Microleakage in Class II composite restorations with margins below the CEJ: In vitro evaluation of different restorative techniques

OBJECTIVES The purpose of this in vitro study was to evaluate the microleakage in "deep" Class II composite restorations with gingival cavosurface margin below the CEJ (cemento-enamel junction) and restored with different techniques. STUDY DESIGN Fifty human teeth were used. In each tooth two standardized Class II slot cavities (on mesial and on distal surfaces) were prepared: the buccolingual extension of the cavities was 4 mm; the gingival wall was located in dentin/cementum (2 mm beyond the CEJ). The prepared teeth were randomly assigned to 5 experimental groups (of 10 specimens and 20 cavities each) and restored. Group 1: Filtek TM Supreme XTE Flowable (3MESPE) + Universal Filtek Supreme XTE (3MESPE), Group 2: GrandioSO Heavy Flow (Voco) + GrandioSo (Voco), Group 3: SDR™ (Dentsply Caulk) + Esthet-X® HD (Dentsply Caulk), Group 4: SonicFill (Kerr), Group 5: Grandio (Voco). After thermocycling, the specimens were immersed in a 0.5% basic fuchsine dye solution and incubated at 37°C for 24 hours. The teeth were subsequently sectioned mesiodistally. All specimens were examined at 25 in a stereomicroscope and standardized digital images were obtained. Dye penetration was measured from gingival margins. RESULTS The results demonstrated no significant leakage differences between Group 4 and Group 5, that both showed significantly higher frequency distribution of Score 0. Group 2 and Group 3 showed a significant prevalence of Score 1, whereas Group 1 showed significantly higher frequency of Score 2. CONCLUSIONS None of the restorative techniques tested completely eliminated microleakage dye penetration in dentin margins; marginal adaptation in Class II composite restorations with gingival wall below the CEJ varied in both substrates and from different restorative techniques used.