Revisiting Microleakage: Persistent Challenges in Restorative Dentistry
Main Article Content
Abstract
The infiltration of fluids, bacteria, and ions at the interface between dental restorations and tooth structure remains a persistent challenge in restorative dentistry, significantly impacting the longevity and clinical success of restorations. This review comprehensively examines the factors contributing to microleakage, evaluates various detection methodologies, and explores strategies to mitigate its adverse effects. Emphasizing an evidence-based approach, the review highlights key considerations in restorative techniques, material selection, and adhesive protocols that enhance marginal integrity. By synthesizing current research and clinical recommendations, this article provides practical guidance for clinicians to minimize microleakage and improve the durability of dental restorations.
Article Details
Section

This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Li H, Huang Y, Zhou X, Zhu C, Han Q, Wang H, Xu HH, Ren B, Cheng L. Intelligent pH-responsive dental sealants to prevent long-term microleakage. Dent Mater. 2021;37(10):1529-41. https://doi.org/10.1016/j.dental.2021.08.002
2. Amaireh AI, Al-Jundi SH, Alshraideh HA. In vitro evaluation of microleakage in primary teeth restored with three adhesive materials: ACTIVA™, composite resin, and resin-modified glass ionomer. Eur Arch Paediatr Dent. 2019;20:359-67. https://doi.org/10.1007/s40368-019-00428-6
3. Matharu S, Spratt DA, Pratten J, Ng YL, Mordan N, Wilson M, Gulabivala K. A new in vitro model for the study of microbial microleakage around dental restorations: a preliminary qualitative evaluation. Int Endod J. 2001;34(7):547-53. https://doi.org/10.1046/j.1365-2591.2001.00475.x
4. Jodaikin A. Experimental microleakage around ageing dental amalgam restorations: a review. J Oral Rehabil. 1981;8(6):517-26. https://doi.org/10.1111/j.1365-2842.1981.tb00526.x
5. Bilgrami A, Alam MK, Qazi FU, Maqsood A, Basha S, Ahmed N, Syed KA, Mustafa M, Shrivastava D, Nagarajappa AK, Srivastava KC. An in-vitro evaluation of microleakage in resin-based restorative materials at different time intervals. Polymers. 2022;14(3):466. https://doi.org/10.3390/polym14030466
6. Dennison JB, Sarrett DC. Prediction and diagnosis of clinical outcomes affecting restoration margins. J Oral Rehabil. 2012;39(4):301-18. https://doi.org/10.1111/j.1365-2842.2011.02267.x
7. Gong H, Guo X, Cao D, Gao P, Feng D, Zhang X, Shi Z, Zhang Y, Zhu S, Cui Z. Photopolymerizable and moisture-curable polyurethanes for dental adhesive applications to increase restoration durability. J Mater Chem B. 2019;7(5):744-54. https://doi.org/10.1039/C8TB01716F
8. Rathi SD, Nikhade P, Chandak M, Motwani N, Rathi C, Chandak M. Microleakage in composite resin restoration-a review article. J Evol Med Dent Sci. 2020;9(12):1006-1. https://doi.org/10.14260/jemds/2020/216
9. Namazi AH, Mishaeel S. Shear bond strength of hydroxyapatite liner to composite resin: effect of dentin bonding agents. Health. 2018;10(1):10-9080. https://doi.org/10.19080/ADOH.2018.09.555760
10. Gong H, Zhang X, Guo X, Gao P, Zhao Q, Xu T, Shi X, Zhu S, Cui Z. Advances in reducing microleakage in dental composites. Rev Roum Chim 2019;64(6):519-27. https://doi.org/10.33224/rrch/2019.64.6.08
11. Ceballos L, Osorio R, Toledano M, Marshall GW. Microleakage of composite restorations after acid or Er-YAG laser cavity treatments. Dent Mater. 2001;17(4):340-6. https://doi.org/10.1016/S0109-5641(00)00092-0
12. Corona SA, Borsatto MC, Dibb RP, Ramos RP, Brugnera A, Pécora JD. Microleakage of class V resin composite restorations after bur, air-abrasion or Er: YAG laser preparation. Oper Dent. 2001;26(5):491-7.
