Composite vs. ionomer vs. mixed restoration of wedge-shaped dental cervical lesions: Marginal quality relative to...

Dental cervical restorations may be impacted by resultants of occlusal loads that may have already contributed to the development of the lesion and should rely on materials' favorable properties to bear the stresses. The marginal quality of cervical restorations made with materials of different moduli of elasticity in essence, isolated, or in combination, was evaluated relative to eccentric occlusal loading. Cervical wedge-shaped cavities, prepared in extracted premolars, were restored with a composite resin (CR), a restorative ionomer (GIC), or the composite in combination with a lining ionomer (Mixed restoration: M). Half of the teeth in each group were subjected to eccentric occlusal loading (eol; 150 N / 10⁶ cycles / 2.5 Hz; CReol / GICeol / Meol, n = 10), and the others were stored in 37 °C distilled water (Control: c; CRc / GICc / Mc, n = 10). A fluorescein-modified adhesive favored delimitation of formed gaps, which were evaluated by confocal laser scanning microscopy regarding their presence, location related to the cavity walls, and width and depth (µm), at a 5% significance level. From a comprehensive perspective, neither the loading nor the materials were significantly associated with the qualitative response variables or exerted any influence over the quantitative variables. More specifically, the use of the different materials was significantly associated with the frequency of gaps exclusively when loading was applied (Chi-square test, p = 0.029, CR > M > GIC). Though the marginal quality of cervical restorations may not be influenced by eccentric occlusal loading or the use of different materials, even in association in general, the unfavorable aspects of the use of the composite may be relevant, particularly in face of the existence of eccentric occlusal loads.