Influence of cavity size and restoration methods on the cusp deflection in composite restoration

Mi-Ra Lee; In-Bog Lee; Chang-In Seok; Sang-Tag Lee; Chung-Moon Um

doi:10.5395/JKACD.2004.29.6.532

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Original Article Influence of cavity size and restoration methods on the cusp deflection in composite restoration: Mi-Ra Lee, In-Bog Lee, Chang-In Seok, Sang-Tag Lee, Chung-Moon Um; 2004;29(6):-540.
DOI: https://doi.org/10.5395/JKACD.2004.29.6.532
Published online: November 30, 2004

Department of Conservative Dentistry, College of Dentistry, Seoul National University, Korea.

Corresponding author: Chung-Moon Um. Department of Conservative Dentistry, College of Dentistry, Seoul National University, 28 Yoengun-dong, Chongro-gu, Seoul, Korea, 110-749. Tel: 82-2-2072-3953, 2651 Fax: 82-2-2072-3859, inboglee@snu.ac.kr

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Abstract
REFERENCES

Abstract

The aim of this study was to measure the cusp deflection during composite restoration for MOD cavity in premolar and to examine the influence of cavity dimension, C-factor and restoration method on the cusp deflection.

Thirty extracted maxillary premolar were prepared to four different sizes of MOD cavity and divided into six groups. The width and depth of the cavity were as follows. Group 1; 1.5 × 1 mm, Group 2; 1.5 × 2 mm, Group 3; 3 × 1 mm, and Group 4-6; 3 × 2 mm respectively. Group 1-4 were restored using bulk filling method with Z-250 composite. However, Group 5 was restored incrementally, and Group 6 was restored with an indirect resin inlay.

The cusp deflection was recorded at the buccal and lingual cusp tips using LVDT probe for 10,000 seconds. The measured cusp deflections were compared between groups, and the relationship between the cube of the length of cavity wall/the cube of the thickness of cavity wall (L³ / T³), C-factor and cusp deflection or %flexure (100 × cuspal deflection / cavity width) was analyzed.

The cusp deflection of Group 1-4 were 12.1 µm, 17.2 µm, 16.2 µm and 26.4 µm respectively. The C-factor was related to the %flexure rather than the cusp deflection. There was a strong positive correlationship between the L³ / T³ and the cusp deflection. The cusp deflection of Group 5 and 6 were 17.4 µm and 17.9 µm respectively, which are much lower value than that of Group 4.
Keywords: Cusp deflection; Cavity dimension; C-factor; Bulk-cure; Incremental cure; Indirect resin inlay

Figure 1

Configuration of the instrument for measuring cusp deflection.

Figure 2

Diagram of prepared cavity.

a. The dimension of occlusal cavity and proximal box (W: Width of cavity, D: Depth of cavity, L: Length of cavity wall)

b. Simplified cavity shape for calculation of the C-factor.

Figure 3

Representative curves of cusp deflection as a function of time.

a. Bulk cure (Group 1-4)

b. Bulk cure vs. Incremental cure and Indirect Resin Inlay (Group 4, 5 and 6)

Figure 4

Mean cusp deflections for each tested group.

Figure 5

a. A positive correlationship was present between the L³/T³ and the cusp deflection.

b. A positive correlationship was present between the C-factor and the %flexure.

Table 1

The prepared cavity sizes in this study

Group 1-4; for bulk cure.

Group 5; for incremental cure.

Group 6; for indirect resin inlay.

Table 2

The prepared cavity wall dimension, the L³/T³, C-factor, cusp deflection and %flexure measured.

Standard deviations are in parenthesis.

%flexure = 100×(cusp deflection/cavity width) %

Table 3

The results of correlation analysis between the L³/T³, C-factor, and cusp deflection or %flexure.

