Jodaikin, A.

Sparrius, O.

English

Wits Institutional Repository on DSPACE

Journal of the Dental Association of South Africa, 35, 821-824
Experimental marginal leakage around Isocap® and 
Compocap S® restorations
A Jodaikin and O Sparrius
MRC/University of the Witwatersraiul Dental Research Institute, 1 Jan Smuts Avenue, Johannesburg, 2001.
Keywords: resin restorations
SUMMARY
Experimental marginal leakage around IsoeapK and 
Compocap SR restorations placed with or without prior 
etching o f cavity margins was compared using a fluores­
cent dye technicpte. A ll o f  the restorations examined 
leaked to some extent. No statistically significant differ­
ences were found between the marginal leakage o f the 
lsocapn and Compocap SR restorations. Statistically sig­
nificant differences in experimental marginal leakage 
were found between the etched and unetched prep­
arations. Restorations placed in conjunction with the 
etching technicpte displayed less experimental marginal 
leakage.
OI’SOMMING
'n Rluoressercnde kleurstof is gebruik out eksuerimen- 
tele randlekkasie om Isoeap11 en Compocap''" herstel- 
lings met geeiste en ongeeiste kawiteitsrancle tc oncler- 
soelc. A l die herstellings het 'n mate van lekkasie getoon. 
Cecil statistics nocmenswaardige verskille is tussen die 
randlekkasie van die lsocapK en CompocapSK herstel­
lings gevind nie. Statistics nocmenswaardige verskille is 
wel tussen die geetste en ongeeiste preparate gevind. In 
gevalle waar die geetste tegniek gebruik is het herstellings 
minder eksperimentele randlekkasie getoon.
INTRODUCTION
Clinical marginal leakage may hasten the breakdown 
and dissolution of certain biomaterials and tooth sub­
stance and may cause tooth or restoration discolour­
ation, post-operative tooth sensitivity, pulpal inflamm­
ation and dental caries with their sequelae. However, 
the clinical significance of experimental marginal leak­
age remains speculative as it demonstrates a potential, 
but not a clinical reality (Roydhousc, l%S). This does 
not preclude the possibility that the best seal against an 
experimental penetrant may be the best seal against 
dinical marginal leakage (Swartz and Philips, 1962).
Isositc* is a direct filling resin marketed as a hand- 
mixed, two paste system (IsopastR), an ultra-violet acti- 
ivation system (IsoluxR) and a normal (Isoeap — NR) 
mid a syringc-capsulated (IsocapR) system. Isosite, 
which is a microfill restorative material, contains or­
ganic submicron particles in a matrix based on a modi­
fied Bowen resin. Although microfill restorative ma­
terials can be polished to a higher gloss than the con­
ventional composites, they have a relatively high coeffi­
cient of thermal expansion (Braden, 1979 and Dogan, 
Van Lccuwen and Norris, 1980).
Nelson, Wolcott and Paffenbarger (1952) have empha­
sized the importance of a material’s coefficient of ther­
mal expansion with respect to marginal percolation. 
However, Asmussen and Jorgensen (1978), have stated 
that, provided that a relatively small wall-to-wall poly­
merization contraction and adequate expansion due to 
water absorption occurs, temperature changes within 
realistic limits will not influence the marginal integrity.
The manufacturers of Isosite (Technical Information 
1977*) have claimed that the coefficient of thermal ex­
pansion of a dental material evaluated as an isolated 
factor docs not predict the marginal seal in a clinical sit­
uation. They also claimed that an essential factor in 
producing a marginal seal is the controlled water ab­
sorption of a dental restoration in relation to its poly­
merization shrinkage. In other words, if the water ab­
sorption ovcr-compcnsatcs for the polymerization 
shrinkage, as realised in lsopastR, the restorative ma­
terial will produce in the cavity an effect similar to a 
cork in a bottle-neck. The restoration is thus firmly re­
tained in the cavity because the over-compensating 
water absorption produces a tight marginal seal by ade­
quate expansion.
The purpose of this study was to determine and to com­
pare the in vitro experimental marginal leakage of an 
Isosite syringc-capsulated system, IsocapR* (selected 
for case of mixing control) and a similar syringc-capsul­
ated conventional composite system, Compocap SR*.
"VivjulciH. Scliaan. LcichtcmtcinVivailcnt. Scliaan. l.cidilcnstcin.
Journnl o f the D .A .S .A . —  December 1980
