REVISTA ODONTOLOGÍA VITAL
ROVROVODONTOLOGÍA VITAL P. 7
No. 43, Vol 2, 07-15 2025 (23) I ISSN:2215-5740
In vitro study of marginal microleakage levels in restorations with Bulk
Fill resins using the deproteinization technique prior to acid etching
:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
Estudio in vitro de los niveles de microltración marginal en
restauraciones con resinas Bulk Fill utilizando la técnica de
desproteinización previo al grabado ácido.
Cosio Dueñas, H.a Incarroca Quispe, D.b Lazo Otazú, L.C
a. MSc. Estomatología, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Perú
b. DDS. Universidad Alas Peruanas, Cusco, Perú
c. MSc. Salud, Universidad Nacional de San Antonio Abad del Cusco
Recibido 2024-08-17
Revisado 2024-10-23
Aceptado 2024-10-29
SUMMARY
Introduction:
Currently, the market offers Bulk Fill resins that are used with the monobloc or single-increment technique (up to 4 or 5 mm).
These resins are characterized by a lower ller content and larger ller particles, improved translucency, and a different
chemical structure of the monomers in the ller compounds, which—when placed in a single block—reduce polymerization
stress.
Objective:
To evaluate the level of marginal microleakage of two Bulk Fill resins using the deproteinization technique prior to acid etching.
Methods:
This is an in vitro study in which 64 extracted premolars underwent standardized cavity preparations. The teeth were
randomly divided into four groups and subjected to a manual thermocycling process of 500 cycles.
All samples were immersed in a 2% methylene blue solution for 24 hours. Microleakage was then observed with a
stereomicroscope.
Results:
For the Aura Bulk Fill resin, microleakage in enamel was observed in 25% of the deproteinized samples and in 18.8% of the
non-deproteinized samples. For the Filtek Bulk Fill resin, 31.3% of the samples exhibited microleakage in enamel with the
deproteinization technique and 25.0% without deproteinization. No statistically signicant differences were found.
Conclusions:
All samples presented microleakage, with similar levels in both brands of Bulk Fill resins, and no signicant differences were
observed with the application of the deproteinization technique.
Keywords:
Marginal microleakage; Bulk Fill resins; deproteinization.
Cosio Dueñas, H., Incarroca Quispe, D., Lazo Otazú, L. (2025) In vitro study of marginal microleakage levels in restorations with Bulk Fill resins using the deproteinization technique prior to acid
etching. Odontología Vital, 2(43) 7-15. https://doi.org/10.59334/ROV.v2i43.639
ROVROVODONTOLOGÍA VITAL
REVISTA ODONTOLOGÍA VITAL
P. 8
No. 43, Vol 2, 07-15 2025 (23) I ISSN:2215-5740
INTRODUCTION
Currently, the vast majority of restorations
in dental practice are performed using
nanohybrid resins applied with the incremental
technique, which involves the placement
and photopolymerization of layers no thicker
than 2 mm. In very deep cavities, this extends
the restoration time and increases the risk of
incorporating voids. Moreover, the repeated
polymerization shrinkage from each increment
may generate increased stress at the tooth–
restoration interface, raising the probability of
bond failure. This can lead to the formation of an
interface between the tooth and the restoration,
and eventually, bacterial and uid inltration,
resulting in immediate sensitivity and long-term
caries development (López, 2017; Rojas and Ríos,
2021).
Efforts in resin materials aim primarily to prevent
microleakage, which is the main cause of failure
in adhesive dentistry. Microleakage is dened
as the passage of bacteria, uids, molecules,
or ions through the tooth–restoration interface,
a persistent problem in resin restorations
(Baltacioglu et al., 2024). It is considered a
negative outcome that may occur due to the
volumetric changes or contraction of the resin
during photopolymerization, but it can also result
from temperature uctuations within the oral
cavity, the type of resin, the adhesive system
used, the restoration technique, or the design of
the cavity preparation (Cáceres et al., 2021; Rojas
and Ríos, 2021).