^** Correlation is significant at the 0.01 level

REFERENCES

1. de Gee AF, Feilzer AJ, Davidson CL. True linear polymerization shrinkage of unfilled resins and composites determined with a linometer. Dent Mater. 1993;9: 11-14.Article PubMed
2. Song YX, Inoue K. Linear shrinkage of photo-activated composite resins during setting. J Oral Rehabil. 2001;28: 335-341.Article PubMed
3. Lee IB. A new method-real time measurement of the initial dynamic volumetric shrinkage of composite resins during polymerization. J Korean Acad Conserv Dent. 2001;26: 134-140.
4. Rosin M, Urban AD, Gartner C, Bernhardt O, Splieth C, Meyer G. Polymerization shrinkage-strain and microleakage in dentin-bordered cavities of chemically and light-cured restorative materials. Dent Mater. 2002;18: 521-528.Article PubMed
5. Goldman M. Polymerization shrinkage of resin-based restorative materials. Aust Dent J. 1983;28: 156-161.Article PubMed
6. Rees JS, Jacobsen PH. The polymerization shrinkage of composite resins. Dent Mater. 1989;5: 41-44.Article PubMed
7. Lai JH, Johnson AE. Measuring polymerization shrinkage of photo-activated restorative materials by a water-filled dilatometer. Dent Mater. 1993;9: 139-143.Article PubMed
8. Opdam NJ, Roeters FJ, Feilzer AJ, Verdonschot EH. Marginal integrity and postoperative sensitivity in Class 2 resin composite restorations in vivo. J Dent. 1998;26: 555-562.Article PubMed
9. Carvalho RM, Pereira JC, Yoshiyama M, Pashley DH. A review of polymerization contraction: the influence of stress development versus stress relief. Oper Dent. 1996;21: 17-24.PubMed
10. Segura A, Donly KJ. In vitro posterior composite polymerization recovery following hygroscopic expansion. J Oral Rehabil. 1993;20: 495-499.Article PubMed
11. Alomari QD, Reinhardt JW, Boyer DB. Effect of liners on cusp deflection and gap formation in composite restorations. Oper Dent. 2001;26: 406-411.PubMed
12. Suliman AH, Boyer DB, Lakes RS. Polymerization shrinkage of composite resins: comparison with tooth deformation. J Prosthet Dent. 1994;71: 7-12.Article PubMed
13. Meredith N, Setchell DJ. In vitro measurement of cuspal strain and displacement in composite restored teeth. J Dent. 1997;25: 331-337.Article PubMed
14. McCullock AJ, Smith BG. In vitro studies of cusp reinforcement with adhesive restorative material. Br Dent J. 1986;161: 450-452.Article PubMed PDF
15. Suliman AA, Boyer DB, Lakes RS. Interferometric measurements of cusp deformation of teeth restored with composites. J Dent Res. 1993;72: 1532-1536.Article PubMed PDF
16. Pearson GJ, Hegarty SM. Cusp movement of molar teeth with composite filling materials in conventional and modified MOD cavities. Br Dent J. 1989;166: 162-165.Article PubMed PDF
17. Jantarat J, Panitvisai P, Palamara JE, Messer HH. Comparison of methods for measuring cuspal deformation in teeth. J Dent. 2001;29: 75-82.Article PubMed
18. Hood JA. Biomechanics of the intact, prepared and restored tooth: some clinical implications. Int Dent J. 1991;41: 25-32.PubMed
19. Davidson CL, de Gee AJ. Relaxation of polymerization contraction stresses by flow in dental composites. J Dent Res. 1984;63: 146-148.PubMed
20. Unterbrink GL, Liebenberg WH. Flowable resin composites as "filled adhesives": literature review and clinical recommendations. Quintessence Int. 1999;30: 249-257.PubMed
21. Versluis A, Douglas WH, Cross M, Sakaguchi RL. Does an incremental filling technique reduce polymerization shrinkage stresses? J Dent Res. 1996;75: 871-878.Article PubMed PDF
22. Abbas G, Fleming GJ, Harrington E, Shortall AC, Burke FJ. Cuspal movement and microleakage in premolar teeth restored with a packable composite cured in bulk or in increments. J Dent. 2003;31: 437-444.Article PubMed
23. Rees JS, et al. A reappraisal of the incremental packing technique for light cured composite resins. J Oral Rehabil. 2004;31: 81-84.Article PubMed
24. Rees JS, Jacobsen PH. Stresses generated by luting resins during cementation of composite and ceramic inlays. J Oral Rehabil. 1992;19: 115-122.Article PubMed
25. Ericson D, Paulsson L, Sowiak H, Derand T. Reduction of cusp deflection resulting from composite polymerization shrinkage, using a light-transmitting cone. Scand J Dent Res. 1994;102: 244-248.Article PubMed
26. Davidson CL, de Gee AJ. Light-curing units, polymerization, and clinical implications. J Adhes Dent. 2000;2: 167-173.PubMed
27. Feilzer AJ, De Gee AJ, Davidson CL. Increased wall-to-wall curing contraction in thin bonded resin layers. J Dent Res. 1989;68: 48-50.PubMed
28. Feilzer AJ, De Gee AJ, Davidson CL. Setting stress in composite resin in relation to configuration of the restoration. J Dent Res. 1987;66: 1636-1639.Article PubMed PDF
29. Davidson CL, Feilzer AJ. Polymerization shrinkage and polymerization shrinkage stress in polymer-based restoratives. J Dent. 1997;25: 435-440.Article PubMed
30. Lee IB, Son HH, Kwon HC, Um CM, Cho BH. The effect of viscosity, specimen geometry and adhesion on the linear polymerization shrinkage measurement of light cured composites. J Korean Acad Conserv Dent. 2003;28: 457-466.Article
31. Davidson CL, Van Zeghbroeck L, Feilzer AJ. Destructive stresses in adhesive luting cements. J Dent Res. 1991;70: 880-882.Article PubMed PDF
32. Alster D, Feilzer AJ, de Gee AJ, Davidson CL. Polymerization contraction stress in thin resin composite layers as a function of layer thickness. Dent Mater. 1997;13: 146-150.Article PubMed
33. Craig RG, Powers JM. Restorative dental materials. 2002;11th ed. Mosby, Inc; 87-88.
34. Blank JT. Scientifically based rationale and protocol for use of modern indirect resin inlays and onlays. J Esthet Dent. 2000;12: 195-208.Article PubMed
35. Watts DC, Cash AJ. Determination of polymerization shrinkage kinetics in visible-light-cured materials: methods development. Dent Mater. 1991;7: 281-287.Article PubMed

