Class II restorations: influence of a liner with rubbery qualities on the occurrence and size of cervical gaps

The aim of this study was to evaluate the ability of new rubbery liners, used as a cervical increment, to relieve contraction stress and thereby reduce the formation of cervical gaps in class II composite restorations. The investigated liners were made of polyester-acrylate (PE(1), PE(2) or PE(3)) or silicone-acrylate (S), mixed with UDMA, without (A, B, C, D) or with HEMA (AH, BH, CH, DH). A silanized filler was added to the mixture, DH, to give composites with 20, 40, 60, and 70% (w/w) of filler (DHF20, DHF40, DHF60, DHF70, respectively). The presence and width of cervical gaps were determined using a light microscope. Statistical analysis showed that six of the 12 rubbery liners (AH-DH, DHF20-DHF40) significantly decreased gap formation in comparison with the control group. In addition, the polymerization shrinkage, flow, and strain capacity of these liners were measured and the influence of these factors on gap formation was examined. Two- and three-dimensional regression analyses showed significantly negative linear correlations between gap formation and strain capacity, and between gap formation and flow, and a significantly positive linear correlation between gap formation and shrinkage.