Marginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro StudyMarginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro Study

Authors

  • Ahmed Gamal Abdelwahed Department of Conservative Dentistry, Faculty of Dentistry, October 6 University, Giza, Egypt https://orcid.org/0000-0003-4748-0200
  • Shereen Essam Department of Conservative Dentistry, Faculty of Dentistry, October 6 University, Giza, Egypt
  • Monaliza M. Abdelaziz Department of Conservative Dentistry, Faculty of Dentistry, October 6 University, Giza, Egypt

DOI:

https://doi.org/10.3889/oamjms.2022.8353

Keywords:

Marginal adaptation, Bulk-fill, Resin composite

Abstract

Aim: To investigate the marginal adaptation and depth of cure of a flowable bulk-fill giomer (BEAUTIFIL Flow Plus X [BFP]), a flowable bulk-fill resin composite (PALFIQUE BULK FLOW [PBF]) bulk-fill resin composite, a packable bulk-fill giomer (BEAUTIFL-Bulk Restorative [BBR]), and two packable bulk-fill resin composites (X-tra fil [XF]) and (Filtek™ One Bulk Fill Restorative [FOB]).

Materials and Methods: Twenty-five standardized class II cavities were prepared in the occlusomesial surfaces of maxillary premolars. A self-etching dental adhesive was used. All restorative materials were applied, and light cured according to their manufacturer's instructions. The teeth were subjected to 2500 thermal cycles between 5° C and 55° C. Epoxy resin replicas were obtained to examine the marginal by calculating the percentage of the continuous margin over the total margin length. using SEM at 200× magnification. For assessing the depth of cure, fifty specimens with 4 mm height were prepared. Vickers microhardness testing was used to assess the depth of cure was calculating the bottom-to-top ratio of each specimen. If this ratio reaches 0.80 or more, an adequate depth of cure is achieved.

Results: Regarding marginal adaptation, there was no significant difference between different groups before (p=0.398) and after (p=0.644) thermocycling. Within all groups, there was a significant decrease in marginal adaptation after thermocycling (p<0.001). Regarding the depth of cure, all restorative materials achieved the required 0.8 bottom-to-top ratio.  There was a significant difference between different groups (p<0.001).  The highest value was found in BFP group (0.97±0.02), while the lowest value was found in BBR group (0.81±0.11).

Conclusions: The marginal adaptation and depth of cure of bulk-fill giomer restorative materials are acceptable. Therefore, their use in restoration of 4-mm deep class II cavities is appealing.

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References

Haak R, Näke T, Park KJ, Ziebolz D, Krause F, Schneider H. Internal and marginal adaptation of high-viscosity bulk-fill composites in Class II cavities placed with different adhesive strategies. Odontology. 2019;107(3):374-82. https://doi.org/10.1007/s10266-018-0402-1

Frankenberger R, Reinelt C, Glatthöfer C, Krämer N. Clinical performance and SEM marginal quality of extended posterior resin composite restorations after 12 years. Dent Mater. 2020;36(7):e217-28. https://doi.org/10.1016/j.dental.2020.03.022 PMid:32451207

Yazici AR, Kutuk ZB, Ergin E, Karahan S, Antonson SA. Sixyear clinical evaluation of bulk-fill and nanofill resin composite restorations. Clin Oral Investig. 2022;26(1):417-26. https://doi.org/10.1007/s00784-021-04015-2 PMid:34110494

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(2):180-9. https://doi.org/10.2341/17-068-L PMid:29148914

Al-Nahedh HN, Alawami Z. Fracture resistance and marginal adaptation of capped and uncapped bulk-fill resin-based materials. Oper Dent. 2020;45(2):E43-56. https://doi.org/10.2341/17-367-L PMid:31750801

Opdam NJ, Bronkhorst EM, Roeters JM, Loomans BA. A retrospective clinical study on longevity of posterior composite and amalgam restorations. Dent Mater. 2007;23(1):2-8. https://doi.org/10.1016/j.dental.2005.11.036 PMid:16417916

