Influence of Carbonated Acid Beverage on Fracture Resistance and Marginal Gap Formation in Different Restorative Approaches to Non-carious Cervical Lesions

Objective: This study is to evaluate fracture resistance, failure mode, and gap formation at the restorative interface of unrestored or restored non-carious cervical lesions (NCCLs) submitted to a short-term erosive environment.

Materials And Methods: Artificial NCCLs were produced in vitro in bovine incisors, and were randomly divided into four restorative resins groups (n = 22): nanohybrid-NR; bulk-fill-BR; flow with a nanohybrid layer-FNR; bulk-fill with a nanohybrid layer-BNR; and a group unrestored-UR (n = 16). Half of the specimens were submitted to an erosive challenge (per 5 min, 3 × a day for 7 days, before and after restoration), and the other half, was immersed in artificial saliva. After, all teeth undergone thermal (5 ºC, 37 ºC, and 55 ºC, 3600 cycles) and mechanical (50 N, 2 Hz, 300,000 cycles) aging. Eighty teeth were subjected to compressive loading, and resistance and failures were analyzed, while 24 teeth were evaluated for gaps by microcomputed tomography. Statistical tests were performed (p < 0.05).

Results: The restorative approaches affected fracture resistance (η = 0.14, p = 0.023), and gap formation (η = 0.18, p = 0.012) and so did the immersion medium (fracture η = 0.09, p = 0.008; gap η = 0.09, p = 0.017). BNR showed the highest resistance, while UR the lowest. FNR showed the highest gaps in both immersion media. Neither the resin groups nor the immersion media were associated with failure mode.

Conclusions: The erosive immersion medium based in acid beverages has been shown to affect NCCLs with or without restoration, but when Bulk-Fill resin is covered by nanohybrid resin, the performance is good.

Clinical Relevance: Erosion negatively affects restorations, but unrestored NCCL shows worse biomechanical performance in stress-bearing situations.