[Downloaded free from http://www.jisppd.com on Tuesday, September 22, 2015, IP: 187.235.154.

29]

Original Article

Comparative evaluation of microleakage

of conventional and modifications of glass ionomer
cement in primary teeth: An in vitro study
Shruthi AS, Nagaveni NB, Poornima P, Selvamani M1, Madhushankari GS1, Subba Reddy VV
Departments of Pedodontics and Preventive Dentistry and 1Oral and Maxillofacial Pathology and Microbiology, College of Dental
Sciences, Davangere, Karnataka, India

ABSTRACT
Aims: The aim of the present study was to
evaluate the microleakage among conventional,
resin modified glass ionomer cements (GIC), and
compomer cements in primary teeth. Materials
and Methods: Forty-five over retained non carious
primary molars beyond exfoliation time were
collected and randomly divided into three groups (n
= 15). Group A: GC Fuji II; Group B: Vitremer; Group
C: Compoglass F. A standard Class V cavity was
prepared on the buccal surface of each tooth with no
mechanical retention and restored accordingly. Then
all the samples were subjected to thermocycling for
250 cycles at different temperatures and covered
with nail varnish. Later, samples were immersed
in 0.5% methylene blue dye for 24 h. Teeth were
sectioned buccolingually through the center of the
restoration and studied under a stereomicroscope
for dye penetration. Data obtained were analyzed
using KruskalWallis ANOVA and MannWhitney
U-test. Results: Samples restored with vitremer
showed comparatively higher microleakage than
the samples in other groups. However, overall
there were no significant difference between the
microleakage scores of the samples in all three
groups (P > 0.05). Conclusion: It can be concluded
that none of the three GICs was free from
microleakage. Hence, further research is required to
compare microleakage of the newer material.

KEYWORDS: Glass ionomer, microleakage, modified

glass ionomer, primary teeth

Introduction
Carious teeth are the most common complaint in
children. In pediatric dentistry restoring these teeth
is one of the major treatments. The ideal requisites for
a restorative material are that it should have a good
color stability, biocompatibility, and have a coefficient

Address for correspondence:

Dr. Nagaveni NB,

Department of Pedodontics and Preventive Dentistry,
College of Dental Sciences, Davangere - 577 004,
Karnataka, India.
E-mail: nagavenianurag@gmail.com
Access this article online
Quick response code

Website:
www.jisppd.com
DOI:
10.4103/0970-4388.165662
PMID:
******

of thermal expansion are similar to that of natural

tooth structure, excellent marginal seal, and should
have the ability to adhere chemically to both enamel
and dentine.[1] Microleakage is the most common
causes of failure of almost all restorative materials
since it is a major contributing factor to secondary
caries and pulpal irritation[2] and this type of leakage
around dental restorative materials is a major problem
in clinical dentistry.[3] It may be defined as the clinically
undetectable passage of bacteria, fluids, molecules, or
ions between a cavity wall and the restorative material
applied to it. This may occur because of dimensional
This is an open access article distributed under the terms of the Creative
Commons Attribution-NonCommercial-ShareAlike 3.0 License, which
allows others to remix, tweak, and build upon the work non-commercially,
as long as the author is credited and the new creations are licensed under
the identical terms.
For reprints contact: reprints@medknow.com

How to cite this article: Shruthi AS, Nagaveni NB, Poornima

P, Selvamani M, Madhushankari GS, Subba Reddy VV.
Comparative evaluation of microleakage of conventional and
modifications of glass ionomer cement in primary teeth: An
in vitro study. J Indian Soc Pedod Prev Dent 2015;33:279-84.