13. El-Mowafy O, El-Badrawy W, Eltanty A, Abbasi K, Habib N. Gingival microleakage of Class II resin composite restorations with fiber inserts. Oper Dent. 2007;32(3):298-305. https://doi.org/10.2341/06-86
14. Alla RK. Dental Materials Science. Jaypee Brothers Medical Publishers Pvt Limited, New Delhi, India, 2013; 1-388
15. Ravi RK, Alla RK, Shammas M, Devarhubli A. Dental Composites-A Versatile Restorative Material: An Overview. Ind J Dent Sci. 2013;5(5):111-115.
16. Saridena US, Sanka GS, Alla RK, Ramaraju AV, Sajjan MCS, Mantena SR. An overview of advances in glass ionomer cements. Int J Dent Mater. 2022;4(4):89-94. https://doi.org/10.37983/IJDM.2022.4403
17. Cenci MS, Pereira-Cenci T, Donassollo TA, Sommer L, Strapasson A, Demarco FF. Influence of thermal stress on marginal integrity of restorative materials. J Appl Oral Sci. 2008;16(2):106-10. https://doi.org/10.1590/S1678-77572008000200005
18. Pinto-Sinai G, Brewster J, Roberts H. Linear Coefficient of Thermal Expansion Evaluation of Glass Ionomer and Resin-Modified Glass Ionomer Restorative Materials. Oper Dent. 2018;43(5):E266-E272. https://doi.org/10.2341/17-381-L
19. Sun J, Eidelman N, Lin-Gibson S. 3D mapping of polymerization shrinkage using X-ray micro-computed tomography to predict microleakage. Dent Mater. 2009;25(3):314-20. https://doi.org/10.1016/j.dental.2008.07.010
20. SitaRamaraju DV, Alla RK, Alluri VR, Raju MA. A review of conventional and contemporary luting agents used in dentistry. Am J Mater Sci Eng. 2014;2(3):28-35. https://doi.org/10.12691/ajmse-2-3-1
21. Nicholson JW, Swift Jr EJ. Compomers. J Esthet Restor Dent. 2008;20(1):3-4. https://doi.org/10.1111/j.1708-8240.2008.00141.x
22. Gudapati S. Cavosurface margins for various restorations. IP Ind J Conserv Endod 2022;7(3):113-119. https://doi.org/10.18231/j.ijce.2022.025
23. Hilton TJ, Ferracane JL. Cavity preparation factors and microleakage of Class II composite restorations filled at intraoral temperatures. Am J Dent. 1999;12(3):123-30.
24. Hakimeh S, Vaidyanathan J, Houpt ML, Vaidyanathan TK, Von Hagen S. Microleakage of compomer class V restorations: effect of load cycling, thermal cycling, and cavity shape differences. J Prosthet Dent. 2000;83(2):194-203. https://doi.org/10.1016/S0022-3913(00)80012-8
25. Shenoi PR, Kokane VB, Thawale HV, Kubde RR, Gunwal MK, Shahu SP. Comparing marginal microleakage in Class V cavities restored with flowable composite and Cention-N using confocal microscope-an in-vitro study. Indian J Dent Res. 2021;32(3):348-353. https://doi.org/10.4103/ijdr.IJDR_90_20
26. Andermatt L, Özcan M. Micro-shear bond strength of resin composite cement to coronal enamel/dentin, cervical enamel, cementoenamel junction and root cementum with different adhesive systems. J Adhesion Sci Technol. 2021;35(19), 2079–2093. https://doi.org/10.1080/01694243.2021.1872195
27. Anaraki SN, Sadaghyani M, Ardalani R. Effect of Cavity Dimentions with the Same C-Factor on Micro Leakage of Composite Resin Cavities. J Res Dent Sci 2019;16(4): 253-259. https://doi.org/10.29252/jrds.16.4.253
28. Idriss S, Abduljabbar T, Habib C, Omar R. Factors associated with microleakage in Class II resin composite restorations. Oper Dent. 2007;32(1):60-6. https://doi.org/10.2341/06-16
29. Van Meerbeek B. Controversy in dental adhesive technology: etch-and-rinse vs self-etch approach. InKuraray Symposium, Date: 2009/11/01-2009/11/01, Location: San Francisco, California 2009 Nov 1 (Vol. 31, No. 3, pp. 16-17). AEGIS publications. Accessed on 01.03.2025. https://compendiumlive.com/2010/compendium-supplement-kuraray/controversy-in-dental-adhesive-technology-etch-and-rinse-vs-self-etch-approach?utm_source=chatgpt.com
30. Santini A, Plasschaert AJ, Mitchell S. Effect of composite resin placement techniques on the microleakage of two self-etching dentin-bonding agents. Am J Dent. 2001;14(3):132-6.