On the other hand, ongoing improvements in
biomaterials are aiming to minimize the effects
of polymerization contraction, thereby reducing
the risk of bond loss and microleakage. This has
led to the introduction of single-increment or
Bulk Fill resins, which are intended to decrease
working time, reduce the number of clinical
steps, minimize the formation of voids or gaps,
prevent interlayer contamination, and lessen
polymerization shrinkage (Sampaio et al., 2024).
This new concept in restoration involves applying
the resin in a single block of up to 4 or 5 mm,
ensuring uniform polymerization, simplifying
the procedure, reducing working time, lowering
shrinkage during polymerization, and reducing
voids within the increments (Behery et al., 2018;
Rodríguez et al., 2018; Rojas and Ríos, 2021). Bulk
Fill resins are based on modications in chemical
composition, increased translucency, the use
of alternative resin monomers compared
to conventional ones, and a different ller
technology (Sampaio et al., 2024).
There are two classes of Bulk Fill resins available
in the market:
• Low-viscosity (owable) Bulk Fill resins:
These have a lower ller content and a uid
consistency, making them suitable as a
base in restorations.
• High-viscosity (condensable) Bulk Fill resins:
These contain conventional llers, are more
condensable, and have higher viscosity,
making them suitable for lling the entire
cavity with the single-increment technique
(Khairy et al., 2024; Sampaio et al., 2024).
Fifth-generation adhesive systems are widely
used in restorative dentistry to bond the
restorative material to the dental tissue. These
adhesive systems involve two steps: acid etching
and the application of the adhesive.
The acid etching or conditioning of the cavity
surface for restorations requires the use of 37%
phosphoric acid for 15 seconds on enamel and
10 seconds on dentin. This treatment increases
REVISTA ODONTOLOGÍA VITAL
ROVROVODONTOLOGÍA VITAL P. 9
No. 43, Vol 2, 07-15 2025 (23) I ISSN:2215-5740
the surface area of the enamel by modifying the
enamel prisms and their surrounding structure,
thereby creating a high-energy surface
conducive to adhesion. Essentially, a previously
smooth surface is transformed into one with
microporosities through which the low-viscosity
adhesive system can penetrate (Licla and
Albites, 2015; Zheng et al., 2022).
Furthermore, 5.25% sodium hypochlorite (NaClO)
is used as a bactericidal and bacteriostatic
agent, but more recently it has been employed
as a deproteinizing agent to complement
adhesive systems, being applied before acid
etching (Gerardo et al., 2020).
Sodium hypochlorite is recognized for its ability
to remove denatured proteins from the enamel
and dentin surfaces, thereby obtaining a surface
free of disorganized organic matrix. This allows
the formation of three-dimensional channels
that integrate optimally with the initial adhesive
layer, resulting in better adhesion (Lang et al.,
2020; Roque et al., 2021).
Deproteinization is a technique with signicant
potential for increasing the bond strength
of adhesive materials, as it is noninvasive,
convenient, and low-cost (Gurgel et al., 2011;
López et al., 2019; Zheng et al., 2022).
Sodium hypochlorite acts as a deproteinizing
substance on the tooth surface, removing
the organic material (dentin smear layer and
protein residues) present in the cavity. This can
improve the effectiveness of acid etching and,
consequently, the adhesive capability of bulk-ll
resins, thereby reducing microleakage.
Therefore, the objective of the present
study was to evaluate, in vitro, the levels of
microleakage that occur in Bulk Fill resins when
using conventional etching techniques with the
additional application of sodium hypochlorite.
METHODS
This experimental in vitro study was approved
by the Ethics Committee of Universidad Alas
Peruanas. Sixty-four premolars, extracted
for orthodontic reasons, were used. All study
procedures were conducted in accordance with
the principles of the Helsinki Declaration.
The 64 premolars were rst cleaned using
ultrasonic methods and then stored in distilled
water until processing. Standardized simple
occlusal cavity preparations with a depth of
4 mm were made on all selected teeth. The
samples were randomly distributed into four
groups (n = 16):
• Group 1: Restored with Aura Bulk Fill-SDI resin
after applying 5.25% sodium hypochlorite for
deproteinization prior to acid etching.
• Group 2: Restored with Aura Bulk Fill-SDI
resin without the use of 5.25% sodium
hypochlorite before acid etching.
