The use of flowable composite resins as liners in class II packable composite restoration has been suggested by some manufacturers. However, the contributions of this technique are unproven. The purpose of this study was to compare the gingival microleakage in class II packable composite restorations with or without the use of flowable composite resins as liners.

Slot cavities were prepared on both proximals of 80 extracted human molars and randomly assigned to 8 groups of 20 each. The gingival margins were located at 1mm above CEJ in 80 cavities (group1-4) and 1mm below CEJ in 80 cavities (group5-8). The prepared teeth were mounted in the customized tray with adjacent teeth to simulate clinical conditions and metallic matrix band (Sectional matrix) and wooden wedges were applied. After acid etching and application of Single Bond, each group was restored with the following materials using incremental placement technique: Group 1,5 (Filtek P60), group 2, 3, 4 and group 6, 7, 8 (AeliteFlo, TetricFlow, Revolution/Filtek P60). All specimens were thermocycled 500 times between 5℃ and 55℃ with 1 mimute dwell time, immersed 2% methylene blue dye for 24 hours and then rinsed with tab water. The specimens were embedded in clear resin and sectioned longitudinally through the center of restoration with a low speed diamond saw. Dye penetration at gingival margin was viewed at 20 magnification and analyzed on a scale of 0 to 4. Kruscal-Wallis One way analysis and Mann-Whitney Rank sum test were used to analyze the results.

The results of this study were as follows.

1. The leakage values seen at the enamel margin were significantly lower than those seen at the dentin margin(P<0.05).

2. On the enamel margin, packable composite resins with flowable liners showed lower leakage than those without flowable liners, but there were no significant differences among the four groups(P>0.05).

3. On the dentin margin, four groups demonstrated moderate to severe leakage, and there were no significant differences in leakage values(P>0.05).

Low-viscosity composite resins may produce better sealed margins than stiffer compositions (Kemp-Scholte and Davidson, 1988; Crim, 1989). Flowable composites have been recommended for use in Class V cavities but it is also controversial because of its high rates of shrinkage. On the other hand, in the study comparing elastic moduli and leakage, the microfill had the least leakage (Rundle et al. 1997). Furthermore, in the 1996 survey of the Reality Editorial Team, microfills were the clear choice for abfraction lesions.

The purpose of this study was to evaluate the microleakage of 6 compostite resins (2 hybrids, 2 microfills, and 2 flowable composites) with and without load cycling.

Notch-shaped Class V cavities were prepared on buccal surface of 180 extracted human upper premolars on cementum margin. The teeth were randomly divided into non-load cycling group (group 1) and load cycling group (group 2) of 90 teeth each. The experimental teeth of each group were randomly divided into 6 subgroups of 15 samples. All preparations were etched, and Single bond was applied. Preparations were restored with the following materials (n=15): hybrid composite resin [Z250(3M Dental Products Inc. St.Paul, USA), Denfil(Vericom, Ahnyang, Korea)], microfill [Heliomolar RO(Vivadent, Schaan, Liechtenstein), Micronew(Bisco Inc. Schaumburg, IL, USA)], and flowable composite [AeliteFlo(Bisco Inc. Schaumburg, IL, USA), Revolution(Kerr Corp. Orange, CA, USA)]. Teeth of group 2 were subjected to occlusal load (100N for 50,000 cycles) using chewing simulator(MTS 858 Mini Bionix II system, MTS Systems Corp., Minn. USA). All samples were coated with nail polish 1mm short of the restoration, placed in 2% methylene blue for 24 hours, and sectioned with a diamond wheel. Enamel and dentin/cementum margins were analyzed for microleakage on a sclale of 0 (no leakage) to 3 (3/3 of wall). Results were statistically analyzed by Kruscal-Wallis One way analysis, Mann-Whitney U-test, and Student-Newmann-Keuls method. (p=0.05)