Effect of dual cure composite as dentin substitute on marginal integrity of class II open-sandwich restorations

The current study compared the marginal adaptation of Class II open-sandwich restorations with a RMGIC versus a dual-cure composite as dentin substitute. Class II cavities were prepared on 50 extracted human third molars. The teeth were randomly assigned to two groups of 25 teeth to compare one dual cure composite (MultiCore Flow) with one resin-modified glass-ionomer cement (Fuji II LC) in open-sandwich restorations recovered with a light cure composite. The teeth were thermomechanocycled (2000 cycles, 5 degrees C to 55 degrees C; 100,000 cycles, 50 N/cm2). The specimens were then sealed with a 1 mm window around the cervical margin interface. Samples were immersed in a 50% w/v ammoniacal silver nitrate solution for two hours and exposed to a photo-developing solution for six hours. The specimens were sectioned longitudinally and silver penetration was directly measured using a light microscope. The results were expressed as a score from 0 to 3. The data were analyzed with a non-parametric Kruskal and Wallis test. The degree of leakage significantly increased with MultiCore Flow (median 2) compared to Fuji II LC (median 1). Resin-modified glassionomer cements remain the best intermediate material when open-sandwich restorations are indicated. A comparison of the degradation of these materials over time remains a topic to be investigated by future studies.