The Effect of Cavity Disinfectant on Microleakage of Self-adhesive Composite Restorations in Class V Cavities

Abstract

Objectives: This in vitro study was aimed to evaluate the effect of chlorhexidine digluconate (CHX) containing cavity disinfectant on microleakage of Class V self-adhesive resin-based composite restorations. Materials and Methods: Forty non-beveled Class V cavities (4x2x2mm) with occlusal and cervical margins on enamel were prepared on lingual and buccal surfaces of 20 molar teeth. Samples were randomly divided into 4 groups (n=10); and lingual cavities were disinfected with 2% CHX (Bisco). Cavities were restored using 2 different self-adhesive composites: Vertise Flow (Kerr); Activa BioACTIVE (Pulpdent) according to manufacturer’s instructions. Following 20 s polymerization with Valo (Ultradent) LED curing light, finishing and polishing were performed using Finishing Discs (Bisco). Teeth were coated with a nail polish excluding the restoration area and aged in distilled water at 24°C for 6 months. After immersion of the samples in 2% methylene blue solution, they were sectioned longitudinally in buccolingual direction with a diamond saw (Isomet 1000, Buehler). Microleakage on occlusal/gingival margins were scored under x8 and x20 magnification using a stereomicroscope (Leica MZ7.5). For statistical evaluation, Chi-square test was used. The significance level was set at p <0.05. Results: No statistically significant difference was detected between the total microleakage scores at occlusal and gingival margins (p=0.735; 0.944). Likewise, there was no significant difference between the gingival/occlusal margins of the restorations (p=0.216). CHX application did not show any statistically significance between microleakage values in Class V cavities restored with Vertise Flow or Activa BioACTIVE. (p=0.942; 0.577). Conclusions: CHX cavity disinfectant did not prevent microleakage in Class V cavities restored with self-adhesive composites.

Keywords

• Bioactive material
• cavity disinfectant
• class v cavity
• microleakage
• self-adhesive composite

Kavite Dezenfektanının Sınıf V Kavitelerde Self Adeziv Kompozit Restorasyonların Mikrosızıntısı Üzerine Etkisi

Abstract

Amaç: Bu in vitro çalışmanın amacı, klorheksidin diglukonat (CHX) içeren kavite dezenfektanının, sınıf V self-adeziv rezin bazlı kompozit restorasyonların mikrosızıntısı üzerindeki etkisini değerlendirmektir. Gereç ve Yöntemler: 20 insan azı dişinin hem bukkal hem de lingual yüzeylerine oklüzal ve servikal marjinleri mine üzerinde olan 40 adet standart sınıf V kavite (4x2x2mm) hazırlandı. Örnekler rastgele 4 gruba ayrıldı (n-10); tüm lingual kaviteler %2 CHX (Bisco) ile dezenfekte edildi. Kaviteler 2 farklı self-adeziv kompozit (Vertise Flow, Kerr; Activa BioACTIVE, Pulpdent) kullanılarak üretici talimatlarına göre restore edildi. Valo (Ultradent) LED ışıklı cihaz ile 20 sn polimerizasyon sonrası Finishing Discs (Bisco) kullanılarak bitim ve polisaj işlemleri yapıldı. Dişlerin restorasyon alanı dışında kalan yüzeyleri şeffaf oje ile kaplandı ve distile suda oda sıcaklığında (24°C) 6 ay yaşlandırıldı. Numuneler %2'lik metilen mavisi solüsyonuna bir saat daldırıldıktan sonra, hassas kesme cihazı (Isomet 1000, (Buehler)) ile bukkolingual yönde boylamasına kesitler alındı. Oklüzal/gingival mikrosızıntı stereomikroskop (Leica MZ7.5) kullanılarak x8 ve x20 büyütme altında skorlandı. İstatistiksel değerlendirme için, ki-kare testi kullanıldı ve anlamlılık düzeyi p<0.05 olarak belirlendi. Bulgular: Kaviteye CHX uygulamasına göre restorasyonların oklüzal ve gingival mikrosızıntı değerlerinde istatistiksel olarak anlamlı fark bulunmadı (p=0.735; 0.944). Benzer şekilde, gingival ve oklüzal kenarlardaki mikrosızıntı seviyeleri arasında anlamlı fark saptanmadı (p=0.216). Vertise Flow veya Activa BioACTIVE ile restore edilen CHX ile muamele edilmiş ve edilmemiş sınıf V kavitelerde mikrosızıntı değerleri arasında istatistiksel açıdan anlamlı fark tespit edilmedi (p=0.942; 0.577). Sonuç: CHX kavite dezenfektanı, self-adeziv kompozitlerle restore edilen sınıf V kavitelerde mikrosızıntıya engel olmamıştır.

Keywords

• biyoaktif materyal
• kavite dezenfektanı
• mikrosızıntı
• self adeziv kompoizt
• sınıf V kavite

