Comparative evaluation of marginal adaptation and microleakage of low-shrinking composites after thermocycling and mechanical loading.

AIMS: The aim of this study was to evaluate and correlate marginal adaptation and microleakage of different low-shrinking composites. MATERIALS AND METHODS: Standardized class V cavities (n = 20/group) with occlusal margin in enamel and gingival margin in dentin were restored with low-shrinking silorane-based (Filtek Silorane) or methacrylate-based (Clearfil Majesty Posterior, Grandio, Reflexions XLS, Tetric EvoCeram, Premise, Ceram-X Duo, Aelite LS Posterior) composites and a conventional composite (Filtek Z250). All teeth were stored in water (24 h), thermocycled (5000×), and mechanically loaded (60,000×). Marginal adaptation of epoxy resin replicas was analyzed using scanning electron microscope. Microleakage of the restoration was assessed by dye penetration on sectioned specimens under stereomicroscopy. Data were statistically analyzed with Mann-Whitney U test, with a significance of P < 0.05. Pearson's correlation test was used to evaluate the correlation between results of margin analysis and microleakage. RESULTS: No statistical difference in marginal gap formation was determined between Filtek Silorane and Z250. The lowest microleakage score at dentin margins was recorded for Filtek Silorane, which was not significantly different from that of all other groups. No similar ranking between the results of microleakage at enamel and dentin margins was observed for the materials tested. Marginal adaptation was not correlated to microleakage, except for Filtek Silorane, Grandio, and Filtek Z250. CONCLUSIONS: Compared to the conventional composite Filtek Z250, Filtek Silorane demonstrated no improvements with reduced marginal gap formation. Low-shrinking properties of composites appear to have no ability of sealing restoration margins and preventing leakage.

Gene-environment Interactions in the Etiology of Dental Caries.

Dental caries is a multifactorial disease that can be conceptualized as an interaction between genetic and environmental risk factors. The aim of this study is to examine the effects of AMELX, CA6, DEFB1, and TAS2R38 gene polymorphism and gene-environment interactions on caries etiology and susceptibility in adults. Genomic DNA was extracted from the buccal mucosa, and adults aged 20 to 60 y were placed into 1 of 2 groups: low caries risk (DMFT ≤ 5; n = 77) and high caries risk (DMFT ≥ 14; n = 77). The frequency of AMELX (+522), CA6 (T55M), DEFB1 (G-20A), and TAS2R38 (A49P) single-nucleotide polymorphisms was genotyped with the polymerase chain reaction-restriction fragment length polymorphism method. Environmental risk factors examined in the study included plaque amount, toothbrushing frequency, dietary intake between meals, saliva secretion rate, saliva buffer capacity, mutans streptococci counts, and lactobacilli counts. There was no difference between the caries risk groups in relation to AMELX (+522) polymorphism (χ(2) test, P > 0.05). The distribution of CA6 genotype and allele frequencies in the low caries risk group did not differ from the high caries risk group (χ(2) test, P > 0.05). Polymorphism of DEFB1 (G-20A) was positively associated, and TAS2R38 (A49P) negatively associated, with caries risk (χ(2) test, P = 0.000). There were significant differences between caries susceptibility and each environmental risk factor, except for the saliva secretion rate (Mann-Whitney U test, P = 0.000). Based on stepwise multiple linear regression analyses, dental plaque amount, lactobacilli count, age, and saliva buffer capacity, as well as DEFB1 (G-20A), TAS2R38 (A49P), and CA6 (T55M) gene polymorphism, explained a total of 87.8% of the variations in DMFT scores. It can be concluded that variation in CA6 (T55M), DEFB1 (G-20A), and TAS2R38 (A49P) may be associated with caries experience in Turkish adults with a high level of dental plaque, lactobacilli count, and age and when saliva buffer capacity is low.

A randomized controlled clinical trial of a HEMA-free all-in-one adhesive in non-carious cervical lesions at 1 year.

OBJECTIVES: One-step self-etch adhesives are the most recent generation of adhesives introduced onto the market. The objective of this randomized controlled clinical trial was to test the hypothesis that a one-step self-etch adhesive performs equally well as a conventional three-step etch&rinse adhesive (gold standard). METHODS: Fifty-two patients had 267 non-carious cervical lesions restored with Gradia Direct Anterior (GC). These composite restorations were bonded either with the 'all-in-one' adhesive G-Bond (GC) or with the three-step etch&rinse adhesive Optibond FL (Kerr). The restorations were evaluated after 6 and 12 months clinical service regarding their retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. A logistic regression analysis with generalized estimating equations was used to account for the clustered data (multiple restorations per patient). RESULTS: The recall rate at 1 year was 98%. The statistical analysis revealed a relatively low patient factor, indicating that supplementary information could be obtained from the additional restorations placed per patient. The retention rate for G-Bond was 98.5% compared to 99.3% for Optibond FL, due to the retention loss of two and one restorations, respectively. There were no significant differences between the two adhesives regarding the evaluated parameters except for the presence of small enamel marginal defects with G-Bond. CONCLUSIONS: After 12 months, the simplified one-step G-Bond and the three-step Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation of marginal adaptation, and G-Bond exhibited more small enamel marginal defects.