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6]

Original Article

Comparative evaluation of secondary caries formation

around light‑cured fluoride‑releasing restorative
materials
N Sathyajith Naik, VV Subba Reddy1, ND Shashikiran2
Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences, Bareilly, Uttar Pradesh, 1Department of Pedodontics
and Preventive Dentistry, College of Dental Sciences, Davangere, Karnataka, 2Department of Pedodontics and Preventive Dentistry,
School of Dental Sciences, Krishna Institute of Medical Sciences, Karad, Maharashtra, India

ABSTRACT Address for correspondence:

Dr. Sathyajith Naik N,
Aim: The aim of this study was to compare and
Department of Pedodontics and Preventive Dentistry, Institute
evaluate secondary caries formation around of Dental Sciences, Bareilly - 243 006, Uttar Pradesh, India.
light‑cured fluoride‑releasing restorative materials. E-mail: sathyajithnaik@gmail.com
Methodology: Standard Class V cavities were
prepared on the buccal and lingual surfaces of
forty extracted healthy premolars. The teeth were Access this article online
randomly divided into four groups of ten teeth each Quick response code Website:
and labeled as Group I, II, III, and IV and restored www.jisppd.com
with one of the following materials, namely, DOI:
Fuji II LC (Group I), Vitremer (Group II), F‑2000
10.4103/0970-4388.199235
(Group III), and Z‑100 (Group IV; Control). The teeth
PMID:
were thermocycled and immersed in jars containing
an acid gel for caries‑like lesion formation. After ******

15 weeks, the samples were removed, washed, and

sectioned buccolingually through the restoration.
The sections were then grounded to a thickness of
80–100 µm. After imbibition in water, the sections
were mounted on slides and lesions were examined,
measured, and photographed with Leica DMRB
Research Microscope. The observation recorded was
subjected to (a) analysis of variance, (b) Studentized
range test (Newman–Keuls), (c) Snedecor’s F‑test.
Results: The depth of the outer lesion in teeth
restored with Z‑100 (Group IV; Control) was
significantly higher than the teeth restored with
F‑2000 (Group III), Vitremer (Group II), and Fuji
II LC (Group I) (P < 0.01). The depth of the outer
lesion in teeth restored with F‑2000 (Group III) was
also significantly higher than the teeth restored with
Vitremer (Group II) and Fuji II LC (Group I) (P < 0.01).
However, there was no significant difference in
depth of the outer lesions among the teeth restored
with Vitremer (Group II) and Fuji II LC (Group I). No
wall lesion (WL) was evident in teeth restored with
Vitremer (Group II) and Fuji II LC (Group I). The WL
length and body depth in teeth restored with Z‑100
(Group IV; Control) were significantly higher than
the teeth restored with F‑2000 (Group III) (P < 0.01).
Conclusion: It was concluded that Fuji II LC and
Vitremer had a inhibitory effect on the development
of WL and OL depth. Even though F‑ 2000 was not
fully effective in preventing the development of WL,
there was significant reduction in WL and depth when
compared to Z‑100.
KEYWORDS: Artificial caries, fluoride‑releasing
restoratives, secondary caries, thermocycling
Introduction
Amalgam has been the traditional material for filling
cavities in posterior teeth for the last 150 years due to its
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,
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the identical terms.
For reprints contact: reprints@medknow.com
How to cite this article: Naik NS, Subba Reddy VV,
Shashikiran ND. Comparative evaluation of secondary caries
formation around light-cured fluoride-releasing restorative
materials. J Indian Soc Pedod Prev Dent 2017;35:75-82.