Tables & Figures

Figure 1

Configuration of the instrument for measuring cusp deflection.

Figure 2

Diagram of prepared cavity.

a. The dimension of occlusal cavity and proximal box (W: Width of cavity, D: Depth of cavity, L: Length of cavity wall)

b. Simplified cavity shape for calculation of the C-factor.

Figure 3

Representative curves of cusp deflection as a function of time.

a. Bulk cure (Group 1-4)

b. Bulk cure vs. Incremental cure and Indirect Resin Inlay (Group 4, 5 and 6)

Figure 4

Mean cusp deflections for each tested group.

Figure 5

a. A positive correlationship was present between the L³/T³ and the cusp deflection.

b. A positive correlationship was present between the C-factor and the %flexure.

Table 1

The prepared cavity sizes in this study

Group 1-4; for bulk cure.

Group 5; for incremental cure.

Group 6; for indirect resin inlay.

Table 2

The prepared cavity wall dimension, the L³/T³, C-factor, cusp deflection and %flexure measured.

Standard deviations are in parenthesis.

%flexure = 100×(cusp deflection/cavity width) %

Table 3

The results of correlation analysis between the L³/T³, C-factor, and cusp deflection or %flexure.

^** Correlation is significant at the 0.01 level

REFERENCES

1. de Gee AF, Feilzer AJ, Davidson CL. True linear polymerization shrinkage of unfilled resins and composites determined with a linometer. Dent Mater. 1993;9: 11-14.Article PubMed
2. Song YX, Inoue K. Linear shrinkage of photo-activated composite resins during setting. J Oral Rehabil. 2001;28: 335-341.Article PubMed
3. Lee IB. A new method-real time measurement of the initial dynamic volumetric shrinkage of composite resins during polymerization. J Korean Acad Conserv Dent. 2001;26: 134-140.
4. Rosin M, Urban AD, Gartner C, Bernhardt O, Splieth C, Meyer G. Polymerization shrinkage-strain and microleakage in dentin-bordered cavities of chemically and light-cured restorative materials. Dent Mater. 2002;18: 521-528.Article PubMed
5. Goldman M. Polymerization shrinkage of resin-based restorative materials. Aust Dent J. 1983;28: 156-161.Article PubMed
6. Rees JS, Jacobsen PH. The polymerization shrinkage of composite resins. Dent Mater. 1989;5: 41-44.Article PubMed
7. Lai JH, Johnson AE. Measuring polymerization shrinkage of photo-activated restorative materials by a water-filled dilatometer. Dent Mater. 1993;9: 139-143.Article PubMed
8. Opdam NJ, Roeters FJ, Feilzer AJ, Verdonschot EH. Marginal integrity and postoperative sensitivity in Class 2 resin composite restorations in vivo. J Dent. 1998;26: 555-562.Article PubMed
9. Carvalho RM, Pereira JC, Yoshiyama M, Pashley DH. A review of polymerization contraction: the influence of stress development versus stress relief. Oper Dent. 1996;21: 17-24.PubMed
10. Segura A, Donly KJ. In vitro posterior composite polymerization recovery following hygroscopic expansion. J Oral Rehabil. 1993;20: 495-499.Article PubMed
11. Alomari QD, Reinhardt JW, Boyer DB. Effect of liners on cusp deflection and gap formation in composite restorations. Oper Dent. 2001;26: 406-411.PubMed
12. Suliman AH, Boyer DB, Lakes RS. Polymerization shrinkage of composite resins: comparison with tooth deformation. J Prosthet Dent. 1994;71: 7-12.Article PubMed
13. Meredith N, Setchell DJ. In vitro measurement of cuspal strain and displacement in composite restored teeth. J Dent. 1997;25: 331-337.Article PubMed
14. McCullock AJ, Smith BG. In vitro studies of cusp reinforcement with adhesive restorative material. Br Dent J. 1986;161: 450-452.Article PubMed PDF
