Three-year clinical evaluation of a two-step self-etch adhesive with or without selective enamel etching in non-carious cervical sclerotic lesions

Abstract

The purpose of this prospective, controlled, randomized study was to evaluate the 3-year clinical performance of a two-step self-etch adhesive (AdheSE, Ivoclar Vivadent; Schaan, Liechtenstein) in non-carious cervical sclerotic lesions with or without selective acid-etching of the enamel margins. Twenty-two patients (mean age 51.5) having at least two pairs of non-carious cervical sclerotic erosion⁄attrition⁄abfraction lesions with incisal or occlusal margins in the enamel and gingival margins in the dentin were included in the study. The two-step self-etch adhesive was applied following either the self-etch approach (AdheSE non-etch, n = 52) or a similar application approach, including prior selective acid-etching of the enamel margins (AdheSE etch, n = 52). Composite resin Point 4 (Kerr Corp; Orange, CA, USA) was used as the restorative material for all 104 restorations. The restorations were evaluated at baseline and after 1, 2, and 3 years, according to the modified USPHS criteria. Data were analyzed using McNemar's test (p < 0.05). The retention rates for AdheSE non-etch were 100 %, 98 %, and 91.5 %; whereas, 100 %, 100 %, and 97.9 % retention rates were recorded for AdheSE etch after 1, 2, and 3 years, respectively. No significant differences were detected between the retention rates, marginal adaptation at the dentin side, secondary caries, and postoperative sensitivity (p > 0.05). A significantly higher number of restorations in AdheSE non-etch group showed clinically acceptable slight marginal discoloration (p = 0.0001) and clinically acceptable small marginal defects at the enamel side (p = 0.008) than in the AdheSE etch group. After 3 years, the two-step self-etch adhesive exhibited acceptable clinical performance with or without selective enamel etching in non-carious cervical sclerotic lesions. Selective acid-etching of the enamel margins enhanced the performance of the two-step self-etch adhesive in terms of marginal discoloration and marginal adaptation at the enamel side.