 4: Ariston Liner/Ariston. Dentin bonding systems and resin composites were applied according to the manufacturer's instructions. The specimens were stored in distilled water for one week at 37 degrees C, thermocycled (5 degrees-55 degrees C x 2000), stained with 50% aqueous silver nitrate, immersed in a diluted developer solution (24 hours), rinsed and sectioned in two pieces with a low speed saw (Isomet). Dye penetration (Score 0-4) was determined separately at the occlusal enamel margin and cementoenamel junction. The volumetric polymerization shrinkage of materials was determined with the apparatus of Watts and Cash (Watts Cash, 1991) for 300 seconds. Polymerization shrinkage results were as follows: Filtek Flow (3.5% +/- 0.1) > Admira (2.1% +/- 0.1) = Ariston AT (2.3% +/- 0.1) > Filtek Z-250 (1.8% +/- 0.1) (One-way Anova, post hoc Bonferroni test at p = 0.05 level). No statistical difference was found at the enamel margins for any of the materials (Score 0-1). At the cemento-enamel junction, all test groups showed significantly higher microleakage when compared to the enamel margins (Kruskal-Wallis test, Mann-Whitney U). Dye penetration results at dentin were as follows: Filtek Flow + Filtek Z-250 = Admira < Ariston AT = Filtek Z-250. microleakage than the ion-releasing and hybrid composites lined only with bonding agent at the cementoenamel junction in Class II cavities.     

Comparative study of sealing ability of two root-end-filling materials with and without the use of dentin-bonding agents

The purpose of this study was to examine microleakage of two root-end-filling materials with and without the use of bonding agents. For microleakage measurement a fluid transport model was used. Sixty single-rooted teeth were used in this study. They were prepared with step-back technique and then an apicoectomy was performed. Then the teeth were divided into four groups. Group A were filled with Fuji II LC glass-ionomer cement, group B were filled with Fuji II LC and a new bonding agent, Fuji Bond, group C were filled with Admira composite resin, and group D were filled with Admira and Admira Bond, a new bonding agent. At 24 h, 1 month, and 2 months after filling the leakage along these filling materials was determined under a low pressure of 0.1 atm. At all experimental times, glass-ionomer groups showed significantly less microleakage than resins groups. Between Admira and Admira Bond groups, significantly less leakage was observed in the root sections with Admira Bond at 24 h.     

Cuspal movement and microleakage in premolar teeth restored with posterior filling materials of varying reported volumetric shrinkage values

OBJECTIVES: To investigate the effect of polymerisation shrinkage stress of various aesthetic posterior filling materials on cuspal movement and cervical gingival microleakage of mesio-occlusal-distal (MOD) restorations placed in increments in extracted maxillary premolar teeth. METHODS: Forty sound extracted upper premolar teeth were subjected to standardised preparation of a large MOD cavity. One curing regimen was used and each posterior filling material was placed in eight increments with the appropriate bonding system. A twin channel deflection-measuring gauge allowed a measurement of individual cusp deflections at each stage of polymerisation. Restored teeth were thermocycled before immersion in 0.2% basic fuchsin dye for 24h. After sagittal sectioning of the restored teeth in a mesio-distal plane, the sectioned restorations were examined to assess cervical gingival microleakage. RESULTS: In general, cuspal deflection measurements were dependent upon the constituent monomers and the associated shrinkage on curing, with significantly increased cuspal movement (P<0.05) being recorded for Z100 (20.03+/-2.92 microm) compared with Filtek Z250 (12.34+/-2.18 microm), P60 (13.41+/-4.43 microm) and Admira (11.2+/-2.58 microm). No significant differences were identified between the posterior filling materials when the cervical gingival microleakage scores were examined. CONCLUSIONS: It would appear that a reduction in the manufacturers' reported volumetric polymerisation shrinkage for Z100 (4.0%) to below 3% for Filtek Z250, P60 and Admira, resulted in a significant reduction in the associated cuspal strain on the MOD cavity. The diluent triethyleneglycol dimethacrylate (TEGDMA) increases the polymerisation shrinkage of Z100 resin-based composite due to an increased concentration of carbon-to-carbon double bonds (CC). The replacement of TEGDMA with urethane dimethacrylate (UDMA) and Bis-EMA in Filtek Z250 and P60, decreases the polymerisation shrinkage stress by increasing the cross-linking of polymer networks. However, no group was identified as producing less gingival microleakage at the cervical dentine cavosurface margin when the cavities were sectioned and examined, regardless of the reported variations in cuspal strain and the associated volumetric polymerisation shrinkage values.     

