SEM analysis of marginal expansion and gap formation in Class II composite restorations.
OBJECTIVE
Morphological changes in terms of marginal expansion have been observed at the dentin-composite interface of resin composite restorations with the scanning electron microscope (SEM), which could not be described with the criteria conventionally used for quantitative marginal analysis. The purpose of the present study was to elucidate the influence of marginal expansion upon marginal integrity and clarify the cause of these morphological changes.


METHODS
A total of 22 extracted human molars were restored with Class II resin composite restorations, with and without the use of a dentin bonding agent. The cervical restoration margin was located below the cemento-enamel-junction (CEJ). The marginal adaptation at the dentin- and enamel-composite interfaces was evaluated and measured on replicas using quantitative SEM analysis after different storage periods. The chemical composition of the marginal expansion was determined qualitatively by EDX (Energy Dispersive X-Ray) analysis using original tooth samples. The results obtained from quantitative SEM analysis were statistically analyzed by applying the Mann-Whitney U-test and the error rates method.


RESULTS
Significantly less marginal expansion occurred at the enamel interface than at the dentin-composite interface (p < or = 0.01). Within the dentin, less marginal expansion was observed with the use of a dentin bonding agent than without a dentin bonding agent (p < or = 0.05). At 1 y, a significant (p < or = 0.05) decrease in marginal expansion was observed in both groups. EDX analysis revealed that the chemical composition of the marginal expansion is comparable to the resin composite, since peaks for silicon, barium and ytterbium could be found at these sites.


CONCLUSIONS
In Class II resin composite restorations below the CEJ, partial disruption of the adhesive bond may occur initially when curing the restoration. Water sorption causes gap reduction by hygroscopic expansion, seen in the SEM as a volume increase. Thus, the observed morphological changes can be regarded as an early sign of insufficient adhesion between composite and dentin at sites where disruption of the bond occurred initially, whether or not a dentin bonding agent was used.
Dental School, University of Regensburg, Germany. birger.thonemann@klinik.uni-regensburg.de
B M
BM
Thonemann
M
M
Federlin
G
G
Schmalz
K A
KA
Hiller
D000179:Acrylates; D003188:Composite Resins / Q000737:chemistry*; D018772:Dental Marginal Adaptation; D003793:Dental Restoration, Permanent / Q000379:methods*; D003804:Dentin / Q000648:ultrastructure; D017220:Dentin-Bonding Agents; D006801:Humans; D008855:Microscopy, Electron, Scanning; D019279:Resin Cements; D018709:Statistics, Nonparametric
D000179:Acrylates; D003188:Composite Resins; D017220:Dentin-Bonding Agents; D019279:Resin Cements; C078484:Syntac dentine adhesive; C090969:Tetric; C040415:heliobond