2015 Journal of Indian Society of Pedodontics and Preventive Dentistry | Published by Wolters Kluwer - Medknow

279

[Downloaded free from http://www.jisppd.com on Tuesday, September 22, 2015, IP: 187.235.154.29]

Shruthi, et al.: In vitro evaluation of microleakage in primary teeth

changes, changes in temperature, and mechanical

stress, or lack of adaptation of the restorative material
resulting in a gap at the tooth-material junction.[4]
There has always been a keen interest in the
adaptation of dental restorative materials to the
walls of cavities and the retentive ability of a material
to seal the cavity against the ingress of oral fluids
and microorganisms.[3] This seepage can cause
hypersensitivity of restored tooth, tooth discoloration,
recurrent caries, and accelerated deterioration of the
restorative material.[4] Over 50 years, many changes
have been occurred in the development of restorative
materials.[3] After introducing glass ionomer cements
(GIC), they became popular because of their chemical
adhesion and fluoride release property.[5] These
physical and chemical properties make GIC excellent
restorative material for the management of carious
teeth in pediatric dentistry. However, these traditional
GICs are associated with some disadvantages such
as delayed setting reaction, low early strength, and
other poor esthetics.[4] As a result, the conventional
GIC has undergone many modifications to overcome
these limitations. The introduction of newer GICs
such as light cured GIC, resin modified GIC (RMGIC),
compomer, and nanofilled GIC has touched the current
restorative field with maximum benefits. Therefore,
the present in vitro study is undertaken to evaluate
the microleakage among conventional, RMGIC, and
compomer cements in primary teeth.

Materials and Methods

Forty-five noncarious primary molars extracted for
orthodontic purpose or because of over retention were
selected for the study. Surface debridement of all the
teeth was performed with a hand-scaling instrument
and the teeth were stored in normal saline. The teeth
were randomly divided into three groups consisting of
15 teeth each according to the glass ionomer materials
used as follows, Group A (GC Fuji II), Group B
(Vitremer), and Group C (Compoglass F). A standard
Class V cavity was prepared on the buccal surface
of each tooth with no mechanical retention using
diamond straight bur under air Water cooling. The
preparations measured 4 mm long, 2 mm width, and
2mm deep. The depth of the cavity was measured
with a periodontal probe.
For Group A, dentin conditioner was applied to the
walls of the cavity for 15 s with a cotton pellet, rinsed
with water for 30 s and blotted dry with tissue paper.
The standard powder to liquid ratio was achieved with
1 level scoop of powder to 1 drop of liquid. Using the
plastic spatula, the powder and liquid were mixed
according to the manufacturers instructions, and
finally, the cavity was restored. Excess material was
removed and a coat of petroleum jelly was applied
over the restoration.
280

For Group B, the primer was applied to the cavity and

was dried using an air syringe for about 15 s. Then the
dried primed surfaces were light cured for 20 s. The
light cured surfaces appeared glossy. The powder and
liquid were mixed according to the manufacturers
instructions. Mixed GIC was then loaded into a
delivery tip followed by the insertion of a piston,
which flushes the excess cement from the back of the
delivery tip. Then the loaded cement was syringed
into the prepared cavity by keeping the syringe tip
immersed in the material to minimize air entrapment.
The restoration was then condensed and contoured
with a plastic filling instrument and cured for 40 s.
For Group C, the cavity was dried and etched for 30 s.
After 30 s the etchant was washed and the cavity was
dried again, but not desiccated. Then dentin bonding
agent was applied to the enamel and dentin and cured
for 20 s. Cavifils of the compoglass F was again fitted
to the dispenser and was applied in layers of 2 mm
thickness and excess material was removed and light
cured for 40 s.
All the teeth (45) from the three groups were
then subjected to thermocycling for 250 cycles at
temperatures of 5C 2C, 37C 2C, and 60C 2C
in a controlled water bath using a thermostat.
The apices of all the teeth were sealed with acrylic
resin. Each tooth was covered with two coats of nail
varnish except for an area approximately 2 mm from
the periphery of the restoration. All the teeth were
immersed in 0.5% methylene blue dye for 24 h. After
removal from the dye solution, the teeth were allowed
to dry. Then teeth were sectioned buccolingually
through the center of the restoration using a diamond
disk.
The specimens were then studied under a
stereomicroscope with a magnification of 20 to
measure the depth of the dye penetration on the
occlusal and gingival walls of both halves of the teeth.
The scoring was done as described by Khera and Chan.[4]
0 = No leakage.
1 = Dye penetrating is to the lesser than and up to onehalf of the depth of the prepared cavity.
2 = Dye penetrating is to more than one-half of the
depth of the prepared cavity but not up to the
junction of the axial and occlusal or gingival wall.
3 = Dye penetrating up to the junction of the axial and
occlusal or gingival wall but not including the axial
wall.
4 = Dye penetration including the axial wall.