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.     

The effect of fiber placement or flowable resin lining on microleakage in Class II adhesive restorations

PURPOSE: The aim of this in vitro study was to evaluate the effect of two fibers (polyethylene or glass) and a flowable resin liner on microleakage in Class II adhesive restorations. MATERIALS AND METHODS: Class II adhesive cavities were prepared on mesial and distal surfaces of 40 extracted sound human molars. The cavity margins were below or above the CEJ. The teeth were randomly divided into four groups according to the restoration technique: group 1: restored with a resin composite (AP-X, Kuraray) in bulk after SE Bond (Kuraray) treatment; group 2: flowable resin liner (Protect Liner F, Kuraray) was used before composite restoration; in group 3, a polyethylene fiber (Ribbond) and in group 4, a glass fiber (everStick NET, StickTech) was placed into the bed of flowable resin before composite restoration. Samples were finished, stored in distilled water for 7 days at room temperature, and then thermocycled for 300 cycles between 5 degrees C and 55 degrees C. After sealing the apices, the teeth were varnished within 1 mm of the margins and placed in 0.5% basic fuchsin dye for 24 h at 37 degrees C. After rinsing, the teeth were sectioned longitudinally through the restorations and microleakage was evaluated with a stereomicroscope. Marginal penetration was scored on a 0 to 4 scale, and the data were statistically analyzed using Kruskal-Wallis and the Mann-Whitney U-test. RESULTS: Flowable resin, everStick NET, and Ribbond THM used in combination with flowable resin significantly reduced leakage at occlusal margins in cavities with enamel margins (p < 0.05). When the leakage values on cervical dentin margins were evaluated, there was no statistically significant difference among the tested groups (p > 0.05). CONCLUSION: Use of flowable composite alone or in combination with polyethylene or glass fibers reduces occlusal leakage in Class II adhesive cavities with enamel margins.     

Microleakage of Class II packable resin composites lined with flowables: an in vitro study

Flowable resin materials have been suggested as liners beneath packable composites to improve marginal integrity. This investigation evaluated the effect of low-viscosity liners on microleakage in Class II packable composite restorations. Twenty Class II cavities were prepared in extracted third molars for each of four packable composites (Heliomolar HB, Prodigy Condensable, Surefil and Tetric Condense). Ten restorations were placed for each material with their corresponding bonding agent per manufacturer's suggestion; in addition, 10 were placed with the flowable liner recommended by the manufacturer for that material. Samples were finished, stored in distilled water for at least 24 hours and thermocycled for 1,000 cycles between 5 degrees and 55 degrees C with a one-minute dwell time. Apices were sealed with epoxy cement and the teeth were varnished to within 1 mm of the margins. Samples were placed in 0.5% basic fuschin dye for 24 hours, rinsed, embedded in resin and sectioned to produce multiple sections. Microleakage was rated (0-4 ordinal scale) at both the occlusal and cervical margins. Data were analyzed with Kruskal-Wallis ANOVA for main effect and ranked sum analysis for pairwise testing (alpha = 0.05). All materials, either separately or in combination with a flowable liner, had greater leakage scores at the cervical margin compared to the occlusal margin. All packable systems tested did not yield a reduction in microleakage with the use of a flowable liner in vitro; however, the packable system with the flowable compomer used as a liner yielded significantly less overall microleakage compared to the three systems that used a resin composite liner.