The Causes and Effects of Micro-leakage in Posterior Composite Restorations

The Causes and Effects of Micro-leakage in Posterior Composite Restorations

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BACKGROUND
Composite restoration usage in dentistry is increasing. Because of this interest in the longevity and reliability of composite fillings also is increasing1. One problem that can occur with composite restorations is micro-leakage. This is when microgaps at the tooth-restoration interface allow fluids and bacteria into the restoration2. These gaps are formed when the material is polymerized and shrinks, which causes the material to pull away from the margins of the preporation2. Problems that can arise from micro-leakage are secondary carries, hypersensitivity, pulp stimulation, and marginal discoloration3. This is why dentists are trying to find ways to reduce micro-leakage of composite restorations.

RESEARCH
There are many different areas that can be looked at in attempting to find ways to reduce micro-leakage of composite fillings.

Liners
In comparing micro-leakage of resin-modified glass-ionomers (RMGI), flowable composite liners, and no liners, it was found that by applying a RMGI liner before placing the composite decreased the extent of micro-leakage3. By doing this, the farthest the micro-leakage occurred was to the cervical wall, whereas with composite liners and no liners there was leakage to the cervical wall and into the axial wall3. The reason for the difference could be attributed to the bond between the glass ionomer and composite. This bond is weak and can be thought of as an unbounded wall, leading to less shrinkage stress to the bonds between composite and dentin3.

Desensitizers
If desensitizers are used before adhesives this adds a new layer to the restoration and there could be a difference with marginal sealing. On enamel there is no effect with reducing or increasing micro-leakage however whe...


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...bamide Peroxide In Vitro. Operative Dentistry 2010; 35(6): 634-40.
6. Khosravi K, Ataei E, Mousavi M, et al. Effect of Phosphoric Acid Etching of Enamel Margins on the Microleakage of a Simplified All-in One and Self-etch Adhesive System. Operative Dentistry 2009; 34(5):531-36.
7. Bagis Y, Baltacioglu I, Kahyaogullari S. Comparing Microleakage and the Layering Methods of Silorane-based Resin Composite in Wide Class II MOD Cavities. Operative Dentistry 2009; 34(5):578-85.
8. Karaman E, and Ozgunaltay G. Polymerization Shrinkage of Different Types of Composite Resins and Microleakage With and Without Liner in Class II Cavities. Operative Dentistry 2014; 39(2):00-00.
9. Afshar H, Jafari A, Khami M, et al. Evaluation of Microleakage in Composite-Composite and Amalgam-Composite Interfaces in Tooth with Preventive Resin Restoration. Journal of Dentistry 2012; 9(2):128-34.

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