Statistical analysis

The results were tabulated and statistically analyzed

by using KruskalWallis ANOVA for multiple group
comparison followed by MannWhitney U-test for
pairwise comparison.

Journal of Indian Society of Pedodontics and Preventive Dentistry | Oct-Dec 2015 | Vol 33 | Issue 4 |

[Downloaded free from http://www.jisppd.com on Tuesday, September 22, 2015, IP: 187.235.154.29]

Shruthi, et al.: In vitro evaluation of microleakage in primary teeth

Results
In Group A, 46.7% of samples showed score 0 and
53.3% of samples showed score 1, whereas in Group
B, 33.3% of samples showed score 0, 53.4% of samples
showed dye score 1, and 13.3% of samples showed
score 2, and in Group C, 46.7% of samples showed
score 0, 33.3% of samples showed score 1, and 20.0% of
samples showed score 2 [Table 1 and Graph 1].
KruskalWallis ANOVA test for different groups
showed the mean score standard deviation (SD) of
0.5 0.5 for Group A (GC Fuji II), mean score SD of
0.8 0.7 for Group B (Vitremer), and mean score SD of
0.7 0.8 for Group C (Compoglass F) showing H value
of 3.15 and P = 0.2 [Table 2].
MannWhitneys U-test was applied to compare the
significance in microleakage scores between any of the
two groups studied. When Group A was compared
with Group B, the P value obtained was 0.35, which
was not significant. When Group A was compared

with Group C, the P value was 0.62, which was found

not significant and when Group B was compared with
Group C, the P value was 0.74, which was again not
statistically significant [Figures 1-3 and Table 3].
Table 1: Distribution of samples with
corresponding microleakage scores
Group

Number of
samples

Group A (GC Fuji II)

Group B (Vitremer)
Group C (Compoglass F)

15
15
15

Microleakage scores n (%)

0
7 (46.7)
5 (33.3)
7 (46.7)

1
8 (53.3)
8 (53.4)
5 (33.3)

2 (13.3)
3 (20.0)

2 = 4.08, P = 0.39, NS = Not significant

Table 2: Mean score and SD of three groups

Group
Group A (GC Fuji II)
Group B (Vitremer)
Group C (Compoglass F)
KruskalWallis ANOVA

Number of
samples
15
15
15

Mean score SD
0.50.5
0.80.7
0.70.8
H=3.15, P=0.21, NS

SD = Standard deviation; NS = Not significant

Figure 1: Score 0 (no leakage)

Figure 2: Score 1 (dye penetrating is to the lesser than and up to onehalf of the depth of the prepared cavity)

Figure 3: Score 2 (dye penetrating is to more than one-half of the

depth of the prepared cavity but not up to the junction of the axial
and occlusal or gingival wall)

Graph 1: Distribution of different microleakage scores in three groups

Journal of Indian Society of Pedodontics and Preventive Dentistry | Oct-Dec 2015 | Vol 33 | Issue 4 |

281

[Downloaded free from http://www.jisppd.com on Tuesday, September 22, 2015, IP: 187.235.154.29]

