|Year : 2014 | Volume
| Issue : 2 | Page : 130-134
Analysis of microleakage of temporary restorative materials in primary teeth
Geórgia Linhares dos Santos1, Ana Paula Caldeira de Andrada Beltrame2, Thaísa Cezária Triches2, Marcos Ximenes-Filho2, Daniel Baptista2, Michele Bolan1
1 Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil
2 Post Graduate Programme in Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil
|Date of Web Publication||17-Apr-2014|
Ana Paula Caldeira de Andrada Beltrame
Caldeira de Andrada Beltrame, Prof. Walter de Bona Castelan 502, Córrego Grande, Florianópolis, Santa Catarina - 88037-300
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Aim: The aim of this study was to compare the coronal microleakage of restorative materials used between sessions of endodontic treatment in primary teeth. Materials and Methods: Forty healthy primary canines were chosen and randomly allocated to four groups: Group 1 - Cimpat Branco ® (n = 10), Group 2 - Bioplic ® (n = 10), Group 3 - Maxxion R ® glass ionomer cement (n = 10), and Group 4 (control) - Z350 ® composite resin (n = 10). Class V cavities were created and fillings carried out following the manufacturer's instructions. The teeth were submitted to thermocycling, sealed, and immersed in 0.5% basic fuchsin solution for 24 h. The teeth were split along their long axis in the vestibulolingual direction and the tooth-restorative material interface was photographed. The percentage of microleakage was calculated using the ImageJ program. Data were analyzed using the analysis of variance (ANOVA) F-test and Bonferroni's t-test, with a 5% level of significance. Results: The following mean percentages of microleakage were found: Group 1 = 16.08%, Group 2 = 46.98%, Group 3 = 47.93%, and Group 4 = 11.03%. Statistically, significant differences were found in the comparison of Groups 1 and 4 to Groups 2 and 3. Conclusion: Cimpat Branco ® had a lower percentage of microleakage in comparison to Bioplic ® and Maxxion R ® glass ionomer cement.
Keywords: Deciduous dentition, endodontics, restoration
|How to cite this article:|
dos Santos GL, Beltrame Ad, Triches TC, Ximenes-Filho M, Baptista D, Bolan M. Analysis of microleakage of temporary restorative materials in primary teeth. J Indian Soc Pedod Prev Dent 2014;32:130-4
|How to cite this URL:|
dos Santos GL, Beltrame Ad, Triches TC, Ximenes-Filho M, Baptista D, Bolan M. Analysis of microleakage of temporary restorative materials in primary teeth. J Indian Soc Pedod Prev Dent [serial online] 2014 [cited 2020 Apr 2];32:130-4. Available from: http://www.jisppd.com/text.asp?2014/32/2/130/130963
| Introduction|| |
The temporary restorative materials used between sessions of endodontic treatment must have adequate sealing capacity to prevent access to the cavity, thereby, impeding the marginal leakage of fluids, debris, and microorganisms from the oral cavity to the root canal system; and preventing the loss of therapeutic agents inserted in the pulp chamber. , Therefore, such materials play an important role in the success of endodontic treatment in primary teeth. Other important properties include biocompatibility, ease of handling, insertion and removal, high mechanical resistance to compression and traction, good resistance to temperature changes, and compatibility with intracanal therapeutics. ,
There is often a long interval between temporary and definitive filling after endodontic treatment in primary teeth.  In pediatric dental treatment, the temporary restorative material should be chosen with an even greater care, to avoid delays in treatment, repeat procedures, and possible physical and psychological stresses for the child.
Studies have examined the microleakage of temporary restorative materials in permanent teeth and the results demonstrate that no material has all the desirable properties for perfect sealing. ,, The materials most commonly used as temporary sealants between endodontic sessions are glass ionomer cement and substances based on zinc oxide and eugenol. A photocured material with a bisphenol A-glycidyl methacrylate (BIS-GMA) base, known as Bioplic ® (Biodinβmica), has recently been launched in the market. Bioplic ® has important characteristics for endodontic treatment in pediatric dentistry, such as its compatibility with composite resin, good marginal seal, and ease of removal with a curette and without requirement of burs.  Studies on permanent teeth have shown the efficacy of this material in terms of lower percentages of leakage. A number of authors have found that Bioplic ® has sealing quality similar to that of Cimpat Branco ® (Septodont) or Coltosol ® (Vigodent), and better than that of intermediate restorative material (IRM ® , Dentsply). ,
Due to a lack of papers published on primary teeth, the purpose of the present in vitro study was to compare the coronal microleakage of the following temporary restorative materials used between sessions of endodontic treatment in primary teeth: Cimpat Branco ® (Septodont, Lancaster, USA), Bioplic ® (Biodinβmica, Ibiporγ, Paranα, Brazil) and Maxxion R ® glass ionomer cement (FGM, Joinville, Santa Catarina, Brazil), using Z350 ® composite resin (3M, St. Paul, Minnesota, USA) as a control.
| Materials and Methods|| |
This study received approval from the research ethics committee of the Universidade Federal de Santa Catarina, Brazil (process n. 093/08).
