Effect of insertion technique and adhesive system on microleakage of class V resin composite restorations

Purpose: To evaluate the effect of different insertion techniques and adhesive systems on microleakage of Class V composite resin restorations. Materials and Methods: Forty-eight human molars were randomly assigned to four groups (n = 12). Standardized mixed Class V cavities (enamel and dentin margins) were prepared at the CEJ. A total-etch (Adper Scotchbond MultiPurpose) and a self-etching (iBond) adhesive system were evaluated using either an incremental or single-step (bulk) insertion technique. The preparations were restored with Esthet•X micromatrix hybrid composite. The teeth were thermocycled 1000 cycles, immersed in 1% methylene blue dye for 24 h, and invested in acrylic resin. The specimen blocks were then sectioned longitudinally, with dye penetration (microleakage) examined with a 20X binocular microscope. Enamel and dentin margins were scored separately for microleakage using an ordinal ranking system. Results were analyzed using non-parametric tests at a p < 0.05 level of significance. Results: Significance was exhibited between the groups (adhesive material/insertion technique) at the coronal and apical margins. At the coronal margin, the total-etch adhesive/incremental insertion group exhibited significantly less leakage than the other groups, while at the apical margin, the total-etch adhesive/incremental insertion group showed significantly less leakage than the self-etching adhesive/bulk insertion group. Significantly less leakage was found at the coronal margins compared to the apical margins of the material/technique groups. Conclusion: The use of a total-etch adhesive system and incremental insertion of composite significantly reduced microleakage at the coronal and apical margins of Class V composite restorations.