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Original paper
The effect of the cavosurface angle of dentin cavities prepared in extracted human molars on the
cavity adaptation of a resin composite was evaluated by measuring the gap width between the
resin composite and the dentin cavity wall. Cavities with cavosurface angles of 90, 120,
135, or 150 were pretreated with one of two commercial dentin bonding systems or an experi-
mental dentin bonding system. The contraction gap width was measured at both the cavity
margin and the section cavity using a light microscope. Complete cavity adaptation was ob-
tained with pretreatment of the experimental groups regardless of the Cavosurface angle. The
contraction gap observed at the cavity margin was prevented with the two commercial dentin
bonding systems when the cavosurface angle was increased to 150 degrees. A high correlation
was observed between the contraction gap width and the proportion of the free surface to the
INTRODUCTION
limited to removing only the infected or strongly discolored tooth substances and to
preserve as much of the sound tooth structure as possible. Thus, the conventional
box-form cavity has not been practiced in the clinic11), and the clinical cavosurface
angle for resin composite restoration may, possibly, be larger than 90 degrees. The
purpose of the present study was to examine the relationship between the cavosurface
angle of the dentin cavity and the adaptation of the resin composite.
The proximal enamel of an extracted human molar was flatly eliminated on a wet
carborundum paper grit (number 220) and a cavity approximately 3mm in diameter
depth, and with a cavosurface angle of 90, 120, 135 or 150 degrees was prepared using
machine as shown in Fig. 1. The cavity wall was pretreated by one of two commer-
cial dentin bonding systems (Clearfil Liner Bond 2 (LB2), Kuraray, Osaka, Japan or
Single Bond (SB), 3M, St. Paul, MN, USA) according to the manufacturers' instruc-
tions. Then a light-cured commercial resin composite (Silux Plus, 3M, St. Paul, MN,
USA) was filled in the cavity and the free surface of the resin composite was gently
and momentarily pressed on a glass plate mediated with a plastic matrix. The com-
posite was then irradiated for 40sec using a lamp unit (Wite Light, Takara Belmond
Co., Osaka, Japan). After storing the specimens in water at room temperature of
24}1 for 10min, the over-filled excess of the resin composite was eliminated on a
wet carborundum paper and the composite surface including the surrounding dentin
surface was polished on a linen cloth mediated with an alumina slurry, grain size 0.03
m. In the experimental groups, the dentin cavity wall was conditioned with 0.5
mol/L ethylenediamine tetraacetic acid (EDTA) that was neutralized to pH 7.4 with
sodium hydroxide for 60sec, followed by rinsing and drying. Then the cavity was
primed with a 35 vol% of glyceryl mono-methacrylate (GM) solution for 60sec fol-
Fig. 1 Experimental fine grain diamend Fig. 2 Sectioned cavities with cavosurface
points with various apical angles. angles of 90, 120, 135 and 150 de-
grees.
WU et al. 297
lowed by air blasting; the dual-cured dentin bonding agent (Clearfil Photo Bond,
Kuraray, Osaka, Japan) was applied and irradiated for 10sec prior to placement of
the resin composite filling.
The marginal integrity was inspected under a light microscope and the width of
the possible marginal gap was measured with a screw micrometer (Eyepiece Digital;
Leitz, Wetzlar, Germany) mounted on the ocular lens of a microscope (Metaloplan;
Leitz, Wetzlar, Germany). The gap width measurement was performed at eight
points every 45 degrees along the cavity margin, and the contraction gap value was
expressed by sum of the diametrically opposing widths in percentage to the cavity di-
ameter. The contraction gap of the specimen was presented by the maximum of the
four contraction gap values. After the marginal gap width measurement, the speci-
men was sectioned along the long tooth axis through the center of the cavity and the
section of the specimen was polished on wet carborundum paper followed by polishing
on a linen cloth mediated with an alumina slurry as presented in Fig. 2. The cavity
adaptation of the resin composite was inspected under a light microscope, and the
maximum gap width at the occlusal, axial and apical dentin cavity walls was meas-
ured with a screw micrometer. The placement and polymerization of the resin com-
posite including the gap width measurement were carried out by the same method as
for the commercial dentin bonding systems. Ten specimens for each cavosurface
angle and dentin bonding system, 120 in total, were prepared.
RESULTS
The gap widths measured are presented in Tables 1 and 2. Complete adaptation, both
in the marginal and sectioned cavity observation, was obtained with the experimental
dentin bonding system regardless of the cavosurface angle. In the two commercial
dentin bonding systems, complete marginal sealing was observed when the
cavosurface angle was increased to 150 degrees. However, observations of the sec-
tioned cavity, revealed that complete cavity adaptation was not obtained even when
the cavosurface angle was regulated to 150 degrees.