© 2017 Journal of Indian Society of Pedodontics and Preventive Dentistry | Published by Wolters Kluwer - Medknow 75
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Naik, et al.: Evaluation of secondary caries formation
effectiveness and cost. Resin composite has become an
esthetic alternative to amalgam restoration.[1] However,
secondary caries formation around existing restoration
represents the primary reason for replacement of
amalgam and composite resin restorations.[2] Lack of
marginal integrity[3] and contraction of the restoration
away from the cavity walls to form a micro‑gap
followed by leakage are considered to be the important
factors leading to the eventual development of
“secondary caries” at the restoration/tissue interface.[4]
The ability of a restorative material to resist a secondary
caries attack and microleakage at its margins will
largely determine whether a restoration will succeed
or fail. Development of an ideal restorative material,
which provides a permanent seal with tooth structure,
has been thwarted by complicating factors present
in the oral environment, i.e., changes in intraoral
temperature (thermal expansion), solubility of the
certain restorative material in saliva, and changes in
pH.[5] Consequently, increased emphasis has been
placed on the development of a restorative material
with anticariogenic properties.
Glass‑ionomer cement has replaced silicate cement, and
clinical experience indicated that fluoride release from
glass ionomer provides a reduction on secondary caries.
Conventional glass‑ionomer materials have shown to
inhibit secondary caries formation on the tooth surface
and along the tooth/restorative interface.[6] However,
the conventional glass‑ionomer cement suffers from
certain disadvantages. These disadvantages are short
working time, long setting time, and susceptibility to
early moisture contamination, desiccation after setting
and brittleness.[7]
In recent years, to overcome these disadvantages,
hybrid glass‑ionomer materials have been introduced
that combine resin composite and glass ionomer
cement technologies.[8] The ability of these new
materials to impart resistance to the development of
secondary caries, however, is unproven and would
be dependent on the physiochemical properties of the
materials itself, enabling sufficient fluoride release in
its resin‑based formulations and on its ability to seal
the tooth/restoration interface.
Since, there is a paucity of information available on the
use of newer light‑cured fluoride‑releasing restorative
materials with improved properties, especially in
relation to the prevention of secondary caries around
such materials; this in vitro study was designed to
compare and evaluate secondary caries formation
around the following light‑cured fluoride‑releasing
restorative materials, namely,
a. Fuji II LC
b. Vitremer
c. F‑2000 Compomer
d. Z‑100 Composite (Control).
76 Journal of Indian Society of Pedodontics and Preventive Dentistry | January-March 2017 | Vol 35 | Issue 1 |
Methodology
Selection and distribution of samples
Forty healthy premolars extracted due to orthodontic
reasons were collected, cleaned of debris and tissue
tags, and stored in 10% formalin solution until were
used further. The samples were divided into four
groups, comprising ten teeth each and labeled as
Group I, II, III, and IV and kept in separate containers.
• Group I: Restored with Fuji II LC
• Group II: Restored with Vitremer
• Group III: Restored with F‑2000 Compomer
• Group IV: Restored with Z‑100 Composite (Control).
Preparation of samples
For each tooth, two standardized Class V cavity
were prepared, one each in buccal and lingual
surface measuring 3.0 mm mesiodistally, 1.5 mm
occluso‑gingivally, and 1.5 mm in depth. The cavity
was prepared using No. 557 straight fissure diamond
bur mounted in a high‑speed handpiece with bur
being oriented at right angle to the tooth surface to
produce a cavosurface angle close to 90°. The prepared
cavity was rinsed with distilled water and dried with
compressed air. The samples in each group were
restored with the respective materials assigned to the
group as mentioned above. The procedure was carried
out as per the manufacturer’s instructions.
Group I: Restored with Fuji II LC
After conditioning the tooth surface for 10 s, the cavity
was rinsed with water and air‑dried. Powder and
liquid mixture was placed in the cavity and light cured
for 40 s. The overfilled material was reduced to the
correct contour.
Group II: Restored with Vitremer
The primer was applied to the prepared cavity for
30 s and air‑dried and light cured for 20 s. Powder and
liquid mixture was placed in the cavity and light cured
for 40 s. The overfilled material was reduced to correct
contour. The gloss was applied, and light cured for 20 s.
Group III: Restored with F-2000 Compomer
F‑2000 Compomer primer/adhesive was applied to the
prepared cavity. After 30 s, it was gently air‑dried for
5–10 s and light cured for 10 s. The material was then
carried to the prepared cavity using a plastic filling
instrument and light cured for 40 s. The overfilled
material was reduced to correct contour.
Group IV: Restored with Z-100 composite
The prepared cavity was etched using Scotchbond
Etchant for 15 s, then rinsed and dried. Then, the
adhesive was applied and light cured for 10 s. The
materials were carried to the prepared cavity using a
plastic filling instrument and light cured for 40 s. The
overfilled material was reduced to correct contour.
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Naik, et al.: Evaluation of secondary caries formation

