Evaluation of microleakage in class-II bulk-fill composite restorations
Alaa Turkistani, Adnan Nasir, Yasser Merdad, Ahmed Jamleh, Ehab Alshouibi, Alireza Sadr, Junji Tagami, Turki A. Bakhsh
Abstract
Despite the clinical appeal of restoring deep class II cavities in single increment using bulk-fill resin composite, sealing of bulk-filled composite restorations is a concern. This study evaluated interfacial adaptation of bulk-fill composite restoration to axial wall and gingival floor of class II cavities using cross-polarization optical coherence tomography (CP-OCT). Box-shaped class II cavities were prepared in extracted molars and divided into three groups (n = 7) according to adhesive used; Clearfil SE Bond 2 (SE2), Tetric-N Bond Self-Etch (TSE) or Tetric-N Bond Universal (TNU). All adhesives were applied in self-etch mode and according to manufacturers' recommendation. Then, preparations were bulk-filled with Filtek Bulk Fill Posterior Restorative resin composite and immersed in a contrast agent. Tomographic images of axial wall and gingival floor of each restoration were obtained by CP-OCT (IVS-300, Santec) with a central wavelength of 1330 nm and were imported to an image analysis software to quantify microleakage. Mann–Whitney U test showed statistically significant difference in microleakage percentage between the groups at both axial wall and gingival floor (p < 0.05). SE2 group had the lowest percentage of microleakage (p < 0.05), as only few cross-sections showed areas of reflections from contrast agent penetrating into axial wall (8.23 ± 6.8) and gingival floor (7.07 ± 4.1), followed by TNU group (18.13 ± 12.9 axially and 30.61 ± 11.9 gingivally). Microleakage was frequently observed at the axial wall and gingival floor of TSE group, showing the highest percentages of 25.50 ± 12.5 and 36.97 ± 10.2, respectively (p < 0.05). All tested groups exhibited different extent of interfacial microleakage, however, two-step self-etch adhesive yielded superior adaptation in comparison to one-step self-etch adhesive and universal adhesive.