• Group 3: Restored with Filtek Bulk Fill-3M resin
after applying 5.25% sodium hypochlorite for
deproteinization prior to acid etching.
• Group 4: Restored with Filtek Bulk Fill-3M
resin without the use of 5.25% sodium
hypochlorite before acid etching.
The application of 5.25% sodium hypochlorite for
60 seconds was performed to deproteinize the
surface before applying 37% phosphoric acid
(Del Valle et al., 2021). Fifth-generation adhesives
were applied to all cavity preparations
according to the manufacturers’ protocols.
ROVROVODONTOLOGÍA VITAL
REVISTA ODONTOLOGÍA VITAL
P. 10
No. 43, Vol 2, 07-15 2025 (23) I ISSN:2215-5740
The restorations were performed using the
single-increment (bulk) technique and were
light-cured for 15 seconds at an intensity of 1000
mW (Mosharraan et al., 2023).
After 24 hours, all samples underwent an articial
aging process through manual thermocycling
for 500 cycles, with temperature changes from
5°C to 55°C. At each extreme, the immersion
lasted 20 seconds, with 10-second intervals
between temperature changes.
Following the aging process, microleakage
was evaluated by coating each tooth with two
layers of nail varnish, leaving a 2-mm margin
around the restoration free. The apices were
sealed with a fast-curing acrylic resin. The teeth
were then immersed in a 2% methylene blue
solution for 24 hours at 37°C (Baracco et al.,
2016; Navarrete, 2018). Finally, each tooth was
sectioned in a bucco-palatal direction using a
diamond disc and subsequently polished with
rubber abrasives. A stereomicroscope was used
to record the levels of microleakage according
to the following criteria:
• Level 1: No microleakage observed.
• Level 2: Dye penetration at the enamel–
restoration interface (microleakage in
enamel).
• Level 3: Dye penetration reaching the
dentin–restoration interface (microleakage
in dentin).
• Level 4: Dye penetration reaching the pulpal
oor of the restoration (microleakage at the
oor).
RESULTS
Despite the manufacturers’ efforts to minimize
polymerization shrinkage stress with the
introduction of Bulk Fill resins, the challenge
remains signicant. When evaluating the degree
of microleakage in two commercially available
resins subjected to the complementary
deproteinization technique prior to acid etching,
high levels of marginal microleakage were
still observed. In all the samples restored with
Aura Bulk Fill resin, microleakage was recorded.
Comparison between the deproteinized and
non-deproteinized techniques showed no
statistically signicant differences (P = 0.564)
(see Table 1).
Table 1. Marginal Microleakage Levels in Aura Bulk Fill – SDI Resin Based on Phosphoric Acid Conditioning with or without
a Deproteinizing Agent
Microleakage Level With Deproteinization
(N)
With Deproteinization
(%)
Without
Deproteinization (N)
Without
Deproteinization (%)
No Microleakage 0 0% 0 0%
Microleakage in Enamel 4 25% 3 18.8%
Microleakage in Dentin 4 25% 3 18.8%
Microleakage at the Floor 8 50% 10 62.5%
TOTAL 16 100% 16 100%
a Non-parametric Mann-Whitney U Test
REVISTA ODONTOLOGÍA VITAL
ROVROVODONTOLOGÍA VITAL P. 11
No. 43, Vol 2, 07-15 2025 (23) I ISSN:2215-5740
In restorations with Filtek Bulk Fill resin, all
samples exhibited microleakage. When
comparing based on the deproteinization
Table 2. Marginal Microleakage Level in Filtek Bulk Fill – 3M Resin
Based on the Etching Technique
Microleakage Level With Deproteinization
(N)
With Deproteinization
(%)
Without
Deproteinization (N)
Without
Deproteinization (%)
No Microleakage 0 0% 0 0%
Microleakage in
Enamel
5 31.3% 4 25.5%
Microleakage in
Dentin
6 37.5% 6 37.5%
Microleakage at the
Floor
5 31.3% 6 37.5%
Total 16 100.0% 16 100.0%
technique, no statistically signicant differences
were found (p = 0.696) (Table 2).
