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Dietschi D, Askari M, Rossier I, Caseiro L, Krejci I, Leprince JG, Di Bella E, Ardu S. Marginal Adaptation of In Vitro Class II Restorations Made Out of Bulk or Conventional Composite Using Single- or Multi-Layered Techniques. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6325. [PMID: 37763602 PMCID: PMC10533156 DOI: 10.3390/ma16186325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
Objective: Testing the influence of various restorative materials (conventional or bulkfill composites) and filling techniques (single- or multi-layered techniques) on the in vitro marginal adaptation of large class II direct composites with supra and sub-gingival margins subjected to thermomechanical loading (TML). Methods: A total of 40 prepared teeth were attributed randomly to five experimental groups. In Group 1, restorations were made of multi-layered high-viscosity conventional composite (Tetric EvoCeram); in Groups 2 and 3, restorations were made of a high viscosity bulkfill composite (Tetric EvoCeram Bulk Fill) applied in one (Group 2) or three layers (Group 3); in Groups 4 and 5, restorations were made of a flowable bulkfill composite (SDR flow) applied in one (Group 4) or two layers (Group 5), covered with a layer of high-viscosity conventional composite (Ceram-X Universal). A single adhesive (OptiBond FL) was used in all groups. All specimens were submitted to a staged TML comprising three phases (2 × 500,000 and 1,000,000 cycles) at 50 N with 3350 thermal cycles (5 to 55 °C) every 500,000 cycles. The tooth-restoration interfaces on proximal surfaces were evaluated quantitatively by scanning electron microscopy, before and after each TML phase, hence at three timepoints (T0, T1, T2 and T3). The following segments were considered for evaluation: proximal, vertical enamel margins (assessed individually on both restoration sides), cervical enamel (restoration side above CEJ) and cervical dentin margin (restoration side below the CEJ). Results: TML induced a significant reduction in continuous adaptation at both enamel and dentin margins in all groups, with percentages of continuous margins ranging from 75.2 to 91.8% at T0, and decreasing to values ranging from 21.3 to 73.9% at T3. Both composite systems and layering protocols had a significant influence on marginal adaptation of the restorations, with statistical associations depending on the restoration group and the timepoint considered. Defective margins in enamel were all of a cohesive nature with micro-fractures, while in dentin, interfacial gaps were the main defect observed. Conclusions/Clinical significance: The present results highlighted significant degradation of marginal adaption after long-term in vitro fatigue test using materials even with high-viscosity conventional resin composites, applied with a proper layering approach in medium-large sub-gingival cavities. While no significant differences were observed at the dentin cervical margins, there was a tendency for better adaptation at the enamel margin when using a higher modulus material with a multi-layered technique.
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Affiliation(s)
- Didier Dietschi
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Mustafa Askari
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Isaline Rossier
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Luciana Caseiro
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Ivo Krejci
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Julian Gregoire Leprince
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
| | - Enrico Di Bella
- Department of Political and International Studies, University of Genoa, 16126 Genoa, Italy;
| | - Stefano Ardu
- Division of Cariology and Endodontology, Section of Dental Medicine, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland; (D.D.); (M.A.); (I.R.); (L.C.); (I.K.); (J.G.L.)
