Evaluation of non-carious cervical restorations with different cavity configurations: a microscopy and OCT analysis
DOI:
https://doi.org/10.2340/biid.v13.46121Keywords:
Composite resins, non-carious cervical lesions, dental marginal adaptation, optical coherence tomographyAbstract
The aim of this in vitro study was to assess marginal and internal gap formation in simulated non-carious cervical lesions (NCCLs) of different cavity configurations and restored with either bulk-fill or nanofilled resin composite, before and after thermocycling. NCCLs with 2.3 mm diameter and approximately 3.5 mm3 volume were prepared in 40 human molars in two cavity configurations (n = 20): saucer (1.3 mm depth) or wedge (1.9 mm depth) shape. The adhesive Clearfil SE Bond was used in all groups. These cavities were randomly divided according to the resin composite used (n = 10): Filtek Z350 XT or Filtek One Bulk Fill Restorative. The marginal and internal adaptation of the composite at cavity margins was assessed before and after thermal aging (TA) (5000 cycles between 5 and 55°C) using a plane light microscope and optical coherence tomography (OCT), respectively. The 3D images captured by OCT were analyzed by obtaining 16 B-scans per specimen using a custom-made script for software MATLAB R2019a, Update 3. Data were analyzed by two-way analysis of variance and paired t-tests (α = 0.05). Regarding the marginal gap, there was no statistically significant difference between the saucer and wedge cavity configurations, before or after TA, nor between cavities restored with bulk-fill or nanofilled composite (p > 0.05). Likewise, for the internal gap, no significant differences were found for the cavity configuration nor the resin composite (p > 0.05). Restorations placed in saucer or wedge cavity configurations showed similar marginal and internal adaptation, regardless of the type of resin composite, and gap formation was not aggravated by thermocycling.
Downloads
References
Peumans M, De Munck J, Mine A, Van Meerbeek B. Clinical effectiveness of contemporary adhesives for the restoration of non-carious cervical lesions: a systematic review. Dent Mater. 2014;30:1089–103. DOI: https://doi.org/10.1016/j.dental.2014.07.007
Santos MJ, Ari N, Steele S, Costella J, Banting D. Retention of tooth-colored restorations in non-carious cervical lesions – a systematic review. Clin Oral Investig. 2014;18:1369–81. DOI: https://doi.org/10.1007/s00784-014-1220-7
Hur B, Kim HC, Park JK, Versluis A. Characteristics of non-carious cervical lesions – an ex vivo study using micro computed tomography. J Oral Rehabil. 2011;38:469–74. DOI: https://doi.org/10.1111/j.1365-2842.2010.02172.x
Sugita I, Nakashima S, Ikeda A, Burrow MF, Nikaido T, Kubo S, et al. A pilot study to assess the morphology and progression of non-carious cervical lesions. J Dent. 2017;57:51–6. DOI: https://doi.org/10.1016/j.jdent.2016.12.004
Borges ALS, Borges AB, Xavier TA, Bottino MC, Platt JA. Impact of quantity of resin, C-factor, and geometry on resin composite polymerization shrinkage stress in class V restorations. Oper Dent. 2014;39:144–51. DOI: https://doi.org/10.2341/12-440-L
Correia AMO, Pereira VEM, Bresciani E, Platt JA, Borges ALS, Caneppele TMF. Influence of cavosurface angle on the stress concentration and gaps formation in class V resin composite restorations. J Mech Behav Biomed Mater. 2019;97:272–7. DOI: https://doi.org/10.1016/j.jmbbm.2019.05.034
Correia AMO, Andrade MR, Tribst JPM, Borges ALS, Caneppele TMF. Influence of bulk-fill restoration on polymerization shrinkage stress and marginal gap formation in class V restorations. Oper Dent. 2020;45:E207–16. DOI: https://doi.org/10.2341/19-062-L
Kwon Y, Ferracane J, Lee IB. Effect of layering methods, composite type, and flowable liner on the polymerization shrinkage stress of light cured composites. Dent Mater. 2012;28:801–9. DOI: https://doi.org/10.1016/j.dental.2012.04.028
Fronza BM, Rueggeberg FA, Braga RR, Mogilevych B, Soares LES, Martin AA, et al. Monomer conversion, microhardness, internal marginal adaptation, and shrinkage stress of bulk-fill resin composites. Dent Mater. 2015;31:1542–51. DOI: https://doi.org/10.1016/j.dental.2015.10.001
Sunbul HA, Silikas N, Watts DC. Polymerization shrinkage kinetics and shrinkage-stress in dental resin-composites. Dent Mater. 2016;32:998–1006. DOI: https://doi.org/10.1016/j.dental.2016.05.006
Van Ende A, De Munck J, Lise DP, Van Meerbeek B. Bulk-fill composites: a review of the current literature. J Adhes Dent. 2017;19:95–109.
