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ORIGINAL ARTICLE
Year : 2006  |  Volume : 24  |  Issue : 1  |  Page : 15-18
 

Microleakage of restorative materials: An in vitro study


Department of Pedodontics and Preventive Dentistry, K.L.E.S.'s Institute of Dental Sciences, Belgaum, Karnataka, India

Correspondence Address:
Shobha Deshpande
Department of Pedodontics and Preventive Dentistry, D. Y. Patil Dental College and Hospital, Nerul, Navi Mumbai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.22828

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  Abstract 

The present study was conducted with the aim of evaluating and comparing the microleakage of glass ionomer, composite resin and compomers. Class V cavities were made in thirty intact caries free premolars and restored with restorative materials to be tested respectively. The teeth were thermocycled and subjected to silver nitrate dye penetration. They were subsequently sectioned buccolingually. Microleakage was evaluated under a stereomicroscope and data subjected to statistical analysis. The study concluded that microleakage was evident in all restorative materials, with glass ionomer showing maximum leakage followed by composite resin. Compomer demonstrated the best results with minimum leakage.


Keywords: Compomer, Composite resin, Glass ionomer, Microleakage


How to cite this article:
Mali P, Deshpande S, Singh A. Microleakage of restorative materials: An in vitro study. J Indian Soc Pedod Prev Dent 2006;24:15-8

How to cite this URL:
Mali P, Deshpande S, Singh A. Microleakage of restorative materials: An in vitro study. J Indian Soc Pedod Prev Dent [serial online] 2006 [cited 2018 Jul 22];24:15-8. Available from: http://www.jisppd.com/text.asp?2006/24/1/15/22828


There has always been a keen interest in the adaptation of dental restorative materials to the walls of the cavity and the retentive ability of a material to seal the cavity against ingress of oral fluids and microorganisms. Microleakage around dental restorative materials is a major problem in clinical dentistry. It may be defined as the clinically undetectable passage of bacteria, fluids, molecules or ions between a cavity wall and the restorative materials applied to it.[1] This seepage can cause hypersensitivity of restored teeth, tooth discoloration, recurrent caries, pulpal injury and accelerated deterioration of some restorative materials.

Over the past fifty years, many changes have occurred in development and availability of restorative materials for children. Fluoride releasing and chemical bonding properties of glass ionomer cements are well known. However, poor physical properties such as tendency to undergo surface crazing, low fracture resistance, and esthetics limit its use. Composites on the other hand possess excellent physical and mechanical properties such as compressive, flexural and tensile strength as well as esthetics. The only disadvantage with composite is that several clinical steps are required to obtain a good interfacial bond. Because of perceived inadequacies in the ease of use of composites inspite of their excellent physical properties, compomers were introduced in 1992. Compomers contain 20% glass ionomer cement combined with 20% visible light polymersied resin component. Acid etching is optional. Their excellent physical properties along with fluoride releasing ability, minimal steps in placement and composite like esthetics make them the strongest and most esthetically desirable material.

Most restorative materials show varying degrees of marginal leakage because of dimensional changes and lack of adaptability to cavity walls. The relationship between marginal leakage in restorations and type of restorative materials used has been extensively studied both in clinical and laboratory experiments. In the absence of definitive clinical data, laboratory microleakage studies are a well accepted method of screening adhesive restorative materials for marginal seal. Microleakage investigation of compomers and their comparison with other materials have compared only a limited number of products but in general have shown adequately sealed restoration margins.

The purpose of this in vitro study, therefore, was to compare the sealing ability of glass ionomer cement (Fuji2), composite resin (Z100) and glass ionomer resin cement (Compomer F2000) in standard Class V cavities using 50% silver nitrate dye.


  Materials and Methods Top


Thirty caries free premolars extracted for orthodontic purposes were selected for the study to evaluate the microleakage. The teeth were examined by transillumination to exclude teeth exhibiting enamel fractures as these might allow dye penetration. The teeth were thoroughly cleaned and stored in distilled water with few thymol crystals added to it. Standard Class V cavities were prepared with an ISO size (No.014) inverted cone and straight fissure (No.010) bur 1.5 mm oclusally from the cemento-enamel junction. The bur was changed after every five specimens. Cavity size was standardized to a size of 3x2x2 mm dimensions. All preparations were carried out with high speed air rotar with water spray coolant by the same operator. Following cavity preparation, specimens were randomly divided into three experimental groups (n=10) and were filled according to manufacturers instructions.

Group A: Fuji 2, G C Corporation, Tokyo, Japan

Group B: Z100, 3M Dental Products, St.Paul. U.S.A.

Group C: F2000, 3M Dental Products, St.Paul, U.S.A.