The samples were then subjected to thermocycling for Results

800 cycles between 5°C and 55°C with a dwell time
of 30 s. Subsequently, the samples were coated with
an acid‑resistant varnish except 1 mm around the
cavosurface margin. The teeth were then immersed in
jars containing an acid gel for caries‑like lesion formation
for 15 weeks. The gel consisted of 10% methylcellulose
and 0.1M lactic acid, with pH adjusted to 4.5 using
potassium hydroxide. After 15 weeks, the samples were
removed, rinsed thoroughly with water, and sectioned
buccolingually through the restoration using a diamond
sectioning saw. The sections were then ground to a
thickness of approximately 80–100 µm. After 24 h of
imbibition in water, the sections were mounted on
slides, and the lesions were examined, measured, and
photographed with Leica DMRB Research Microscope.
Evaluation method
The lesions formed consists of two parts, outer surface
lesion (OL) and cavity WL. Measurements of both
buccal and lingual lesions were made using a calibrated
eyepiece reticule.
The measurement includes:
• The body depth of the outer lesion (OL) was
measured as the largest distance between the
enamel surface and the inner border of the lesion
• The body depth of the wall lesion (WL) was
measured as the largest distance between the
restoration and the inner border of the lesion
• The WL length was measured from the enamel
surface to the innermost extended portion of the
WL toward the axial wall of the cavity.
All relative measurements from both buccal and
lingual lesions were averaged, and the data from each
group were recorded and subjected to the standard
statistical analysis, namely:
a. Analysis of variance
b. Studentized range test (Newman–Keuls)
c. Snedecor’s F‑test.
Table 1 shows the observations of the outer lesions
depth, WL length, and WL body depth.
Outer lesion depth
It was observed that the outer lesion depth for
Group I ranged from 115.50 to 225.75 µm with a
mean of 161.7 ± 38.20 µm, Group II ranged from
78.75 to 162.75 µm with a mean of 121.30 ± 28.60 µm,
Group III ranged from 157.50 to 325.50 µm with a mean
of 231.80 ± 58.60 µm, and Group IV ranged from 294.00
to 425.25 µm with a mean of 364.7 ± 44.4 µm [Table 2
and Figures 1‑4]. The depth of the lesion in teeth
restored with Z‑100 (Group IV) was significantly
higher than the teeth restored with F‑2000 (Group III),
Vitremer (Group II), and Fuji II LC (Group I) (P < 0.01).
However, there was no significant difference in
the depth of lesion among the teeth restored with
Vitremer (Group II) and Fuji II LC (Group I).
Wall lesion (wall lesion length and wall lesion body
depth)
Regarding the WL, no microscopic evidence of
demineralization was found along cavity wall adjacent to
Vitremer (Group II) and Fuji II LC (Group I) restorations.
On the other hand, WL was found in teeth restored with
F‑2000 (GROUP III) and Z‑100 (Group IV). It was observed
that the WL length for Group III ranged from 220.50 to
384.50 µm with a mean of 300.70 ± 51.80 µm [Table 3] and
the WL body depth ranged from 10.50 to 47.25 µm with a
mean of 26.80 ± 12.00 µm [Table 4].
The WL length for Group IV ranged from 314.50 to
556.50 µm with a mean of 471.60 ± 84.30 µm [Table 3] and
the WLs body depth for Group IV ranged from 52.50 to
136.50 µm with a mean of 85.00 ± 27.80 µm [Table 4].
The WL length and body depth in teeth restored
with Z‑100 were significantly higher than in the teeth
restored with F‑2000 (P < 0.01) [Figure 5].

Table 1: Measurement in µm of the lesion developed in relation to restorative materials

Specimen Fuji ii lc Vitremer F‑2000 Z‑100
no Outer Wall lesion Outer Wall lesion Outer Wall lesion Outer Wall lesion
lesion Lesion Body lesion Lesion Body lesion Lesion Body lesion Lesion Body
length depth length depth length depth length depth
1 131.25 No wall lesion 94.50 No walllesion 220.50 272.00 26.25 367.50 525.00 78.75
2 194.25 141.75 178.50 261.50 10.50 330.75 472.50 57.75
3 141.75 89.25 272.00 315.50 26.25 425.25 556.50 105.00
4 115.50 78.75 325.50 384.50 47.25 304.50 384.50 52.50
5 183.75 131.25 157.50 240.50 15.75 362.25 525.00 99.75
6 126.00 110.25 283.50 341.25 42.00 416.00 556.50 136.50
7 225.75 162.75 199.50 315.00 21.00 384.50 546.00 115.50
8 162.75 131.25 240.50 304.50 26.25 294.00 405.50 73.50
9 204.75 157.50 157.50 220.50 15.75 362.25 430.50 68.25
10 131.25 115.50 283.50 351.75 36.75 400.25 314.50 63.00
Mean 161.7±38.2 121.3±28.6 231.8±58.6 300.7±51.8 26.8±12.0 364.7±44.4 471.6±84.3 85.0±27.8

