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635 1872 1 PB
635 1872 1 PB
635 1872 1 PB
ABSTRACT
Aims
and
objectives: To
evaluate
the
effect
of
10% carbamide peroxide bleaching gel on marginal integrity of
tooth colored restorative materials.
Materials and Methods: Forty five human premolar teeth
extracted for orthodontic reason with good enamel integrity were
selected for the study and divided into three groups of 15 teeth
each. Class-V cavities were prepared on the buccal surfaces of the
teeth. The cavities were restored with composite resin, resin
modified glassionomer, and conventional glass ionomer in the
respective groups. 10 teeth in each group were subjected
to thermocycling. After thermocycling the teeth were exposed to
the bleaching agent. The remaining teeth were kept aside as
control. After bleaching, all the teeth, including the control groups
were subjected to microleakage analysis.
Results: Statistical significant differences(P<0.001) were seen
between the control groups and the experimental groups. The
marginal integrity of the resin modified glass ionomer was less
affected while exposing to bleaching, when compared to
composite resin and conventional glass ionomer.
Conclusion: The results suggest that resin modified
glass ionomer performed better at both enamel and dentin
margins when compared to the other two experimental groups.
Keywords:
carbamide peroxide,
restorative resins, glass ionomer.
Introduction
bleaching,
microleakage,
RESEARCH
2.5mm in height and 1.5mm in depth. Bur was replaced
after every fifth cavity preparation. The teeth were
randomly divided into three groups with each group
comprising of fifteen teeth and fifteen restorations
each. The restored teeth were stored in distilled water
at 37C for five days before subjecting them to
bleaching treatment. This will prevent dehydration of
the teeth and also mimick the mouth temperature6.
Each group was restored with the following restorative
materials,
Group
1was
restored
with
microhybrid flowable composite resin, EsthetX flow (Dentsply
,USA).
The
prepared
cavity
was
etched
with Scotchbond multipurpose etchant(3M ESPE, USA)
for 10 seconds, rinsed thoroughly with water for 30
seconds and dried with gentle blow of air .The bonding
agent, prime & bond NT(Dentsply,USA) was then
applied as per the manufacturers instructions and was
cured for 20 seconds. The composite was placed with a
two-step procedure. The first increment was placed in
the gingival part of the prepared cavity, flowed with a
syringe tip provided by the manufacturer to avoid air
entrapment and cured for 40 seconds. The second
increment was flowed into the rest of the cavity and
cured.
Restorations were finished and polished with coarse,
medium, fine, and ultra-fine polishing discs (Soflex-3M,
USA).
Group 2 - was restored with resin modified
glass ionomer cement,Fuji II LC(GC corporation, Japan).
The prepared cavities were conditioned with dentin
conditioner (GC corporation, Japan) and the restorative
material was placed and cured as per the
manufacturers instructions. The restoration was
finished and polished and a protective varnish (GC
corporation, Japan) coating was applied to the restored
surfaces.
Group 3 - was restored with conventional
glass ionomer cement, Fuji II (GC corporation, Japan).
The prepared cavities were conditioned and the
restorative material was placed as per the
manufacturers instructions. The restoration was
finished and polished and a protective varnish (GC
Corporation, Japan) coating was applied to the restored
surfaces.
Ten teeth in each group were randomly selected
and thermocycled for 300 cycles at 5C and 55C with a
dwell time of 60 seconds each. Five teeth in each group
were treated as control groups and these teeth were
neither subjected to thermocycling nor the bleaching
procedure. Thermocycling has been used invitro as a
means to simulate the aging effects that the
restorative materials are subjected to in the mouth22.
