dental materials

Dental Materials 17 (2001) 347353 www.elsevier.com/locate/dental

Current luting cements: marginal gap formation of composite inlay and their mechanical properties
M. Irie*, K. Suzuki
Department of Biomaterials, Okayama University Dental School, 2-5-1, Shikata-cho, Okayama 700-8525, Japan Received 15 November 1999; revised 2 August 2000; accepted 27 September 2000

Abstract Objective: The aims of this investigation were to investigate the effect of thermocycling on the marginal gap formation of composite inlays using three types of luting cements (Compolute, PermaCem, Fuji Plus, Panavia 21: as a control) and on mechanical properties of four luting cements. Methods: The maximum marginal gap in the dentin cavity of each of ten resin inlay specimens in each group, was measured by a microscope before and after 10,000 thermocycles. The dimensional change, shear bond strength to dentin, and material and conditions for exural strength and modulus testing were examined. Results: Compolute and Panavia 21 showed marginal gaps of approximately 10 mm before thermocycling. In contrast, the gap widths after thermocycling was signicantly wider. Although the gap widths of PermaCem and Fuji Plus were approximately 60110 mm prior to thermocycling, they were signicantly smaller in width after thermocycling. Statistical differences in the shear bond strength to dentin were not observed before or after thermocycling for all materials. The exural strength and modulus were signicantly increased after thermocycling compared with three products and with all four products, respectively. Signicance: The mechanical properties of all four luting cements were closely related to their marginal gap formations and these mechanical factors have important roles in determining their marginal gap formations. q 2001 Academy of Dental Materials. Published by Elsevier Science Ltd. All rights reserved.
Keywords: Luting cement; Marginal gap formation; Composite inlay; Mechanical property; Thermocycling

1. Introduction Composite inlays provided acceptable or excellent service in several years clinical evaluation studies [16]. Resin composite inlays are easier to fabricate and less expensive than ceramics [7]. A marginal gap is frequently generated when restorative materials are used in dentin cavities due to the polymerization contraction of the restorative materials [813]. Marginal gaps between tooth structure and luting cements are frequently created by polymerization contraction of the luting cement [14,15]. Contraction gaps occurring at the dentincement interface of cemented ceramic inlays may be of the order of 1 to 7 mm in standardized cavities with internal shoulders which have a 200 micron lm thickness [16,17]. These gaps may act as sites for bacterial growth, which can cause pulpal irritation and consequent sensitivity [18,19]. The seal or bond of the luting cement to the tooth surface is therefore of the greatest
* Corresponding author. Tel: 181-86-235-6668, Fax: 181-86-235-66. E-mail address: mirie@dent.okayama-u.ac.jp (M. Irie).

signicance in many restorative procedures, and is often the most important factor in achieving clinical success. The bond established between a luting agent and the dentin wall in a cavity is stressed not only because of polymerization contraction, but also by temperature changes. Due to the difference in thermal expansion between tooth and luting agent, cycling of an inlay restoration between high and low temperatures may cause rupture of the bond between the luting cement and the tooth. Temperature cycling also causes uid percolation in the gap created in the luting agentdentin interface [20]. Currently, there are three main types of luting cements commercially available for a composite or a ceramic inlay; resin composite, polyacid-modied resin composite (compomer), and resin-modied glass-ionomer cement (RMGIC). RMGIC is claimed to show improved marginal seal by hygroscopic expansion and improved bond strength after storage in water [13,21]. Previous investigations by the authors would suggest that use of compomer as a luting agent does not improve its marginal seal as the result of hygroscopic expansion, at least in the short term [21,22].

