Clinical and microbiological effects of different restorative materials on the periodontal tissues adjacent to subgingival class V restorations.
OBJECTIVE
The relationship between subgingival dental restorations and periodontal health has been thoroughly investigated for many years. However, longitudinal data on the subgingival microflora features after the placement of well-finished subgingival restorations are still lacking. Therefore, this study compares the short-term clinical and microbiological features occurring in the gingiva after the completion of different subgingival restorations.


METHODS
Sixteen systemically healthy subjects, 10 males and six females (ages: 31.7-45.8 years; mean age 39.3+/-5.1 years), who were non-smokers and were positive for the presence of three cervical abrasion/erosion defects to be restored in three different adjacent teeth were enrolled in this study. The cervical abrasion/erosion defects were each restored by using one of three different materials: amalgam, glass ionomer cement, or composite resin. Immediately before class V cavity preparations and restorations (baseline), clinical monitoring and subgingival plaque sampling were performed in the mid-buccal aspect of each experimental restored tooth and in one adjacent sound, non-treated, control tooth. These procedures were repeated every 4 months over the following 1 year.


RESULTS
Throughout the study, the clinical parameters recorded did not change significantly in any of the experimental groups, and no differences were detected among them at each clinical session. Over this time, no significant changes in the composition of the subgingival microflora were observed in amalgam, glass ionomer cement, and control groups. Conversely, in the composite resin group, there was a significant increase in the total bacterial counts, and a significant (p<0.05) decrease in Gram-positive, aerobic bacteria, which was associated with a significant (p<0.05) increase in the Gram-negative, anaerobic microbiota.


CONCLUSIONS
Over a 1-year observation period, amalgam, glass ionomer cement, and composite resin subgingival restorations do not significantly affect the clinical parameters recorded. However, composite resin restorations may have some negative effects on the quantity and quality of subgingival plaque.
Paolantonio
Michele
M
Department of Oral Sciences, School of Dentistry, University "G D'Annunzio", Chieti, Italy. mpaolantonio@unich.it
D'ercole
Simonetta
S
Perinetti
Giuseppe
G
Tripodi
Domenico
D
Catamo
Giovanni
G
Serra
Emanuela
E
Bruè
Claudia
C
Piccolomini
Raffaele
R
D000328:Adult; D015169:Colony Count, Microbial; D003188:Composite Resins / Q000737:chemistry; D003723:Dental Amalgam / Q000737:chemistry; D003737:Dental Cavity Preparation / Q000145:classification; D003764:Dental Materials / Q000737:chemistry*; D003773:Dental Plaque / Q000382:microbiology / Q000473:pathology; D003793:Dental Restoration, Permanent / Q000145:classification*; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000382:microbiology / Q000473:pathology*; D005899:Glass Ionomer Cements / Q000737:chemistry; D006089:Gram-Negative Anaerobic Bacteria / Q000254:growth & development; D006094:Gram-Positive Bacteria / Q000254:growth & development; D006801:Humans; D008297:Male; D008875:Middle Aged; D014072:Tooth Abrasion / Q000628:therapy; D014077:Tooth Erosion / Q000628:therapy; D014092:Tooth Root / Q000473:pathology
D003188:Composite Resins; D003764:Dental Materials; D005899:Glass Ionomer Cements; D003723:Dental Amalgam