Da Rosa Rodolpho PA, Donassollo TA, Cenci MS, Loguércio AD, Moraes RR, Bronkhorst EM, et al. 22-Year clinical evaluation of the performance of two posterior composites with different filler characteristics. Dent Mater. 2011;27(10):955-63. https://doi.org/10.1016/j.dental.2011.06.001 PMid:21762980

van Dijken JW, Pallesen U. A randomized 10-year prospective follow-up of Class II nanohybrid and conventional hybrid resin composite restorations. J Adhes Dent. 2014;16(6):585-92. https://doi.org/10.3290/j.jad.a33202 PMid:25516885

van Dijken JW, Lindberg A. A 15-year randomized controlled study of a reduced shrinkage stress resin composite. Dent Mater. 2015;31(9):1150-8. https://doi.org/10.1016/j.dental.2015.06.012 PMid:26205382

Oskoee SS, Bahari M, Navimipour EJ, Ajami AA, Ghiasvand N, Oskoee AS. Factors affecting marginal integrity of Class II bulk-fill composite resin restorations. J Dent Res Dent Clin Dent Prospects. 2017;11(2):101-9. https://doi.org/10.15171/joddd.2017.019 PMid:28748051

Ferracane JL. Developing a more complete understanding of stresses produced in dental composites during polymerization. Dent Mater. 2005;21(1):36-42. https://doi.org/10.1016/j.dental.2004.10.004 PMid:15681000.

Mantri SP, Mantri SS. Management of shrinkage stresses in direct restorative light-cured composites: A review. J Esthet Restor Dent. 2013;25(5):305-13. https://doi.org/10.1111/jerd.12047 PMid:24148979

Kaisarly D, Gezawi ME. Polymerization shrinkage assessment of dental resin composites: A literature review. Odontology. 2016;104(3):257-70. https://doi.org/10.1007/s10266-016-0264-3 PMid:27540733

Soares CJ, Faria-E-Silva AL, Rodrigues MP, Vilela ABF, Pfeifer CS, Tantbirojn D, et al. Polymerization shrinkage stress of composite resins and resin cements-what do we need to know? Braz Oral Res. 2017;31 Suppl 1:e62. https://doi.org/10.1590/1807-3107BOR-2017.vol31.0062 PMid:28902242

Veloso SR, Lemos CA, de Moraes SL, 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(1):221-33. https://doi.org/10.1007/s00784-018-2429-7 PMid:29594349

Arbildo-Vega HI, Lapinska B, Panda S, Lamas-Lara C, Khan AS, Lukomska-Szymanska M. Clinical effectiveness of bulk-fill and conventional resin composite restorations: Systematic review and meta-analysis. Polymers (Basel). 2020;12(8):1786. https://doi.org/10.3390/polym12081786 PMid:32785019

Bellinaso MD, Soares FZM, Rocha RO. Do bulk-fill resins decrease the restorative time in posterior teeth? A systematic review and meta-analysis of in vitro studies. J Investig Clin Dent. 2019;10(4):e12463. https://doi.org/10.1111/jicd.12463 PMid:31560449

Berti LS, Turssi CP, Amaral FL, Basting RT, Junqueira JLC, Panzarella FK, et al. Clinical and radiographic evaluation of high viscosity bulk-fill resin composite restorations. Am J Dent. 2020;33(4):213-7. PMid:32794397

Yu P, Yap A, Wang XY. Degree of conversion and polymerization shrinkage of bulk-fill resin-based composites. Oper Dent. 2017;42(1):82-9. https://doi.org/10.2341/16-027-L PMid:28002693

Ajaj RA, Farsi NJ, Alzain L, Nuwaylati N, Ghurab R, Nassar HM. Dental bulk-fill resin composites polymerization efficiency: A systematic review and meta-analysis. J Comp Sci. 2021;5(6):149. https://doi.org/10.3390/jcs5060149

Reis AF, Vestphal M, Amaral RC, Rodrigues JA, Roulet JF, Roscoe MG. Efficiency of polymerization of bulk-fill composite resins: A systematic review. Braz Oral Res. 2017;31 Suppl 1:e59. https://doi.org/10.1590/1807-3107BOR-2017.vol31.0059 PMid:28902239

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(2):95-109. https://doi.org/10.3290/j.jad.a38141 PMid:28443833

Gerula-Szymańska A, Kaczor K, Lewusz-Butkiewicz K, Nowicka A. Marginal integrity of flowable and packable bulk fill materials used for Class II restorations-a systematic review and meta-analysis of in vitro studies. Dent Mater J. 2020;39(3):335-44. https://doi.org/10.4012/dmj.2018-180 PMid:31932546