0109-5641/01/$20.00 + 0.00 q 2001 Academy of Dental Materials. Published by Elsevier Science Ltd. All rights reserved. PII: S 0109-564 1(00)00093-2

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Table 1 Luting agents investigated. Information provided by the manufacturers (A: Resin composite, B: polyacid-modied resin composite (compomer), C: resinmodied glass-ionomer cement) Materials (type) Compolute Aplicap (A) PermaCem (B) Fuji Plus Capsule (C) Panavia 21 (A) Manufacturer Espe, Seefeld, Germany DMG, Hamburg, Germany GC, Tokyo, Japan Kuraray, Kurashiki, Japan Batch no. 002 98340056 211087 U: 0293, C: 0323 Material composition Silanized llers (72.5%), monomers (26.7%), initiator (0.8%), ller content: 72 wt%, powder/liquid: 2.7 g/1.0 g Fine barium ionomer glass in a matrix of Bis-GMA, other dental resin, catalyst, ller content: 70 wt% P: Fluoro-alumino-silicate, L: copolymer of acrylic and maleic acid, HEMA, water, initiator, powder/liquid: 2.0 g/1.0 g Silanized llers, Monomers, Initiators, Filler content: 77wt%

Although each type is physically and chemically unique, no one luting agent is ideal for all situations. Chemical variation of the tooth substrate, dimensional changes, and differences in the coefcient of thermal expansion of luting materials with tooth restorative, all affect the sealing ability and possibly also the clinical durability [23]. A exural test was used in this investigation to assess the mechanical properties of luting agents, because such testing has previously been carried out to evaluate the mechanical strength of various luting materials [24,25]. The RMGICs and conventional glass-ionomer cements are claimed to improve marginal sealability by enhancing the exural strength during the days/weeks after light-activation [13,21]. In this study, therefore, we evaluated the effect of thermocycling on the marginal gap using three types of luting agents. We also examined the bond strength, dimensional change during setting and thermocycling, and the exural strength and modulus of these luting materials to establish ways to improve sealing. Any or all of these factors may inuence marginal gap formation.

using a high-speed mixer (Silamat, Vivadent, Schaan, Liechtenstein) for 10 s. For light activation, a curing unit (New Light VL-II, GC, Tokyo, Japan; irradiated diameter: 13 mm) was used. Human premolars, extracted for orthodontic reasons, were used for this project. After extraction, the teeth were immediately stored in cold, distilled water at about 48C for 12 months before testing. Ten specimen composite inlay restorations were produced using each luting agent and one composite inlay material (Z 100, 3M Dental Products, St Paul, MN, USA; Batch No.: 7UG; Shade: 3A; Filler: 66.0 vol%, 84.5 wt%). 2.1. Marginal gap in the tooth cavity Extracted premolars were embedded in slow setting epoxy resin (Epox Resin, Struers, Copenhagen, Denmark). A at dentin surface was obtained by grinding the tooth with wet silicon carbide paper (#220), then a cylindrical cavity was prepared with a tungsten carbide bur (200,000 rpm) and a custom bur rotating at 4000 rpm under wet conditions to a depth of approximately 1.5 mm with a diameter of 3.5 mm, held rigidly in a custom-made drill press. One cavity was prepared in each tooth on the coronal region and the medial surface (Fig. 1 ). A total of 40 cavities were prepared in 40 teeth for this study. Composite inlays (Z 100) were made with a Teon mold (3.3 mm in diameter and 1.5 mm in height). The lled material was cured for 40 s. After composite inlay construction, the tting of the inlay in the prepared dentin cavity was checked. The prepared cavity surface was treated with the

2. Materials and methods The basic properties of the three luting agents and the one resin luting cement as a control used in this study are summarized in Tables 1 and 2. All procedures were performed in accordance with the manufacturers' instructions. Capsules of Compolute and Fuji Plus were triturated

Table 2 Treating agents investigated. Information provided by the manufacturers: HEMA, 2-hydroxyethyl methacrylate; MMC, methacryl-magnesium-chelate; MAM, malonic acid-alkyl-methacrylate; 5-NMSA, N-methacryloyl-5-aminosalicylic acid; MDP, 10-methacryloxy dihydrogen phosphate Materials EBS Multi Manufacturer Espe, Seefeld, Germany Batch no. 168 001 001 98270083 98230062 170151 A: 053 Material composition Etching gel: phosphoric acid Primer: HEMA (45%), water (36%), amine (10%), MMC (9%), stabilizers Bond: bismethacrylate (73%), MAM (17%), HEMA (7%), amine-diol-methacry (1%), photo-initiator (2%) Primer A 1 B: HEMA, water, dimedthacrylates, polymethacrylated polycarbonic acid, NaF, catalyst Mono: Bis-GMA, TEGDMA, polymethacrylated, oligomaleic acid, catalyst Citric acid (10%), ferric chloride (2%), water HRMA, 5-NMSA, MDP, water, catalyst