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Naik, et al.: Evaluation of secondary caries formation

Table 2: Mean (±sd) in µm of the outer lesions developed in relation to the restorative materials
Group Restorative Outer lesion length F‑ value α Difference
material Range Mean±SD significance* Group compared Significance*
I Fuji ii lc 115.5‑225.75 161.7±38.2 59.41 I‑ii Ns
Ii Vitremer 78.75‑162.75 121.3±28.6 P<0.01 I‑iii P<0.01
Iii F‑2000 157.5‑325.5 231.8±58.6 Ii‑iii P<0.01
Iv Z‑100 294.0‑425.25 364.7±44.4 I‑iv P<0.01
Ii‑iv P<0.01
Iii‑iv P<0.01
* anova f‑test ** newman‑keul’s studentitized range test least significance difference=66µm

Figure 1: View of the section showing a typical caries‑like lesion Figure 2: View of the section showing a typical caries‑like lesion
formed around a light‑cured glass‑ionomer (Fuji II LC) restoration formed around a light‑cured glass‑ionomer (Vitremer) restoration
that has been lost from cavity preparation during sectioning. An outer that has been lost from the cavity preparation during sectioning. An
surface lesion present but no cavity wall lesion exists outer surface lesion present but no cavity wall lesion exists

Figure 3: View of the section showing a typical caries‑like lesion

Figure 4: View of the section showing a typical caries‑like lesion
formed around compomer (F‑2000) restoration that has been lost
formed around composite resin (Z‑100) restoration that has been lost
from the cavity preparation during sectioning. It consists of an outer
from the cavity preparation during sectioning. It consists of an outer
surface lesion and cavity wall lesion
lesion (OL) and cavity wall lesion (WL)

Discussion materials so that clinicians can make rational decisions

Clinical evaluation of the caries preventing capability
of all the new material being produced would be
both an expensive and lengthy process. Yet, there is
a need to determine the relative efficacies of different
on what material to use. Keeping this in mind, the
present in vitro study was carried out.
The development of secondary caries around
any restorative material is determined by the

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Naik, et al.: Evaluation of secondary caries formation

fluids, and acidic products takes place along the

enamel‑restoration interface, secondary caries is likely
to develop.[9]

It has been proved that secondary caries formation

occurs mainly at the cervical margins of the tooth than
when compared with occlusal margins.[10] Hence, in
the present study, Class V cavity was prepared on a
buccal and lingual aspect of a cervical portion of the
crown.

