Models of Caries Formation around Dental Composite Restorations

The main reason cited for the replacement of dental composite restorations is the recurrence of caries. Numerous models-both in vitro, with acid gels or bacterial biofilms, and in situ, with dental appliances-have been used to study caries formation around dental composites. The literature shows that many factors may affect caries formation, including marginal gap formation, gap size, the local chemical environment, the durability of the bonded interface, the extent of bacterial penetration, and the presence of mechanical loading. Studies have also shown that what have been called wall lesions may form independent of surface lesions, though not likely due to microleakage through very small gap spaces in the clinical situation. Gap size and mechanical loading have been shown to be related to lesion severity within in vitro models, but these results do not correspond exactly with those obtained from in situ studies using restorations in dental appliances. Though not conclusive, some in vitro models have shown that certain materials possessing antimicrobial characteristics may reduce the severity of lesion formation, suggesting possible pathways for developing new composite and adhesive materials for restorations with potentially enhanced longevity.