Ecusit Fuji Plus ED Primer

DMG, Hamburg, Germany GC, Tokyo, Japan Kuraray, Kurashiki, Japan

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2.3. Change in dimension and weight after thermocycling In order to estimate the degree of hygroscopic expansion during 10,000 thermocycles, the diameter and weight of each luting agent, about a xed point on a specimen sized 3.5 mm in diameter and 1.5 mm in height, were measured with an electric micrometer (Digimicro MU-1001B, Nikon, Tokyo, Japan) and with an electric balance (Analytical Balance AJ100, Mettler, Greifensee, Switzerland) before and after thermocycling. The changes of the specimen's dimension and weight before (base line) and after thermocycling were expressed as percentages. 2.4. Shear bond strengths to dentin. Bond strengths to dentin were measured to evaluate the bonding effect between the luting agent and the cavity preparations before and after thermocycling. The specimens were human premolars embedded in slow-setting epoxy resin (Epox Resin, Struers, Copenhagen, Denmark). Flat surfaces of dentin were obtained by grinding the tooth with wet silicon carbide paper (#1000). The dentin surface was treated with the conditioner/primer according to each manufacturer's instructions as described above. Each material was placed into a Teon mold (3.6 mm in diameter, 2.0 mm in height) set on the dentinal surface, and hardened as described above. The specimens thus obtained were mounted on a testing machine (5565, Instron, Canton, MA, USA), and shear stress was applied at a cross-head speed of 0.5 mm/min. Measurements were carried out under two different conditions: before and after thermocycling. After the shear bond strength measurements, all the failed specimens were analyzed utilizing a light microscope (4 ) (SMZ-10, Nikon, Tokyo, Japan) to determine the nature of fractures [12,13]. 2.5. Flexural strength and exural modulus of elasticity Teon molds (25 2 2 mm) were used to prepare the specimens for determining the exural strength measurements. Compolute and PermaCem were cured in three overlapping sections, each cured for 40 s. Fuji Plus and Panavia 21 were hardened as described above. The exural strengths were measured using the three-point bending method with a 20 mm span and a load speed of 0.5 mm/min (5565, Instron, Canton, MA, USA) outlined in ISO 9917-2 (1996). At the same time, the exural modulus of elasticity was calculated with a software program (Series IX, Instron, Canton, MA, USA). The exural strength and exural modulus of elasticity were determined for luting agents using four materials under two conditions decreed for marginal gap determination, i.e., before and after thermocycling. All procedures, except for cavity preparation and mechanical testing, were performed in a thermo-hygrostatic room kept at 23 ^ 0.58C and 50 ^ 2% relative humidity. The results were analyzed statistically using the Mann Whitney U-test, Duncan's new multiple-range test

Fig. 1. Left: Schematic representation of design and placement of cylindrical dentin cavity (diameter 3.5 mm) restored by resin inlay (diameter 3.3 mm). Right: Schematic representation of measured point of maximum gap width between resin cement and dentin.