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Dietschi D, Curto FD, Di Bella E, Krejci I, Ardu S. In vitro evaluation of marginal adaptation in medium- and large size direct class II restorations using a bulk-fill or layering technique. J Dent 2021; 115:103828. [PMID: 34678337 DOI: 10.1016/j.jdent.2021.103828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES to test if cavity dimensions and restorative protocol have potential to influence in-vitro adaptation of class II restoration after simulated thermo-occlusal stressing. METHODS A total of 32 prepared teeth were randomly assigned to one of the 4 experimental groups depending on cavity size, composite system and filling technique; group 1: small cavity and multi-layered conventional restorative composite (Tetric Evo-ceram: TEC), group 2: small cavity and flowable bulk-filled composite (SDRFlow: SDR) + one single occlusal layer of conventional restorative composite (TEC), group 3: large cavity and multilayered conventional restorative composite (TEC) and group 4: large cavity and bulk-filled flowable composite (SDR) + one single occlusal layer conventional restorative composite (TEC). All specimens were submitted to 500'000 cycles of thermomechanical loading (50 N, 5 to 55 °C). The proximal tooth-restoration interface was analyzed quantitatively by SEM, prior and after thermomechanical loading. RESULTS Before loading, continuous enamel adaptation varied from 61.49% (Gr 1) to 68.39% (Gr 4) proximally and from 50.93% (Gr2) to 68.65% (Gr1) cervically, with no statistical difference among groups for both segments. After thermomechanical loading, continuous enamel adaptation varied from 36.6% (Gr2) to 46.6% (Gr1) proximally, without significant difference, and from 20.2% (Gr4) to 51.3% (Gr1) cervically; statistical differences in cervical enamel adaptation were found in-between groups 1 and 2 (p = 0.0479), 1 and 4 (P = 0.0116), 2 and 3 (p = 0.0028) and 3 and 4 (p = 0.001). Before loading, dentin continuous adaptation varied from 55.32% (Gr3) to 81.82% (Gr4) with statistical difference in-between those groups (p = 0.045); after loading, dentin continuous adaptation varied from 31.56% (gr2) to 51% (Gr4) with a statistical difference between those 2 groups (p = 0.019). The drop in adaptations values after loading was significant in all groups and segments. CONCLUSIONS The impact of the restorative technique and cavity size on marginal adaptation appeared essentially after simulated fatigue for enamel adaptation. Cervical enamel and dentin continuous adaption of small and large bulk-filled restorations dropped significantly while the change was lower in layered restorations made of conventional restorative composite. CLINICAL SIGNIFICANCE Restorations made with bulk-filled flowable composite behaved differently from layered ones using conventional resin composite, according to cavity size and loading.
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Affiliation(s)
- Didier Dietschi
- Department of Cariology, Endodontology & Pediatric Dentistry, School of Dentistry, University of Geneva, Geneva, Switzerland.
| | - Filipo Del Curto
- Department of Cariology, Endodontology & Pediatric Dentistry, School of Dentistry, University of Geneva, Geneva, Switzerland
| | - Enrico Di Bella
- Department of Political Sciences, University of Genoa, Genoa, Italy
| | - Ivo Krejci
- Department of Cariology, Endodontology & Pediatric Dentistry, School of Dentistry, University of Geneva, Geneva, Switzerland
| | - Stefano Ardu
- Department of Cariology, Endodontology & Pediatric Dentistry, School of Dentistry, University of Geneva, Geneva, Switzerland
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Signore A, Solimei L, Arakelyan MG, Arzukanyan AV, De Angelis N, Amaroli A. Marginal quality of a full-body bulk-fill composite placed with an universal adhesive system in etch-and-rinse and self-etch mode: An in vitrostudy. J Clin Exp Dent 2021; 13:e835-e844. [PMID: 34512924 PMCID: PMC8412802 DOI: 10.4317/jced.58081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/15/2021] [Indexed: 11/27/2022] Open
Abstract
Background Marginal seal of a nanohybrid bulk-fill composite compared to a nanohybrid conventional composite, using a universal adhesive (UA) applied in etch-and-rinse (ER) and self-etch (SE) mode was investigated.
Material and Methods Thirty-six intact molars were selected and two standardized cavities in each tooth were prepared and allocated into four groups according to restorative material and etching strategy. All samples were placed in a 1% methylene blue solution for 24 h, then cut in the middle of the restorations obtaining two parts (n=144) and used for microscopic evaluation (50x) for dye penetration measurements.
Results The data were analysed by ANOVA and Tukey post-hoc test (p<0.05). Marginal seal was influenced by adhesive strategy (p<0.05) but not from the composite used (p>0.05).
Conclusions Simplified restorations with nanohybrid bulk-fill composite showed comparable marginal leakage to incrementally placed nanohybrid composite. The UA used with a ER technique resulted in better marginal seal irrespective of the restorative material used. Key words:Bulk-fill composite, universal adhesive, self-etching, etch-and-rinse, marginal seal.