When comparing the levels of microleakage
in the two types of resin without the
deproteinization technique, no statistically
signicant differences were found
(p = 0.287) (Table 3).
Table 3. Marginal Microleakage Level in Conditioning Without Deproteinization by Resin Brand
Microleakage
Level Filtek Bulk Fill - 3M (N) Filtek Bulk Fill - 3M (%) Aura Bulk Fill - SDI (N) Aura Bulk Fill - SDI (%)
No Microleakage 0 0% 0 0%
Microleakage in
Enamel 4 25.0% 3 18.8%
Microleakage in
Dentin 6 37.5% 3 18.8%
Microleakage at
the Floor 6 37.5% 10 62.5%
Total 16 100.0% 16 100.0%
When comparing the levels of microleakage in
the two types of resin using the deproteinization
technique, no statistically signicant differences
were found (p = 0.423) (Table 4).
Table 4. Marginal Microleakage Level in Conditioning with Deproteinization by Resin Brand
Microleakage Level Filtek Bulk Fill - 3M (N) Filtek Bulk Fill - 3M (%) Aura Bulk Fill - SDI (N) Aura Bulk Fill - SDI (%)
No Microleakage 0 0% 0 0%
Microleakage in
Enamel 5 31.3% 4 25.0%
Microleakage in Dentin 6 37.5% 4 25.0%
Microleakage at the
Floor 5 31.3% 8 50.0%
Total 16 100.0% 16 100.0%
ROVROVODONTOLOGÍA VITAL
REVISTA ODONTOLOGÍA VITAL
P. 12
No. 43, Vol 2, 07-15 2025 (23) I ISSN:2215-5740
DISCUSSION
In adhesive restorations, a high percentage
of failure is recorded due to polymerization
shrinkage and marginal microleakage.
Additionally, when a restoration remains in
the oral cavity for a long time, it is exposed to
thermal dimensional changes, which could lead
to the detachment of the adhesive restoration
and thus be another factor contributing to
marginal microleakage (Del Valle et al., 2021).
This loss of adhesion between the restorative
material and the tooth allows the ingress of
bacteria and uids, which can penetrate the
dentin-pulp complex, leading to negative
consequences such as postoperative
sensitivity and, in the long term, recurrent caries
(Mosharraan et al., 2023).
Polymerization shrinkage in conventional
resins is minimized through the incremental
technique, where the material is layered
obliquely to achieve better peripheral
sealing and, consequently, less peripheral
microleakage (Elgendy et al., 2019). Bulk Fill resins
have emerged as an alternative to reduce
polymerization stress at the adhesive interface.
A case report demonstrated that Bulk Fill resins
maintain proper anatomical conservation and
good marginal sealing, with no observed failures
over time and acceptable clinical performance,
despite encouraging results from studies with
two or three years of follow-up (Grandon et al.,
2020; Kury et al., 2020).
In an in vitro study, the degree of microleakage
and adhesive strength of Bulk Fill resins was
evaluated by applying 18% EDTA gel compared
to 37% phosphoric acid. Microleakage was
observed at the enamel level with 37%
phosphoric acid, and microleakage at both
enamel and dentin levels was noted when
EDTA was used for 60 seconds. When EDTA
was applied for 90 seconds, microleakage
was recorded only at the enamel level,
demonstrating that microleakage remains
highly prevalent in single-increment restorations
(Cayo et al., 2019). When comparing the levels
of microleakage between conventional resins
and Bulk Fill resins, no statistically signicant
differences were found. However, high levels of
microleakage were observed in Bulk Fill resins,
similar to the results obtained in this study (Lorca
et al., 2023).
Despite being marketed as an alternative
to counteract the negative effects of
polymerization shrinkage—using 4 to 5 mm deep
increments, theoretically leading to minimal or
no shrinkage upon polymerization (Del Valle et
al., 2021)—an in vitro study on primary dentition
found high levels of microleakage, results similar
to ours (Rojas & Ríos, 2021). Furthermore, when
evaluating microleakage in Class II cavities in
primary molars restored with Bulk Fill resins and
conventional resins, no signicant differences
in microleakage were observed between the
two groups. Thus, it was determined that Bulk Fill
resins serve as an alternative to conventional
resins, primarily due to their ease and speed of
application (Mosharraan et al., 2023).