conditioner/primer according to each manufacturer's instruction as described in Table 2. The appropriate luting agent (Table 1) was applied in the treated cavity using a syringe tip (Centrix C-R Syringe System, Centrix, Connecticut, USA). Each composite inlay was inserted, then covered with a plastic strip and exposed to a visible light source for 40 s. The Panavia 21 and Fuji Plus restored specimens were stored in an incubator at 378C and 100% relative humidity for 5 min after mixing, until the luting agent was set. The excess luting material around the composite inlay was removed with a tungsten carbide bur and wet ground with silicon carbide paper (#1000), followed by polishing with linen with an aqueous slurry of 0.3 mm aluminum oxide (Alfa Micropolish, Buehler Ltd, Chicago, USA) and rinsing with distilled water immediately after polishing. Each restoration margin was inspected under a traveling microscope (400 , Measurescope, MM-11, Nikon, Tokyo, Japan) for the presence, location, and extent of marginal gaps. The maximum gap width and the opposing width (if any) between the material and the cavity wall were measured using an optical microscope as previously described [12,13,26] (Fig. 1). The marginal gap was expressed as the sum of these two values. Measurements of the marginal gap width were performed under before and after thermocycling (thermal stress, 10,000 cycles, 4 and 608C; 1 min dwell time). 2.2. Marginal gap in the Teon cavity before thermocycling As Teon does not react with luting agents, it was used as a mold to measure the degree of setting shrinkage (immediately after setting, before thermocycling) of the luting agents. The prepared Teon mold, a depth of 1.5 mm with a diameter of 3.5 mm, was placed on a silicone oil-coated glass plate, because such a glass plate would not react or bond to the luting agent. Each Teon mold was lled with luting agent using a syringe tip, then covered with a plastic strip until set. After setting, the degree of the setting shrinkage was determined as previously described. The marginal gap in the Teon cavity was expressed as the sum of the two values described above [12,13].

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M. Irie, K. Suzuki / Dental Materials 17 (2001) 347353 Table 3 Maximum marginal gap width (mm) between dentin cavity and luting agent (N 10. ( ): Number of specimens having no gaps ( )*: Range of gap width. Means with the same letters were not signicantly different by Duncan's new multiple-range test (p , 0.05, non-parametric [27])) Luting agent The sum of the marginal gaps for all ten specimens Before (immediately) After thermocycling Compolute PermaCem Fuji Plus Panavia 21
a

(non-parametric, [27]), t-test, or the complex chi-squared test. 3. Results Table 3 summarizes the summed data for the marginal gaps observed in the tooth cavities under two conditions (before and after thermocycling). Statistical difference was observed between before and after thermocycling in any product (p , 0.05). In this case, the mean of data was not appropriate because many specimens had no gaps. Therefore the sum of data was used. When the specimen was inspected before thermocycling, Compolute and Panavia 21 were observed to have a marginal gap of approximately 10 mm. In contrast, we observed 4070 mm gap width increases when the specimens were inspected after thermocycling. Although PermaCem and Fuji Plus were observed to have approximately 60110 mm gaps before, the two products showed gaps decreased approximately by 10 60 mm after thermocycling. The mean cement lm thickness of all four luting agents at each measured point was 50100 mm where a marginal gap was observed. However, approximately half of the specimens inspected showed no gaps in the surrounding margin. Therefore the mean cement lm thickness of all specimens could not be calculated or expressed in the table, and because it was thought that the lm thickness of cement had no effect on the presence of any marginal gap formation in these cases. Table 4 summarizes the marginal gap widths between the various luting agents and the Teon molds. The right hand column presents the degree of linear setting shrinkage before thermocycling. The marginal gap width of Fuji Plus was signicantly smaller than those of other materials. Table 5 summarizes the changes in dimension and weight after thermocycling. In summary, the degree of hygroscopic expansion for Fuji Plus was signicantly larger than those of other materials. Tables 6 and 7 summarize the shear bond strength to the dentin surface and the mode of fracture, respectively. No statistical difference was observed between before and after thermocycling in any product. Before thermocycling, the greatest bond strength and the smallest coefcient of variation was obtained for Compolute. After thermocycling, the results for Compolute showed a similar tendency. For PermaCem, both before and after thermocycling the values of bond strength and coefcient of variation were greater than those for Fuji Plus. Although there was no signicant difference in bond value between Fuji Plus and Panavia 21 either before or after thermocycling, the extent of coefcient of variation for Panavia 21 was greater than that of Fuji Plus. In all groups, no signicant difference of the fracture mode was observed between before and after thermocycling. The proportions of the three groups (Compolute, Fuji Plus, and Panavia 21) were similar. On the other

Alpha value a

14(7) (06)* A 106 (0) (518)* B 58 (4) (016)* C 16 (6) (07)* A

35 (2) (06)* D E 59 (2) (014)* E 13 (8) (08)* D 69 (1) (036)* E

, 0.05 , 0.05 , 0.05 , 0.05

Signicantly different by MannWhitney U-test between the two sums.

