Resistance of cementum in Class II and V cavities to penetration by an adhesive system

As the cervical margin located in cementum-dentin is still the most unpredictable area of an adhesive resin restoration, the aim of this investigation was to evaluate the morphology of the cementum layer at the cervical margins of Class V and Class II cavities and the impregnability of this layer to resin bonding systems.

Three different types of in vitro investigations of the cervical margins were performed by scanning electron microscopy: 1) direct anatomical observation of conditioned cavities; 2) observation of resin replicas; and 3) observation of resin infiltration. During direct observation, the presence of opened tubules was evaluated; in the resin replicas, the presence of resin tags and their density were observed; in the observation of resin infiltration, the presence of an acid-resistant interdiffusion was investigated.

From direct observation, cut tubules were seen 200 microns from the cervical margin. After treatment with a dentin bonding system, the outer layer was infiltrated by the resin. In the resin replica, the presence of resin tags was detectable 150-200 microns from the margin. In Class II samples, the presence of an outer layer at the cervical margin, which could not be identified as bulk dentin or cementum, was clearly detectable by both direct and indirect observation. In the Class V samples, the border between this layer and bulk dentin was less evident.

The presence of a cementum layer of approximately 150-200 microns at the cervical margins of cavities may pose a serious clinical problem for reliable bonding. Although in the present study the observation of a zone of resin-impregnated cementum may confirm the improvement obtained with the last generation of hybridizing dentin bonding systems, the effectiveness of the bond is still unclear.