Dental and Medical Problems

Dent. Med. Probl.
Index Copernicus (ICV) – 109.28, MNiSW – 11
Rejection rate – 43.33%
License – Creative Commons: Attribution 3.0 Unported (CC BY 3.0)
ISSN 1644-387X (print),   ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2018, vol. 55, nr 4, October-December, p. 383–388

doi: 10.17219/dmp/99264

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Gingival microleakage of class II bulk-fill composite resin restorations

Mikroprzeciek dziąsłowy wypełnień klasy II z żywic kompozytowych typu bulk-fill

Haytham Behery1,A,B,C,D,E,F, Omar El-Mowafy1,A,C,D,E,F, Wafa El-Badrawy1,A,E,F, Sameh Nabih2,A,E,F, Belal Saleh2,A,E,F

1 Department of Restorative Dentistry, Faculty of Dentistry, University of Toronto, Canada

2 Department of Operative Dentistry, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt


Background. Bulk-fill composites were developed to simplify composite placement and minimize polymerization shrinkage stresses, which can improve gingival marginal adaptation in deep class II cavities.
Objectives. The objective of this study was to compare the gingival microleakage of class II cavities restored with bulk-fill composites to that of incrementally restored ones with a conventional composite at 2 storage periods.
Material and Methods. Forty freshly extracted intact molars were employed. Two standardized class II slot cavities, 3-millimeter-wide buccolingually, with the gingival floor 0.5 mm below the cementoenamel junction (CEJ) and the axial wall depth of 1.3 mm were prepared in each tooth (80 cavity preparations). The prepared teeth were divided equally into 3 bulk-fill groups (Tetric EvoCeram® Bulk Fill, X-tra Fil® and QuiXX®) and 1 control group (TPH Spectra® HV). Each group was subdivided into 2 equal subgroups (n = 10) according to the storage period in distilled water (24 h and 6 months). The Adper® Single Bond Plus adhesive was used with all the restorative materials. The cavities in the experimental groups were restored with 4-millimeter bulk-fill composites in 1 increment, while the cavities in the control group were restored with 2 increments of the thickness of 2 mm. The polymerization light was applied from the occlusal surfaces. The teeth were then immersed in 2% procion red dye solution, sectioned and examined under a stereomicroscope to determine the extent of dye penetration. The data was statistically analyzed using the Kruskal–Wallis test and the Mann–Whitney U test.
Results. The Kruskal–Wallis test revealed no significant differences in the mean microleakage scores among all the groups after 24-hour and 6-month storage (p = 0.945 and p = 0.928, respectively). The Mann–Whitney U test revealed an increase in the mean microleakage scores in all the groups after 6-month storage; however, the scores were not significantly different from the means obtained after 24 h (p = 0.259 for Tetric EvoCeram Bulk Fill; p = 0.205 for X-tra Fil; p = 0.166 for QuiXX; p = 0.155 for TPH Spectra HV).
Conclusion. Gingival microleakage of bulk-fill composites in class II cavities was not significantly different from that of incrementally restored ones with a conventional composite. The increase in the mean gingival microleakage of the specimens stored for 6 months was not statistically significantly different in comparison to the values obtained after the 24-hour storage period for each composite.

Key words

composite resin, microleakage, bulk-fill, dental restorations

Słowa kluczowe

żywica kompozytowa, mikroprzeciek, bulk-fill, wypełnienia dentystyczne

References (32)