Enamel proteins interfere with the establishment
of proper acid etching patterns, making
deproteinization a promising technique
for improving adhesive mechanisms.
Deproteinization involves removing proteins from
the enamel surface, which can be achieved
with sodium hypochlorite, capable of degrading
defective proteins and dissolving the smear
layer and residual contaminated tissue (López
et al., 2019). Applying sodium hypochlorite
before acid etching enhances the amount
REVISTA ODONTOLOGÍA VITAL
ROVROVODONTOLOGÍA VITAL P. 13
No. 43, Vol 2, 07-15 2025 (23) I ISSN:2215-5740
and quality of the etched surface, thereby
potentially optimizing adhesive capability
and improving resin bonding strength on
enamel (López et al., 2019). Despite theoretical
evidence, Cayo and Carrillo found high levels
of marginal microleakage even when using 10%
sodium hypochlorite, ndings that align with
our results. While sodium hypochlorite is an
effective conditioning agent, it did not produce
the desired effect when applied before single-
increment resin restorations (Cayo & Carrillo,
2020).
Many ndings from both in vitro and clinical
studies suggest that Bulk Fill resins may slightly
increase the failure rate of restorations in the
medium term. However, no increased risk of
postoperative sensitivity has been reported
compared to other resin materials (Larraechea
et al., 2020).
CONCLUSIONS
Despite the use of sodium hypochlorite, which
has demonstrated its ability to remove organic
material from the tooth surface and enhance
acid etching effectiveness and adhesion,
microleakage was present in all samples. This
indicates that regardless of the brand of Bulk
Fill resin or the use of the deproteinization
technique, the levels of microleakage remained
high and similar. Therefore, it must be
considered that microleakage can lead to the
premature failure of restorations, as it allows
the penetration of bacteria and uids into the
interface between the tooth and restoration,
potentially causing postoperative sensitivity or
secondary caries over time.
AUTHOR CONTRIBUTION:
The authors have contributed to the conception,
planning, execution and approval of the nal
version of this article.
Conict of interest:
The authors declare that they have no conicts
of interest.
Funding:
No funding was received to assist with the
preparation of this manuscript
Author contribution statement:
Conceptualización y diseño: HCD, DIQ
Revisión de literatura: HCD, LLO
Metodología y validación: HCD, DIQ, LLO
Análisis formal: HCD, LLO
Investigación y recopilación de datos: HCD, DIQ
Recursos: HCD, DIQ
Análisis e interpretación de datos: HCD, LLO
Redacción-preparación del borrador
original: HCD, LLO
Redacción-revisión y edición: HCD, DIQ, LLO
Supervisión: HCD, LLO
Administración de proyecto: HCD, DIQ
ROVROVODONTOLOGÍA VITAL
REVISTA ODONTOLOGÍA VITAL
P. 14
No. 43, Vol 2, 07-15 2025 (23) I ISSN:2215-5740
REFERENCES:
Baltacioglu, I. H., Demirel, G., Öztürk, B., Aydin, F., & Orhan, K. (2024). Marginal adaptation of bulk-ll resin
composites with different viscosities in class II restorations: A micro-CT evaluation. BMC Oral Health, 1(24),
228-228. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863248
Baracco, B., Fuentes, M. V., & Ceballos, L. (2016). Efecto del termociclado y del grabado ácido previo en la
resistencia adhesiva al esmalte de distintos adhesivos autograbadores. Cient. dent., 13(1), 49-56. https://
coem.org.es/pdf/publicaciones/cientica/vol13num1/49-56.pdf
Behery, H., El-Mowafy, O., El-Badrawy, W., Nabih, S., & Saleh, B. (2018). Gingival microleakage of class II bulk-ll
composite resin restorations. Dent Med Probl, 383-388. https://dx.doi.org/10.17219/dmp/99264
Cáceres, L. M., Núñez, H., & Perdomo, M. (2021). Evaluación de la microltración en restauraciones con resina
Clase I. Revista Estomatológica Herediana, 31(4), 242-247. https://doi.org/10.20453/reh.v31i4.4091
Cayo, C. F., & Carrillo, A. A. (2020). Sellado marginal aplicando hipoclorito de sodio versus ácido fosfórico
como acondicionador dental. Revista Cubana de Estomatología, 57(1). http://scielo.sld.cu/scielo.
