Purpose: 1) To evaluate the marginal sealing efficacy of Biodentine at the cervical margins of approximal cavities placed in molars; 2) to evaluate and compare the use of Biodentine in combination with resin-based adhesives and a resin composite, compared with a resin-modified glass-ionomer cement (Fuji II LC).
Materials and Methods: Sixty approximal cavities were prepared on mesial and distal surfaces of 30 extracted human third molars. The teeth were randomly assigned into 6 groups of 10 cavities each: (G1) Biodentine, (G2) Fuji II LC as a filling material, (G3) Biodentine as a base + Optibond Solo Plus + silane + Filtek Z250, (G4) as in G3 without silane, (G5) Biodentine as a base + Septobond SE + Filtek Z250, (G6) Fuji II LC as a base + Optibond Solo Plus + Filtek Z250. The materials were applied according to the manufacturers instructions. Biodentine required no dentin or enamel surface conditioning treatment. The teeth were thermocycled 2500x (5°C to 55°C). The specimens were then sealed with a 1-mm window around the marginal interface. Samples were immersed in a 50% w/v silver nitrate solution and exposed to a photodeveloping solution. The teeth were embedded in resin (Sody 33) and sectioned through the restorations. The silver penetration was directly measured using a light microscope. The results were expressed as ordinal scores from 0 to 3 at cervical, interfacial, and enamel margins. The data were analyzed with the nonparametric Kruskal-Wallis, Games Howell, and Wilcoxon signed rank tests (p < 0.05).
Results: No statistically significant differences were found between the 6 groups, neither for the dentin cervical margins nor for cervical lining (Biodentine or Fuji II LC)/resin composite interfaces. Statistically significant differences were observed between G5 (median score = 2.0) and the other groups (median score = 1.0) for the enamel margins. Statistically significant differences were found between enamel and dentin cervical margins in G2 (enamel median score = 1.0; dentin median score = 1.5) and G5 (enamel median score = 2.0; dentin median score = 1.0).
Conclusion: Within the limits of this in vitro study, Biodentine as dentin substitute in cervical lining restorations or as a restorative material in approximal cavities when the cervical extent is under the CEJ seems to perform well without any conditioning treatment. However, the operating time is longer than when a RMGIC (Fuji II LC) is used.
Keywords: Ca3SiO5-based dentin substitute, resin-modified glass-ionomer cement, microleakage