Table 1 Maximum contraction gap width (%) of SP in a concave dentin cavity with
various cavosurface angle
%, n=10
*Experimental: the dentin cavity wall was conditoned with 0 .5mol/L EDTA for 60
sec, primed with 35 vol% of glyceryl mono-methacrylate for 60sec and Clearfil Photo
Bond was applied prior to the Silux Plus filling.
Values joined by a vertical line were not different by the statistical analysis of
Kruskal-Wallis, one way analysis by ranks, or Mann-Whitney U-test (p>0.05).
Values given as (n) indicate the number of gap-free specimens.
298 EFFECT OF CAVOSURFACE ANGLE ON DENTIN CAVITY
Table 2 Maximum contraction gap width (m) of the SP measured on the sectioned
dentin cavity
n=10
Mean}SD of the gap width; the number of completely gap-free specimens are in ().
Values joined by a vertical line were not different by the statistical analysis of
Table 3 Propotion of free surface to adhesive surface or volume of the resin composite
calculated
The calculated proportions of free surface to volume or adhesive surface are pre-
sented in Table 3. The free surface (S), and adhesive surface (S90, S120, S135 and S150) of
the resin composite at each cavity were calculated using the follow formulae:
The volume (V90, V120, V135 and V150) of the resin composite in each cavity was calcu-
h/3. Where the cavity surface diameter (2R) was 3.0mm, and the cavity depth (H)
WU et al. 299
Fig. 4 Relationship between the contraction Fig. 5 Relationship between the contraction
gap width and the proportion of free gap width and the proportion of free
surface to adhesive surface of resto- surface to volume of restoration.
ration.
300 EFFECT OF CAVOSURFACE ANGLE ON DENTIN CAVITY
was 1.5mm. The cavity floor radius (r) of 120 degrees, the cavity depth (h) of 150
degrees and the length of the cavity wall (L) were determined by the cavosurface
angle and diameter (Fig. 3). In addition, the relationship between the marginal gap
and the proportion of free surface to adhesive surface or volume of composite is
shown in Figs. 4 and 5; as shown in the figures, high correlation was recognized be-
tween the contraction gap and these two factors. In particular, the gap width exhib-
ited an extremely high correlation with the proportion of free surface to adhesive
surface of the composite; Pearson's coefficient of correlation was -0.696 for LB2 and
-0 .523 for SB, and the probability of correlation in both groups was higher than
99%.
DISCUSSION
The primary requirement for a dentin bonding system is to maintain a bond between
the resin material and the three-dimensional dentin cavity wall until polymerization
of the resin composite is complete. However, the efficacy of dentin bonding systems
has been widely evaluated by measuring the bond strength of the resin composite to
the two-dimensional flat dentin surfaces. The bonding mechanism has been proposed
based on observation of the ultra-microstructure at the sectioned resin-dentin adhe-
sive interface. By these measurements and observations, the detailed bonding mecha-
nism of dentin adhesives has been explained by resin monomer impregnation into the
interfibrous network of the dentin collagen which is exposed by decalcification of the
dentin conditioner, then expanded by dentin priming12-16). However, it has not been
possible to evaluate the interaction between the efficacy of a dentin bonding system
and the contraction stress of the resin composite or the behavior of the resin compos-
ite in the cavity during polymerization shrinkage because the specimens for the above
mentioned investigations were conducted using dentin rod coated with dentin adhe-
sives or using a resin composite cylinder bonded to a flat dentin substrate. With re-
spect to bond strength measurement, adhesive fractures in the dentin and cohesive
fractures in the resin composite cylinder were frequently experienced in bond strength
measurement whereas these two failures are not observed in contraction gap measure-
ment. It should be noted that contraction gaps are observed between the top surface
of the dentin and the resin composite despite the formation of a hybrid layer17). It is
possible to speculate that monomer diffusion into the etched dentin to form the hy-
brid layer is not essential for cavity adaptation between the resin composite and the
dentin cavity wall. Therefore, it was apparent that bonding efficacy of the dentin
bonding system should be evaluated by observation of the marginal integrity of the
resin composite in the cavity rather than by measurement of the load required to de-
stroy the two-dimensional bond between the resin composite and the substrate dentin.
From a clinical point of view, the most important requirement for a dentin bonding
system is maintenance of the bond between the unpolymerized resin composite paste
and the dentin cavity wall until polymerization is complete. Clinical failure of the
dentin bonding system is detected as the separation of the resin composite from the
WU et al. 301
cavity wall just after polymerization of the composite. The gap is frequently detected
by the explorer along the cervical margin where enamel the cavity wall is thinnest.