php?script=sci_abstract&pid=S0034-75072020000100008&lng=es&nrm=iso&tlng=es
Cayo, C., Llancari, L., Mendoza, R., & Cervantes, L. (2019). Marginal lling and adhesive resistance
of bulk ll resin applying 18% edta gel compared with 37% phosphoric acid gel in vitro dental
conditioning. J. Oral Res. (Impresa), 3(8), 228-235. http://www.scopus.com/inward/record.
url?scp=85073714359&partnerID=8YFLogxK
Del Valle, A. M., Del Rosario, N. M., & Christiani, J. J. (2021). FILTRACIÓN MARGINAL Y CONTRACCIÓN EN LA
POLIMERIZACIÓN EN NUEVAS RESINAS BULK FILL: UNA REVISIÓN DE LA LITERATURA. Rev. Ateneo Argent. Odontol,
64(1), 77-82. https://docs.bvsalud.org/biblioref/2021/06/1252984/articulo12.pdf
Elgendy, H., Maia, R. R., Skiff, F., Denehy, G., & Qian, F. (2019). Comparison of light propagation in dental
tissues and nano-lled resin-based composite. Clinical Oral Investigations, 23(1), 423-433. https://doi.
org/10.1007/s00784-018-2451-9
Gerardo, M., Villarreal, L. A., Domínguez, J. A., Cuevas, J. C., Donohué, A., Reyes, S. Y., Zaragoza, E. A., & Espinoza,
L. F. (2020). Evaluación de la adhesión de sistemas adhesivos de grabado total en esmalte dental bovino
usando un agente desproteinizante: Un estudio in vitro. Rev. ADM, 1, 22-27. http://-admin.bvsalud.org/
document/view/w7dsj
Grandon, F., Muster, M., & Wendler, M. (2020). Solving color irregularities with a bioactive bulk-ll restorative
system: Case report and 24-months follow up. J. Oral Res. (Impresa), 5(9), 430-436. http://www.joralres.
com/index.php/JOR/article/view/joralres.2020.086/880
Gurgel, I. P., Ataíde, M., Azevedo, M. E., & Resende, M. A. J. (2011). Inuencia del tiempo de almacenamiento en
la resistencia de unión a la dentina desproteinizada, utilizando tres diferentes adhesivos dentales. Acta
Odontológica Venezolana, 49(4). https://www.actaodontologica.com/ediciones/2011/4/art-10/
Khairy, N. M., Elkholany, N. R., & Elembaby, A. E. (2024). Evaluation of surface microhardness and gingival
marginal adaptation of three different bulk-ll owable resin composites: A comparative study. J Esthet
Restor Dent, 6(32), 920-929. https://dx.doi.org/10.1111/jerd.13211
Kury, M., Goulart, M., Thomé, T., Conceição, E. N., Coelho-de-Souza, F. H., Cavalli, V., & Erhardt, M. C. G.
(2020). Three-year follow-up of owable bulk-ll resin restorations in posterior teeth: A double-blind
randomized controlled clinical trial. Rev. Fac. Odontol. Porto Alegre, 2(16), 50-63. https://seer.ufrgs.br/
RevistadaFaculdadeOdontologia/article/view/104810
Lang, M. G., Villarreal, L. A., Domínguez, J. A., Cuevas, J. C., Donohué-Cornejo, A., Reyes, S. Y., Zaragoza, E. A.,
& Espinosa, L. F. (2020). Evaluation of adhesion of total etch adhesive systems on bovine dental enamel
using a deproteinizing agent: An in vitro study. Revista de la Asociación Dental Mexicana, 77(1), 22-27.