821
A Jodaikin and O Sparrius 
MATERIALS AND METHODS
Unblemished, noil-carious, extracted human canine 
teeth were selected from a batch that had been stored 
for several months at - 5 °C. The teeth were examined 
under a binocular operating microscope** (at a mag­
nification of X 16) and the visible, fracture-free regions 
on the middle third of the labial surface in which the 
cavities could be prepared were outlined with pencil. 
Any teeth presenting fractures in the middle third of 
the buccal regions were discarded. Oval cavities (ap­
proximately 4 mm x V / 2  mm) with the bases in the 
outer third of the dentine and with bevelled margins 
(approximately 0.5 - 1,0 mm wide) were cut within the 
outlined labial regions using a water-cooled tungsten 
carbide fissure bur *** in an air turbine handpiece. The 
bur was changed after every 8 cavities to ensure that all 
cavities were cut with a sharp instrument. The prep­
arations were then examined with the operating micro­
scope at a magnification of X16 and specimens with 
fractures associated with the cavity margins were dis­
carded.
Each of two operators produced 40 satisfactory cavities 
in this manner. The 80 prepared teeth were pooled and 
stored at room temperature in a screw top jar on cotton 
wool saturated with distilled water containing a few 
granules of thymol disinfectant. Fifty teeth were rand­
omly selected, thoroughly washed and dried with an air 
and water syringe before being etched for 60 seconds. 
Equal numbers of etched cavities were thoroughly 
washed and dried and alternately filled according to the 
manufacturer’s instructions with Compocap SR and Iso­
cap1*. The remaining 30 specimens were thoroughly 
washed and dried and their cavities alternately filled 
with the two restorative materials, without any prior 
etching. A primer (contact resin) was not applied to 
any of the preparations. All the specimens were then 
stored at room temperature for 24 hours in distilled 
water containing a few granules of thymol, before being 
polished with a recommended polishing kit*.
The polished specimens were then placed in a thermal 
cycling machine**** and subjected to cyclic tempera­
ture changes by alternate immersions in water at 15 °C 
and 45 °C employing immersion times of 45 seconds. 
There were 24 runs of thermal cycling and each spec­
imen was exposed to a mean of 2 408 immersions (S.D. 
116).
After each thermal cycling run, the batch of specimens 
was dried with compressed air and the tooth surfaces 
around the restorations painted with two applications 
of varnish, leaving only the restorations and an area of 
about 1 mm width around their margins free of varnish. 
The specimens were then immersed in an aqueous 
fluorescent dye * for 24 hours at room temperature. 
Alter removal from the dye solution, the specimens 
were thoroughly washed in running water and the tooth 
crowns then scraped clean of varnish. The specimens 
were thereafter embedded in clear polyester** resin for 
subsequent sectioning. Two transverse parallel sections
** Carl Zeiss. Oberkochcn. Germany.
*** Juia Carbide Balirer Burs, i-‘ruses Fieasas CTG2I 014.
****Mcdu|uip Hngincering. P.O. Box 5b.V»0. Pinegowrie. Kamllnirg. R.S.A. 
+ Black Ray. Ultra-Violet Products. Inc. San Gabriel. California. U S.A. 
+ + Jacksons Fibreglass (Ptv) Limited. Johannesburg. R.S.A.
were cut at 100pm intervals at the junction of the 
middle and outer thirds of the restorations, using a 
water-cooled, lowspecd saw***. The sections were 
mounted in glycerine and examined by transmitted 
ultra-violet fluorescent microscopy****
Damaged sections were discarded. Each investigator 
independently graded the observed marginal leakage 
according to the following scoring system (Fig. 1.):
Score 0 Score 1 Score 2
Material
Fluorescent Dyc□ Enamel
Restorative
Dentine.
l-'ii;. / Experimental Marginal leakage scoring system.
0 =  No experimental marginal leakage — no dye pen­
etration between the restoration and cavity wall.
1 =  Moderate marginal leakage — no dye penetration
beyond the dentino-enamel junction.
2 =  Severe marginal leakage — dye penetration
beyond the dentino-enamel junction.
The scoring system was applied to two sections per 
tooth specimen, and the highest score obtained from 
each specimen was adopted as the degree of marginal 
leakage. Inter- and intra-examiner variations were as­