Table 4 Marginal gap width in Teon mold before thermocycled (immediately) (N 10. Diameter in Teon mold: 3.5 mm. Means with the same letters were not signicantly different by Duncan's new multiple-range test (p , 0.05)) Luting agent Mean (S.D.) (mm) Compolute PermaCem Fuji Plus Panavia 21
a

(%) a 0.53 (0.09) C 0.47 (0.06) C 0.90 (0.10) D 0.45 (0.06) C

18.7 (2.9) A 16.6 (2.1) A 31.6 (3.5) B 15.6 (2.1) A

Percentage of the measured diameter in Teon mold.

Table 5 Changes (%) of luting agents after thermocycled (N 10. Means with the same letters were not signicantly different by Duncan's new multiplerange test p , 0.05)) Luting agent Mean (S.D.) Dimension Compolute PermaCem Fuji Plus Panavia 21 0.14 (0.04) A 0.13 (0.03) A 2.08 (0.29) B 0.14 (0.06) A Weight 0.18 (0.04) C 0.52 (0.06) C 5.53 (0.87) D 1.34 (0.19) E

Table 6 Shear bond strength (MPa) between dentin surface and luting agent (N 10. NS: Not signicantly different (p , 0.05). Means with the same letters were not signicantly different by Duncan's new multiple-range test (p , 0.05)) Luting agent Mean (S.D., coefcient of variation (%)) Before (immediately) Compolute PermaCem Fuji Plus Panavia 21
a

p-value a

After thermocycled 17.10 (4.03, 24) 14.22 (5.63, 40) 7.37 (1.95, 26) 9.06 (3.66, 40) D D E E NS NS NS NS

18.22 (3.09, 17) A 10.75 (4.56, 42) B 7.03 (1.87, 27) C 9.72 (3.98, 41) BC

t-test.

M. Irie, K. Suzuki / Dental Materials 17 (2001) 347353 Table 7 Analysis of fracture mode data corresponding to those in Table 6. (N number of specimens. AF: adhesive fracture at bonding site, MF: mixture fracture, CF: cohesive fracture) Luting agent Number with each fracture mode Before (immediately) Compolute PermaCem Fuji Plus Panavia 21
a

351

p-value a

After thermocycled 8) 6) 8) 8) NS NS NS NS

N 10 (AF: 0, MF: 3, N 10 (AF: 0, MF: 2, N 10 (AF: 0, MF: 0, N 10 (AF: 3, MF: 0,

N 10 (AF: 0, MF: 2, CF: N 10 CF: 8) (AF: 3, MF: 1, CF: N 10 CF: 10) (AF: 0, MF: 2, CF: N 10 CF: 7) (AF: 2, MF: 0, CF: CF: 7)

