Microleakage in Composite Resin Restoration- A Review Article.

The most important feature that a material must have is sufficient, long term sealing of the restorative margins. No restorative material developed to date is completely adhesive to the tooth structure. Every restorative material allows some degree of passage of fluids and micronutrients through it. It is termed as Leakage. By definition Micro leakage is “the clinically undetectable passage of bacteria, fluids, molecules or ions between a cavity wall and the restorative material”. It is the flow of a substance into a defect at the interface of restoration and tooth margin. Marginal leakage around restorative margins has been a concern with various clinical conditions. It includes quickening of the breakdown and dissolution of restorative materials. Marginal staining leads to collapse of margins, compromise in aesthetics and with time the need to substitute the restoration. Microleakage depends on several variables like dimensional change of restorative material mainly because of thermal contraction, polymerisation shrinkage, water sorption, mechanical stresses and dimensional changes of tooth. Almost all microleakage studies suggested that the majority of the materials accessible currently leak meaning that they allow penetration of dyes, radioisotopes, or bacteria. Microleakage can be calculated by various in vitro methods with or without thermocycling like staining, SEM, chemical agents, neutron activation analysis, ionization, autoradiography, radioisotope, and reversible radioactive adsorption. Reducing the marginal leakage and enhancing the marginal adaptation involves various factors like choice or combinations of materials, use of cavity liner or base, cavity design or configuration factor changes, acid etching and bonding, technique of restoration placement, direct or indirect techniques, sealing the marginal gaps, and different curing strategies. This article describes in depth the knowledge about various aspects of leakage such as sequelae and causes of microleakage, methods of detection of microleakage in vitro as well as clinically, and the measures taken to reduce or decrease the microleakage when restoring tooth with resin-based restorations.

Utilization of Resin Infiltration for the Minimally Invasive Composite Restoration / 대한소아치과학회지

This study was aimed to assess the new trial for minimal cavity preparation in composite restoration combined with resin infiltration, focusing at application sequence.32 human primary molars with early carious lesions around small cavity were selected and randomly divided into two groups, according to the sequence of cavity preparation (P), composite filling (F) and resin infiltration (I) as IPF and PFI group. Each group was assessed about amount of tooth reduction, features of resin infiltration, and marginal leakage around restoration.Amount of tooth reduction evaluated using micro-CT was decreased compared with the original lesion size in both groups. Features of resin infiltration were verified under confocal laser scanning microscopy. In both groups, infiltrant resin was found on all around the composite and maintained in spite of extent of decalcification even after artificial caries induction. Marginal micro leakage assessed with silver nitrate immersion and micro-CT was found more frequently in PFI group.The technique combining resin infiltration and composite restoration might ensure better adhesion prognosis as applied by the sequence of resin infiltration, cavity preparation, and composite filling. This new trial was thought meaningful in minimizing the cavity size and contributing to minimal invasive dentistry.

In-vitro comparative study of marginal leakage and penetration ability of moisture-tolerant and conventional resin-based pit and fissure sealants with different surface preparations

This in-vitro study aimed to evaluate and compare the marginal leakage and penetration ability of a moisture-tolerant (Embrace WetBondTM) and a conventional (ClinproTM) resin-based sealants under three different enamel surface preparations (acid etched, acid etched and saliva contaminated and bur preparation and acid etched). One hundred and twenty extracted caries free human premolars teeth were cleaned and randomly divided into six groups of equal numbers, according to the type of sealants used and surface preparations. All the sealed teeth were subjected to thermocycling and immersed in a methylene blue dye. Each tooth was then embedded into acrylic resin before it was sectioned into four sections per tooth. Marginal leakage and unfilled surface area (indicating penetration depth of resin) were then measured using an optical 3D measurement device (Alicona Infinite Focus®). Both sealants exhibited comparable proportion of marginal leakage on acid etched only surfaces. Moisture-tolerant sealant showed the least proportion of marginal leakage on bur prepared and etched surfaces. Presence of saliva has detrimental effect on adhesion of both sealants. Nevertheless, depth of penetration of sealant into the fissures is comparable with both sealant types irrespective of the surface preparations.