The specimens were stored in distilled water for twenty four hours. After this the teeth were subjected to thermocycling. Temperatures used were 12°C + 2 and 60°C + 2. The time used for the alternate immersion of specimens in hot and cold solutions was one minute. The restorations were subjected to 1500 cycles. Two coats of nail polish were applied to all tooth surfaces except for 1mm around the restoration. The apices were sealed with sticky wax. The teeth were subjected to a dye solution of 50% silver nitrate (Ranbaxy Ind. Ltd.) in small, dark closed bottles for 4 hours and kept away from light. After this the teeth were then immersed in a photographic film developing solution (D76, Kodak Ind. Ltd.) for 4 hours under 200 watt bulb. The light source was as close as possible to the specimens. After dye exposure, the teeth were cleaned under running tap water for 5 minutes and the nail polish was removed with scalpel. Teeth were then sectioned buccolingually with the section dividing the restoration at its midpoint mesiodistally creating two test specimens with exposure of the tooth interface from the cavosurface margin to the pulpal wall. The specimens were observed under stereomicroscope with a magnification of 10x and the degree of marginal leakage was determined by the criteria described by Khera and Chan[12] as follows

0º=No leakage

1º=Less than and upto one half of the depth of the cavity preparation was penetrated by the dye

2º=More than one half of the depth of the cavity preparation was penetrated by the dye but not upto the junction of the axial and occlusal or cervical wall.

3º=Dye penetration was upto the junction of the axial and occlusal or cervical wall but did not include the axial wall.

4º=Dye penetration included the axial wall

Dye penetration was evaluated by a single observer. Data was subjected to statistical analysis to compare the microleakage around Fuji2, Z100 and F2000. For each group the values of mean and standard deviation were calculated. To find whether the microleakage in the three groups is homogenous, analysis of variance was conducted. To find between which two groups there was significant difference in the leakage, unpaired 't' test was conducted.


  Results Top


Within Group A the values of degree of microleakage ranged incisally between 1 to 4. Smilar observations were found for gingival wall with more number of samples showing 4th degree of microleakage [Table - 1].

Group B illustrated 0 degree or no microleakage for three samples at the incisal margin. Rest of the samples showed mild marginal leakage of 1 degree. Within the same group gingival margin showed 2 degree of microleakage for the samples.

Group C showed 1 degree of microleakage incisally in all the ten samples. Gingivally it showed 1 degree of microleakage with almost all samples except in two samples it depicted 2 degrees and 4 degrees of microleakage [Table - 2].

Fuji2 has the highest microleakage with a mean of 2.9 and standard deviation 1.4491 followed by Z100 with a mean of 2.4 and standard deviation 0.8433. F2000 showed the least microleakage with a mean of 1.4 and standard deviation 0.9661 [Table - 3]

Analysis of variance test showed that the leakage was not homogenous amongst the three groups [Table - 4].

The results of 't' test showed that there is a significant difference in microleakage between Z100 and F2000 ( P <0.05) and Fuji2 and F2000 ( P <0.05). Fuji2 and Z100 showed no significant difference in the microleakage between them [Table - 5].


  Discussion Top


There is a constant search for the material and technique that ensures adhesion to the tooth structure in order to minimize the leakage potential. Microleakage is used as a measure by which clinicians and researchers can predict the performance of a restorative material. The present study was designed to evaluate the sealing properties of Glass ionomer cement (Fuji2, Group A). Composite (Z100, Group B) and Glass ionomer resin cement (F2000, Group C) and was based on the primise that no available restorative material is perfectly adaptable to the tooth structure.

Standardised Class five cavities to a size of 3x2x 2mm were prepared with high speed air rotar and water spray coolant. In the present study no attempt was made to correlate the results with instrumentation. It is possible that some observed variations in the individual experimental groups may have resulted from differences in the texture of cut surface.[3] They were restored with the various experimental materials used in the study according to the manufacturers instructions. After restoration, the teeth were subjected to thermocycling. Thermocycling is the invitro process of subjecting the restoration on the tooth to temperature extremes compatible with the oral cavity. This stimulates introduction of hot and cold extremes in the oral cavity and shows the relationship between coefficient of thermal expansion between the tooth and restorative material.[4] The silver nitrate technique of detecting the microleakage is an acceptable technique of studying microleakage.[5],[6] The silver ion is extremely small 0.059 nm when compared to a typical bacterium which is 0.5-0.1 µm.Therefore, it is more penetrative and hence a severe test of a material to prevent its ingress through microcrevices. In this study fifty percent silver nitrate was used to immerse the invitro model which later was reacted with photographic developing solution.

After the teeth were sectioned they were observed for leakage under stereomicroscope at 10x magnification [Figure - 1][Figure - 2][Figure - 3]. Upon examining the samples under stereomicroscope, the restoration exhibiting the least leakage at the gingival margin was F2000.[6],[7],[8] This observation may be due to the product being made up of carboxylated methacrylate resin and fluoroalluminosilicate glass filler. As with popular dental composite, the current compomers also set by light initiated polymerization and are one part paste packaged primarily in capsules. Its composition is such that it contains both adhesive and primer in a single component and hence, it is considered to have good handling characteristics.