Shruthi, et al.: In vitro evaluation of microleakage in primary teeth

Table 3: Group wise comparisons

Groups compared
Group A versus B
Group A versus C
Group B versus C

P
0.35, NS
0.62, NS
0.74, NS

MannWhitneys U-test, NS = Not significant

Discussion
Microleakage is the most common causes of failure of
almost all restorative materials and there has always
been a keen interest in the adaptation of dental
restorative materials to the walls of cavities and the
retentive ability of a material to seal the cavity against
the ingress of oral fluids and microorganisms.[3,5]
This seepage can cause hypersensitivity of restored
tooth, tooth discoloration, recurrent caries, pulpal
injury, and accelerated deterioration of the restorative
material.[4] Accordingly, there is an interest in finding
an ideal restorative material which has better bond
characteristics, thus, minimizing microleakage and
reducing the potential for caries development.[2]
An important advancement in glass ionomer
technology that has influenced dentistry for children
is the development of the RMGIC, which was
introduced in the early 1990s.[3] The RMGIC harden
initially by free-radical photopolymerization of the
resin component in the formulation. A chemical resin
polymerization reaction and the glass ionomer setting
reaction subsequently progress. The addition of the
resin component not only decreases initial hardening
time and handling difficulties, but also substantially
increases wear resistance and physical strengths of the
cement. This restorative material has been established
in pediatric practice and their favorable longevity as
a permanent restoration in primary teeth have been
demonstrated in several clinical studies.[6,7]
Compomers have become available more recently,
which is in 1992 and are recommended for use as
a pediatric restorative material. They are the single
component materials that combine the advantage
of both composite resin and GIC[8] and are officially
termed polyacid-modified, resin-based composites.
The mechanical properties of tensile and flexural
strength, as well as wear resistance of compomers, are
superior to that of glass ionomers.[9]
The current study examined the microleakage of
different types of glass ionomer restorations placed
in Class V cavities in primary teeth and subjected
to thermocycling. This thermocycling is a standard
protocol in the restorative literature when bonded
materials are evaluated, simulating in vivo aging by
subjecting bonded materials to cyclic exposures of
hot and cold temperatures and shows the relationship
coefficient of thermal expansion between the tooth and
the restorative material.[10,11]
282

The relationship between marginal leakage in

restorations and the type of restorative materials
has been extensively studied in both laboratory and
clinical studies. In the absence of definitive clinical
data, laboratory microleakage studies[8] are a wellaccepted method of screening the marginal sealing
efficiency.[12] There are several methods to detect
microleakage. These include the use of dyes, chemical
tracers and radioactive tracers, scanning electron
microscopy, neutron activation analysis, and fluid
filtration. Among these methods, measurement of dye
penetration on sections of restored teeth is the most
commonly used technique[13] because it is simple,
inexpensive, fast technique, and does not require
the use of complex laboratory equipments. Several
dye penetration studies have been performed using
methylene blue, India ink, basic fuschin, crystal violet,
as well as fluorescin.[14] Hence, the same method of dye
penetration was employed in the present study and
the dye used was methylene blue.
The results obtained in this study showed that all
the three restorative materials that were investigated
exhibited no difference in microleakage. However,
in contrary the results obtained in other study[15]
showed that all the three restorative materials that
they investigated exhibited more microleakage on
the gingival margins than on the occlusal margins.
However, no material was able to completely eliminate
microleakage and also this study was conducted on
permanent teeth not on primary teeth. This finding
is in agreement with other studies which concluded
that cavity preparations with enamel margin result
in consistently stronger bonds. Unique challenges
are encountered with dentin surface bonding due
to enamel that is 92% inorganic hydroxyapatite and
dentin that is 45% inorganic by volume.[16,17]
A study which also showed that there was no
statistically significant difference in the microleakage
of between GC Fuji II and GC Fuji II LC (RMGIC) both
occlusal and gingival margins.[15,18,19] However, few
studies have shown that there is statistically significant
difference in microleakage of these materials.[16,20] This
could be due to the difference in experimental designs
and testing methods used in these studies.
In accordance to the present study, the results in
another study demonstrated that none of the three
GICs was free from microleakage. However, the
nanofilled RMGIC showed the least microleakage.
Gorseta et al. observed that nanoionomer showed
lower microleakage values when compared with the
conventional GIC, and emphasized the efficacy of
nanoionomer cements to be used in routine dental
practice.[4]
A study which was carried on both primary and
permanent teeth showed that the conventional GIC
(Fuji II) showed more leakage than all other groups.