Correia AMO, Tribst JPM, Matos FS, Platt JA, Caneppele TMF, Borges ALS. Polymerization shrinkage stresses in different restorative techniques for non-carious cervical lesions. J Dent. 2018;76:68–74. DOI: https://doi.org/10.1016/j.jdent.2018.06.010
He J, Garoushi S, Säilynoja E, Vallittu PK, Lassila L. The effect of adding a new monomer ‘Phene’ on the polymerization shrinkage reduction of a dental resin composite. Dent Mater. 2019;35:627–35. DOI: https://doi.org/10.1016/j.dental.2019.02.006
Canali GD, Ignácio SA, Rached RN, Souza EM. One-year clinical evaluation of bulk-fill flowable vs. regular nanofilled composite in non-carious cervical lesions. Clin Oral Investig. 2018;23:889–97. DOI: https://doi.org/10.1007/s00784-018-2509-8
Correia AMO, Jurema ALB, Andrade MR, Borges ALS, Bresciani E, Caneppele TMF. Clinical evaluation of noncarious cervical lesions of different extensions restored with bulk-fill or conventional resin composite: preliminary results of a randomized clinical trial. Oper Dent. 2020;45:E11–20. DOI: https://doi.org/10.2341/18-256-C
Alqudaihi FS, Cook NB, Diefenderfer KE, Bottino MC, Platt JA. Comparison of internal adaptation of bulk-fill and increment-fill resin composite materials. Oper Dent. 2018;44:E32–44. DOI: https://doi.org/10.2341/17-269-L
Fronza BM, Makishi P, Sadr A, Shimada Y, Sumi Y, Tagami J, et al. Evaluation of bulk-fill systems: microtensile bond strength and non-destructive imaging of marginal adaptation. Braz Oral Res. 2018;32:e80. DOI: https://doi.org/10.1590/1807-3107bor-2018.vol32.0080
Peutzfeldt A, Mühlebach S, Lussi A, Flury S. Marginal gap formation in approximal ‘bulk fill’ resin composite restorations after artificial ageing. Oper Dent. 2018;43:180–9. DOI: https://doi.org/10.2341/17-068-L
Nahedh HA, Sibai NS. Evaluation of interfacial gap volume of two low-shrinkage composites using micro-computed tomography. Oper Dent. 2017;42:658–68. DOI: https://doi.org/10.2341/15-301-L
Zavattini A, Mancini M, Higginson J, Foschi F, Pasquantonio G, Mangani F. Micro-computed tomography evaluation on microleakage of class II composite restorations: an in vitro study. Eur J Dent. 2018;12:369–74. DOI: https://doi.org/10.4103/ejd.ejd_28_18
Han SH, Sadr A, Tagami J, Park SH. Internal adaptation of resin composites at two configurations: influence of polymerization shrinkage and stress. Dent Mater. 2016;32:1085–94. DOI: https://doi.org/10.1016/j.dental.2016.06.005
Hayashi J, Shimada Y, Tagami J, Sumi Y, Sadr A. Real-time imaging of gap progress during and after composite polymerization. J Dent Res. 2017;96:992–8. DOI: https://doi.org/10.1177/0022034517709005
Han SH, Sadr A, Shimada Y, Tagami J, Park SH. Internal adaptation of composite restorations with or without an intermediate layer: effect of polymerization shrinkage parameters of the layer material. J Dent. 2019;80:41–8. DOI: https://doi.org/10.1016/j.jdent.2018.10.013
Hayashi J, Espigares J, Takagaki T, Shimada Y, Tagami J, Numata T, et al. Real-time in-depth imaging of gap formation in bulk-fill resin composites. Dent Mater. 2019;35:585–96. DOI: https://doi.org/10.1016/j.dental.2019.01.020
Makishi P, Shimada Y, Sadr A, Tagami J, Sumi Y. Non-destructive 3D imaging of composite restorations using optical coherence tomography: marginal adaptation of self-etch adhesives. J Dent. 2011;39:316–25. DOI: https://doi.org/10.1016/j.jdent.2011.01.011
Bista B, Sadr A, Nazari A, Shimada Y, Sumi Y, Tagami J, et al. Nondestructive assessment of current one-step self-etch dental adhesives using optical coherence tomography. J Biomed Opt. 2013;18:76020. DOI: https://doi.org/10.1117/1.JBO.18.7.076020
Bortolotto T, Bahillo J, Richoz O, Hafezi F, Krejci I. Failure analysis of adhesive restorations with SEM and OCT: from marginal gaps to restoration loss. Clin Oral Invest. 2015;19:1881–90. DOI: https://doi.org/10.1007/s00784-015-1402-y
Braga RR, Boaro LC, Kuroe T, Azevedo CL, Singer JM. Influence of cavity dimensions and their derivatives (volume and ‘C’ factor) on shrinkage stress development and microleakage of composite restorations. Dent Mater. 2006;22:818–23. DOI: https://doi.org/10.1016/j.dental.2005.11.010