The marginal integrity of a resin composite obtained just after irradiation is en-
sured by the elastic stress from the center of the resin composite toward the cavity
wall, which is generated by water absorption of the resin composite. In addition,
after the completion of polymerization of the composite, the cavity adaptation of the
resin composite should be promptly inspected to eliminate the effects of volumetric
expansion by water absorption of the resin composite which might close the possible
contraction gap18).
In this study, contraction gap formation both at the cavity margin and in the
sectioned cavity was prevented completely in only one group, in which the experimen-
tal dentin bonding system was applied prior to the resin composite filling even when
the cavosurface angle was a minimum of 90 degrees. In two commercial dentin bond-
ing systems, contraction gap formation was minimized when the cavosurface angle
was as large as 150 degrees, although gap formation could not be completely pre-
vented as revealed by observation of the sectioned dentin cavity. This improvement
of marginal adaptation of the resin composite by an increased cavosurface angle can
be explained by the proportion of free surface to adhesive surface or the volume of
the resin composite. High correlation was observed between the marginal gap width
and the proportion of free resin composite surface to adhesive surface of the restora-
tion in this study. This finding suggests that the marginal sealing of the resin com-
posite restoration was effectively improved by the flow of resin composite from the
free surface. In the bond strength measurement, the proportion of free surface to ad-
hesive surface theoretically increased more than 1.0. In addition, it is thought that
contraction gaps are never formed between flat dentin and a resin composite. To ex-
plain the mechanism of dentin bonding system for resin composite restoration, speci-
mens should be prepared consistently with a proportion of free surface to adhesive
surface of not larger than 1.0 because in clinical situations the resin composite is re-
stored into a concave cavity in which the free surface of the resin composite is al-
ways smaller than the adhesive surface.
As discussed above, the experimental dentin bonding system was more effective
than the two commercial dentin bonding systems tested because the proportion of the
free surface to the adhesive surface leading to a complete marginal seal of the resin
composite was as low as 0.33 whereas that of the commercial systems was as high as
0.87. In previous reports, the bonding mechanism of the experimental dentin bonding
system was explained by the possible interaction between the high Ca-content in the
substrate dentin and the functional monomer in the dentin bonding agent. In addi-
tion, the high degree of polymerization of the Ca-monomer compound at the adhesive
interface was considered to be essential for dentin bonding19,20). EDTA conditioning
had the advantage of removing the smear layer slightly decalcifying the sound dentin
beneath the smear layer. Chigira et al. speculated that the GM solution exhibited a
complete priming effect in the EDTA-conditioned dentin because it maintained a high
monomer content at the adhesive interface which was observed as a high density zone
302 EFFECT OF CAVOSURFACE ANGLE ON DENTIN CAVITY
under a transmission electron microscope21). The two commercial dentin bonding sys-
tems were developed to simplify the bonding procedure by the introduction of dentin
etching with phosphoric acid or a self-etching dentin primer composed of HEMA, but
the dentin cavity adaptation of the resin composite mediated with these dentin bond-
ing systems was not complete22). It is possible that the quantities of Ca-monomer
compound at the adhesive interface were decreased with the decalcification of the
dentin by the dentin conditioner. The difference in the priming effects between the
HEMA and GM might be explained by the HEMA primer promoting the monomer dif-
fusion into the dentin, resulting in a low monomer concentration at the adhesive in-
terface22). Cavity adaptation at the axial cavity wall is extremely difficult to obtain,
probably because the contraction stress is concentrated at the cavity floor even when
the cavosurface angle is increased23). Our results were similar to those reported by
Kinomoto et al.23), who investigated the distribution of internal stress of resin com-
posite restoration using photoelastic analysis with a box-shape cavity and reported
that not only at the axial wall but also on the cavity floor the largest normal stress
occurred near the internal line angle. The minimum principal stress close to the
cavosurface margin might be the smallest due to the flow of composite decreased
with increasing distance from the free outer surface. In addition, this study was per-
formed using different cavity forms with a constant free surface, and the volume of
resin composite was significantly reduced with increasing cavosurface angle. The im-
proved cavity adaptation with an increase in the proportion of free surface to volume
might have been due to the decrease of the contraction stress of the resin composite.
To conclude, the contraction gap observed at the cavity margin was minimized
with two commercial dentin bonding systems when the cavosurface angle was in-
creased to 150 degrees, although these dentin bonding systems did not completely pre-
vent gap formation. Complete cavity adaptation was obtained in all specimens
pretreated with the experimental dentin bonding system, regardless of the cavosurface
angle. This study suggested that increasing the cavosurface angle results in a signifi-
cant improvement of marginal adaptation of resin composites, and the proportion of
the free surface to the adhesive surface of the resin composite may be an important
standard to evaluate the efficacy of dentin bonding systems.
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