Comparative Evaluation of Microleakage With Total-Etch, Universal (Self-Etch Mode), and Nano Adhesive Systems in Class V Composite Restorations: An In-Vitro Study

Objectives: The adhesion of bonding agents and their longevity are of interest to dentistry. Microleakage remains the major cause of composite restoration failures, which in turn depends on bonding between the restorative material and tooth substrate. The objective of this study is to evaluate and compare the microleakage with total-etch, universal, and nano adhesive systems in Class V composite restorations, utilizing a dye penetration method. Methods: Forty-five extracted premolars were included in the present study, and a Class V cavity on the facial surface of each tooth was prepared. The samples were divided into three groups of 15 teeth each depending on the bonding agents used, following which composite restoration was done. Specimens were thermocycled, and nail varnish was applied except around the restorations. Specimens were then immersed in 2% methylene blue for 24 hours and rinsed; sectioning was done and viewed under a stereomicroscope with 10X magnification. Results: The mean microleakage score was reported to be significantly higher in the universal adhesive system in the self-etch mode (3.60 ± 0.55) when compared with the total-etch adhesive system (2.40 ± 0.55) and least in the nano adhesive system (1.20+.45) (p value <.05). Conclusion: The study findings revealed that nano adhesives showed lesser microleakage as compared to total-etch and universal adhesive systems. Clinical significance: The study strengthens the findings that the nano adhesives have reduced microleakage, resulting in better marginal integrity and increased longevity of restoration. This study signifies that an eighth-generation bonding agent is reported to be better than the other bonding agents used in this study.