Paganini A, Attin T, Tauböck TT. Margin integrity of bulk-fill composite restorations in primary teeth. Materials (Basel). 2020;13(17):3802. https://doi.org/10.3390/ma13173802 PMid:32872141

Rengo C, Goracci C, Ametrano G, Chieffi N, Spagnuolo G, Rengo S, et al. Marginal leakage of class V composite restorations assessed using microcomputed tomography and scanning electron microscope. Oper Dent. 2015;40(4):440-8. https://doi.org/10.2341/14-022-L PMid:25602350

Haak R, Brückner A, Häfer M, Scholz M, Schneider H. Is there an association between clinical and SEM quantitative marginal analysis in a 90-month trial? J Adhes Dent. 2021;23(1):37-46. https://doi.org/10.3290/j.jad.b916821 PMid:33512114

Tosco V, Vitiello F, Furlani M, Gatto ML, Monterubbianesi R, Giuliani A, et al. Microleakage analysis of different bulk-filling techniques for Class II restorations: µ-CT, SEM and EDS evaluations. Materials (Basel). 2020;14(1):31. https://doi.org/10.3390/ma14010031 PMid:33374708

Ramić BD, Stojanac IL, Drobac MR, Kantardžić IR, Maletin AZ, Cvjetićanin MT, et al. Application of scanning electron microscopy in the observation of dentin-adhesive interface. Microsc Res Tech. 2021;84(4):602-7. https://doi.org/10.1002/jemt.23618 PMid:33044003

Carrera CA, Lan C, Escobar-Sanabria D, Li Y, Rudney J, Aparicio C, et al. The use of micro-CT with image segmentation to quantify leakage in dental restorations. Dent Mater. 2015;31(4):382-90. https://doi.org/10.1016/j.dental.2015.01.002 PMid:25649496

Ramic BD, Drobac MR, Stojanac IL, Premovic MT, Petrovic LM. The micromorphological characterization of adhesive bond in dentin different locations. Microsc Res Tech. 2018;81(1):33-7. https://doi.org/10.1002/jemt.22953 PMid:28987026

Heintze SD. Systematic reviews: I. The correlation between laboratory tests on marginal quality and bond strength. II. The correlation between marginal quality and clinical outcome. J Adhes Dent. 2007;9 Suppl 1:77-106. PMid:18341236

Heintze SD. Clinical relevance of tests on bond strength, microleakage and marginal adaptation. Dent Mater. 2013;29(1):59-84. https://doi.org/10.1016/j.dental.2012.07.158 PMid:22920539

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(2):190-200. https://doi.org/10.2341/13-324-L PMid:25216940

Bouschlicher MR, Rueggeberg FA, Wilson BM. Correlation of bottom-to-top surface microhardness and conversion ratios for a variety of resin composite compositions. Oper Dent. 2004;29(6):698-704. PMid:15646227

Moore BK, Platt JA, Borges G, Chu TM, Katsilieri I. Depth of cure of dental resin composites: ISO 4049 depth and microhardness of types of materials and shades. Oper Dent. 2008;33(4):408-12. https://doi.org/10.2341/07-104 PMid:18666498

Garcia D, Yaman P, Dennison J, Neiva G. Polymerization shrinkage and depth of cure of bulk fill flowable composite resins. Oper Dent. 2014;39(4):441-8. https://doi.org/10.2341/12-484-L PMid:24304339

Francois P, Fouquet V, Attal JP, Dursun E. Commercially available fluoride-releasing restorative materials: A review and a proposal for classification. Materials (Basel). 2020;13(10):2313. https://doi.org/10.3390/ma13102313 PMid:32443424

Vallittu PK, Boccaccini AR, Hupa L, Watts DC. Bioactive dental materials-Do they exist and what does bioactivity mean? Dent Mater. 2018;34(5):693-4. https://doi.org/10.1016/j.dental.2018.03.001 PMid:29571660.

