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Original article

Marginal GAP and Alteration of Enamel Around Adhesive Restorations of Teeth (in vitro SEM investigation)

By
Stefan Dačić ,
Dragica Simonović Dačić ,
Dragica Simonović Dačić
Goran Radičević ,
Goran Radičević
Aleksandar Mitić ,
Aleksandar Mitić
Goran Tošić ,
Goran Tošić
Ivan Ristić ,
Ivan Ristić
Stefan Veličković
Stefan Veličković

Abstract

There are three adhesive restorative systems: etch and rinse (total etch), self etch and glass ionomer systems. Marginal gap and alteration of marginal enamel around composite and glass ionomer restoration may be influenced by the use of adhesive restorative procedure. The aim of this study was to evaluate the marginal integrity and morphology of the enamel surface around margins of composite and glass ionomer restorations, after storage in cariogenic-acid solution. Seventy class V cavities were prepared with margins at enamel. Cavities were restored with: (I) 1. Single Bond + Z 250 and  2. Single Bond + Filek flow, using etch and rinse adhesive system; (II) 3. Prompt-L-Pop + Z 250 and  4. Prompt-L-Pop + Filtek flow, using self etch adhesive system; (III) 5. Vitremer, glass ionomer system. After the restorative procedure, the teeth with restorations were subjected to demineralization for 7 and 28 days. Samples were stored in a demineralizing solution (lactic acid, pH 4.5, 0,1M) at 370C or in deionized water (control group). The margins of restorations (width of the gap) and perimarginal enamel were examined by scanning electron microscope (SEM). The data were analyzed using the ANOVA -  Dunnet test. Hybrid composite resin with etch and rinse adhesive system (Single Bond/ Z 250) showed the best adaptation to enamel margins. Glass ionomer restorations showed significantly bigger gap formation compared to etch and rinse and self etch systems (p<0,01). The SEM examination showed demineralized perimarginal enamel zone around all types of restorations as well. These zones were characterized by severe signs of erosion, alteration of rods, porosities. Slight alterations were found on the enamel surfaces not included in the perimarginal zone.  Marginal adaptation of restorations to enamel was more effective with etch and rinse adhesive system than self etch and glass ionomer approaches. Stronger demineralization of the perimarginal enamel was observed around composite restorations.

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