  1. El-Mowafy O, El-Badrawy W, Eltanty A, Abbasi K, Habib N. Gingival microleakage of Class II resin composite restorations with fiber inserts. Oper Dent. 2007;32:298–305.
  2. Uno S, Asmussen E. Marginal adaptation of a restorative resin polymerized at reduced rate. Scand J Dent Res. 1991;99:440–444.
  3. Alomari QD, Reinhardt JW, Boyer DB. Effect of liners on cusp deflection and gap formation in composite restorations. Oper Dent. 2001;26:406–411.
  4. Lee MR, Cho BH, Son HH, Um CM, Lee IB. Influence of cavity dimension and restoration methods on the cusp deflection of premolars in composite restoration. Dent Mater. 2007;23:288–295.
  5. Behery H, El-Mowafy O, El-Badrawy W, Saleh B, Nabih S. Cuspal deflection of premolars restored with bulk-fill composite resins. J Esthet Restor Dent. 2016;28:122–130.
  6. Ilie N, Hickel R. Investigations on a methacrylate-based flowable composite based on the SDR technology. Dent Mater. 2011;27:348–355.
  7. Rothmund L, Reichl FX, Hickel R, et al. Effect of layer thickness on the elution of bulk-fill composite components. Dent Mater. 2017;33:54–62.
  8. Misilli T, Gonulol N. Water sorption and solubility of bulk-fill composites polymerized with a third generation LED LCU. Braz Oral Res. 2017;31:e80.
  9. Leprince JG, Palin WM, Vanacker J, Sabbagh J, Devaux J, Leloup G. Physico-mechanical characteristics of commercially available bulk-fill composites. J Dent. 2014;42:993–1000.
  10. Kim RJ, Kim YJ, Choi NS, Lee IB. Polymerization shrinkage, modulus, and shrinkage stress related to tooth-restoration interfacial debonding in bulk-fill composites. J Dent. 2015;43:430–439.
  11. Schneider LF, Cavalcante LM, Silikas N. Shrinkage stresses generated during resin-composite applications: A review. J Dent Biomech. 2010;2010:131630.
  12. Ahmed W, El-Badrawy W, Kulkarni G, Prakki A, El-Mowafy O. Gingival microleakage of class V composite restorations with fiber inserts. J Contemp Dent Pract. 2013;14:622–628.
  13. Kidd EA. Microleakage: A review. J Dent. 1976;4(5):199–206.
  14. De Munck J, Van Landuyt K, Peumans M, et al. A critical review of the durability of adhesion to tooth tissue: Methods and results. J Dent Res. 2005;84:118–132.
  15. Klein CA, Jr., da Silva D, Reston EG, Borghetti DL, Zimmer R. Effect of at-home and in-office bleaching on marginal microleakage in composite resin restorations using two adhesive systems. J Contemp Dent Pract. 2018;19:248–252.
  16. Eakle WS, Ito RK. Effect of insertion technique on microleakage in mesio-occlusodistal composite resin restorations. Quintessence Int. 1990;21:369–374.
  17. Ciucchi B, Bouillaguet S, Holz J. Proximal adaptation and marginal seal of posterior composite resin restorations placed with direct and indirect techniques. Quintessence Int. 1990;21:663–669.
  18. Ferrari M, Davidson CL. Sealing performance of Scotchbond Multi-Purpose-Z100 in class II restorations. Am J Dent. 1996;9:145–149.
  19. Hilton TJ, Schwartz RS, Ferracane JL. Microleakage of four class II resin composite insertion techniques at intraoral temperature. Quintessence Int. 1997;28:135–144.
  20. Rodrigues LK, Cury JA, Nobre dos Santos M. The effect of gamma radiation on enamel hardness and its resistance to demineralization in vitro. J Oral Sci. 2004;46:215–220.
  21. White JM, Goodis HE, Marshall SJ, Marshall GW. Sterilization of teeth by gamma radiation. J Dent Res. 1994;73:1560–1567.
  22. Sperandio M, Souza JB, Oliveira DT. Effect of gamma radiation on dentin bond strength and morphology. Braz Dent J. 2001;12:205–208.
  23. Tay FR, Gwinnett AJ, Pang KM, Wei SH. Resin permeation into acid-conditioned, moist, and dry dentin: A paradigm using water-free adhesive primers. J Dent Res. 1996;75:1034–1044.
  24. Perdigao J, Van Meerbeek B, Lopes MM, Ambrose WW. The effect of a re-wetting agent on dentin bonding. Dent Mater. 1999;15:282–295.
  25. El-Bouhi YMM. Bond performance and nanoleakage of resin/dentin interface under different intrapulpal pressures. PhD thesis. Cairo University, Egypt, 2009.
  26. Rengo C, Spagnuolo G, Ametrano G, et al. Marginal leakage of bulk fill composites in Class II restorations: A microCT and digital microscope analysis. Int J Adhes Adhes. 2015;60:123–129.
  27. Gwinnett AJ, Yu S. Effect of long-term water storage on dentin bonding. Am J Dent. 1995;8:109–111.
  28. Gale MS, Darvell BW. Thermal cycling procedures for laboratory testing of dental restorations. J Dent. 1999;27:89–99.
  29. Wahab FK, Shaini FJ, Morgano SM. The effect of thermocycling on microleakage of several commercially available composite Class V restorations in vitro. J Prosthet Dent. 2003;90:168–174.
  30. Mahmoud SH, Al-Wakeel Eel S. Marginal adaptation of ormocer-, silorane-, and methacrylate-based composite restorative systems bonded to dentin cavities after water storage. Quintessence Int. 2011;42:e131–e139.
  31. Khosravi K, Mousavinasab SM, Samani MS. Comparison of microleakage in Class II cavities restored with silorane-based and methacrylate-based composite resins using different restorative techniques over time. Dent Res J (Isfahan). 2015;12:150–156.
  32. Crim GA. Effect of aging on microleakage of restorative systems. Am J Dent. 1993;6:192–194.