31. Guéders AM, Charpentier JF, Albert AI, Geerts SO. Microleakage after thermocycling of 4 etch and rinse and 3 self-etch adhesives with and without a flowable composite lining. Oper Dent. 2006;31(4):450-5. https://doi.org/10.2341/05-55
32. Tran XV, Tran KQ. Microleakage and characteristics of resin-tooth tissues interface of a self-etch and an etch-and-rinse adhesive systems. Restor Dent Endod. 2021;46(2):e30. https://doi.org/10.5395/rde.2021.46.e30
33. Yollar M, Karaoğlanoğlu S, Altıparmak ET, Oktay EA, Aydın N, Ersöz B. The effects of dental adhesives total etch; self-etch and selective etch application procedures on microleakage in class II composite restorations. Eur Oral Res. 2023;57(3):151-8. https://doi.org/10.26650/eor.20231197657
34. Navyasri K, Alla RK, Vineeth G, Suresh Sajjan MC. An overview of dentin bonding agents. Int J Dent Mater. 2019 Nov 15;1(2):60-7. https://doi.org/10.37983/IJDM.2019.1204
35. Giachetti L, Russo DS, Bertini F, Pierleoni F, Nieri M. Effect of operator skill in relation to microleakage of total-etch and self-etch bonding systems. J Dent. 2007;35(4):289-93. https://doi.org/10.1016/j.jdent.2006.09.007
36. Karaman E, Yazici AR, Aksoy B, Karabulut E, Ozgunaltay G, Dayangac B. Effect of operator variability on microleakage with different adhesive systems. Eur J Dent. 2013;7(S 01):S060-5. https://doi.org/10.4103/1305-7456.119075
37. Battancs E, Fráter M, Sáry T, Gál E, Braunitzer G, Szabó P B, Garoushi S. Fracture behavior and integrity of different direct restorative materials to restore noncarious cervical lesions. Polymers. 2021;13(23):4170. https://doi.org/10.3390/polym13234170
38. Kassem AS, Atta O, El‐Mowafy O. Fatigue resistance and microleakage of CAD/CAM ceramic and composite molar crowns. J Prosthodont: Implant, Esthetic and Reconstructive Dentistry. 2012;21(1):28-32. https://doi.org/10.1111/j.1532-849X.2011.00773.x
39. Darbyshire PA, Messer LB, Douglas WH. Microleakage in class II composite restorations bonded to dentin using thermal and load cycling. J Dent Res. 1988;67(3):585-7. https://doi.org/10.1177/00220345880670031201
40. Khvostenko D, Salehi S, Naleway SE, Hilton TJ, Ferracane JL, Mitchell JC, Kruzic JJ. Cyclic mechanical loading promotes bacterial penetration along composite restoration marginal gaps. Dent Mater. 2015;31(6):702-10. https://doi.org/10.1016/j.dental.2015.03.011
41. Carrera CA, Li Y, Chen R, Aparicio C, Fok A, Rudney J. Interfacial degradation of adhesive composite restorations mediated by oral biofilms and mechanical challenge in an extracted tooth model of secondary caries. J Dent. 2017;66:62-70. https://doi.org/10.1016/j.jdent.2017.08.009
42. Maganur PD, Prabhakar AR, Sugandhan S, Namineni S. Evaluation of microleakage of RMGIC and Flowable composite immersed in soft drink and fresh fruit juice: An in vitro study. Int J Clin Pediatr Dent. 2010;3(3):153-161. https://doi.org/10.5005/jp-journals-10005-1071
43. Cenci MS, Tenuta LM, Pereira-Cenci T, Del Bel Cury AA, Ten Cate JM, Cury JA. Effect of microleakage and fluoride on enamel-dentine demineralization around restorations. Caries Res. 2008;42(5):369-79. https://doi.org/10.1159/000151663