15. Suliman AA, Boyer DB, Lakes RS. Interferometric measurements of cusp deformation of teeth restored with composites. J Dent Res. 1993;72: 1532-1536.Article PubMed PDF
16. Pearson GJ, Hegarty SM. Cusp movement of molar teeth with composite filling materials in conventional and modified MOD cavities. Br Dent J. 1989;166: 162-165.Article PubMed PDF
17. Jantarat J, Panitvisai P, Palamara JE, Messer HH. Comparison of methods for measuring cuspal deformation in teeth. J Dent. 2001;29: 75-82.Article PubMed
18. Hood JA. Biomechanics of the intact, prepared and restored tooth: some clinical implications. Int Dent J. 1991;41: 25-32.PubMed
19. Davidson CL, de Gee AJ. Relaxation of polymerization contraction stresses by flow in dental composites. J Dent Res. 1984;63: 146-148.PubMed
20. Unterbrink GL, Liebenberg WH. Flowable resin composites as "filled adhesives": literature review and clinical recommendations. Quintessence Int. 1999;30: 249-257.PubMed
21. Versluis A, Douglas WH, Cross M, Sakaguchi RL. Does an incremental filling technique reduce polymerization shrinkage stresses? J Dent Res. 1996;75: 871-878.Article PubMed PDF
22. Abbas G, Fleming GJ, Harrington E, Shortall AC, Burke FJ. Cuspal movement and microleakage in premolar teeth restored with a packable composite cured in bulk or in increments. J Dent. 2003;31: 437-444.Article PubMed
23. Rees JS, et al. A reappraisal of the incremental packing technique for light cured composite resins. J Oral Rehabil. 2004;31: 81-84.Article PubMed
24. Rees JS, Jacobsen PH. Stresses generated by luting resins during cementation of composite and ceramic inlays. J Oral Rehabil. 1992;19: 115-122.Article PubMed
25. Ericson D, Paulsson L, Sowiak H, Derand T. Reduction of cusp deflection resulting from composite polymerization shrinkage, using a light-transmitting cone. Scand J Dent Res. 1994;102: 244-248.Article PubMed
26. Davidson CL, de Gee AJ. Light-curing units, polymerization, and clinical implications. J Adhes Dent. 2000;2: 167-173.PubMed
27. Feilzer AJ, De Gee AJ, Davidson CL. Increased wall-to-wall curing contraction in thin bonded resin layers. J Dent Res. 1989;68: 48-50.PubMed
28. Feilzer AJ, De Gee AJ, Davidson CL. Setting stress in composite resin in relation to configuration of the restoration. J Dent Res. 1987;66: 1636-1639.Article PubMed PDF
29. Davidson CL, Feilzer AJ. Polymerization shrinkage and polymerization shrinkage stress in polymer-based restoratives. J Dent. 1997;25: 435-440.Article PubMed
30. Lee IB, Son HH, Kwon HC, Um CM, Cho BH. The effect of viscosity, specimen geometry and adhesion on the linear polymerization shrinkage measurement of light cured composites. J Korean Acad Conserv Dent. 2003;28: 457-466.Article
31. Davidson CL, Van Zeghbroeck L, Feilzer AJ. Destructive stresses in adhesive luting cements. J Dent Res. 1991;70: 880-882.Article PubMed PDF
32. Alster D, Feilzer AJ, de Gee AJ, Davidson CL. Polymerization contraction stress in thin resin composite layers as a function of layer thickness. Dent Mater. 1997;13: 146-150.Article PubMed
33. Craig RG, Powers JM. Restorative dental materials. 2002;11th ed. Mosby, Inc; 87-88.
34. Blank JT. Scientifically based rationale and protocol for use of modern indirect resin inlays and onlays. J Esthet Dent. 2000;12: 195-208.Article PubMed
35. Watts DC, Cash AJ. Determination of polymerization shrinkage kinetics in visible-light-cured materials: methods development. Dent Mater. 1991;7: 281-287.Article PubMed

