journal article·2026-05-01Open access

Do Different Durations of Hyperbaric Oxygen Therapy Affect the Microleakage of Bulk-Fill Composites?

Cemile Kedici Alp, Sena Sumra Kaçmaz, Ayşenur Yazım, Zeynep Aydin, Recep Özkan

Abstract

This in vitro study evaluated the effect of exposure duration (5, 20, and 40 days) to constant increased ambient pressure (2.4 atmospheres absolute; ATA) on microleakage at the dentin–composite interface of teeth restored with two bulk-fill composites. Specimens stored in distilled water at atmospheric pressure (1 atm) served as controls. A total of 192 extracted human molars with standardized Class V cavities were randomly assigned to two groups: sonic-activated bulk-fill composite (SonicFill) or conventional bulk-fill composite (Filtek One Bulk Fill). Each group was subdivided into controls maintained under atmospheric pressure (1 atm) and specimens under hyperbaric pressure (2.4 ATA), and exposed for 5, 20, or 40 days (total of 12 groups, n = 16 per group). Microleakage was assessed using the dye penetration method and scored under a stereomicroscope according to ISO criteria. Statistical analyses were performed using Fisher’s Exact chi-squared and Fisher–Freeman–Halton Exact tests (α = 0.05). No significant differences were found between materials or pressure conditions at 5 and 20 days (p > 0.05). After 40 days, both composites showed significantly higher microleakage at increased pressure than atmospheric controls (p < 0.05). Microleakage increased over time in the hyperbaric groups, while no time-dependent changes occurred at atmospheric pressure. After 40 days, prolonged exposure to elevated pressure increased microleakage, whereas shorter exposure produced no significant changes. Both materials demonstrated similar susceptibility to pressure-related deterioration.
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Research context

OpenAlex topics: Dental Erosion and Treatment · Dental materials and restorations · Endodontics and Root Canal Treatments

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Emek, Ankara 06490, Türkiye

Department of Underwater and Hyperbaric Medicine, Erzurum City Hospital, Erzurum 25240, Türkiye

References (44)

