Marginal and Internal Adaptation of Cervical Restorations Using Direct, Direct–indirect, and Indirect Techniques
This study aimed to evaluate the external and internal adaptations of cervical restorations using different restorative techniques. Forty extracted and intact human premolars received standardized cervical preparations to simulate non-carious cervical lesions. The teeth were randomly divided into four groups (n=10) according to the restorative technique: D, direct composite restoration without a base (Palfique LX5, Tokuyama Dental Corp Inc, Tokyo, Japan); DB, direct composite restoration with a flowable composite liner (Estelite Flow Quick -High Flow, Tokuyama Dental Corp Inc); DI, direct–indirect composite restoration bonded with flowable composite; and I, indirect restoration bonded with flowable composite. Marginal adaptation of the restorations was observed in different segments of the margins using a scanning electron microscope. Analyses of internal adaptation were performed using micro-computed tomography. The Kruskal–Wallis and Mann–Whitney tests were used for statistical analysis of the data (α=5%). No significant differences were found in the marginal adaptation of the groups (p>0.05), although a significantly higher percentage of continuous margin was found in the proximal segment than in the cervical segment (p<0.05). No significant differences were detected between the groups in terms of internal adaptation (p>0.05). All the restorative techniques evaluated for the restoration of cervical lesions performed similarly in terms of marginal and internal adaptation.SUMMARY
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Scanning electronic microscopy images of samples showing the interface between the dentin margin and the adhesive restoration. (A): view of a cervical margin at 45× magnification; (B): division of the tooth/restoration interface into three segments (45×); (C): cervical margin showing 100% adaptation (300×).
Images of axial slices by micro-computed tomography. (A): Specimen of Group D restored with direct technique; (B): specimen of Group DB restored with direct technique with a flowable liner (arrow); (C): specimen of Group DI restored using the direct–indirect technique and bonded with flowable composite (arrow); (D): specimen of Group I restored using the indirect technique and bonded with flowable composite (arrow).
Contributor Notes
Clinical Relevance
Cervical restorations using direct, direct–indirect, and indirect techniques with a flowable liner did not demonstrate advantages in terms of marginal and internal adaptation for the restoration of non-carious cervical lesions.