Ilie N, Fleming GJ. In vitro comparison of polymerisation kinetics and the micro-mechanical properties of low and high viscosity giomers and RBC materials. J Dent. 2015;43(7):814-22. https://doi.org/10.1016/j.jdent.2015.04.009 PMid:25930017

Rusnac ME, Gasparik C, Irimie AI, Grecu AG, Mesaroş AŞ, Dudea D. Giomers in dentistry-at the boundary between dental composites and glass-ionomers. Med Pharm Rep. 2019;92(2):123-8. https://doi.org/10.15386/mpr-1169 PMid:31086838

Ilie N. High viscosity bulk-fill giomer and ormocer-based resin composites: An in-vitro comparison of their mechanical behaviour. Stoma EDU J. 2016;3(1):54-62.

Campos EA, Ardu S, Lefever D, Jassé FF, Bortolotto T, Krejci I. Marginal adaptation of Class II cavities restored with bulk-fill composites. J Dent. 2014;42(5):575-81. https://doi.org/10.1016/j.jdent.2014.02.007 PMid:24561041

Jang JH, Park SH, Hwang IN. Polymerization shrinkage and depth of cure of bulk-fill resin composites and highly filled flowable resin. Oper Dent. 2015;40(2):172-80. https://doi.org/10.2341/13-307-L PMid:25136904

Lima RB, Troconis CC, Moreno MB, Murillo-Gómez F, de Goes MF. Depth of cure of bulk fill resin composites: A systematic review. J Esthet Restor Dent. 2018;30(6):492-501. https://doi.org/10.1111/jerd.12394 PMid:30375146

Al-Harbi F, Kaisarly D, Bader D, El Gezawi M. Marginal integrity of bulk versus incremental fill Class II composite restorations. Oper Dent. 2016;41(2):146-56. https://doi.org/10.2341/14-306-L PMid:26266653

Patel MC, Bhatt RK, Makwani DA, Dave LD, Raj VS. Comparative evaluation of marginal seal integrity of three bulkfill composite materials in Class II cavities: An in vitro study. Adv Hum Biol. 2018;8:201-5. Available from: https://www.aihbonline.com/text.asp?2018/8/3/201/241923

Yantcheva SM. Marginal adaptation and micropermeability of Class II cavities restored with three different types of resin composites-a comparative ten-month in vitro study. Polymers (Basel). 2021;13(10):1660. https://doi.org/10.3390/polym13101660 PMid:34065229

Hashimoto M, Fujita S, Endo K, Ohno H. In vitro degradation of resin-dentin bonds with one-bottle self-etching adhesives. Eur J Oral Sci. 2009;117(5):611-7. https://doi.org/10.1111/j.1600-0722.2009.00664.x PMid:19758260

Bacelar-Sá R, Sauro S, Abuna G, Vitti R, Nikaido T, Tagami J, et al. Adhesion evaluation of dentin sealing, micropermeability, and bond strength of current HEMA-free adhesives to dentin. J Adhes Dent. 2017;19(4):357-64. https://doi.org/10.3290/j.jad.a38866 PMid:28849795

Kurokawa H, Takamizawa T, Rikuta A, Tsubota K, Miyazaki M. Three-year clinical evaluation of posterior composite restorations placed with a single-step self-etch adhesive. J Oral Sci. 2015;57(2):101-8. https://doi.org/10.2334/josnusd.57.101 PMid:26062858

Alshali RZ, Salim NA, Sung R, Satterthwaite JD, Silikas N. Qualitative and quantitative characterization of monomers of uncured bulk-fill and conventional resin-composites using liquid chromatography/mass spectrometry. Dent Mater. 2015;31(6):711-20. https://doi.org/10.1016/j.dental.2015.03.010 PMid:25882276

Ilie N, Bucuta S, Draenert M. Bulk-fill resin-based composites: An in vitro assessment of their mechanical performance. Oper Dent. 2013;38(6):618-25. https://doi.org/10.2341/12-395-L PMid:23570302

Al Sunbul H, Silikas N, Watts DC. Polymerization shrinkage kinetics and shrinkage-stress in dental resin-composites. Dent Mater. 2016;32(8):998-1006. https://doi.org/10.1016/j.dental.2016.05.006 PMid:27240744

Menees TS, Lin CP, Kojic DD, Burgess JO, Lawson NC. Depth of cure of bulk fill composites with monowave and polywave curing lights. Am J Dent. 2015;28(6):357-61. PMid:26897758