The sample consisted of 40 primary canines with crown intact, extracted for reasons not related to this study. The teeth had been stored in a 10% formalin solution not exceeding 6 months. The laboratory stages were carried out by a single calibrated investigator. Since the selected crown had different sizes, standardized class V cavities were prepared (3 mm in length × 3 mm in width × 1.5 mm in depth), then washed and dried. Number-2 spherical drill burs (S.S. White®, New Jersey, USA) were used at high speed. After the cavities were performed, the teeth were washed in water, dried, and randomly divided into four groups (n = 10): Group 1 - Cimpat Branco ® , Group 2 - Bioplic ® , Group 3 - Maxxion R ® glass ionomer cement, and Group 4 - Z350 ® resin composite. All materials were used following the manufacturer's instructions.
The filled specimens were stored under 100% humidity at 37°C for 24 h, followed by 500 of 30-second cycles; thermal cycling at temperatures of 5°C and 55°C. The surface of the teeth was then sealed with Araldite ® (Brascola Ltda, Joinville, Brazil) on the apical portion and two coats of nail polish over the entire tooth, leaving a margin of 1 mm around the filling. The teeth were immersed in a 0.5% solution of basic fuchsin solution and transferred to an incubator at 37°C for 24 h. Finally, the specimens were rinsed in running water to remove the excess stain from the surface, dried, and stored once again in an oven.
The teeth were split along their long axis in the vestibulolingual direction with a double-faced diamond disc (KG Sorensen ® , Sγo Paulo, Brazil) and the tooth-restorative material interface was photographed with a Canon EOS Digital XTI camera (Canon U.S.A. Inc ® , New York, USA). The percentage microleakage (extent of stained surface/total surface of the restorative material) was analyzed by a previously calibrated single examiner and calculated using ImageJ program (Microsoft Corp ® , Washington, Redmond, USA) [Figure 1]. Microleakage was determined from the penetration of dye at the tooth-filling interface in the incisal and cervical segments.
|Figure 1: Measurement of the extent of stain by Image J: (a) Gingival margin's total length (representing 100% of microleakage). (b) Gingival margin's real length of microleakage (obtained by proportional mathematic)|
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The mean percentage of microleakage was calculated for each group for comparison purposes. Statistical analysis of the data consisted of the analysis of variance (ANOVA) F-test and Bonferroni's t-test, with the level of significance set at 5%.
| Results|| |
The intraclass correlation coefficient (ICC) revealed satisfactory, reproducible results (ICC > 0.4) [Table 1]. The ANOVA F-test revealed statistically significant differences between groups. With the results of the Bonferroni's t-test, considering a level of significance of 5%, revealed Groups 1 and 4 had significantly lower mean percentages of leakage in comparison to Groups 2 and 3 [Table 2].
|Table 1: Intraclass correlation coeffi cient for analysis of the assessor|
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|Table 2: Mean, standard deviation and results of Bonferroni's t-test in comparison of mean percentage of leakage between groups|
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The material that offered the lowest percentage of marginal leakage was Z350 ® composite resin (Group 4), followed by Cimpat Branco ® (Group 1), Bioplic ® (Group 2) and Maxxion R ® glass ionomer cement (Group 3) [Figure 2].
|Figure 2: Photograph of the tooth-fi lling interface of a sample from each group: (a) Group 4 - Z350® resin composite (3M), (b) Group 1 - Cimpat Branco® (Septodont), (c) Group 2 -Bioplic® (Biodinâmica), and (d) Group 3 - Maxxion R® glass ionomer cement (FGM)|
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| Discussion|| |
The use of an adequate temporary restorative material between endodontic visits is important for the success of a treatment. A number of studies have been carried out on permanent teeth to determine the material with the best sealing properties. ,, The main property of such material is the sealing capacity to prevent the leakage of fluids, bacteria, and ions to the interior of the root canal system. However, the description of an adequate temporary filling material for use on primary teeth between endodontic sessions continues to be lacking in the literature; as studies have shown that there are differences between the dental tissues of permanent teeth and primary teeth. ,,
The present study examined the microleakage of the following currently available temporary filling materials on primary teeth: Cimpat Branco ® , Bioplic ® and Maxxion R ® glass ionomer cement. Composite resin (Z 350 ® ) was used as a control.