Show source-provided references
1. Diş Hekimliğinde Mikrosızıntı ve Mikrosızıntı Araştırma Yöntemleri
2. Depth of Cure of Contemporary Bulk-Fill Resin-Based Composites10.4012/dmj.2015-402 ↗
3. Investigations on a Methacrylate-Based Flowable Composite Based on the SDR Technology10.1016/j.dental.2010.11.014 ↗
4. Effect of Bulk/Incremental Fill on Internal Gap Formation of Bulk-Fill Composites10.1016/j.jdent.2014.01.005 ↗
5. Depth of Cure of Resin Composites: Is the ISO 4049 Method Suitable for Bulk Fill Materials?10.1016/j.dental.2012.02.002 ↗
6. In Vitro Comparison of Mechanical Properties and Degree of Cure of Bulk Fill Composites10.1007/s00784-012-0702-8 ↗
7. Two-Year Clinical Performance of Sonic-Resin Placement System in Posterior Restorations
8. In Vitro Evaluation of Marginal Adaptation of Direct Class II Composite Restorations Made of Different “Low-Shrinkage” Systems10.2341/15-217-L ↗
9. Placing Posterior Composites: A New, Practical, Efficient Technique
10. Ivoclar Vivadent (2013). Tetric EvoCeram Bulk Fill: The Bulk Composite Without Compromises, Ivoclar Vivadent. Scientific Documentation.
11. Barodontalgia at 12,000 Feet10.14219/jada.archive.1978.0480 ↗
12. Barodontalgia: A Dental Consideration for the SCUBA Diving Patient
13. Diving Dentistry: A Review of the Dental Implications of Scuba Diving10.1111/j.1834-7819.2011.01340.x ↗
14. Investigation of Implant Internal Screw Loosening under Hyperbaric Conditions: An In Vitro Study10.1111/cid.12997 ↗
15. Zhang, Y., Zhou, Y., Jia, Y., Wang, T., and Meng, D. (2023). Adverse Effects of Hyperbaric Oxygen Therapy: A Systematic Review and Meta-Analysis. Front. Med., 10.10.3389/fmed.2023.1160774 ↗
16. Clinical Utility of Hyperbaric Oxygen Therapy in Dentistry10.4103/2045-9912.260651 ↗
17. Undersea and Hyperbaric Medical Society (2026, April 02). HBO Indications. UHMS. Available online: https://www.uhms.org/resources/featured-resources/hbo-indications.html.
18. Ortega, M.A., Fraile-Martinez, O., García-Montero, C., Callejón-Peláez, E., Sáez, M.A., Álvarez-Mon, M.A., García-Honduvilla, N., Monserrat, J., Álvarez-Mon, M., and Bujan, J. (2021). A General Overview on the Hyperbaric Oxygen Therapy: Applications, Mechanisms and Translational Opportunities. Medicina, 57.10.3390/medicina57090864 ↗
19. Cooper, J.S., Hanley, M.E., and Hendriksen, S. (2025). Hyperbaric Treatment of Chronic Refractory Osteomyelitis. StatPearls, StatPearls Publishing.
20. Investigation of Microleakage in Adhesive Restorations under Hyperbaric Conditions: An In Vitro Study10.1016/j.ijadhadh.2022.103295 ↗
21. Measurement of the Internal Adaptation of Resin Composites Using Micro-CT and Its Correlation with Polymerization Shrinkage10.2341/12-378-L ↗
22. Polymerization Shrinkage: Effects of Boundary Conditions and Filling Technique of Resin Composite Restorations10.1016/j.jdent.2004.02.010 ↗
23. Effect of a Hyperbaric Environment (Diving Conditions) on Adhesive Restorations: An In Vitro Study10.1038/sj.bdj.2017.764 ↗
24. Impact of Various Pressures on Fracture Resistance and Microleakage of Amalgam and Composite Restorations10.28920/dhm48.3.168-172 ↗
25. Evaluation of Marginal Adaptation and Microleakage of Three Glass Ionomer-Based Class V Restorations: An In Vitro Study10.1055/s-0039-3401435 ↗
26. Evaluation of Microleakage and Micromorphological Analysis of Different Self-Adhesive Restorative Systems in Class V Cavities: Laboratory Study10.4317/jced.62843 ↗
27. (2003). Dental Materials—Testing of Adhesion to Tooth Structure (Standard No. ISO/TS 11405:2003).
28. Hyperbaric Oxygen Therapy: Side Effects Defined and Quantified10.1089/wound.2016.0718 ↗
29. Lee, J.S., Cha, Y.S., and Lim, J. (2023). Association between Number of Hyperbaric Oxygen Therapy Sessions and Neurocognitive Outcomes of Acute Carbon Monoxide Poisoning. Front. Med., 10.10.3389/fmed.2023.1127978 ↗
30. The Use of Hyperbaric Oxygen Therapy in Acute Hearing Loss: A Narrative Review10.1007/s00405-019-05469-7 ↗
31. Wiśniewska, B., Piekarski, K., Spychała, S., Golusińska-Kardach, E., Perek, B., and Wyganowska, M.L. (2026). HBOT as a Potential Adjunctive Therapy for Wound Healing in Dental Surgery—A Narrative Review. J. Clin. Med., 15.10.3390/jcm15020605 ↗
32. Hyperbaric Oxygen Therapy as Treatment of Diabetic Foot Ulcers10.1002/dmrr.2256 ↗
33. Huang, E.T. (2024). Hyperbaric Medicine Indications Manual, Best Publishing Company. [15th ed.].
34. Knowledge, Attitudes, and Behaviors of Family Physicians Towards Hyperbaric Oxygen Therapy
35. Barodontalgia: A Review, and the Influence of Simulated Diving on Microleakage and on the Retention of Full Cast Crowns10.1093/milmed/164.3.221 ↗
36. Influence of the Methodology and Evaluation Criteria on Determining Microleakage in Dentin–Restorative Interfaces10.1007/s00784-006-0061-4 ↗
38. Influence of Bulk-Fill Restoration on Polymerization Shrinkage Stress and Marginal Gap Formation in Class V Restorations10.2341/19-062-L ↗
39. Polymerization Shrinkage, Modulus, and Shrinkage Stress Related to Tooth-Restoration Interfacial Debonding in Bulk-Fill Composites10.1016/j.jdent.2015.02.002 ↗
40. Evaluation of Polymerization Shrinkage, Microhardness, and Depth of Cure of Different Types of Bulk-Fill Composites10.1111/jerd.13473 ↗
41. Monomer Elution and Shrinkage Stress Analysis of Addition-Fragmentation Chain-Transfer-Modified Resin Composites in Relation to the Curing Protocol10.1016/j.dental.2024.07.029 ↗
42. 3M Oral Care (2017). 3M Filtek One Bulk Fill Restorative Technical Product Profile; Technical Product Profile, 3M Oral Care.
43. Filler Leachability of Composites Stored in Distilled Water or Artificial Saliva10.1177/00220345960750091201 ↗
44. The Role of Oral Environmental Factors in the Degradation of Resin-Dentin Interfaces: A Comprehensive Review10.1016/j.jdent.2025.105839 ↗