44. Bourgi R, Cuevas‐Suarez CE, Devoto W, Monjarás‐Ávila AJ, Monteiro P, Kharma K, Lukomska‐Szymanska M, Hardan L. Effect of contamination and decontamination methods on the bond strength of adhesive systems to dentin: A systematic review. J Esthet Restor Dent. 2023;35(8):1218-38. https://doi.org/10.1111/jerd.13078
45. Nair P, Ilie N. The long-term consequence of salivary contamination at various stages of adhesive application and clinically feasible remedies to decontaminate. Clin Oral Investig. 2020;24(12):4413-26. https://doi.org/10.1007/s00784-020-03307-3
46. Helvatjoglou-Antoniades M, Theodoridou-Pahini S, Papadogiannis Y, Karezis A. Microleakage of bonded amalgam restorations: effect of thermal cycling. Oper Dent. 2000;25(4):316-23. https://doi.org/10.2341/16-132-L
47. Zanatta RF, Lungova M, Borges AB, Torres CR, Sydow HG, Wiegand A. Microleakage and shear bond strength of composite restorations under cycling conditions. Oper Dent. 2017;42(2):E71-80. https://doi.org/10.4103/0972-0707.85793
48. Jadhav S, Hegde V, Aher G, Fajandar N. Influence of light curing units on failure of direct composite restorations. J Conserv Dent. 2011;14(3):225-7.
49. Malhotra N, Mala K. Light-curing considerations for resin-based composite materials: a review. Part I. Compendium. 2010;31(7):498-506.
50. Malhotra N, Mala K. Light-curing considerations for resin-based composite materials: a review. Part II. Compendium. 2010;31(8):583-92.
51. Index M, Leaders CE. Light Curing in Restorative Dentistry: The Devil Is in the Details Dentistry Today. 2020 13. https://www.dentistrytoday.com/light-curing-in-restorative-dentistry-the-devil-is-in-the-details/?utm_source=chatgpt.com Accessed on 15th February 2025.
52. Reges RV, Costa AR, Correr AB, Piva E, Puppin-Rontani RM, Sinhoreti MA, Correr-Sobrinho L. Effect of light-curing units, post-cured time and shade of resin cement on Knoop hardness. Braz Dent J. 2009;20:410-3. https://doi.org/10.1590/S0103-64402009000500009
53. Ramic BD, Premovic MT, Stojanac IL, Drobac MR, Petrovic LM. Improved marginal adaptation of composite restorations by using different placement and light polymerization techniques. Am J Dent. 2018;31(1):7-12.
54. Delgado AJ, Ritter AV, Donovan TE, Ziemiecki T, Heymann HO. Effect of finishing techniques on the marginal integrity of resin‐based composite and resin‐modified glass ionomer restoration. J Esthet Restor Dent. 2015;27(4):184-93. https://doi.org/10.1111/jerd.12140
55. Szczesio-Wlodarczyk A, Sokolowski J, Kleczewska J, Bociong K. Ageing of dental composites based on methacrylate resins—A critical review of the causes and method of assessment. Polymers. 2020;12(4):882. https://doi.org/10.3390/polym12040882
56. Bin-Shuwaish MS, AlHussaini AA, AlHudaithy LH, AlDukhiel SA, Al-Jamhan AS. An in vitro evaluation of microleakage of resin based composites bonded to chlorhexidine-pretreated dentin by different protocols of a universal adhesive system. Saudi Dent J. 2021;33(7):503-10. https://doi.org/10.1016/j.sdentj.2020.09.006
57. de Almeida JB, Platt JA, Oshida Y, Moore BK, Cochran MA, Eckert GJ. Three different methods to evaluate microleakage of packable composites in Class II restorations. Oper Dent. 2003;28(4):453-60.
