Effects of flowable resin on bond strength and gap formation in class I restorations

Objectives. This study measured resin/dentin bond strengths and evaluated gap formation at the pulpal floor of occlusal composite restorations using a flowable resin as a liner with either bulk or incremental placement of the restorative composite. Methods. Class I occlusal preparations were made in 16 extracted molars, and were randomly divided into two groups for restoration using either One-Step adhesive (OS, BISCO) and Renew composite (RW, BISCO) or OptiBond SOLO adhesive (SOLO, Kerr) and Herculite XRV composite (XRV, Kerr). A flowable resin [ÆliteFlo (AE, BISCO) or Revolution (RV, Kerr)] was applied as a liner in half of the specimens of each group. The lined and unlined groups were restored with composite cured in bulk, or cured in 1.5 mm increments. After 24 h in water, the teeth were sectioned into 0.7-mm thick slabs and were examined with an optical microscope (400×) to determine the presence of internal resin–dentin gaps. The gap-free specimens were trimmed and were subjected to microtensile bond strength testing. Specimens that contained gaps had Knoop hardness of the restorative material measured. Results. All incrementally filled restorations were well adapted to the pulpal floor but nearly all bulk-cured specimens had gaps between the flowable and the hybrid composites. The use of a flowable resin increased the bond strength of OS, but not SOLO. Significance. The incremental technique prevented gap formation regardless of the use of a flowable resin. In contrast, the use of a flowable composite did not guarantee gap-free restorations or improved bond strength of resin to dentin in bulk-filled restorations.