Maximum leakage was observed for Fuji2 (mean 2.9, standard deviation 1.6691) being attributed to the inherent nature of the material itself. Stereomicroscope photographs have shown the texture of Fuji2 as granulated with many cracks and air voids.[9] The cohesive strength of glass ionomer cement is found to be lower than adhesive strength. The porous nature of the material may be an important factor that enhances potential for microleakage. Though removal of smear layer was considered while using Fuji2 the results from this study showed that it did not decrease the microleakage.[6],[10],[11] However, Welsh Edward, Bullard Harrell in their study found that glass ionomer cement showed minimum leakage.[12],[13]

Composite (Z100) showed moderate leakage (mean 2.4, standard deviation 0.8433). Stereomicroscope photographs showed that the leakage does not extend upto the axial wall but stops where the glass ionomer liner is placed. Light cure glass ionomer liner beneath composite may have reduced the leakage of composite[14] especially at gingival aspect. However,[15] found no difference in the microleakage when liner was not used. Microfilled composites show moderate leakage because of the particle size which improves the flow of the material due to improved viscosity and hence better adaptability.[16] Also the water sorption of these materials is greater which compensates for polymerisation shrinkage[17] which is attributed to less filler content. Visible light curing systems and the use of bonding agents have greatly reduced the toxicity level of resin composite restorations in terms of pulpal responses.

1) Fuji2 showed maximum leakage (mean 2.9, standard deviation 1.4491) with leakage extending to the axial wall.

2) Z100 showed minimum leakage at the incisal wall whereas it showed moderate leakage at the gingival wall (mean 2.4, standard deviation 0.8433).

3) F2000 showed the best results with minimum leakage extending just beyond the enamel dentin junction (mean 1.4, standard deviation 0.9661).

4) There is a significant difference in microleakage between Z100 and F2000 ( P <0.05) and Fuji2 and F2000 ( P <0.05). Fuji2 and Z100 showed no significant difference in the microleakage between them.

 
  References Top

1.Kidd Edwina AM. Microleakage in relation to amalgam and composite restorations: a laboratory study. Br Dental J 1976;141:305-10.  Back to cited text no. 1    
2.Khera SC, Kai CC. Microleakage and enamel finish. J Prosthet Dentist 1978;39:414-9.  Back to cited text no. 2    
3.Swartz ML, Phillips RW. In vitro studies on the marginal leakage of restorative materials. J Am Dent Assoc 1961;62:141-5.  Back to cited text no. 3  [PUBMED]  
4.Crim GA, Swartz ML, Phillips RW. Comparison of four thermocycling techniques. J Prosthet Dentist 1985;53:50-3.  Back to cited text no. 4  [PUBMED]  
5.Kanca Jr III. The effect of microleakage of four dentin-enamel bonding systems. Quint Int 1989;20:359-61.  Back to cited text no. 5    
6.Erdilek Necdet, Ferit Ozata, Figen Sepetcioglu. Microleakage of glass ionomer cement, composite resin and glass ionomer resin cement. J Clin Pediatr Dentist 1997;21:311-4.  Back to cited text no. 6    
7.Morabito A, Defabianis P. Marginal seal of various restorative materials in primary molars. J Clin Pediatr Dentist 1997;22:51-4.  Back to cited text no. 7  [PUBMED]  
8.Brackett William W, Gunnin TD, Gilpatrick RO, Browning WD. Microleakage of class V compomer and light cured glass ionomer restorations. J Prosthet Dentist 1998;79:261-3.  Back to cited text no. 8    
9.Fuks AB, Zvia Hirschfeld, Rafael Grajower. Marginal adaptation of glass ionomer cements. J Prosthet Dentist 1983;49:3:356-60.   Back to cited text no. 9    
10. Alperstein KS, Heber T, Graver, Richard Herold CB. Marginal leakage of glass ionomer cement restorations. J Prosthet Dentist 1983;50:6:803-7.  Back to cited text no. 10    
11.Srisawsdi S, Boyer DB, Reinhardt JW. The effect of removal of the smear layer on microleakage of class V restorations in vitro. Dent Mat 1988;4:384-9.  Back to cited text no. 11    
12.Walsh EL, Hembree JH. Microleakage at the gingival wall with four class V anterior restorative materials. J Prosthet Dentist 1985;54:370-2.  Back to cited text no. 12    
13.Bullard Harrell, Leinfelder F, Russell M. Effect of coefficient of thermal expansion on microleakage. J Am Dent Assoc 1988;116:871-4.  Back to cited text no. 13    
14.Mathis RS, DeWald JP, Moody CR, Ferracane JL. Marginal leakage in class V composite resin restoration with glass ionomer liners in vitro. J Prosthet Dentist 1990;63:522-4.  Back to cited text no. 14  [PUBMED]  
15.Holtan JR, Nystrom GP, Douglas WH, Phelps RA 2nd. Microleakage and marginal placement of a glass ionomer liner. Quint Int 1990;21:117-22.  Back to cited text no. 15    
16.Crim GA. Assesment of microleakage of twelve restorative systems. Quint Int 1987;18:419-21.  Back to cited text no. 16  [PUBMED]  
17.Crim GA. Influence of bonding agents and composites on microleakage. J Prosthet Dentist 1989;61:571-4.  Back to cited text no. 17  [PUBMED]  [FULLTEXT]


    Figures

[Figure - 1], [Figure - 2], [Figure - 3]

    Tables

[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5]


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