sessed after 50 per cent of the specimens had been re­
examined. No statistically significant differences were 
found.
RESULTS
A total of 13 specimens were discarded because the 
specimens were unsuitable for examination owing to 
sectioning errors. On examination, the remaining 67 re­
storations all showed dye penetration, indicating leak­
age. Thus none of them displayed scores of zero. The 
results tire tabulated in Table 1 and were subjected to 
statistical analysis using the Fisher exact probability test 
and the Chi square test where applicable. A p value of 
<  0,01 was selected as the level of statistical signific­
ance. The number of restorations exhibiting moderate 
marginal leakage (Score 1) was compared against the 
number of restorations demonstrating severe marginal 
leakage (Score 2). No statistically significant differ­
ences were found between the experimental marginal
+ + + Isomcl. Bueliler l.lil. 2I2H Greenwood Street. Lv.instou. Illinois. U.S.A. 
+ + + + Univar. Reichert. Vienna. Austria.
Tydskrif vir die T. V.S. A. — Desembcr 1980 
822
Experimental marginal leakage
Tqble 1 Results of experimental marginal leakage around etched
and unctchcd Compocap S® and Isocap® restorations.
SCORE:
0 1 2
Material Etched or 
unctchcd
n % n % n %
Compocap SR etched 0 0 13 62 8 38
unctchcd 0 0 1 9 10 91
Isocap1' etched 0 0 9 43 12 57
unctchcd 0 0 1 7 13 93
leakage around the IsocapK and Compocap1* rcstora-
tions.
However, statistically significant differences were 
found between the etched and unetched specimens. 
Restorations placed in conjunction with the etching 
lechnic]uc displayed less marginal leakage.
DISCUSSION
Enamel fractures, (Fig. 2) possibly produced during 
mechanical cavity preparation, thermal stressing (As- 
niusscn 1974), polymerization shrinkage or elastic hys­
teresis (Jyfrgcnsen, Asmusscn and Shimokobe, 1975) 
may account for the fact that all the restorations 
leaked.
The results appear to advocate the use of an etching 
technique as a significant difference (p <  0,01) was 
found between resolutions placed in etched and mi­
ddled preparations. This conclusion is supported by 
numerous studies including those of Relief (1973), Ba- 
harloo and Moore (1974), Eliasson and Mill (1977) and 
Dogan et al (1980). Unetched cavity preparations filled 
with either type of restorative material permitted more 
leakage than restorations placed in conjunction with 
the etch technique.
Another technique advocated in order to limit marginal 
leakage, other than acid etching, is the use of a primer 
resin (also referred to as an intermediary resin). Al­
though the acid etch technique is widely accepted, the 
use of a primer resin is controversial. Recent exper­
imental marginal leakage studies on microfill restora- 
:ivc materials have however supported the use of a 
'rimer rosin (Dogan et al 1980; Valcke and Austin 
3/80).
Although Eliasson and Mill (1977) staled that the des­
igns of cavosurface margins have little influence on 
marginal leakage patterns, the use of a bevel has been 
advocated (Bjorvatin, 1975; Erikscn and Buonocor. 
1976; Soekwell 1976). A bevel may increase the enamel 
surface area which comes into contact with the restora­
tive material that mechanically bonds to it. The use of a 
restorativc-fcathcr-cdge technique (Buonoeore, Sheyk- 
holcslam and Glena, 1973) may also provide an in­
creased enamel surface area whilst also sealing frac­
tures associated with the cavity preparation. Although 
the bevelled preparation and/or rcsloralive-feathcr- 
jedge technique appear to be theoretically sound, there 
lire practical limitations especially on the cervical mar­
gins of restorations where the tooth enamel is thin (if 
still present) and the gingival tissue is close to the prep-
liy .2  Experiment;)! Marginal leakage of fluorescent live (I-) between 
a restoration (R) anil enamel (It). The fluorescent dye lias also 
penetrated into an enamel fracture, x 50.
aration. 0 ilo  and Jorgensen (1977) showed that be­
velled margins display a reduced number of restora­
tions with fractures in enamel. Thus bevels may not 
only increase enamel — restorative material interlace 
areas, but in some tooth legions may reduce the 
number of fractures which result along the cavity mar­
gins.
Isoeapu which has a relatively high coefficient of ther­
mal expansion has performed satisfactorily in clinical 
studies (Bryant, Rees and Ross, 1979 and Christensen 