Following thermocycling all teeth were exposed to
commercially available 10% carbamide peroxide gel,
Platinum-Overnight (Colgate Palmolive,USA) for eight
hour period per day for 14 days. The bleaching agent
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RESEARCH
Table 1 shows the scores of microleakage analysis for each group at enamel margin as given below
Score 0
Score 1
Score 2
Score 3
Table 2 shows the scores of microleakage analysis for each group at dentin/cementum margins as given below
Score 0
Score 1
Score 2
Score 3
Fig.1 Micro Leakage Assessment under Stereo Microscope in micro-hybrid flowable composite resin (Group 1)
Dentin Margin
39
Enamel Margin
RESEARCH
Fig.2 Micro Leakage Assessment under Stereo Microscope in resin modified glass ionomer cement (Group 2)
Enamel Margin
Dentin Margin
Fig.3 Micro Leakage Assessment under Stereo Microscope in conventional glass ionomer cement (Group 3)
Enamel Margin
Dentin Margin
40
RESEARCH
Results
Sigmastat (Version
3.1, Systat software
Inc, San
Jose, CA) was used for the analysis of data. The analysis
indicates that at enamel margin (P=0.064), there is no
significant statistical difference between the different
restorations. Table 1 shows the microleakage at the
enamel between control and groups 1, 2 & 3 (P<0.001)
there is significant statistical difference between the
control and group 3 (restored with conventional
glass ionomer cement). The analysis at the dentin
margin (Table 2) indicates that between groups
(P=0.097) there is no significant statistical difference.
But, between control and groups 1, 2 & 3 (P<0.001)
there is an indication of significant statistical difference
between control and all the three groups. Fig.1-3 shows
the Micro Leakage Assessment under Stereo
Microscope in group 1-3.
Discussion
The results of this study shows the detrimental effects
of bleaching on the marginal integrity of already
restored cervical cavities with three different
restorative materials. Adverse effect on the marginal
seal of a tooth colored restorative material leads to
marginal gap which in turn leads to microleakage, which
may be responsible for secondary caries, marginal
discoloration, pulpal inflammation and hypersensitivity8,
9, 10, 16,25,26
.
The purpose of the present invitro study was to
evaluate the effect of 10% carbamide peroxide
bleaching gel on marginal integrity of widely used tooth
colored restorative materials. The effect of bleaching
agents on restorative materials have been evaluated by
a number of studies2,6,7,8,9,10,12. Some studies showed
that bleaching class-V composite resin restorations
increases microleakage at dentin/ cementum margins2,
6
.
Several authors have reported that carbamide peroxide
bleaching agents adversely affected the marginal seal of
resin composite restoration6, 8, 9, 10, 20. Also, it has been
shown that teeth exposed to 10% carbamide peroxide
lost calcium, but this amount was similar to that lost
during 2.5 minutes exposure to a cola beverage5. The
carbamide peroxide material used in the above study
was in an acidic base. The low pH may have been
responsible for the calcium loss. Today most of
the carbamide peroxide bleaching agents are available
in a neutral base24.
In our study all the materials were used to restore
standardized class V cavity prepared in a human
premolar tooth with occlusal margins in enamel and
gingival margin in dentin or cementum. The restorative
materials under investigation exhibited a certain
amount of micro leakage in enamel and
dentin/cementum margins after exposure to bleaching
with 10% carbamide peroxide gel.
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Conclusion
It is reported that marginal integrity of tooth colored
restorations when exposed to postoperative bleaching
cycles are detrimentally affected9. Our invitro
microleakage study concurs to some extent to the
previous findings. Invivo, the majority of the scientific
evidence supports to fact that bleaching is safe to both
patients and the restorations
References
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RESEARCH
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MDS
Associate professor.
Dept of Conservative Dentistry & Endodontics,
M.S.Ramaiah Dental College & Hospital,
Bangalore.
2.
Dr. Meena. N.
3.
MDS
Professor.
Dept of Conservative Dentistry & Endodontics,
V.S. Dental College & Hospital, Bangalore.
MDS
Correspondence Address
Dr. Indiresha.H.N
#80, 8th Main, BSK-3rd stage,
Avalahalli Extension, Bangalore 560085.
E-mail: indiresha.hn@gmail.com
Ph nos, 0-9342854675 / 0-9900001103
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