Gingival microleakage of class II bulk-fill composite resin restorations

Background. Bulk-fill composites were developed to simplify composite placement and minimize polymerization shrinkage stresses, which can improve gingival marginal adaptation in deep class II cavities. Objective. The objective of this study was to compare the gingival microleakage of class II cavities restored with bulk-fill composites to that of incrementally restored ones with a conventional composite at 2 storage periods. Material and methods. Forty freshly extracted intact molars were employed. Two standardized class II slot cavities, 3-millimeter-wide buccolingually, with the gingival floor 0.5 mm below the cementoenamel junction (CEJ) and the axial wall depth of 1.3 mm were prepared in each tooth (80 cavity preparations). The prepared teeth were divided equally into 3 bulk-fill groups (Tetric EvoCeram (R) Bulk Fill, X-tra Fil (R) and QuiXX (R)) and 1 control group (TPH Spectra (R) HV). Each group was subdivided into 2 equal subgroups (n = 10) according to the storage period in distilled water (24 h and 6 months). The Adper (R) Single Bond Plus adhesive was used with all the restorative materials.The cavities in the experimental groups were restored with 4-millimeter bulk-fill composites in 1 increment, while the cavities in the control group were restored with 2 increments of the thickness of 2 mm. The polymerization light was applied from the occlusal surfaces. The teeth were then immersed in 2% procion red dye solution, sectioned and examined under a stereomicroscopeto determine the extent of dye penetration. The data was statistically analyzed using the Kruskal-Wallis test and the Mann-Whitney U test. Result. The Kruskal-Wallis test revealed no significant differences in the mean microleakage scores among all the groups after 24-hour and 6-month storage (p = 0.945 and p = 0.928, respectively). The Mann-Whitney U test revealed an increase in the mean microleakage scores in all the groups after 6-month storage; however, the scores were not significantly different from the means obtained after 24 h (p = 0.259 for Tetric EvoCeram Bulk Fill; p = 0.205 for X-tra Fil;p = 0.166 for QuiXX; p = 0.155 for TPH Spectra HV). Conclusion. Gingival microleakage of bulk-fill composites in class II cavities was not significantly different from that of incrementally restored ones with a conventional composite. The increase in the mean gingival microleakage of the specimens stored for 6 months was not a statistically significant difference as compared to the values obtained after the 24-hour storage for each composite.