Miwan Salahalddin A. Rahman * and Tavga Mustafa Faris **

* Conservative Dentistry, School of dentistry, Faculty of Medical Sciences, University of Sulaimani.

Submitted: 4/4/2013; Accepted: 29/9/2013; Published 1/6/2014

DOI Link: https://doi.org/10.17656/jsmc.10047 



Potential liner materials include resin modified glass ionomer (RMGI) and flowable liners have been suggested by some studies to inhibit the occlusal and gingival microleakage in Class II composite restorations, which may act as a flexible intermediate layer, relieving the stresses of polymerization shrinkage and subsequently decreasing the microleakage.


The purpose of this study is to determine the microleakage prevention effect of two different liners (Resin- modified glass ionomer and Flowable composite liner) on the occlusal and gingival cavosurface margin of deep class II cavity restorations using glass-ceramic microhybrid composite.

Materials and Methods

Class II cavities were made on both mesial and distal proximal sides of twenty three extracted permanent molars (n= 45 cavities); the gingival margins were placed (1 mm) apical to the cemento enamel junction, and they were randomly assigned to three groups (n=15 cavities). All the cavities were filled with microhybrid resin composite using centripetal placement technique. In group A, no liner was used under the composite, in group B, RMGI liner was used and in group C, flowable liner was used. The specimens were kept in distilled water for 1 week and then they were thermocycled. In order to evaluate the marginal microleakage, the teeth surfaces were isolated with nail varnish then immersed in a 2% methylene blue dye for 24 hours. The specimens were then carefully sectioned mesially/distally at the center and were studied under a stereomicroscope. Then scoring was done.


The results of this study show that in all of the groups the microleakage at the gingival margin was more than at the occlusal margin; in group A (p < 0.01), and in group B and C (p > 0.05). At the occlusal margin, group A showed higher microleakage than group B (p < 0.01), and group C (p > 0.05). At the gingival margin, group A also showed higher microleakage than group B and C (p < 0.01). At the occlusal and gingival margins, group B showed less microleakage than group C (p > 0.05).


The microleakage at the gingival margin was higher than at the occlusal margin in deep class II microhybrid resin composite restorations. More microleakage was seen in the group in which no liner was used. Therefore, it is imperative to use liner under microhybrid composite in deep class II cavity restorations. Resin Modified glass ionomer liner has the ability to reduce occlusal and gingival microleakage more than flowable liner but statistically the difference was not significant. None of the tested liners were able to prevent occlusal and gingival microleakage completely.


Occlusal and gingival Microleakage, Microhybrid composite, Resin modified glass ionomer liner, Flowable liner.


1- Lindberg A. Resin Composites: Sandwich restorations and Curing techniques. Book, 1sted, Umea University, Sweden; 2005; 90:4 

2- Brannstrom M. Mattsson B., Torstenson B. Material's techniques for lining composite resin restorations: a critical approach. J Dent. 1991; 19(2):71-79.

3- Demarco FF, Ramos OL, Mota CS, Formolo E, Justino LM.  Influence of different restorative techniques on microleakage in Class II cavities with gingival wall in cementum. Oper Dent. 2001; 26(3):253-259. 

4- Alonso RC, Sinhoreti MA, Correr SL,Concani S, Goes MF  . Effect of Resin Liners on the Microleakage of Class V Dental Composite Restorations" J Appl Oral Sci. 2004; 12(1): 56-61.

5- Salim S, Santini A, Safar KN, .Microleakage around glass-ceramic insert restorations luted with a high viscous or flowable composite. J Esthet Restor Dent. 2005; 17(1):30-38.

6- Montes MA, de Goes MF, Ambrosano GM, Duarte RM, Sobrinho LC.  The effect of collagen removal and the use of a low-viscosity resin liner on marginal adaptation of resin composite restorations with margins in dentin. Oper Dent.2003; 28(4):378-387.

7-Unterbrink GL and Liebenberg WH. Flowable resin composites as ‘filled adhesives:’ literature review and clinical recommendations. Quintessence Int. 1999; 30(4):249–257.

8- Ausiello P, Apicalla A, Davidson CL.  Effect of adhesive layer properties on the stress distribution in composite restoration-3D finite element analysis. Dental Material. 2002: 18(4):295-303.

9- Simi B and Suprabha B .Evaluation of microleakage in posterior nanocomposite restorations with adhesive liners. J Conserv Dent.2011; 14(2): 178–181.

