Objectives: Using the push-out technique, this study compared the influence of different composite insertion techniques in Class I cavities on the regional shear bond strength to lateral walls.
Materials and method: Standardized Class I cavities were prepared on the occlusal surface of 60 freshly extracted third molars, which were randomly assigned to one of five groups (n = 10). The cavities were bonded with the self-etch adhesive AdheSE and restored with Tetric Ceram resin composite by one of five techniques: G1, incremental technique (four oblique layers); G2, flowable composite as liner and bulk technique; G3, bulk technique and G4, light cone technique. The total-etch adhesive (Single Bond) and incremental technique were used as the control procedure. Each specimen was sectioned perpendicular to the long axis of the tooth in 1 mm-thick dentin slices. A push-out test was performed to measure regional bond strengths and identify the type of failure. Two additional teeth per group were prepared for the morphological interface study using scanning electron microscopy.
Results: Differences between the groups were tested by one-way ANOVA and Scheffé post hoc test (F = 29.635, p < 0.001). The highest shear bond strength values were obtained with the incremental technique, regardless of the adhesive used. Significant differences in bond strength to superficial and deep dentin were only found when a total-etch adhesive was used (Single Bond).
Conclusions: Use of the incremental technique with total-etch or self-etch adhesives is the most effective method of inserting resin-based composites in large Class I cavities.