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Randomized Controlled Trial
. 2022 Apr 19;19(9):4961.
doi: 10.3390/ijerph19094961.

Influence of Matrix Type on Marginal Gap Formation of Deep Class II Bulk-Fill Composite Restorations

Britta Hahn  1 , Imme Haubitz  1 , Ralf Krug  1 , Gabriel Krastl  1 , Sebastian Soliman  1
Affiliations
Randomized Controlled Trial

Influence of Matrix Type on Marginal Gap Formation of Deep Class II Bulk-Fill Composite Restorations

Britta Hahn et al. Int J Environ Res Public Health. .

Abstract

Background: To test the hypothesis that transparent matrices result in more continuous margins of bulk-fill composite (BFC) restorations than metal matrices. Methods: Forty standardized MOD cavities in human molars with cervical margins in enamel and dentin were created and randomly assigned to four restorative treatment protocols: conventional nanohybrid composite (NANO) restoration (Tetric EvoCeram, Ivoclar Vivadent, Schaan, Liechtenstein) with a metal matrix (NANO-METAL) versus transparent matrix (NANO-TRANS), and bulk-fill composite restoration (Tetric EvoCeram Bulk Fill, Ivoclar Vivadent, Schaan, Liechtenstein) with a metal matrix (BFC-METAL) versus transparent matrix (BFC-TRANS). After artificial aging (2500 thermal cycles), marginal quality was evaluated by scanning electron microscopy using the replica technique. Statistical analyses were performed using the Mann−Whitney U-test and Wilcoxon test. The level of significance was p < 0.05. Results: Metal matrices yielded significantly (p = 0.0011) more continuous margins (46.211%) than transparent matrices (27.073%). Differences in continuous margins between NANO (34.482%) and BFC (38.802%) were not significant (p = 0.56). Matrix type did not influence marginal gap formation in BFC (p = 0.27) but did in NANO restorations (p = 0.001). Conclusion: Metal matrices positively influence the marginal quality of class II composite restorations, especially in deep cavity areas. The bulk-fill composite seems to be less sensitive to the influence of factors such as light polymerization and matrix type.

Keywords: SEM; bulk-fill technique; centripetal technique; class II restoration; marginal gap formation; metal matrix; transparent matrix.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cavity design and cavity dimensions (arrows); E = proximal box located within enamel; O = occlusal cavity; D = proximal box cervically located in dentin; CEJ = cementoenamel junction.
Figure 2
Figure 2
Artificial dental model with mounted specimen tooth, metal matrix secured in a Tofflemire holder, wooden wedges, and separation rings.
Figure 3
Figure 3
Experimental setup with the four experimental groups; red digits represent the order and number of composite increments. NANO = Tetric EvoCeram; BFC = Tetric EvoCeram Bulk Fill; METAL = metal matrix; TRANS = transparent matrix; CEJ = cementoenamel junction.
Figure 4
Figure 4
Representative SEM images of the marginal quality outcomes: (a) continuous margin and (b) marginal gap.
Figure 5
Figure 5
Mean percentages with standard deviation of continuous margins in enamel (E) and dentin (D) in all groups; NANO = Tetric EvoCeram; BFC = Tetric EvoCeram Bulk Fill; METAL = metal matrix band, TRANS = transparent matrix band.
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