Effect of liners on cusp deflection and gap formation in composite restorations.

This study measured deformation of cusps and gap formation associated with MOD resin composite restorations in maxillary premolars with and without the use of low elastic modulus liners. Low elastic modulus liners may reduce the deformation by absorbing polymerization shrinkage stress. Forty maxillary premolars were mounted in stone and slot MOD cavities were prepared. Teeth were randomized into four groups. In Group A, cavities were etched, Single Bond was applied and the cavities were restored with Z-100 composite. In Group B, the same was done except that a layer of flowable composite (Revolution) was place and cured after the bonding agent. In Group C, the same steps were followed as Group A but a layer of glass ionomer (Vitrebond) was placed and cured before the bonding agent. In Group D, a thin layer of composite was placed (after the bonding agent) as a base and cured and the cavities were filled. The distance between indexed cusp tips was measured before the restorations were finished and five minutes and 24 hours after the restorations were completed. The samples were then sectioned mesiodistally and epoxy resin replicas were made and prepared for SEM evaluation of gap formation. The mean contraction of the cusps in microm at 5 minutes and 24 hours, respectively, for each group was A) 47 and 30, B) 35 and 21, C) 23 and 8 and D) 40 and 28. Groups A and D resulted in the highest deformation, B was intermediate and C was the lowest. There was no statistically significant difference in gap formation between the groups.