Journal of Indian Society of Pedodontics and Preventive Dentistry | Oct-Dec 2015 | Vol 33 | Issue 4 |

[Downloaded free from http://www.jisppd.com on Tuesday, September 22, 2015, IP: 187.235.154.29]

Shruthi, et al.: In vitro evaluation of microleakage in primary teeth

However, Fuji IX, the improved conventional GIC

behaved similar to the composite resin and to the
RMGIC (Vitremer). Results suggested that the leakage
in primary and permanent teeth may vary individually
with each type of material, one showing greater primary
tooth leakage, while another showing more permanent
teeth leakage.[2] According to Singla et al.[8] the mean
microleakage of compomer was 2.47 after 24 h dye
immersion. He said this microleakage pattern would
have been attributed to higher resin content as compared
to Fuji II LC, which causes more polymerization
shrinkage leading to increased microleakage. He also
said that there was more microleakage in deciduous
molars when compared with permanent molars, but it
was not statistically significant.
A study similar to the present one, where they included
Fuji IX GP, Fuji II LC, and compoglass to evaluate
tensile bond strength and microleakage on primary
teeth.[9] Here, a total of 82.8% of Fuji II LC samples
did not exhibit any microleakage. The microleakage
of RMGIC was lesser than compomers, this was also
supported by Toledano et al.,[21] Castro and Feigal,[2]
Zyskind et al.,[22] Gladys et al.,[23] Rodrigues et al.[24]
However, in the current study, RMGIC showed more
microleakage than compomer. In the above-mentioned
study, they said only 46.9% of the compomer samples
showed no microleakage. This is comparable to the
present study that 46.70% of compoglass samples did
not show microleakage and also only 33.3 % of vitremer
samples did not show microleakage. Cehreli et al.[25] in
their study said that the absence of surface protection
resulted in significant reduction in the marginal
sealing efficiency of both conventional GIC and glass
carbomer cement with the later yielding the greatest
amount of microleakage among the test groups. As
with other resin-based filling materials, it can be
assumed that surface protection would significantly
increase the marginal sealing of the compomer.[26] In
an in vivo study[1] authors have discussed the amount
of microleakage on the buccal surface of deciduous
molars after restoring the cavity with GC Fuji II LC and
GC Fuji IX GP. Where there was more microleakage in
RMGIC samples than conventional GIC samples. This
is similar to the results what we have obtained in the
present study.
The present study indicated that there was no
significant difference in the microleakage between all
three groups. However, after comparing the individual
scores of microleakage in each samples, it showed that
the RMGIC (vitremer) showed more microleakage
when compared with GC Fuji II and compoglass F.
There are certain limitations noticed in this study:
This was an in vitro study, where the exact oral
environment could not be simulated.
Marginal integrity was evaluated using a single
parameter, that is, estimation of microleakage by
dye penetration method only.

Conclusion
In spite of these limitations, this study has hinted
on the amount of microleakage of conventional and
different modification of GIC in primary teeth and
also showed that there was no complete elimination
of microleakage in any of the groups. Hence, further
research is required to compare microleakage of the
newer cements such as RMGIC and compomers.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References
1. Masih S, Thomas AM, Koshy G, Joshi JL. Comparative
evaluation of the microleakage of two modified glass ionomer
cements on primary molars. An in vivo study. J Indian Soc
Pedod Prev Dent 2011;29:135-9.
2. Castro A, Feigal RE. Microleakage of a new improved glass
ionomer restorative material in primary and permanent teeth.
Pediatr Dent 2002;24:23-8.
3. Abd El Halim S, Zaki D. Comparative evaluation of
microleakage among three different glass ionomer types. Oper
Dent 2011;36:36-42.
4. Upadhyay S, Rao A. Nanoionomer: Evaluation of
microleakage. J Indian Soc Pedod Prev Dent 2011;29:20-4.
5. Mali P, Deshpande S, Singh A. Microleakage of restorative
materials: An in vitro study. J Indian Soc Pedod Prev Dent
2006;24:15-8.
6. Qvist V, Manscher E, Teglers PT. Resin-modified and
conventional glass ionomer restorations in primary teeth:
8-year results. J Dent 2004;32:285-94.
7. Faccin ES, Ferreira SH, Kramer PF, Ardenghi TM, FeldensCA.
Clinical performance of ART restorations in primary teeth:
A survival analysis. J Clin Pediatr Dent 2009;33:295-8.
8. Singla T, Pandit IK, Srivastava N, Gugnani N, Gupta M. An
evaluation of microleakage of various glass ionomer based
restorative materials in deciduous and permanent teeth: An
invitro study. Saudi Dent J 2012;24:35-42.
9. Rekha CV, Varma B, Jayanthi. Comparative evaluation of
tensile bond strength and microleakage of conventional
glass ionomer cement, resin modified glass ionomer cement
and compomer: An in vitro study. Contemp Clin Dent
2012;3:282-7.
10. Nalcaci A, Ulusoy N. Effect of thermocycling on microleakage
of resin composites polymerized with LED curing techniques.
Quintessence Int 2007;38:e433-9.
11. Crim GA, Swartz ML, Phillips RW. Comparison of four
thermocycling techniques. J Prosthet Dent 1985;53:50-3.
12. Raskin A, Tassery H, DHoore W, Gonthier S, Vreven J,
Degrange M, et al. Influence of the number of sections on
reliability of in vitro microleakage evaluations. Am J Dent
2003;16:207-10.
13. Alani AH, Toh CG. Detection of microleakage around dental
restorations: A review. Oper Dent 1997;22:173-85.