Shortall AC, Palin WM, Burtscher P. Refractive index mismatch and monomer reactivity influence composite curing depth. J Dent Res. 2008;87(1):84-8. https://doi.org/10.1177/154405910808700115 PMid:18096900

Fujita K, Ikemi T, Nishiyama N. Effects of particle size of silica filler on polymerization conversion in a light-curing resin composite. Dent Mater. 2011;27(11):1079-85. https://doi.org/10.1016/j.dental.2011.07.010 PMid:21824650

Ferracane JL. Buonocore Lecture. Placing dental composites-a stressful experience. Oper Dent. 2008;33(3):247-57. https://doi.org/10.2341/07-BL2 PMid:18505214

Park J, Chang J, Ferracane J, Lee IB. How should composite be layered to reduce shrinkage stress: Incremental or bulk filling? Dent Mater. 2008;24(11):1501-5. https://doi.org/10.1016/j.dental.2008.03.013 PMid:18433857

Braga RR, Hilton TJ, Ferracane JL. Contraction stress of flowable composite materials and their efficacy as stressrelieving layers. J Am Dent Assoc. 2003;134(6):721-8. https://doi.org/10.14219/jada.archive.2003.0258 PMid:12839408

Yap AU, Pandya M, Toh WS. Depth of cure of contemporary bulkfill resin-based composites. Dent Mater J. 2016;35(3):503-10. https://doi.org/10.4012/dmj.2015-402 PMid:27252008

Rooz MN, Jordehi AY. The effect of shade and thickness on the depth of cure of bulk-fill composites with different viscosities. J Dent (Shiraz). 2020;21(4):322-9. https://doi.org/10.30476/DENTJODS.2020.83927.1061 PMid:33344683

Gonulol N, Ozer S, Tunc ES. Water sorption, solubility, and color stability of giomer restoratives. J Esthet Restor Dent. 2015;27(5):300-6. https://doi.org/10.1111/jerd.12119 PMid:25145876

Singla MG, Relhan N, Virdi I. Comparative evaluation of depth of cure of three high viscosity bulk fill composites versus conventional composite: An in vitro study. Int J Clin Prev Dent. 2018;14(2):145-51. https://doi.org/10.15236/ijcpd.2018.14.2.145

Tsujimoto A, Barkmeier WW, Takamizawa T, Latta MA, Miyazaki M. Depth of cure, flexural properties and volumetric shrinkage of low and high viscosity bulk-fill giomers and resin composites. Dent Mater J. 2017;36(2):205-13. https://doi.org/10.4012/dmj.2016-131 PMid:28154317

Tarle Z, Attin T, Marovic D, Andermatt L, Ristic M, Tauböck TT. Influence of irradiation time on subsurface degree of conversion and microhardness of high-viscosity bulk-fill resin composites. Clin Oral Investig. 2015;19(4):831-40. https://doi.org/10.1007/s00784-014-1302-6 PMid:25138041

Gayatri C, Rambabu T, Sajjan G, Battina P, Priyadarshini MS, Sowjanya BL. Evaluation of marginal adaptation of a selfadhering flowable composite resin liner: A scanning electron microscopic study. Contemp Clin Dent. 2018;9 Suppl 2:S240-5. https://doi.org/10.4103/ccd.ccd_156_18 PMid:30294151

Amaral FL, Colucci V, Palma-Dibb RG, Corona SA. Assessment of in vitro methods used to promote adhesive interface degradation: A critical review. J Esthet Restor Dent. 2007;19(6):340-54. https://doi.org/10.1111/j.1708-8240.2007.00134.x PMid:18005284

Chuenarrom C, Benjakul P, Daosodsai P. Effect of indentation load and time on Knoop and Vickers microhardness tests for enamel and dentin. Mat Res. 2009;2(4):473-6. https://doi.org/10.1590/S1516-14392009000400016

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2022-02-14

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Abdelwahed AG, Essam S, Abdelaziz MM. Marginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro StudyMarginal Adaptation and Depth of Cure of Flowable versus Packable Bulk-fill Restorative Materials: An In Vitro Study. Open Access Maced J Med Sci [Internet]. 2022 Feb. 14 [cited 2026 Oct. 19];10(D):47-56. Available from: https://oamjms.eu/index.php/mjms/article/view/8353

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