References

1. Akturk E, Bektas O, Ozkanoglu S, Akin EG. Do ozonated water and boric acid affect the bond strength to dentin in different adhesive systems?. Nigerian journal of clinical practice. 2019 Dec 1;22(12):1758-.
2. Angeloni V, Mazzoni A, Marchesi G, Cadenaro M, Comba A, Maravi T, Scotti N, Pashley David H, Tay F, Breschi L. Role of chlorhexidine on long-term bond strength of self-adhesive composite cements to intraradicular dentin.
3. Araujo RM, de Paula Eduardo C, Duarte Junior SL, Araujo MA, de Castro Monteiro Loffredo L. Microleakage and nanoleakage: influence of laser in cavity preparation and dentin pretreatment. Journal of clinical laser medicine & surgery. 2001 Dec 1;19(6):325-32.
4. Attiguppe P, Tripathi AP, Sugandhan S, Naik SV, Deepak BM. Nanotechnology in Dentin Disinfection: Can We Preserve the Bond?. International Journal of Clinical Pediatric Dentistry. 2019 Jan;12(1):42.
5. Autio-Gold JT. Clinical evaluation of a medium-filled flowable restorative material as a pit and fissure sealant. Operative dentistry. 2002 Jul 1;27(4):325-9.
6. Balagopal S, Arjunkumar R. Chlorhexidine: the gold standard antiplaque agent. Journal of Pharmaceutical sciences and Research. 2013 Dec 1;5(12):270.
7. Cellik O, Bahsi E. Effect of Different Restorative Materials on Microleakage of Ozone Gas and Traditional Cavity Disinfectant Applied Teeth. Ozone: Science & Engineering. 2019 Mar 4;41(2):175-85.
8. Elkassas DW, Fawzi EM, El Zohairy A. The effect of cavity disinfectants on the micro-shear bond strength of dentin adhesives. European journal of dentistry. 2014 Apr;8(02):184-90.

9. Firouzmandi M, Afzali N, Parsaie Z, Mohammadi N. Effect of Casein Phosphopeptide–Amorphous Calcium Phosphate on Fracture Resistance of Reattached Tooth Fragments Using Conventional and Self-Adhesive Bioactive Flowable Composite. European Journal of Dentistry. 2020 May;14(02):288-93.
10. Ghavamnasiri M, Moosavi H, Tahvildarnejad N. Effect of centripetal and incremental methods in Class II composite resin restorations on gingival microleakage. J Contemp Dent Pract. 2007 Feb 1;8(2):113-20.
11. Gjorgievska E, Nicholson JW, Iljovska S, Slipper IJ. Marginal adaptation and performance of bioactive dental restorative materials in deciduous and young permanent teeth. Journal of Applied Oral Science. 2008 Feb;16(1):1-6.
12. Guo J, Holmes B, Yang B, Li Y, Heo YC, Chen J, Fok A. Determining the temporal development of dentin-composite bond strength during curing. Dental Materials. 2016 Aug 1;32(8):1007-18.
13. Imazato S, Torii Y, Takatsuka T, Inoue K, Ebi N, Ebisu S. Bactericidal effect of dentin primer containing antibacterial monomer methacryloyloxydodecylpyridinium bromide (MDPB) against bacteria in human carious dentin. Journal of oral rehabilitation. 2001 Apr;28(4):314-9.
14. Kleverlaan CJ, Feilzer AJ. Polymerization shrinkage and contraction stress of dental resin composites. Dental Materials. 2005 Dec 1;21(12):1150-7.
15. Lokhande NA, Padmai AS, Rathore VP, Shingane S, Jayashankar DN, Sharma U. Effectiveness of flowable resin composite in reducing microleakage–An in vitro study. Journal of international oral health: JIOH. 2014 Jun;6(3):111.
16. Mishra A, Singh G, Singh S, Agarwal M, Qureshi R, Khurana N. Comparative evaluation of mechanical properties of Cention N with conventionally used restorative materials—an in vitro study. International Journal of Prosthodontics and Restorative Dentistry. 2018;8(4):120-4.
17. Nilgun Ozturk A, Usumez A, Ozturk B, Usumez S. Influence of different light sources on microleakage of class V composite resin restorations. Journal of Oral Rehabilitation. 2004 May;31(5):500-4.
18. Patel MU, Punia SK, Bhat S, Singh G, Bhargava R, Goyal P, Oza S, Raiyani CM. An in vitro Evaluation of Microleakage of Posterior Teeth Restored with Amalgam, Composite and Zirconomer - A Stereomicroscopic Study. J Clin Diagn Res. 2015.
19. Rahimian-Imam S, Ramazani N, Fayazi MR. Marginal microleakage of conventional fissure sealants and self-adhering flowable composite as fissure sealant in permanent teeth. Journal of dentistry (Tehran, Iran). 2015 Jun;12(6):430.
20. Sauro S, Makeeva I, Faus-Matoses V, Foschi F, Giovarruscio M, Maciel Pires P, Martins Moura ME, Almeida Neves A, Faus-Llácer V. Effects of ions-releasing restorative materials on the dentine bonding longevity of modern universal adhesives after load-cycle and prolonged artificial saliva aging. Materials. 2019 Jan;12(5):722.
21. Sharma V, Rampal P, Kumar S. Shear bond strength of composite resin to dentin after application of cavity disinfectants–SEM study. Contemporary clinical dentistry. 2011 Jul;2(3):155.
22. Silveira de Araújo C, Incerti da Silva T, Ogliari FA, Meireles SS, Piva E, Demarco FF. Microleakage of seven adhesive systems in enamel and dentin. J Contemp Dent Pract. 2006 Nov 1;7(5):26-33.
23. Siso HS, Kustarci A, Göktolga EG. Microleakage in resin composite restorations after antimicrobial pre-treatments: effect of KTP laser, chlorhexidine gluconate and Clearfil Protect Bond. Operative dentistry. 2009 May;34(3):321-7.
24. Van Ende A, De Munck J, Lise DP, Van Meerbeek B. Bulk-fill composites: a review of the current literature. J Adhes Dent. 2017 Apr 25;19(2):95-109.
25. Varoni E, Tarce M, Lodi G, Carrassi A. Chlorhexidine (CHX) in dentistry: state of the art. Minerva Stomatol. 2012 Sep 1;61(9):399-419.