Evaluation of micro-CT in the assessment of microleakage under bulk fill composite restorations

Am J Dent. 2022 Jun;35(2):128-132.

Abstract

Purpose: To evaluate microleakage measurements using micro-CT in comparison to dye tracers in Class 2 bulk-fill composite restorations with two adhesive techniques.

Methods: 60 sound molars were prepared with Class 2 cavities having cervical margins in enamel (mesial) and in dentin (distal) and restored with Filtek Bulk Fill, using either a self-etch or total-etch technique. All teeth were thermo-cycled between 5°C and 55°C for 800 cycles and randomly exposed to three tracer dyes: 2% methylene blue, 0.5% basic fuchsin or 50% silver nitrate solutions. Teeth were sectioned mesial-distal and depth of tracer penetration was measured as a ratio of dye penetration from the cavosurface divided by total depth of the cervical floor. The silver nitrate subgroup was micro-CT scanned prior to sectioning, evaluated in 3D serial sections, and calculated volumetrically.

Results: Analysis of ratios for dye tracer penetration showed significantly lower values for methylene blue (0.120). Micro-CT values calculated in 3D as volume (mm³) were significantly greater in enamel for self-etch (0.060) compared to total-etch (0.020). Micro-CT volumetric analysis showed better discrimination with significantly greater leakage in enamel margins using the self-etch adhesive.

Clinical significance: Based on this in vitro study of microleakage, micro-CT volumetric evaluation in serial digital sections improves discrimination and represents a more reliable estimate of true microleakage. In vitro study of microleakage is most useful in comparing adhesive products, but clinical application of the data is questionable.

MeSH terms

  • Composite Resins
  • Dental Cavity Preparation / methods
  • Dental Leakage*
  • Dental Restoration, Permanent / methods
  • Dentin-Bonding Agents
  • Humans
  • Methylene Blue
  • Silver Nitrate
  • X-Ray Microtomography

Substances

  • Composite Resins
  • Dentin-Bonding Agents
  • Silver Nitrate
  • Methylene Blue