Journal of Indian Society of Pedodontics and Preventive Dentistry | Oct-Dec 2015 | Vol 33 | Issue 4 |

283

[Downloaded free from http://www.jisppd.com on Tuesday, September 22, 2015, IP: 187.235.154.29]

Shruthi, et al.: In vitro evaluation of microleakage in primary teeth

14. Going RE. Microleakage around dental restorations:
A summarizing review. J Am Dent Assoc 1972;84:1349-57.
15. Brackett WW, Gunnin TD, Johnson WW, Conkin JE.
Microleakage of light-cured glass-ionomer restorative
materials. Quintessence Int 1995;26:583-5.
16. Phair CB, Fuller JL. Microleakage of composite resin restorations
with cementum margins. J Prosthet Dent 1985;53:361-4.
17. Swift EJ Jr, Perdigo J, Heymann HO. Bonding to enamel and
dentin: A brief history and state of the art, 1995. Quintessence
Int 1995;26:95-110.
18. Davis EL, Yu X, Joynt RB, Wieczkowski G Jr, Giordano L.
Shear strength and microleakage of light-cured glass ionomers.
Am J Dent 1993;6:127-9.
19. Hallett KB, Garcia-Godoy F. Microleakage of resin-modified
glass ionomer cement restorations: An in vitro study. Dent
Mater 1993;9:306-11.
20. Puckett AD, Fitchie JG, Bennett B, Hembree JH. Microleakage
and thermal properties of hybrid ionomer restoratives.
Quintessence Int 1995;26:577-81.

284

21. Toledano M, Osorio E, Osorio R, Garca-Godoy F.

Microleakage of Class V resin-modified glass ionomer and
compomer restorations. J Prosthet Dent 1999;81:610-5.
22. Zyskind D, Frenkel A, Fuks A, Hirschfeld Z. Marginal leakage
around V-shaped cavities restored with glass-ionomer cements:
An in vitro study. Quintessence Int 1991;22:41-5.
23. Gladys S, Van Meerbeek B, Lambrechts P, Vanherle G. Marginal
adaptation and retention of a glass-ionomer, resin-modified
glass-ionomers and a polyacid-modified resin composite in
cervical Class-V lesions. Dent Mater 1998;14:294-306.
24. Rodrigues JA, De Magalhes CS, Serra MC, Rodrigues Jnior
AL. In vitro microleakage of glass-ionomer composite resin
hybrid materials. Oper Dent 1999;24:89-95.
25. Cehreli SB, Tirali RE, Yalcinkaya Z, Cehreli ZC. Microleakage
of newly developed glass carbomer cement in primary teeth.
Eur J Dent 2013;7:15-21.
26. Guelmann M, Bonnin S, Primosch RE, Sderholm KJ.
Microleakage and wall adaptation of conservative restorations.
Am J Dent 2002;15:407-11.

Journal of Indian Society of Pedodontics and Preventive Dentistry | Oct-Dec 2015 | Vol 33 | Issue 4 |