Effects of flowable resin on bond strength and gap formation in Class I restorations.

Objectives: This study measured resin/dentin bond strengths and evaluated gap formation at the pulpal floor of occlusal composite restorations using a flowable resin as a liner with either bulk or incremental placement of the restorative composite.

Methods: Class I occlusal preparations were made in 16 extracted molars, and were randomly divided into two groups for restoration using either One-Step adhesive (OS, BISCO) and Renew composite (RW, BISCO) or OptiBond SOLO adhesive (SOLO, Kerr) and Herculite XRV composite (XRV, Kerr). A flowable resin [AEliteFlo (AE, BISCO) or Revolution (RV, Kerr)] was applied as a liner in half of the specimens of each group. The lined and unlined groups were restored with composite cured in bulk, or cured in 1.5 mm increments. After 24 h in water, the teeth were sectioned into 0.7-mm thick slabs and were examined with an optical microscope (400 x) to determine the presence of internal resin-dentin gaps. The gap-free specimens were trimmed and were subjected to microtensile bond strength testing. Specimens that contained gaps had Knoop hardness of the restorative material measured.

Results: All incrementally filled restorations were well adapted to the pulpal floor but nearly all bulk-cured specimens had gaps between the flowable and the hybrid composites. The use of a flowable resin increased the bond strength of OS, but not SOLO.

Significance: The incremental technique prevented gap formation regardless of the use of a flowable resin. In contrast, the use of a flowable composite did not guarantee gap-free restorations or improved bond strength of resin to dentin in bulk-filled restorations.