Microleakage of Class V Methacrylate and Silorane-based Composites and Nano-ionomer Restorations in Fluorosed Teeth

STATEMENT OF THE PROBLEM: Enamel and dentin marginal sealing ability of the new adhesive materials could play an important role in successful restoration on fluorosed teeth. PURPOSE: The aim of this in vitro study was to evaluate the marginal microleakage of low-shrinkage silorane-based composite, nano-ionomer, and methacrylate-based composite through self-etching approach or with enamel acid etching. MATERIALS AND METHOD: Seventy-two extracted human molars with moderate fluorosed (according to Thylstrup and Fejerskov index, TFI= 4-6) were randomly divided into six groups (n=12). Class V cavities were prepared on the buccal surface at the cementoenamel junction and restored with Clearfil SE Bond/Clearfil AP-X (methacrylate composite), Silorane Adhesive System/Filtek P90 , and nano primer/nano-ionomer according to the manufacturer’s instructions (self-etching approach) or with additional selective enamel acid etching before primer application for each adhesive. After water storage and thermocycling, microleakages of the samples were assessed using dye-penetration technique at the enamel and dentin margins. Data were analyzed using non-parametric tests (α = 0.05). RESULTS: There was a significant difference among the six groups at the enamel margin (p= 0.001), but not at the dentin margin (p= 0.7). For all the three adhesive materials, additional enamel etching resulted in significantly reduced microleakage at the enamel margin (p< 0.05). CONCLUSION: Methacrylate- and silorane-based composites and nano-ionomer revealed a similar and good performance in terms of dentin marginal sealing, but not at the enamel margin. The additional selective enamel etching might improve enamel sealing for the three materials.