Evaluation of marginal leakage of bulk fill flowable composite resin filling with different curing time using micro-computed tomography technology

PURPOSE: To evaluate marginal leakage of bulk fill flowable composite resin filling with different curing time by using microcomputed tomography technology. MATERIALS AND METHODS: 30 previously extracted human molars were randomly divided into 6 groups based upon restorative system and different curing time. Class II cavities (vertical slot cavities) were prepared. An individual metallic matrix was used to build up the proximal wall. The SonicFill or SureFil SDR flow was inserted into the preparation by using 1 bulk increment, followed by light polymerization for different curing times. The different exposure times were 20, 40, and 60 seconds. All specimens were submitted to 5,000 thermal cycles for artificial aging. Micro-CT scanning was performed by using SkyScan 1272. One evaluator assessed microleakage of silver nitrated solution at the resin-dentin interface. The 3D image of each leakage around the restoration was reconstructed with CT-Analyser V.1.14.4. The leakage was analyzed with the Mann-Whitney test. RESULTS: Significant differences were observed between the light curing times, but no significant differences were found between the bulk fill composite resins. Increasing in the photoactivation time resulted in greater microleakage in all the experimental groups. Those subjected to 60 seconds of light curing showed higher microleakage means than those exposed for 20 seconds and 40 seconds. CONCLUSION: Increasing the photoactivation time is factor that may increase marginal microlekage of the bulk fill composite resins. Further, micro-CT can nondestructively detect leakage around the resin composite restoration in three dimensions.

In vitro evaluation of marginal leakage at enamel and dentin treated by different laser densities / Avaliação in vitro da infiltração marginal no esmalte e dentina tratada por diferentes densidades de laser

Objectives: To evaluate “in vitro” the degree of marginal leakage in class V cavities irradiated with Nd:YAG laser onto enamel and dentin pretreated with bonding system (Single Bond, 3M ESPE) without light-curing. Material & Methods: Class V cavities were performed and standardized in 60 bovine incisors. After the acid etching, the teeth were divided into three groups: G1 – Application of bonding system, irradiation with Nd:YAG laser at 140 mJ/pulse without light-curing. G2 – Application of bonding system, irradiation with Nd:YAG laser at 200 mJ/pulse without light-curing. Group C – Application of bonding system and light-curing. Next, resin composite restorations were executed and thermocycled at alternated baths from 2 to 50 ºC (± 2 ºC), totalizing 500 cycles. To assess the microleakage, the teeth were submersed into 50% silver nitrate solution for 24 h, cut at 1 mm of thickness and analyzed through stereoscopy. The following leakage criterion scores were employed: 0 – none leakage; 1 – gingival or incisal wall; 2 – axial wall towards the pulp. Results : It was observed a high leakage frequency with score 1 among the experimental conditions. There was a higher predominance of score 2 leakage for control group at cementum. Concerning to enamel and cementum, Group C was similar to G1. By comparing control group with G2, and G1 with G2, it was verified statistically significant differences. Conclusion: The laser energy provided a reduction of the marginal leakage at enamel and dentin/ cementum; however, the energy density increase resulted in smaller marginal leakage at enamel and dentin/cementum.

Objetivo: A presença de infiltração marginal é considerada a principal causa de fracasso clínico para restaurações em resina composta. Devido a isso alternativas para promover melhor vedação das margens foram desenvolvidas, como a utilização da energia do Nd:YAG laser. Portanto o objetivo deste estudo foi avaliar “in vitro” o grau de infiltração marginal em cavidades classe V irradiadas com Nd:YAG laser sobre esmalte e dentina bovinos pré-tratados com sistema adesivo Single Bond (3M ESPE) não-polimerizado. Material e métodos: Cavidades classe V padronizadas foram realizadas em 60 incisivos bovinos. Após realizar o condicionamento ácido, lavagem e secagem os dentes foram aleatoriamente divididos em 3 grupos: G1 – Aplicação do sistema adesivo, irradiação com Nd:YAG laser a 140 mJ/pulso em seguida a fotopolimerização. G2 – Aplicação do sistema adesivo, irradiação do Nd:YAG laser a 200 mJ/ pulso e fotopolimerização. Grupo C (Controle) – Aplicação do sistema adesivo, seguido da fotopolimerização. Restaurações em resina composta foram realizadas e em seguida submetidas a termociclagem em banhos alternados de 2º a 50ºC(±2ºC), totalizando 500 ciclos. Para a avaliação da microinfiltração, os dentes foram submersos em solução de nitrato de prata 50% por 24 h, os dentes foram cortados com 1 mm de espessura e então analisados os níveis de infiltração marginal ocorrida na interface dente-restauração, por meio de de lupa estereoscópica. Os critérios para a análise de infiltração foram: grau 0 – nenhuma infiltração; grau 1 – parede gengival ou incisal; grau 2 – parede axial em direção a polpa. Resultados: Observou-se alta frequência de infiltração marginal grau 1 entre as condições experimentais. Houve predomínio da infiltração grau 2 somente para o grupo controle em cemento. Nos grupos esmalte e cemento, o Grupo C não apresentou diferença estatística entre o G1...

