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Study of microleakage prevention in recently developed  aesthetic dental restorative materials ,[object Object],[object Object],D. Leung ,  K. Gulabivala, J. Pratten, D. Spratt, A.M. Young   Department of Oral Microbiology, Eastman Dental Institute 256 Grays Inn Road, London, WC1X 8LD  University College London Summary Fig. 1a –During acid / glass reaction, the proton from the acid group is lost and a COO -  group formed.  Consequently, this reaction causes the peaks marked on the left and on the right to decrease, and gives rise to the peak marked in the centre.  The rate of acid / glass reaction can be determined by monitoring any absorbance changes as function of time.  Fig. 1b - During polymerisation, the methacrylate C=C and C-O peaks decrease.  The levels of change observed are consistent with full polymerisation within 2 min after the start of exposure to a dental light.  The changes in spectra at latter time indicates the occurrence of acid / glass reaction (compare Figure 1a and 1b).  This process is required to generate fluoride ions.  Fig. 2- This graph shows fluoride release from the GIC and RMGIC are comparable.  The initial linear relationship with square root of time suggests a diffusion controlled process. Fig. 3a,b – The reduced number of bacteria observable on the GICs and RMGICs in comparision with the amalgam specimens are consistent with reduced bacterial microleakage.  Much of the roughness on the GIC and RMGIC surfaces may be due to a combination of a smear layer and nanoleakage of artificial saliva.  Fig. 3c,d -  Without the smear layer, the structure of dentine tubules can be seen clearly, and the imprinted structure of dentine tubules were observed on the cement surface.  This result suggests better interactions between the cements and the dentine in the absence of smear layer. Materials and Methods Both GICs and RMGICs (Fuji IX GP and Fuji II LC, GC Corporation, respectively) were prepared according to the manufacturer's directions and powder / liquid ratios. FTIR  – Materials of 1 mm thickness were placed onto the single reflection diamond ATR attachment in the sample chamber of a Perkin Elmer 2000 series FTIR spectrometer.  Spectra were then taken at vairous times. Fluoride release  –  The cements were made into discs and the amount of F- ions released into distilled water measured, using a fluoride meter, as a function of time. Microleakage studies  – Dentine cylinders were prepared from bovine teeth.  Each was then centrally drilled and restored with either Amalgam (Tytin FC), a GIC (Fuji IX)  or  an RMGIC (Fuji II LC from GC Corporation) according to  manufacturer’s instructions. Human saliva was used as an inoculum to provide a multi-species biofilm consisting of organisms found in the oral cavity. The biofilms were formed on the dentine cylinders and grown in a Constant Depth Film Fermentor (CDFF) with a continuous supply of artificial saliva.  At selected time periods, samples were removed and examined by Scanning Electron Microscopy (SEM). Smear layer  – The effect of conditioning on smear layer (cutting debris) was also investigated.  The drilled cavities were washed with GC dentine conditioner thoroughly before being restored.  After submerged in sterile artificial saliva for 10 weeks, the samples were examined as described above. Conclusions Due to the toxicity of HEMA, the methacrylate in Fuji II LC, it is important to ensure completion of polymerisation.  From this study, FTIR showed practically 100 % polymerisation of this monomer.  The fluoride release level from the RMGIC was found to be comparable to that of GIC.  This suggests the anti-bacterial properties of RMGIC and GIC should be equally effective. The use of the CDFF model simulated the oral condition and accelerated the microleakage at the dentine restoration interface. A larger number of bacteria were observed from the amalgam restorations.  RMGICs were shown to be equally effective at preventing microleakage as GICs.  This technique, however, could not show us whether this result was due to the sealing abilities of GIC and RMGIC or the anti-bacterial effect from fluoride release.  Longer experimental time and larger sample numbers are needed to distinguish differences between GICs and RMGICs.   The presence of the smear layer prevents interactions of the adhesive material with dentine.  The removal of the smear layer can therefore improve the bonding between the cements and dentine, which can potentially improve the sealing properties and to prevent microleakage to a greater extent. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],For Oral Health Care Sciences http://www.eastman.ucl.ac.uk Eastman Dental Institute http://www.eastman.ucl.ac.uk Fig. 1a – IR spectra of Fuji IX as function of time Fig. 2 – Fluorie ion released from Fuji IX and Fuji II LC Fig. 3a – SEM picture of the amalgam sample at 10 weeks Fig. 3b – SEM picture of the GIC sample at 10 weeks Fig. 3c – SEM picture of the RMGIC surface without conditioning on the smear layer prior to restoration Fig. 3d – SEM picture of the RMGIC surface with conditioning on the smear layer prior to restoration Fig. 1b – IR spectra of Fuji II LC as function of time a b c d

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