http://-admin.bvsalud.org/document/view/w7dsj
REVISTA ODONTOLOGÍA VITAL
ROVROVODONTOLOGÍA VITAL P. 15
No. 43, Vol 2, 07-15 2025 (23) I ISSN:2215-5740
Larraechea, B., Rodríguez, S., & Toledo, J. (2020). Técnica bulk-ll comparada con técnica incremental
para restauraciones posteriores en pacientes con dentición permanente. International journal of
interdisciplinary dentistry, 13(3), 196-200. https://doi.org/10.4067/S2452-55882020000300196
Licla, K., & Albites, U. (2015). Grado de microltración de un sellante resinoso con diferentes sistemas
adhesivos. REVISTA ODONTOLOGÍA PEDIÁTRICA, 14(2), 120-128. http://repebis.upch.edu.pe/articulos/op/
v14n2/a4.pdf
López, N. A., Munayco, E. R., Torres, G., Blanco, D. J., Siccha, A., & López, R. P. (2019). Deproteinization of primary
enamel with sodium hypochlorite before phosphoric acid etching. Acta Odontologica Latinoamericana:
AOL, 32(1), 29-35. https://pubmed.ncbi.nlm.nih.gov/31206572/
López, P. F. (2017). Comparación in vitro de microltración entre una resina nanohibrida y una resina bulk en
molares con restauración clase I, UAC, Cusco-2017 [tesis]. Universidad Andina del Cusco. https://renati.
sunedu.gob.pe/handle/sunedu/338374
Lorca, D., Tif, C., Sarmiento, R., & Sarmiento, J. (2023). In vitro comparison of marginal inltration between
a conventional resin and a bulk-ll resin, in the relocation of cervical margins technique. J. Oral Res.
(Impresa), 1(12), 1-11. https://www.joralres.com/index.php/JOralRes/article/view/joralres.2023.001/1113
Mosharraan, S., Farahmand, N., Poorzandpoush, K., Hosseinipour, Z. S., & Kahforushan, M. (2023). In vitro
microleakage at the enamel and dentin margins of class II cavities of primary molars restored with a
bulk-ll and a conventional composite. Clinical and Experimental Dental Research, 9(3), 512-517. https://
doi.org/10.1002/cre2.729
Navarrete, J. X. (2018). Microltración en la cementación con resina nanohíbrida y Bulk termomodicadas
en incrustaciones Inlay en molares, Cusco-2018 [tesis]. Universidad Alas Peruanas. https://renati.sunedu.
gob.pe/handle/sunedu/710540
Rodríguez, A. M. del V., Christiani, J. J., Alvarez, N., & Zamudio, M. E. (2018). Revisión de resinas Bulk Fill: Estado
actual. Rev. Ateneo Argent. Odontol, 1(58), 55-60. https://www.ateneo-odontologia.org.ar/articulos/lviii01/
articulo6.pdf
Rojas, S. V., & Ríos, T. E. (2021). Microltración marginal de resinas de relleno masivo y nanohíbrida en
molares deciduos. Revista Cubana de Estomatología, 58(2). http://scielo.sld.cu/scielo.php?script=sci_
abstract&pid=S0034-75072021000200007&lng=es&nrm=iso&tlng=es
Roque, J. G., Zavala, N. V., Patiño, N., & Martínez, G. A. (2021). Effect of sodium hypochlorite in ground uorotic
enamel: Shear bond strength and surface analysis. Odovtos International Journal of Dental Sciences,
23(3), 107-119. https://doi.org/10.15517/ijds.2021.47574
Sampaio, C. S., Abreu, J. L. B. de, Kornfeld, B., Silva, E. M. da, Giannini, M., & Hirata, R. (2024). Short curing time
bulk ll composite systems: Volumetric shrinkage, degree of conversion and Vickers hardness. Brazilian
Oral Research, 1(38), e030. https://doi.org/10.1590/1807-3107bor-2024.vol38.0030
Zheng, B., Cao, S., Al-Somairi, M. A. A., He, J., & Liu, Y. (2022). Effect of enamel-surface modications on shear
bond strength using different adhesive materials. BMC Oral Health, 22(1), 222-224. https://doi.org/10.1186/
s12903-022-02254-7
Esta obra esta bajo una Licencia Creative Commons Atribución 4.0 Internacional(CCBY4.0)
Derechos de autor ©2025 Cosio Dueñas, H., Incarroca Quispe, D., Lazo Otazú, L.