58. Çelik Ç, Bayraktar Y, Özdemir BE. Effect of Saliva Contamination on Microleakage of Open Sandwich Restorations. Acta Stomatol Croat. 2020;54(3):273-82. https://doi.org/10.15644/asc54/3/5
59. Carrilho E, Abrantes M, Paula A, Casalta-Lopes J, Botelho M, Ferreira M. Microleakage study of a restorative material via radioisotope methods. Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial. 2014;55(3):129-34. https://doi.org/10.1016/j.rpemd.2014.08.005
60. McCurdy CR Jr, Swartz ML, Phillips RW, Rhodes BF. A comparison of in vivo and in vitro microleakage of dental restorations. J Am Dent Assoc. 1974;88(3):592-602. https://doi.org/10.14219/jada.archive.1974.0107
61. Costa JF, Siqueira WL, Loguercio AD, Reis A, Oliveira Ed, Alves CM, Bauer JR, Grande RH. Characterization of aqueous silver nitrate solutions for leakage tests. J Appl Oral Sci. 2011;19(3):254-9. https://doi.org/10.1590/S1678-77572011000300014
62. Moradi S, Lomee M, Gharechahi M. Comparison of fluid filtration and bacterial leakage techniques for evaluation of microleakage in endodontics. Dent Res J. 2015;12(2):109-14.
63. Taylor MJ, Lynch E. Microleakage. J Dent. 1992;20(1):3-10. https://doi.org/10.1016/0300-5712(92)90002-T
64. Akhavan ZV, Moravej SE, Valian A. Effect of Thermocycling and type of restorative material on microleakage of Class II Restorations. J Dent School. 2016; 34(4): 202-13.
65. Rossomando KJ, Wendt SL Jr. Thermocycling and dwell times in microleakage evaluation for bonded restorations. Dent Mater. 1995;11(1):47-51. https://doi.org/10.1016/0109-5641(95)80008-5
66. Ozel E, Tuna EB, Firatli E. The effects of cavity-filling techniques on microleakage in class II resin restorations prepared with Er:YAG laser and diamond bur: A scanning electron microscopy study. Scanning. 2016;38(5):389-95. https://doi.org/10.1002/sca.21282
67. Zanatta RF, Wiegand A, Dullin C, Borges AB, Torres CR, Rizk M. Comparison of micro-CT and conventional dye penetration for microleakage assessment after different aging conditions. Int J Adhesion Adhesives. 2019;89:161-7. https://doi.org/10.1016/j.ijadhadh.2019.01.008
68. Carrera CA, Lan C, Escobar-Sanabria D, Li Y, Rudney J, Aparicio C, Fok A. The use of micro-CT with image segmentation to quantify leakage in dental restorations. Dent Mater. 2015;31(4):382-90. https://doi.org/10.1016/j.dental.2015.01.002
69. Pioch T, Stotz S, Staehle HJ, Duschner H. Applications of confocal laser scanning microscopy to dental bonding. Adv Dent Res. 1997;11(4):453-61. https://doi.org/10.1177/08959374970110041201
70. Ferracane JL. Resin composite—State of the art. Dent Mater. 2011;27(1):29-38. https://doi.org/10.1016/j.dental.2010.10.020
71. Cramer NB, Stansbury JW, Bowman CN. Recent advances and developments in composite dental restorative materials. J Dent Res. 2011;90(4):402-16. https://doi.org/10.1177/0022034510381263
72. Van Meerbeek B, Yoshihara K, Yoshida Y, Mine AJ, De Munck J, Van Landuyt KL. State of the art of self-etch adhesives. Dent Mater. 2011;27(1):17-28. https://doi.org/10.1016/j.dental.2010.10.023
73. Ilie N, Hickel R. Resin composite restorative materials. Aust Dent J. 2011;56:59-66. https://doi.org/10.1111/j.1834-7819.2010.01296.x
74. Mitra SB, Wu D, Holmes BN. An application of nanotechnology in advanced dental materials. J Am Dent Assoc. 2003;134(10):1382-90. https://doi.org/10.14219/jada.archive.2003.0054
75. Rexhepi I, Santilli M, D'Addazio G, Tafuri G, Manciocchi E, Caputi S, Sinjari B. Clinical Applications and Mechanical Properties of CAD-CAM Materials in Restorative and Prosthetic Dentistry: A Systematic Review. J Funct Biomater. 2023;14(8):431. https://doi.org/10.3390/jfb14080431
76. Schwendicke F, Göstemeyer G, Blunck U, Paris S, Hsu LY, Tu YK. Directly placed restorative materials: review and network meta-analysis. J Dent Res. 2016;95(6):613-22. https://doi.org/10.1177/0022034516631285.