Sellado marginal en restauraciones indirectas, cementadas con dos sistemas adhesivos diferentes / Marginal sealing in indirect restorations, cemented with two different adhesive systems

Propósito: El propósito de esta investigación fue realizar un estudio in vitro del sellado marginal de 80 incrustaciones de resina compuesta cementadas con resina compuesta fluida utilizando un sistema adhesivo autograbante (Go!, SDI, Australia) y un sistema adhesivo con grabado ácido total (Stae, SDI, Australia). Método: Las piezas dentarias restauradas fueron puestas en una estufa a 37ºC y 100 por ciento de humedad relativa durante 48 horas para simular las condiciones bucales. Luego fueron sometidas a termociclado, en una solución de azul de metileno al 1 por ciento. Posteriormente las muestras fueron cortadas en sentido vestíbulo lingual o palatino, para ser observadas bajo un microscopio óptico, para evaluar la interfase diente restauración midiendo los porcentajes de filtración para ambos grupos. Resultados: Los resultados fueron analizados estadísticamente mediante el t-test de Student obteniéndose diferencias significativas entre los dos grupos estudiados. Conclusión: Todos los cuerpos de prueba presentaron algún grado de filtración marginal, sin embargo el grupo que utilizó un sistema adhesivo autograbante demostró tener valores significativamente mayores de filtración que el grupo que utilizó el sistema convencional.

Aim: The purpose of this research was to study the marginal sealing in 80 composite resin inlay, bonded with flow composite resin using a Self-etch fluid (Go!, SDI, Australia) versus a total-etching system (Stae, SDI, Australia). Method: The samples were placed in an oven at 37ºC and 100 percent humidity for 48 hours, after which the samples were thermocycled in a methylene blue 1 percent solution. This cycle was repeated 80 times. The samples were cut transversally, the restorations were observed trough an optical microscope to calculate the percentage of filtration in relation to the total length of the cavity to the axial wall. Results: The results were statistically analyzed by Student t-test. And there were significant differences in the marginal leakage. The group that used a Self-etch adhesive system showed significantly higher marginal leakage values than the group that used the conventional system. Conclusion: All the samples showed some degree of marginal leakage, but the group using a self-etching adhesive system showed marginal leakage values significantly higher than the group using the conventional one.

Quantificação da área de desadaptação marginal de sistemas restauradores estéticos usados em inlays indiretas / Quantification of marginal leakage area of aesthetic restorations systems used in indirect inlays

Introdução e objetivo: A desadaptação marginal em restaurações do tipo inlay é um problema crítico para dentistas, em razão das consequências danosas que sua intensidade pode causar ao dente, ao periodonto e á longevidade da restauração. O objetivo deste trabalho foi avaliar, pelo cálculo da área combinado á maior distância entre a borda cervical da restauração e do preparo, o desajuste marginal cervical de dois sistemas de compósito e um de cerâmica prensada. Material e métodos: Tendo como base um modelo mestre metálico com preparo para inlay MOD, 15 troquéis de gesso tipo IV foram obtidos e distribuídos em três grupos (n = 5): Empress, Sinfony e Z350. Após a confecção das restaurações, cada peça foi posicionada no modelo mestre e fotografada nas faces mesial e distal para, por meio de um programa de análise de imagens, fazer a quantificação da desadaptação marginal cervical. Resultados: Quanto á área de desadaptação marginal cervical, houve diferença (P < 0,05) entre todos os grupos, e o Empress apresentou os maiores valores, seguido pelo Sinfony e pelo Z350. Empress e Sinfony demonstraram, respectivamente, áreas de desadaptação 280% e 110% maiores que Z350. No tocante á maior distância entre as bordas da restauraçõo e as margens do preparo, os grupos Empress e Sinfony foram iguais entre si e estatisticamente diferentes (P < 0,05) do Z350, proporcionando, nesta ordem, desadaptação 215% e 120% maior em relação ao grupo Z350. Conclusão: Tanto para o cálculo da área de desadaptação marginal no terço cervical como para o cálculo da maior distância entre a borda cervical da restauração e do preparo, a desadaptação marginal foi menor no grupo Z350, seguido por Sinfony e Empress. Na análise da desadaptação marginal cervical, todos foram considerados aceitáveis para a prática clínica.