mocycling, only Fuji Plus showed a signicantly lower mean value compared to other products. When the specimens underwent thermal stress, the value of the exural modulus was signicantly increased for all materials compared with before thermocycling. Before thermocycling, Compolute showed the greatest value of all materials and PermaCem the lowest. After thermocycling, Panavia 21 showed the greatest value of all materials and Fuji Plus the lowest. 4. Discussion In the initial stage of the setting process, the setting shrinkage or setting stress of lling materials has a greater effect on the marginal gap formation in the dentin cavity than the bond strength to the dentin structure [813]. The marginal gap between a tooth structure and a luting agent is frequently the result of polymerization contraction of a thin lm of luting agent [16,17]. Therefore, a marginal gap will form if the adhesion between the tooth and luting agent does not compensate for the stress exerted by luting agent shrinkage in the initial stage of setting (before thermocycling). This study demonstrated that for three luting agents, not including PermaCem, at least 50% of specimens had no marginal gaps before thermocycling. The two resin composites, Compolute and Panavia 21, showed the best results. The rates of setting shrinkage of these two products were almost equal to, and were signicantly smaller than that of Fuji Plus. It had almost no effect on the bonding ability or strength in the early stage of setting, although the bond strength value of Compolute was signicantly greater than that of Panavia 21. The gap width of Fuji Plus was signicantly greater than those of the two resin composites, Compolute and Panavia 21 (only luting agent, without treating agent). This was the main reason why the rate of setting shrinkage of Fuji Plus was signicantly larger than those of the two products (Table 4). The rate of setting shrinkage had a greater effect on gap formation compared with the value of bond strength, as mentioned above. The gap width for PermaCem before thermocycling was the largest of all the products. However, the rate of setting shrinkage was not signicantly different compared with those of Compolute and Panavia 21. The bond value of PermaCem was not signicantly different from that of Panavia 21 and the failure pattern was almost entirely cohesive fracture. The value of exural modulus of PermaCem was the lowest of all products. The value of elastic modulus represents the stiffness of a material [28], and it was supposed that the difference in degree of setting or polymerization rate of the material was apparent in the difference of the elastic moduli. For PermaCem, the value of the elastic modulus after thermocycling increased by approximately seven times compared with that before. However, in another case (Compolute, Fuji Plus and Panavia 21), the value of the

Complex chi-square test.

hand, in the PermaCem group, the proportion of adhesive fracture after the thermocycling condition was slightly increased, compared with that before. Tables 8 and 9 summarize the exural strength and the exural modulus under the two conditions, respectively. When the specimens underwent thermal stress, the strength and modulus of Compolute were signicantly decreased, those of PermaCem and Panavia 21 were increased, and those of Fuji Plus showed no signicant difference. Before thermocycling, Compolute showed the greatest value of any material and Fuji Plus showed the lowest value. After therTable 8 Flexural strength (MPa) between before and after thermocycled (N 10, NS: Not signicantly different (p , 0.05). Means with the same letters were not signicantly different by Duncan's new multiple-range test (p , 0.05)) Luting agent Mean (S.D.) Before (immediately) Compolute PermaCem Fuji Plus Panavia 21
a

p value a After thermocycled 66.24 (6.09) E 67.57 (10.35) E 27.06 (2.90) F 71.17 (5.53) E , 0.01 , 0.001 NS , 0.001

74.53 (5.91) A 41.81 (4.36) B 23.79 (3.56) C 29.74 (3.87) D

t-test.

Table 9 Flexural modulus (GPa) between before and after thermocycled (N 10. Means with the same letters were not signicantly different by Duncan's new multiple-range test (p , 0.05)) Luting agent Mean (S.D.) Before (immediately) Compolute PermaCem Fuji Plus Panavia 21
a

p value a After thermocycled 7.76 (1.13) E 5.33 (0.39) F 4.18 (0.33) G 8.71 (0.78) H , 0.001 , 0.001 , 0.001 , 0.001

2.91 (0.26) A 0.80 (0.19) B 2.10 (0.50) C 2.56 (0.40) D

t-test.