Peumans M, De Munck J, Van Landuyt K, Van Meerbeek B. Thirteen-year randomized controlled clinical trial of a two-step self-etch adhesive in non-carious cervical lesions. Dent Mater. 2015;31:308–14. DOI: https://doi.org/10.1016/j.dental.2015.01.005
Asmussen E, Jørgensen KD. A microscopic investigation of the adaptation of some plastic filling materials to dental cavity walls. Acta Odontol Scand. 1972;30(1):3–21. DOI: https://doi.org/10.3109/00016357209004588
Eliguzeloglu E, Eraslan O, Omurlu H, Eskitascioglu G, Belli S. The effect of cavity shape and hybrid layer on the stress distribution of cervical composite restorations. Eur J Dent. 2011;5:180–5. DOI: https://doi.org/10.1055/s-0039-1698877
Boaro LC, Brandt WC, Meira JB. Experimental and FE displacement and polymerization stress of bonded restorations as a function of the C-factor, volume and substrate stiffness. J Dent. 2014;42:140–8. DOI: https://doi.org/10.1016/j.jdent.2013.11.016
Correia AMO, Bresciani E, Borges AB, Pereira DM, Maia LC, Caneppele TMF. Do tooth- and cavity-related aspects of noncarious cervical lesions affect the retention of resin composite restorations in adults? A systematic review and meta-analysis. Oper Dent. 2020;45:E124–40. DOI: https://doi.org/10.2341/19-091-L
Benetti AR, Havndrup-Pedersen C, Honoré D, Pedersen MK,
Pallesen U. Bulk-fill resin composites: polymerization contraction, depth of cure, and gap formation. Oper Dent. 2015;40:190–200. DOI: https://doi.org/10.2341/13-324-L
Braga RR, Ballester RY, Ferracane JL. Factors involved in the development of polymerization shrinkage stress in resin-composites: a systematic review. Dent Mater. 2005;21:962–70. DOI: https://doi.org/10.1016/j.dental.2005.04.018
Shah PK, Stansbury JW, Bowman CN. Application of an addition-fragmentation-chain transfer monomer in di(meth)acrylate network formation to reduce polymerization shrinkage stress. Polym Chem. 2017;8:4339–51. DOI: https://doi.org/10.1039/C7PY00702G
Filtek one bulk fill, 3M [Internet]. [cited 2023 Mar 06]. Available from: https://multimedia.3m.com/mws/media/1509317O/filtek-one-bulk-fill-technical-profile.pdf
Veloso SRM, Lemos CAA, de Moraes SLD, do Egito Vasconcelos BC, Pellizzer EP, de Melo Monteiro GQ. Clinical performance of bulk-fill and conventional resin composite restorations in posterior teeth: a systematic review and meta-analysis. Clin Oral Investig. 2019;23:221–33. DOI: https://doi.org/10.1007/s00784-018-2429-7
Correia AMO, Jurema ALB, Bresciani E, Caneppele TMF. Effects of lesion size on the 30-month clinical performance of restorations with bulk fill and a regular nanofilled resin composite in noncarious cervical lesions. Clin Oral Investig. 2023;27:3083–93. DOI: https://doi.org/10.1007/s00784-023-04914-6
Benetti AR, Michou S, Larsen L, Peutzfeldt P, Pallesen U, van Dijken JWV. Adhesion and marginal adaptation of a claimed bioactive, restorative material. Biomater Investig Dent. 2019;6(1):90–8. DOI: https://doi.org/10.1080/26415275.2019.1696202
Yoshida Y, Nagakane K, Fukuda R, Nakayama Y, Okazaki M, Shintani H, et al. Comparative study on adhesive performance of functional monomers. J Dent Res. 2004;83:454–8. DOI: https://doi.org/10.1177/154405910408300604
Heintze SD, Ruffieux C, Rousson V. Clinical performance of cervical restorations – a meta-analysis. Dent Mater. 2010;26:993–1000. DOI: https://doi.org/10.1016/j.dental.2010.06.003
De Munck J, Van Landuyt K, Peumans M, Poitevin A, Lambrechts P, Braem M, et al. A critical review of the durability of adhesion to tooth tissue: methods and results. J Dent Res. 2005;84:118–32. DOI: https://doi.org/10.1177/154405910508400204
Choma M, Sarunic M, Yang C, Izatt J. Sensitivity advantage of swept source and Fourier domain optical coherence tomography. Opt Express. 2003;11:2183–9. DOI: https://doi.org/10.1364/OE.11.002183
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Ayla Macyelle de Oliveira Correia, Peter Hamilton Tomlins, Robert William Read, Taciana Marco Ferraz Caneppele, Eduardo Bresciani, Ana Raquel Benetti
This work is licensed under a Creative Commons Attribution 4.0 International License.
Biomaterial Investigations in Dentistry is a Diamond Open Access peer-reviewed journal, publishing research in oral biomaterials science. The publishing of articles is free for authors, thanks to the support of Acta Odontologica Scandinavica Society (AOSS), a not-for-profit society. 
