Microleakage of nanofilled resin-modified glass-ionomer/silorane- or methacrylate-based composite sandwich Class II restoration: effect of simultaneous bonding.

OBJECTIVES Microleakage of composite restorations at the cervical margin placed apically to the cementoenamel junction (CEJ) is still a concern. This study evaluated the effect of simultaneous bonding application on cervical sealing of nano-ionomer/silorane- or methacrylate-based composite open sandwich Class II restorations in the modified technique compared with that of conventional bonding. METHODS AND MATERIALS In 60 sound maxillary premolars, two standardized Class II cavities were prepared with cervical margins 1 mm below the CEJ. The teeth were randomly divided into six groups of 10 teeth each. In the first three groups (groups 1-3), Clearfil SE Bond and Clearfil APX (Kuraray) were used for restoration in the total bonding technique (group 1), conventional open sandwich technique associated with a nano-ionomer (Ketac N100, 3M ESPE) (group 2), and modified open sandwich technique with simultaneous bonding application for both nano-ionomer and composite (group 3). In the second three groups (groups 4-6), Silorane Adhesive and Filtek Silorane composite (3M ESPE) were used in the same manner as in the first three groups, respectively. RESULTS The simultaneous bonding application in the modified sandwich restorations (with SE Bond or Silorane Adhesive) resulted in a significant reduction of the cervical microleakage compared with that of the conventional bonding (p<0.05). However, microleakage of the modified technique was similar to that of the total bonding (with SE Bond or Silorane Adhesive) (p>0.05), both showing good marginal seal.