Resin composites: Modulus of elasticity and marginal quality

Objective: To investigate how the modulus of elasticity of resin composites influences marginal quality in restorations submitted to thermocyclic and mechanical loading. Methods: Charisma, Filtek Supreme XTE and Grandio were selected as they were found to possess different moduli of elasticity but quite similar polymerization contraction. MOD cavities (n = 30) were prepared in extracted premolars, restored and then subjected to thermocyclic and mechanical loading. Marginal quality of the restorations before and after loading was analyzed on epoxy replicas under a scanning electron microscope. The percentage of gap-free margins and occurrence of paramarginal fractures were registered. Modulus of elasticity and polymerization contraction were analyzed with parametric and margins with nonparametric ANOVA and post hoc Tukey HSD or Wilcoxon rank-sum tests, respectively. The number of paramarginal fractures was analyzed with exact Fisher tests (alpha = 0.05). Results: Grandio demonstrated significantly more gap-free enamel margins than Charisma and Filtek Supreme XTE, before and after loading (p < 0.01), whereas there was no difference between Charisma and Filtek Supreme XTE (p > 0.05). No significant effect of resin composite (p = 0.81) on the quality of dentine margins was observed, before or after loading. Deterioration of all margins was evident after loading (p < 0.0001). More paramarginal enamel fractures were observed after loading in teeth restored with Grandio when compared to Charisma (p = 0.008). Conclusions: The resin composite with the highest modulus of elasticity resulted in the highest number of gap-free enamel margins but with an increased incidence of paramarginal enamel fractures. Clinical significance: The results from this study suggest that the marginal quality of restorations can be improved by the selection of a resin composite with modulus of elasticity close to that of dentine, although an increase in paramarginal enamel fractures can result as a consequence. (C) 2014 Elsevier Ltd. All rights reserved.