Comparative evaluation of microleakage of a carbomer/fluoroapatite-enhanced glass-ionomer cement on primary teeth restorations

Abstract

Aim: Carbomer cement represents a novel glass-ionomer which gradually mineralises into fluoroapatite. Purpose of this study was to evaluate microleakage around restorations in deciduous teeth made with composite resin, conventional glass-ionomer cement, resin-modified glass-ionomer cement and carbomer/fluoroapatite-enhanced glass-ionomer cement.

Materials and methods: A group of 40 primary upper canines, primary upper and lower molars was divided into 4 groups (n=10). Class I cavities were prepared by diamond cylindrical bur at high speed and were restored with a composite resin (Group 1), with a glass- ionomer cement (Group 2), with a resin-modified glass-ionomer cement (Group 3) and with a carbomer/fluoroapatite-enhanced glass- ionomer cement (Group 4). Hard tissue's bonding involved, in the case of composite resin a total etch bonding procedure, and in glass ionomers the use of their respective primers. Restorations were finished and polished. A 24-hour water storage was followed by thermocycling (1500 cycles, 5°C - 36°C - 55°C - 36°C with a dwell time of 15 seconds) and dye penetration test with immersion in 5% methylene blue for 24 hours. In order to assess the degree of microleakage longitudinal cuts were produced by means of a microtome at 0.5 mm and at 1 mm from the restoration margin, and photographs were taken with a stereomicroscope at 100X. Microleakage was classified according to the number of surfaces and the depth at which dye penetration was observed. Data were analysed with ANOVA and post-hoc analysis was performed with Bonferonni test (p<0.05).

Results: Statistical analysis exhibited no significant statistical difference between Group 2 and Group 3 (p>0.05). Statistical difference was exhibited between Group 3 and Group 4 (p<0.01), with Group 4 exhibiting lower microleakage values. Group 1 exhibited the lowest mean microleakage values and statistical difference in comparison with all groups (p<0.001). Group 4 exhibited the lowest microleakage values among the cements.

Conclusion: Superior marginal integrity is achieved in restored primary teeth when composite resin is used. If the clinical case suggests the use of a glass-ionomer cement, carbomer/fluoroapatite-enhanced glass-ionomer cement is prefered in terms of microleakage.