10- Aboushala A, Kugel G, Hurley E.  Class II "composite resin restorations using glass-ionomer liners: microleakage studies. J Clin Pediatr Dent. 1996; 21(1):67-70.

11- 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(2):135-139.

12- Sadeghi M.  The Effect of Fluid Composite as Gingival Layer on Microleakage of Class II Composite Restorations .Dental Research Journal. 2007; 4( 1): 40-47

13- Taher NM. Mechanical properties of flowable composites. Saudi Dental Journal. 2001; 13 (1): 20-24.

14- Leevailoj C, Cochran MA, Matis BA, Moore BK, Platt JA.  Microleakage of posterior packable resin composites with and without flowable liners. Oper Dent. 2001; 26(3):302-307.

15- Attar N, Tam LE, McComb D.  Flow, strength, stiffness and radioopacity of flowable resin composites. J Can Dent Assoc. 2003; 69(8):516-521.

16- Adalberto S., Fernando L., Giovanna, Á, Fernando F. "Influence of different restorative techniques on marginal seal of class II composite restorations" J Appl Oral Sci. 


17- Attar N, Turqut MD, Gungor HC. The effect of flowable resin composites as gingival increments on the microleakage of posterior resin composites. Oper Dent .2004; 29(2):162-167.

18- Bogra P, Gupta S, Kumar S. Comparative evaluation of microleakage in class II cavities restored with Ceram X and Filtek P-90: An in vitro study. Contemp Clin Dent. 2012 Jan; 3(1):9-14

19- Radhika M, Girija SS, Kumaraswamy BN, Neetu M .Effect of different placement techniques on marginal microleakage of deep class-II cavities restored with two composite resin formulations. J Conserv Dent. 2010; 13(1): 9–15.

20- Rodrigues Junior SA, Pin LF, Machado G, Della Bona A, Demarco FF. Influence of different restorative techniques on marginal seal of class II composite restorations. J Appl Oral Sci. 2010 Jan-Feb; 18(1):37-43.

21- Basavanna R, Garg A, Kapur R. Evaluation of gingival microleakage of class II resin composite restorations with fiber inserts: An in vitro study. J Conserv Dent. 2012 Apr; 15(2):166-9.

22- Alomari QD, Reinhardt JW, Boyer DB. Effect of liners on cusp deflection and gap formation in composite restorations. Oper Dent. 2001; 26(4):406-411.

23- Alvarez GC, Barceló SF, Guerrero IJ, Sáez EG, Canseco MA.  Calculation of contraction rates due to shrinkage in light-cured composites. Dent Mater.  2004; 20(3):228–235.

24- Giachetti L., Scaminaci R, Bambi C. and Grandini R. A Review of Polymerization Shrinkage Stress: Current Techniques for Posterior Direct Resin Restorations. The Journal of Contemp Dent Pract. 2006; 7, (4): 79-88.

25- Usha H, Kumari A, Mehta D, Kaiwar A, Jain N. Comparing microleakage and layering methods of silorane-based resin composite in class V cavities using confocal microscopy: An in vitro study. J Conserv Dent. 2011; 14(2): 164–168.

26- Ruiz J, Mitra S .Using cavity liners with posterior composite restorations. Compend Contin Educ Dent. 2006; 27(6):347-351.

27- Browning WD. The benefits of glass ionomer self-adhesive materials in restorative dentistry. Compend Contin Educ Dent. 2006; 27(5): 308-314.

28-Majety KK, Pujar M .In vitro evaluation of microleakage of class II packable composite resin restorations using flowable composite and resin modified glass ionomers as intermediate layers. J Conserv Dent.  2011; 14(4): 414–417.

29- Leclaire CC, Blank LW, Hargrave JW, Pelleu GB Jr. Use of a two-stage composite resin fill to reduce microleakage below the cementoenamel junction. Oper Dent. 1988; 13(1): 20-23.

30- Arora V, Kundabala M, Parolia A, Thomas MS, Pai V. " Comparison of the shear bond strength of RMGIC to a resin composite using different adhesive systems: An in vitro study. J Conserv Dent .2010; 13(2): 80-83.

31- Braga RR, Hilton TJ, Ferracane JL. "Contraction stress of flowable composite materials and their efficacy as stressrelieving liners" J Am Dent Assoc.; 2003: 134(6): 721-728.