The purpose of thermocycling was to stimulate

thermal conditions existing in the oral cavity. If the
coefficient of thermal expansion of a restorative
material differs significantly from that of the tooth
structure, the dimensions of the space around the
Figure 5: Schematic representation of various parts of caries like filling material will change as the tooth is subjected to
lesions formed around a restoration. The carious lesion consists of a temperature variations.[11] It will be realistic clinically
primary surface lesion (OL) and a secondary cavity wall lesion(WL). if the thermocycling regime includes short dwell time
The measurements made on each lesion are: (1) The body of depth of and several hundred cycles as done in this study.
the outer surface lesion is measured as the largest distance between
the enamel surface and the inner border of the lesion; (2) the body
The histopathology of the naturally occurring and
depth of the WL is measured as the largest distance between the
restoration and the inner border of the lesion; (3) the WL length is
artificially created lesions associated with secondary
measured from the enamel surface to the innermost extended portion caries has been described.[12,13] The lesion consists
of the WL toward the axial wall of the cavity of two parts – an outer OL showing the features of
primary attack on the enamel surface and the cavity
WL formed as a consequence of microleakage of acidic
Table 3: Mean (± sd) in µm of the wall lesion products and hydrogen ions from the dental plaque
length developed in relation to the restorative or acidified gel along the enamel‑restoration interface
materials [Figure 1].
Group Restorative Wall lesion length Difference
material between gr. Iii Two basic methods exist, i.e., chemical system[14,15]
& iv and bacterial system,[16,17] for an artificial cariogenic
Range Mean±SD F‑value* P‑value challenge to tooth structure. The artificial gel technique
I Fuji ii lc No wall lesion 29.85 P<0.01 is a valuable tool to create artificial caries that appears
Ii Vitremer No wall lesion indistinguishable from the natural lesion when
Iii F‑2000 220.5‑384.5 300.7±51.8 examined by polarized light and microradiography.
Iv Z‑100 314.5‑556.5 471.6±84.3 This technique has the advantage of eliminating the
* snedecor’s f‑ test (2 samples comparison) external variables (substrate and microflora) associated
with the formation of natural caries. It is efficient in
creating a carious lesion within a relatively short
Table 4: Mean (± sd) in microns of the wall lesion period, and the viscosity of the gel simulates a layer
body depth developed in relation to the restorative
of plaque. In the artificial caries system, the surface
materials
enamel is subjected to a constant attack of hydrogen
Group Restorative Body depth Difference ions (i.e., the dissolution of mineral is rate controlled)
material between gr. Iii
while the gel acts as a diffusion barrier for dissolved
& iv
mineral.
Range Mean±sd F‑value* P‑value
I Fuji ii lc No wall lesion 37.14 P<0.01
Various chemical systems used for the formation of
Ii Vitremer No wall lesion the artificial caries‑like lesion are acidified gelatin
Iii F‑2000 10.5‑47.25 26.8±12.0 gel, hydroxyethyl cellulose solution, methane
Iv Z‑100 52.5‑136.5 85.0±27.8 hydroxydiphosphonate, acetic acid‑sodium acetate
* snedecor’s f‑test (2 samples comparison) buffer, diphosphate solution, carboxymethyl cellulose
gel, and methylcellulose gel. In this study, acidified
physiochemical properties of the materials, namely, methyl cellulose gel technique was used because
shrinkage, plasticity, corrosion, solubility, fluoride it is efficient in creating a caries‑like lesion at rates
content and permeability, and its clinical performance, comparable to those occurring in vivo and utilizes a
i.e., cavity sealing ability influenced by the adhesion gel medium with organic and inorganic elements that
of the materials to tooth substance, microleakage, act as a substitute for the plaque occurring in vivo as
and cavity preparation. If microleakage of bacteria, observed by Kotsanos et al.[14]

