Insertion methods and gap/void formation in atraumatic restorative technique: A micro-CT analysis

Area of Science:

• Dental Materials Science
• Minimally Invasive Dentistry

Background:

• Dentin wetting is essential for atraumatic restorative treatment (ART) success.
• High-viscosity glass-ionomer cement (GIC) presents challenges in conventional ART insertion.
• Minimizing gaps and voids is critical for the longevity and efficacy of dental restorations.

Purpose of the Study:

• To evaluate and compare the formation of gaps and voids in ART restorations using three different GIC insertion methods.
• To determine which insertion technique optimizes cavity adaptation and minimizes interfacial gaps.

Main Methods:

• Three ART insertion techniques were tested: conventional, Centrix injection, and a novel double-filling method.
• Micro-computed tomography (micro-CT) was used to quantify gap and void volumes in restored teeth.
• Standardized ART procedures, including dentin conditioning and matrix application, were maintained across all groups.

Main Results:

• The double-filling technique demonstrated significantly lower gap volumes compared to conventional and Centrix injection methods.
• Centrix injection showed a lower gap volume than the conventional technique.
• No statistically significant differences were found in void volumes among the three techniques.

Conclusions:

• The double-filling technique offers superior cavity adaptation by minimizing gaps, crucial for enhanced adhesive, remineralizing, and antibacterial properties of GIC.
• The Centrix injection technique provides a better alternative to conventional insertion regarding gap formation.
• Optimizing GIC insertion methods is vital for improving the clinical performance of ART restorations.