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Comparison of Premolar Cuspal Deflection in Bulk or in Incremental Composite Restoration Methods
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Influence of cavity size and restoration methods on the cusp deflection in composite restoration

J Korean Acad Conserv Dent. 2004;29(6):532-540. Published online November 30, 2004

DOI: https://doi.org/10.5395/JKACD.2004.29.6.532

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Influence of cavity size and restoration methods on the cusp deflection in composite restoration

Figure 1 Configuration of the instrument for measuring cusp deflection.

Figure 2 Diagram of prepared cavity. a. The dimension of occlusal cavity and proximal box (W: Width of cavity, D: Depth of cavity, L: Length of cavity wall) b. Simplified cavity shape for calculation of the C-factor.

Figure 3 Representative curves of cusp deflection as a function of time. a. Bulk cure (Group 1-4) b. Bulk cure vs. Incremental cure and Indirect Resin Inlay (Group 4, 5 and 6)

Figure 4 Mean cusp deflections for each tested group.

Figure 5 a. A positive correlationship was present between the L3/T3 and the cusp deflection. b. A positive correlationship was present between the C-factor and the %flexure.

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Influence of cavity size and restoration methods on the cusp deflection in composite restoration

Table 1

The prepared cavity sizes in this study

Group 1-4; for bulk cure.

Group 5; for incremental cure.

Group 6; for indirect resin inlay.

Table 2

The prepared cavity wall dimension, the L³/T³, C-factor, cusp deflection and %flexure measured.

Standard deviations are in parenthesis.

%flexure = 100×(cusp deflection/cavity width) %

Table 3

The results of correlation analysis between the L³/T³, C-factor, and cusp deflection or %flexure.

^** Correlation is significant at the 0.01 level

Table 1 The prepared cavity sizes in this study

Group 1-4; for bulk cure.

Group 5; for incremental cure.

Group 6; for indirect resin inlay.

Table 2 The prepared cavity wall dimension, the L3/T3, C-factor, cusp deflection and %flexure measured.

Standard deviations are in parenthesis.

%flexure = 100×(cusp deflection/cavity width) %

Table 3 The results of correlation analysis between the L3/T3, C-factor, and cusp deflection or %flexure.

^** Correlation is significant at the 0.01 level