32- Alonso RC, Sinhoreti MA, Correr Sobrinho L, Consani S, Goes MF. Effect of resin liners on the microleakage of class V dental composite restorations. J Appl Oral Sci. 2004 Mar; 12(1):56-61.

33- Neme AM L.Hoelscher DC. Maxson BB. Microleakage in Class II Resin Composite Restorations with Various Adhesive/ Liner Combinations: An In Vitro Study. Oral health J. http://www.oralhealthgroup.com /news/1000127658.  Accessed April 1, 2003.

34- Tung FF, Estafan D, Scherer W. "Microleakage of a condensable resin composite: an in vitro investigation". Quintessence Int; 2000: 31(6): 430-434.

35- Olmez A, Oztas N, Bodur H.  The effect of flowable resin composite on microleakage and internal voids in class II composite restorations. Oper Dent. 2004; 29:713-719.

36- Korkmaz Y, Ozel E, Attar N. Effect of flowable composite lining on microleakage and internal voids in Class II composite restorations.  J Adhes Dent.  2007; 9(2):189-194.

37- Sadeghi M, Lynch CD .The effect of flowable materials on the microleakage of Class II composite restorations that extend apical to the cemento-enamel junction. Oper Dent.  2009; 34(3):306-311.

38- Basavanna R, Garg A, Kapur R. Evaluation of gingival microleakage of class II resin composite restorations with fiber inserts: An in vitro study. J Conserv Dent.   2012; 15(2): 166-169.

39- Tollidos K, Setcos JC. Initial degree of polymerization shrinkage exhibited by flowable composite resins. J Dent Res. 1999; 78:483–485.

40- Ziskind D, Adell I, Teperovich E, Peretz B. The effect of an intermediate layer of flowable composite resin on microleakage in packable composite restorations. Int J Paediatr Dent. 2005; 15(5): 349-354.

41- Tredwin CJ, Stokes A, Moles DR. Influence of flowable liner and margin location on microleakage of conventional and packable class II resin composites. Oper Dent.  2005; 30(1): 32-38.

42-Daneshkazemi AR, Davari AR, Modaresi J, Dastjerdi F, Darezereshki M. Effect of flowable composite on microleakage of packable resine composite in class II cavities. JQUMA. 2009; 13(3):23-28.

43- Moezyzadeh M,  Kazemipoor M . Effect of Different Placement Techniques on Microleakage of Class V Composite Restorations. Journal of Dentistry. 2009; 6(3): 121-129.

44- Tolidis K, Nobecourt A, Randall RC. Effect of a resin-modified glass ionomer liner on volumetric polymerization shrinkage of various composites. Dent Mater.  1998; 14(6): 417-423.

45- Leinfelder KF, Freedman G, Pakroo J. Postoperative sensitivity: bonded cavity liners revisited. Dent Today. 2001; 20(11): 82-87.

46- Ruiz JL, Mitra S. Using cavity liners with direct posterior composite restorations. Compend Contin Educ Dent. 2006 Jun; 27(6):347-351.

47- Bona AD, Pinzetta C, Rosa V. Effect of acid etching of glass ionomer cement surface on the microleakage of sandwich restorations.  J Appl Oral Sci. 2007; 15(3): 230-234.24. 25. 26.

48- Leinfelder KF, Freedman G, Pakroo J. Postoperative sensitivity: bonded cavity liners revisited. Dent Today. 2001; 20:82-87.

49- Derhami K, Coli P, Brännström M. Microleakage in Class 2 composite resin restorations. Oper Dent. 1995; 20(3): 100-105.

50- Neme AM, Maxson BB, Pink FE, Aksu MN.  Microleakage of Class II packable resin composites lined with flowables: An in vitro study. Oper Dent.  2002; 27(6): 600–605.

51- Chimello DT, Chinelatti MA, Ramos RP, Palma Dibb RG.  In vitro evaluation of microleakage of flowable composite in class V restorations. Braz Dent J. 2002; 13(3):184-187. 

52- Santini A, Plasschaert AJ, Mitchell S.  Marginal leakage of filled dentin adhesives used with wet and dry bonding techniques. Am J Dent.2000; 13(2): 93-97.

53- Stockton LW, Tsang ST. Microleakage of Class II Posterior Composite Restorations with Gingival Margins Placed Entirely within Dentin. J Can Dent Assoc.  2007; 73(3):255.

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