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Naik, et al.: Evaluation of secondary caries formation
Various authors[6,9] have suggested that the thickness of
80–100 µ is most ideal for observations under polarized
light microscope. Hence, in this study, histological
analysis was done by sectioning the tooth structure to
approximately 80–100 µ thickness.
Various media used for imbibition studies are water,
quinoline, xylene, benzyl alcohol, methanol, ethanol,
n‑propanol, n‑butanol, n‑pentanol, n‑heptanol, air,
and Thoulet’s solution.[18] In this study, water was used
as an imbibing medium, because when the samples
are imbibed in water (RI ‑ 1.33), the body of the lesion
is identified in the subsurface region as an area of
observed positive birefringence, and superficial to this,
a negative birefringence surface zone is observed. The
amount of positive birefringence produced depends on
the relative volume of space present in the tissue and
on the difference between the refractive indices of the
enamel and the medium occupying the space within
the enamel. As the difference between these refractive
indices increases, the amount of birefringence also
increases.
In the present study, on comparative evaluation, it was
revealed that Fuji II LC and Vitremer had an inhibitory
effect on the development of the experimental WL
and decrease in the depth of the outer lesion. Similar
observation was reported by Tam et al.[19]
Even though F‑2000 was not fully effective in
preventing the development of experimental WL,
there was a significant reduction in the WL length and
body depth and outer lesion depth when compared
with Z‑100 (Control).
The inhibiting effect on the development of
experimental WL and deceased outer lesion in the teeth
restored with Fuji II LC and Vitremer and decreased
depth of experimental WL and outer lesion in the teeth
restored with F‑2000 observed in this study may be due
to fluoride released from the material, fluoride uptake
by the enamel/dentin, and/or less marginal leakage
around the filling.
Bynum and Donly[20] have proved that light‑cured
glass‑ionomer materials provide a significant protection
against caries‑like attack at restorative interface. Cao
et al.,[21] Retief et al.,[22] and Yey et al.[23] have proven
that the apparent caries resistant of enamel and dentin
that forms the cavity walls adjacent to the materials
is because of the availability of fluoride, released
from the light‑cure glass ionomer and compomer.
In vitro studies have shown that fluoride release from
fluoride‑containing restorative materials effectively
protected the tooth tissues from demineralization in
the region near to restorative materials.[24‑26] This ability
depends on the amount of fluoride ions released
from the material[27,28] Mitra[8] have shown that the
fluoride uptake from fluoride‑containing materials by
enamel/dentin is to a depth of 100 µm, and Robert,
80 Journal of Indian Society of Pedodontics and Preventive Dentistry | January-March 2017 | Vol 35 | Issue 1 |
Erickson, and Glasspoole[29] have shown that light‑cure
glass ionomer had better marginal quality than the
resin system.
Short‑ and long‑time fluoride release from the restorative
material are related to their matrices, setting reaction, and
fluoride content.[30] The release of fluoride from restorative
materials occurs by three distinct mechanisms, namely,
surface dissolution, diffusion through microchannels,
and pores and bulk diffusion.[31] This released fluoride
is readily taken up by the cavosurface tooth structure
as well as the enamel and root surfaces adjacent to the
restoration.[32] Retief et al.[22] have shown that fluoride
released from the glass ionomer is not lost over time,
but become incorporated into the mineral component
of enamel, perhaps as fluoridated hydroxyapatite. It
is well known that caries initiation and progression
decrease significantly when fluoride is incorporated
into the enamel, dentin, and cementum.[33] In addition,
fluoride released from glass ionomer restorations may
alter the metabolic activity of plaque formed at the
margins of the restoration, thereby altering the plaque in
the immediate vicinity of the restoration.[34]
The decreased inhibitory effect of F‑2000 on the
development of the experimental WL s and the outer
lesion when compared with Fuji II LC and Vitremer
observed in this study may be because F‑2000 is
more of a composite and less of glass ionomer and
have high thermal expansion and decreased fluoride
release. In addition, F‑2000 is cured by light initiation
polymerization whereas Fuji II LC and Vitremer are
cured by light initiation polymerization, acid‑base
reaction, and chemical cure.[35]
It was also observed that there was increased WL
and outer lesion depth in teeth restored with Z‑100.
A similar finding was observed by Flaiz and Hicks.[36]
The increase in the WL and the outer lesion depth
in teeth restored with Z‑100 might be because of
the absence of fluoride and increased gap around
the restoration. Torstenson and Brannstron,[37] Tjan
et al.[38] have shown that in vitro, the initial gap around
composite restoration vary between 10 and 30 µm.
The ability of the newer fluoride‑releasing light‑cure
restorative materials to resist caries‑like attack at the
enamel‑restorative interface would appear to be of
greater importance in the prevention of secondary
caries. In the present study, Fuji II LC and Vitremer
provided complete protection against secondary
lesion formation in cavity wall enamel, and the extent
of outer lesion was also reduced significantly. Even
through F‑2000 was effective in reducing the WL and
outer lesion when compared to Z‑100, it was not fully
effective in the prevention of experimental lesion such
as Fuji II LC and Vitremer.
The chief advantages of resin‑modified glass‑ionomer
cement (Vitremer and Fuji II LC) and polyacid‑modified
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composite resin (F‑2000) used in the study are good
working time with a degree of command over set and
resistant to secondary caries attack. However, in clinical
use, the oral environmental has an entirely different
effect on the fluoride release, uptake, and resistance
to the development of secondary caries. It must be
stressed that it is too early to make a final judgment of
these interesting materials. At present, the laboratory
and clinical information on their performance is
limited and yet to be completely developed.
This encouraging in vitro data suggest the need for a
well‑controlled clinical trial to evaluate the further clinical
effectiveness of these restorative materials. The verdict of
the cumulative clinical experience must be awaited.
Conclusions
The following conclusions were drawn from this study:
a. Secondary caries (WL and body depth) initiation
and progression are totally prevented when
Fuji II LC and Vitremer were used
b. Secondary caries (WL and body depth) initiation and
progression can be reduced significantly (P < 0.01)
when F‑2000 was used
c. Primary caries (outer lesion) initiation and
progression can be reduced significantly (P < 0.01)
when Fuji II LC, Vitremer, and F‑2000 were used
when compared to Z‑100 (Control)
d. No statistical significance was observed between
Fuji II LC and Vitremer in preventing secondary
caries (WL and body depth) and primary
caries (outer lesion) initiation and progression,
even though Vitremer was more effective than
Fuji II LC
e. Statistical significance (P < 0.01) was observed
when Fuji II LC and Vitremer were used in
preventing primary caries (outer lesion) initiation
and progression when compared with F‑2000
f. The ranked efficacy of the restorative materials
examined in the study is Vitremer >Fuji II
LC > F‑2000 > Z‑100.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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