and Christensen, 1980). 'This may be due to the low 
thermal diffusity of this resin which reduces the effects 
of thermal stresses (McLean, 1979; Braden, 1979), the 
sufficient expansion due to water absorption (Bryant et 
al 1979) and /or other manipulation and clinical factors.
A C K N O W L LDG EM ENTS
We would like to thank Professors P.E. Clcaton-Joncs, 
and C.F. Valcke, Dr. J.C. Austin, Miss E. Vieira and 
Mrs. E. Pain for their guidance and assistance and Mrs. 
J. Parker for typing this manuscript.
REFERENCES
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Asmusscn, E. & J/rgenscn, K.D. (I97<S) Restorative resins: Cocfli- 
cicnt of thermal expansion — a factor of clinical significance ? 
(Juintessence International, 9, 79-82. 
lialiarloo. D. X: Moore, D.L. (197-1) Effect of acid etching on mar­
ginal penetration of composite resin restorations. Journal o f Pros­
thetic Dentistry, 32, 152-156.
Brailen. M. (1979) Developments in the science anil technology of re­
storative materials. Hritisli Dental Journal, 1-16, 318.
Bryant, R.W.. Rees. I-.T. & Ross, I.D. (1979) Clinical evaluation of 
a restorative resin with organic filler. Preliminary report anil dis­
cussion. Australian Dental Journal, 24, 402-407.
Buonoeore M.G., Slicyklioleslam, Z. & Glena, R. (1973) Evaluation 
of an enamel adtiesive to prevent marginal leakage: An in vitro 
study. Journal o f Dentistry for Children, 40, 119-124. 
Bjorvatin, K. (1975) The use of acid etch technique in paedoilonties' 
In Scandinavia: Clinical and technical studies. In The Acid Etch 
Technu/uc eil. Silverston I..M. and Dogon IL. pp. 230-237. Min­
nesota : Nortli Central Publishing Co.
Journal of the D.A.S.A. — December 1980
823
A Jotlaikin and O Sparrius
»
Christensen, R.I’. & Christensen, Ci.J. (1980) In vivo compurison of 
Composite and Micro fill resin: a two year report. Journal of 
Denial Research, 59, Abstract 219 page 322.
Dogan, I.L., van Leeuwen, M.J. & Norris. I). (19,SO) Thermal cyc­
ling studies of new microfill restorative materials in CaJ' isotope 
solutions. Journal o f Dental Research, 59, Abstract 213 page 321.
Eliasson. S.T. & Mill, G.L. (1977) Cavosurfaee design and marginal 
leakage of composite resin restorations. Operative Dentistry. 2, 
55-58.
Erikscn, H.M. & Buonocore. M.G. (197b) Marginal leakage with 
different composite restorative materials in vitro. Journal o f Ora! 
Rehabilitation, 3, 315-322.
Jorgensen, K.D., Asmusscn, E. & Shimokohe, II. (1975) Enamel 
damages caused by contracting restorative resins. Scandinavian 
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McLean. J.W. (1979) The future of restorative materials. Journal of 
Prosthetic Dentistry, 42, 154-158.
Nelson, R.S.. Wolcott, R.B. 4c Paffcnbargcr. Ci.C. (1952) I-'luiil ex­
change at the margins of dental restorations. Journal o f the 
American Dental Association, 44, 288-295.
0ilo, C>. & Jorgensen, K.D. (1977) Effect of bevelling on the occur- 
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Valcke. CM', it Austin. J.C. (1980) The Effectiveness of a Primer 
(contact resin) in Diminishing the Marginal Leakage of a Direct 
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Africa, in press.
ANDREW JODAIKIN is a graduate of the University 
of the Witwatersrand (1978). After a short period in 
general practice he joined the Dental Research Insti­
tute at his alma-mater where he was involved in various 
research projects as well as an MSc. He is at present in 
the Department of Conservative Dentistry where he is 
responsible' for the undergraduate dental materials 
course whilst continuing his research and MSc.
OTTO SPARRIUS also qualified at the University of 
the Witwatersrand in 1978, since when he has been in 
private practice in Johannesburg. Dr Sparrius has 
shown a keen interest in computers and has attended 
the Wits Technikon to further his knowledge. During 
his undergraduate days he was chairman of the Wits 
Fencing Club and a member of the Protea touring team 
(drawn from a number of South African Universities) 
which toured Europe in 1974!
Tydskrif vir die T.V.S.A. — Dcsember 1980
824


Experimental marginal leakage around Isocap® and Compocap S® restorations

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Experimental marginal leakage around Isocap® and Compocap S® restorations

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