The aim of this in vitro study was to compare the approximal marginal
quality of composite fillings using a dentin bonding system to the mar
ginal quality of hybrid ionomer/composite sandwich restorations. Forty
-eight standardized class 2 cavity preparations were prepared in carie
s-free, human third molars. Twelve preparations at a time were filled
either with a composite using the matching dentin bonding system, SZ (
Scotchbond MP/Z100) or PP (PROBOND/Prisma TPH) or with hybrid ionomer/
composite sandwich fillings VZ (Vitremer/Z100) or DP (Dyract/Prisma TP
H). Margins were evaluated before and after thermomechanical loading (
TCML) (5000 cycles [+5 degrees C/+55 degrees C], 72.5 N [1,7 Hz]) by q
uantitative scanning electron microscope analysis using an image analy
zing system. Furthermore, microleakage was assessed by dye penetration
before and after TCML. Statistical analysis was performed using the M
ann-Whitney test at the 0.05 level of significance. SEM analysis after
TCML showed significantly fewer marginal gaps at the material/dentin
interface with VZ (2.2%), DP (7.3%), and PP (6.0%) compared to SZ (29.
6%). After TCML, SZ showed significantly more marginal gaps at the mat
erial/dentin interface, whereas VZ, DP, and PP were not susceptible to
TCML. PP showed the highest percentage in marginal swelling before (1
8.2%) and after TCML (15.9%), while VZ showed no marginal swelling at
all. VZ showed significantly fewer marginal gaps at the composite/hybr
id ionomer interface than DP. After TCML there was no significant diff
erence in marginal gaps between the hybrid ionomer/enamel and the hybr
id ionomer/dentin interface for both Vitremer and Dyract. Using the sa
ndwich technique the Z100/enamel interface had significantly more marg
inal gaps than all other composite/enamel interfaces after TCML. There
was no significant difference in microleakage between the test groups
at the material/dentin interface. SEM analysis and dye penetration sh
owed that hybrid ionomer/composite sandwich restorations have good mar
ginal qualities and may be an alternative to composite restorations us
ing a dentin bonding system.