Influence of Hand Instrumentation and Ultrasonic Scaling on the Microleakage of various Cervical Restorations: An in vitro Study.

INTRODUCTION: In cervical lesions, various restorative materials can be inserted, which can be affected by the application of periodontal scalers. This study evaluated and compared the marginal seal of class V glass ionomer, composite resin, and amalgam restorations after subjecting them to hand instrumentation and ultrasonic scaling.

MATERIALS AND METHODS: In this experimental study, 30 sound human first premolars were selected. In each tooth, buccal and lingual cavities (4 mm mesiodistal width, 3 mm occlusogingival height, and 2 mm depth) were made. The teeth were randomly assigned to three groups of 10 teeth: (1) Glass ionomer group, (2) composite group, and (3) amalgam group. Teeth were subjected to thermocycling procedure for 1,000 cycles between 5 and 55°C water baths and a 1-minute dwell time. Then, each group was randomly subdivided: (1) Margins of 30 restorations were exposed to hand instrumentation procedures by applying 10 working strokes, (2) margins of 30 restorations were exposed to a periodontal tip mounted on a piezoelectric ultrasonic handpiece working at 25 kHz for 10 seconds. The specimens were serially sectioned mesiodistally. Each section was examined under a stereomicroscope. The extent of microleakage was ranked using a 0 to 4 scale at both occlusal and cervical margins of the restorations. Data were analyzed initially using the Kruskal-Wallis test, followed by multiple comparisons using the Mann-Whitney and Wilcoxon test.

RESULTS: The type of restorative material had a significant influence on dye penetration, whether in the enamel margin or in the dentinal margin (p < 0.001). The microleakage of glass ionomer group was the highest. No statistical differences were found in dye penetration between scaling groups (hand instrumentation and ultrasonic scaling) (p > 0.05).

CONCLUSION: Type of restorative material had a significant influence on microleakage. No statistical differences were found in dye penetration between scaling groups.

CLINICAL SIGNIFICANCE: The microleakage of glass ionomer restoration is greater than amalgam and composite restorations after subjecting them to hand instrumentation and ultrasonic scaling.