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Affiliation(s)
- Antonio Signore
- Department of Therapeutic Dentistry, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.,Department of Surgical and Diagnostic Sciences (D.I.S.C.), University of Genoa, Genoa, Italy
| | - Luca Solimei
- Department of Surgical and Diagnostic Sciences (D.I.S.C.), University of Genoa, Genoa, Italy
| | - Marianna-Georgievna Arakelyan
- Department of Therapeutic Dentistry, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Alina-Vladimirova Arzukanyan
- Department of Therapeutic Dentistry, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Nicola De Angelis
- Department of Surgical and Diagnostic Sciences (D.I.S.C.), University of Genoa, Genoa, Italy
| | - Andrea Amaroli
- Department of Therapeutic Dentistry, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.,Department of Orthopaedic Dentistry.Institute of Dentistry, I.M. Sechenov First. Moscow State Medical University. Trubetskaya str., 8, b. 2, 119992. Moscow, Russian Federation
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Shahidi C, Krejci I, Dietschi D. In Vitro Evaluation of Marginal Adaptation of Direct Class II Composite Restorations Made of Different “Low-Shrinkage” Systems. Oper Dent 2017; 42:273-283. [DOI: 10.2341/15-217-l] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
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.
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Affiliation(s)
- C Shahidi
- Cyrus Shahidi, DMD, DDS, MAS, School of Dentistry, University of Geneva, Division of Cariology & Endodontics & Pediatric Dentistry, Geneva, Switzerland
| | - I Krejci
- Ivo Krejci, DMD, privat-docent, School of Dentistry, University of Geneva, Division of Cariology & Endodontics & Pediatric Dentistry, Geneva, Switzerland
| | - D Dietschi
- Didier Dietschi, DMD, PhD, privat-docent, School of Dentistry, University of Geneva, Division of Cariology & Endodontics & Pediatric Dentistry, Geneva, Switzerland, and Department for the Practice of General Dentistry, Case Western University, Cleveland, OH, USA
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Sabbagh J, McConnell R, McConnell MC. Posterior composites: Update on cavities and filling techniques. J Dent 2017; 57:86-90. [DOI: 10.1016/j.jdent.2016.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 11/02/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022] Open
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Jokstad A. Secondary caries and microleakage. Dent Mater 2016; 32:11-25. [DOI: 10.1016/j.dental.2015.09.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 08/24/2015] [Accepted: 09/04/2015] [Indexed: 10/23/2022]
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El-Damanhoury HM, Gaintantzopoulou M. Effect of Thermocycling, Degree of Conversion, and Cavity Configuration on the Bonding Effectiveness of All-in-One Adhesives. Oper Dent 2015; 40:480-91. [DOI: 10.2341/14-185-lr1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The aim of this study was to compare five all-in-one bonding agents with respect to microleakage, microtensile bond strength (μTBS), degree of conversion (DC) and the impact of cavity configuration. The materials tested were Adper Easy Bond, Clearfil S3 Bond, iBond, Optibond All-in-One, Xeno IV, and Adper Single Bond Plus as a control. The DC of each adhesive was measured on the surfaces of dentin discs (n=5) by attenuated total reflectance Fourier transform infrared spectroscopy. One hundred and forty-four extracted human molars were randomly divided and assigned to one of the five tested adhesives and the control group. The μTBS to dentin was measured on flat occlusal dentin with and without thermocycling and to the gingival floor dentin of class II cavities (n=8). All specimens were restored with Filtek Z250 resin composite. Class II samples were immersed in a 5% methylene blue dye solution for 24 hours, and microleakage was examined under a stereomicroscope. Micromorphological analysis of demineralized/deproteinized specimens was done using scanning electron microscopy. The DC and microleakage data were statistically analyzed by one-way analysis of variance (ANOVA) and μTBS data by two-way ANOVA followed by a Bonferroni multiple comparison post hoc test (α=0.05) and Weibull-distribution survival analysis. The relation between different variables and μTBS and microleakage was tested by the Pearson correlation coefficient and regression statistics. A moderate direct relation between DC and μTBS durability was found for all the adhesives tested. Significant wide variations exist among the results obtained for single-bottle adhesives tested regarding their μTBS and microleakage. Some of the all-in-one materials tested have shown significantly inferior results under a high C-factor or after aging. The use of these materials should be carefully considered.
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Affiliation(s)
- HM El-Damanhoury
- Hatem M El-Damanhoury, BDS, MS, PhD, assistant professor, Department of General and Specialist Dental Practice, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates, and Department of Operative Dentistry, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
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Sandoval MJ, Rocca GT, Krejci I, Mandikos M, Dietschi D. In vitro evaluation of marginal and internal adaptation of class II CAD/CAM ceramic restorations with different resinous bases and interface treatments. Clin Oral Investig 2015; 19:2167-77. [DOI: 10.1007/s00784-015-1449-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 03/11/2015] [Indexed: 12/01/2022]
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