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elastic modulus after thermocycling increased by only two or three times. Therefore the luting agent/dentin interface may have been destroyed by the polishing procedure due to insufcient setting before measurement. As a result, the marginal gap width of PermaCem was the largest among the products tested. For three luting agents, but not Fuji Plus, only one or two specimens had no gap after thermocycling. However, in the RMGIC case, Fuji Plus, showed the best result; almost all specimens had no gaps, and the results after thermocycling were signicantly better compared with before. The reasons for this were: (1) hygroscopic expansion of the luting material itself [29,30], (2) reduced setting stress due to water absorption [13,31], and (3) improved bonding ability or setting during the storage in water (for approximately 2 weeks) by the increased value of exural modulus above mentioned. The apparently favorable inuence of hygroscopic expansion of Fuji Plus on the longevity of composite inlays, is the adverse effect of excessive hygroscopic expansion with respect to fracture of ceramic inlays and crowns or occlusal disturbance of restorations or cracking of teeth, also mentioned [32]. However the excessive hygroscopic expansion of Fuji Plus is signicant in this study. Fuji Plus may be protected against rupture of the interface because it has a signicantly higher rate of hygroscopic expansion than the other products, and the expanded luting agent of Fuji Plus may act as a buffer for the interface because of the ductile property caused by low exural modulus [29]. As a result, the thermocycling had no effect on the interface, and the gap after thermocycling was significantly improved compared with that before. The results after thermocycling condition of two resin composites, Compolute and Panavia 21 were signicantly worse than before. Due to the difference in thermal expansion between tooth and luting agent, cycling of an inlay restoration between high and low temperature causes rupture of the bond between the luting agent and the tooth. Temperature cycling also causes percolation in the gap created at the luting agentdentin interface. Because the two products had an almost zero or a very low rate of hygroscopic expansion and showed the highest rate of exural modulus, the difference in dimensional change may have been directly responsible for the rupture of bond between luting agent and tooth, differing from the ductile property of Fuji Plus. The results for Compolute had a smaller mean and a narrow range of gap width, compared with Panavia 21. It is thought that Compolute has the greater bond strength value and smaller exural modulus compared with Panavia 21. The results for the compomer, PermaCem, were not signicantly different from those of the two composite luting agents, and there were no signicant differences in the values of hygroscopic expansion, bond strength and exural strength. However, the results after thermocycling were signicantly improved compared with those before, in the same manner as for Fuji Plus. It appeared that the bond-

ing ability to the tooth structure increased with the development of the luting agent/tooth marginal interaction during thermocycling, and that the exural modulus of the luting material itself improved as the setting process advanced [13]. This study examined three types of commercially available luting agent for composite inlays: Compolute and Panavia 21 (resin composite), PermaCem (polyacid-modied resin composite, Compomer) and Fuji Plus (RMGIC). It is reported that the hygroscopic expansion and the exural strength and modulus of Compolute, Panavia 21, and PermaCem have similar mechanical properties, and that differences in the ller/matrix ratio have a greater effect on these properties [22]. Therefore it was supposed that the three luting agents would show similar gap width formation after thermocycling. It is reported that the water sorption and hygroscopic expansion of RMGICs are useful in reducing the setting stress and in improving the marginal seal [13,21,31]. This effect is caused by the uptake of water into the matrix, forming a poly-HEMA complex [33]. Indeed, the results after thermocycling showed an improved marginal seal. The results of shear bond strength of each luting agent before and after thermocycling were not signicantly different. It was caused by the balance between the development of the luting agent/tooth interaction, the increase in the exural modulus of the luting material itself, and the rupture of the bond between the luting agent and the tooth by thermocycling. The results of before and after thermocycling of bond strength values on Panavia 21 were signicantly lower compared with those of Compolute. This may have been caused by the difference of pre-treatments, such as the difference in the extent of removal of the dentin smear layer. The mean cement lm thickness of the four luting agents at each measured point was approximately 50100 mm when a marginal gap was observed, and this result was consistent with a previous study [15]. However, this result showed a better luting space compared with another previous study [16]. The number of gap-free margins in this study was worse than that of the previous study [15]. This has been due to the difference in thermocycling times. A more valid approach to the evaluation of sealing efcacy with three types of commercially available luting agents for a composite inlay requires further investigation with longer durability testing or load-cycling. It also requires further investigation with many kinds of luting products, since only one of each product type was tested in this study. 5. Conclusion Compolute and Panavia 21 showed marginal gaps of approximately 10 mm before thermocycling, the gap width after thermocycling was signicantly wider. Although the gap widths of PermaCem and Fuji Plus were approximately

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60110 mm prior to thermocycling, they were signicantly smaller after thermocycling. Statistical differences in the shear bond strength to dentin were not observed before and after thermocycling for all materials. The exural strength and modulus were signicantly increased after thermocycling compared with three products and with all four products, respectively. These mechanical properties of all four luting cements were closely related to their marginal gap formations and these mechanical factors have important roles in determining their marginal gap formations. Acknowledgements We gratefully acknowledge the Department of Oral and Maxillofacial Surgery II in Okayama University Dental School. The authors also thank the manufacturers for supplying the materials. References
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