In vitro marginal and internal adaptation of four different base materials used to elevate proximal dentin gingival margins.

ABSTRACT

Background: There is still debate about the most appropriate restorative material category to relocate the proximal deep cervical margins, thus, this study aimed to compare the marginal and internal adaptation of four base materials used for deep margin elevation, and to evaluate each base material/overlying composite interface. Material and Methods: Fifty six molars received class II cavities with dentin/cementum gingival margins. They were divided into four groups and their gingival margins were elevated using either; resin modified glass ionomer (RMGI), highly viscous conventional glass ionomer (HV-GIC), flowable bulk fill resin composite (Bulk Flow) and bioactive ionic resin (Activa). The rest of the cavities were completed with the same overlying composite. Half of each group was either; kept in sterile water for 1 week, or subjected to 18 months water storage and 15,000 thermal cycles. Base materials/gingival dentin interfaces were examined under a scanning electron microscope at different magnifications, and percentage of continuous margin (% CM) and maximum gap width (MGW) were analyzed, in addition to base materials/overlying composite interfaces evaluations. % CM values were statistically analyzed using Two-way analysis of variance, Tukey post hoc tests (at p<0.05) and Pearson's correlation while MGW values were analyzed using Kruskal-Wallis, Mann-Whitney U tests and Spearmen correlation. Results: Both Bulk Flow and Activa had better marginal integrity than RMGI and HV-GIC. All base materials were adversely affected by aging. All base materials/overlying composite interfaces were continuous and age defying. Conclusions: In terms of marginal integrity, Bulk Flow and Activa might be preferable for proximal dentin margin elevation under direct restoration compared to the other tested base materials. Key wordsDeep proximal margin, interface analysis, marginal quality, open sandwich technique.