Introduction and objective: Marginal leakage of inlays restorations is a key issue for dentists, because of the damaging consequences that its intensity may cause to the tooth, periodontium, and longevity of restoration. The aim of this study was to assess the cervical marginal leakage of two composite systems and a pressed ceramic, through area calculation associated with the longest distance between the restoration and preparation cervical edges. Material and methods: Based on a metal pattern model with MOD inlay preparation, 15 type IV dental stone casts were obtained and randomly distributed into three groups (n = 5) as follows: Empress Group, Sinfony Group, Z350 Group. After restorations had been made, each one was positioned on the pattern model. Following, their middle and distal faces were photographed in order to analyze marginal cervical leakage through a computer software program. Results: Cervical marginal leakage area: there was statistically significant difference among the three groups (P < 0.05). Empress Group presented the highest values, followed by Sinfony and Z350 groups. Empress and Sinfony groups showed, respectively, a leakage area of 280% and 110% higher than Z350 group. Longest distance between restoration and preparation edges: Statistically significant differences were not observed between Empress and Sinfony groups; however, they showed statistically significant (P < 0.05) differences when compared to Z350 group (215% and 120% greater leakage than Z350 group, respectively). Conclusion: Considering the cervical marginal leakage area calculation and the longest distance between restoration and preparation edges, marginal leakage was smaller in Z350 group followed by Sinfony and Empress groups. In the analysis of cervical marginal leakage, all groups were clinically acceptable.

in vitro evaluation of marginal leakage using invasive and noninvasive technique of light cure glass ionomer and flowable polyacid modified composite resin used as pit and fissure sealant.

Aim: This study compared the microleakage of light cure glass ionomer and flowable compomer as pit and fissure sealant, with and without tooth preparation. Materials and Methods: One hundred premolars that were extracted for orthodontic purpose were used. After adequate storage and surface debridement, the teeth were randomly divided into four groups. In Group I and III, the occlusal surfaces were left intact, while in Group II and Group IV, tooth surfaces were prepared. Teeth in Group I and Group II were sealed with Light cure glass ionomer, whereas flowable compomer was used to seal teeth in Group III and IV. The sealed teeth were then immersed in dye. Subsequently, buccolingual sections were made and each section was examined under stereomicroscope for microleakage followed by scoring. Results: In group I, microleakage score ranged from 2 to 4 with mean of 3.64 (±0.757), while in group II the range was observed to be 1-4 with mean of 2.88 (±1.236). Group III recorded a range of 0-4 with the mean of 2.20 (±1.443) while 0-2 and 0.60 (±0.707) being the range and mean observed, respectively, for group IV. Conclusion: Flowable compomer placed after tooth preparation showed better penetration and less marginal leakage than the light cure glass ionomer.

Comparative evaluation of marginal microleakage in amalgam restorations of permanent and primary teeth a stereomicroscopic study.

Microleakage and lack of adhesion to the tooth structure are shortcomings that have limited dental amalgam’s use in certain clinical conditions. Studies have shown that the use of adhesive resins as liners under amalgam will create greater retention than mechanical undercuts. The objective of this study is to evaluate the sealing ability of a dentin bonding agent when used as a liner around dental amalgam restorations of both the permanent and the primary teeth.

MARGINAL FITNESS AND MARGINAL LEAKAGE OF FIBER-REINFORCED COMPOSITE CROWNS DEPENDING UPON LUTING CEMENTS / 대한치과보철학회지

As Fiber-reinforced composite restorations cannot be made without leaving a marginal gap, luting cements play a pivotal role in sealing the margins as a prevention against margnal leakage. A recently introduced adhesive resin cement system is claimed to adhere chemically, as well as mechanically, to tooth substances, dental alloys and porcelain. But when considering the clinical variation, conventional cementation using Zinc Phosphate and Glass-Ionomer can be requested. A vitro study was undertaken to compare microleakage and marginal fitness of Fiberreinforced composite crowns(Targis/Vectris) depending upon luting cements. Fifty non-carious human premolar teeth were randomly divided into five experimental groups of 10 teeth each and luted with five luting cements.(Bistite II., Super-bond., Variolink II.), Zinc phosphate and Glass- Ionomer cement) After 24 hours of being luted, all specimens were thermocycled 300 times through water bath of 5degrees C and 55degrees C in each bath, then the quality of the marginal fitness was measured by the Digital Microscope and marginal leakage was characterized using Dye Penetration technique and the Digital Microscope The results were as follows : 1. The mean values of marginal fit were Bistite II(46.78micrometer), Variolink II(56.25micrometer), Super-Bond(56.78 micrometer), Glass-Ionomer(99.21micrometer), Zinc Phosphate(109.49micrometer) indicated a statistically significant difference at p<0.001. 2. The mean microleakage values of tooth-cement interface, restoration-cement interface were increased in the order of Variolink II, Bistite II, Super-Bond, Glass-Ionomer, Zinc Phosphate. 3. Crowns luted with resin cement (Bistite II, Super-Bond, Variolink II, etc) exhibited less marginal gap and marginal leakage than those luted with conventional Glass-Ionomer and Zinc Phosphate cement. 4. The results indicated that all five luting systems yielded comparable and acceptable marginal fit.