Cimpat Branco ® is a zinc oxide and zinc sulfate-based hydrated temporary cement.  It is sold as a powder and premixed liquid, which reduces the mixture inconsistencies found with other temporary filling materials.  Furthermore, it has hygroscopic properties that improve its adaptation to the walls of the cavity. 
Bioplic ® and Cimpat Branco ® are sold as ready-for-use, which makes the work easier and saves time.  Bioplic ® is a photo-cured material composed of BIS-GMA, silicon dioxide, dimethacrylate groups, organic filler, and a photoactivator, which contributes toward a reduction in porosity and improved adaptation to the cavity margins. It can also be easily removed from the cavity using a curette. 
Glass ionomer cement is an acid/base reaction in powder and liquid form that contracts on polymerization.  As it is mixed by the dentist, inconsistencies in the mixture may directly affect the properties of the material.
Among the temporary filling materials tested in the present study, Cimpat Branco ® achieved the best result with regard to microleakage. This is in agreement with the findings of other studies on permanent teeth. , In both the studies cited, the material that provided the best marginal seal was Coltosol ® (a premixed, zinc oxide and zinc sulfate-based cement). Another study, also involving permanent teeth, found that Cimpat Branco ® had a higher percentage of microleakage in comparison to Bioplic ® and Dentalville ® .  However, it should be stressed that the latter investigation used a different methodology from the previously cited studies; having examined the penetration of dye into the pulp chamber by means of the chemical reaction between nickel sulfate and dimethylglyoxime (present in cotton wool).  The present investigation and previous studies cited the use of the tooth-restorative material interface to assess the extent of microleakage. ,
Based on the microleakage test carried out in the present study, Bioplic ® achieved more satisfactory results than Maxxion R ® , which is the temporary material of choice between endodontic sessions in primary teeth. Studies carried out on permanent teeth report that Bioplic ® is the temporary filling material, with the lowest percentage of microleakage. ,, A recent study using Clip ® (Voco, Cuxhaven, Germany) on primary teeth demonstrated better sealing ability in comparison to IRM ® (Dentsply), Coltosol ® (Colton), Cavit ® G (3M) and Adhesor ® (SpofaDental). This temporary restorative material has characteristics similar to Bioplic ® and is light cured. 
In the present study, Maxxion R ® showed the highest percentage of microleakage, which is in agreement with findings described by other authors. , Another study that assessed the microleakage of definitive restorative materials in primary teeth reported that glass ionomer cement modified with resin (Fuji II LC ® ) had a higher percentage of marginal leakage when compared to a resinous material modified with polyacid (Dyract ® - Dentsply) and composite resin (Z100 ® ).  Ramos and Galan (2008) conducted a study on permanent teeth, comparing the extent of microleakage with Bioplic ® , zinc oxide cement and eugenol, gutta-percha and glass ionomer cement, using staining with 0.5% rhodamine-B for 24 h; and found that the best temporary filling material was in fact, glass ionomer cement, which had the lowest percentages of microleakage. 
It is important to highlight the fact that due to the lack of papers published on primary teeth, the data in the literature come mainly from studies performed on permanent teeth, which could result in significant differences from the findings of the present study. Moreover, the methodology employed in the present study differs from the other investigations discussed here, in terms of the assessment of the depth of the microleakage. In most studies, the authors assessed microleakage within the pulp chamber. ,,, In the present study, the assessment was more precise, as it considered the tooth-restoration interface.
Despite the fact that Cimpat Branco ® had the lowest percentage of microleakage among the temporary restorative materials tested, it would be premature to suggest that it is the best material and further studies should be performed on primary teeth to test other properties of this type of material.
Z350 ® composite resin and Cimpat Branco ® had lower percentages of microleakage in comparison to Bioplic ® and Maxxion R ® glass ionomer cement. Among the temporary restorative materials tested, Cimpat Branco ® had the lowest percentage of microleakage. Further studies are needed, especially on primary teeth, to further confirm the identity of the most adequate temporary filling material for use between endodontic treatment sessions. In addition to providing an adequate marginal seal, such material should exhibit biocompatibility with oral tissues, resistance to chewing forces, adequate dimensional stability, and satisfactory interaction with the filling material between endodontic sessions.
| Acknowledgements|| |
This investigation was supported in part by the National Council for Scientific and Technological Development (CNPq). No potential conflicts of interest relevant to this article are reported.
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[Figure 1], [Figure 2]
[Table 1], [Table 2]