Abstract
Objective The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs).Material and Methods Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05).Results The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention.Conclusion GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.
Highlights
Despite many patients following oral-hygiene instructions carefully, non-carious cervical lesions (NCCLs) have increased among patients in various age populations.1 NCCLs are typically seen on the gingival third of the tooth, where the enamel is thinner and the enamel–dentin bond is weaker than in other regions, facilitating substance loss via erosion abrasion and abfraction.2 Treatment of NCCLs is necessary because thermal and pH changes can cause severe hypersensitivity.3 Various treatments are used to manage NCCLs, including surface-modifying agents and toothpastes that occlude dentinal tubules on superficial lesions
The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs)
155 restorations of NCCLs were performed in 20 patients (13 female, 7 male) (Table 1)
Summary
Despite many patients following oral-hygiene instructions carefully, non-carious cervical lesions (NCCLs) have increased among patients in various age populations. NCCLs are typically seen on the gingival third of the tooth, where the enamel is thinner and the enamel–dentin bond is weaker than in other regions, facilitating substance loss via erosion abrasion and abfraction. Treatment of NCCLs is necessary because thermal and pH changes can cause severe hypersensitivity. Various treatments are used to manage NCCLs, including surface-modifying agents and toothpastes that occlude dentinal tubules on superficial lesions. Various treatments are used to manage NCCLs, including surface-modifying agents and toothpastes that occlude dentinal tubules on superficial lesions. For moderate and deep lesions, the only option to eliminate the clinical symptoms and prevent further loss of tooth structure is restoration, usually. Self-etch adhesives may not be suitable for highly sclerotic surfaces.. Despite the negative effects of etch-and-rinse adhesive systems, including technical sensitivity and a greater number of steps, they appear to be more reliable than self-etch adhesives.. Self-etch adhesives are being widely adopted, as they are more user-friendly, have a reduced number of steps and eliminate the need to use phosphoric acid.. Clinical trials have indicated that self-etch adhesives have higher rates of marginal discoloration than etch-andrinse systems and negatively influence the aesthetic appearance of restorations.. Self-etch adhesives may not be suitable for highly sclerotic surfaces. Despite the negative effects of etch-and-rinse adhesive systems, including technical sensitivity and a greater number of steps, they appear to be more reliable than self-etch adhesives. self-etch adhesives are being widely adopted, as they are more user-friendly, have a reduced number of steps and eliminate the need to use phosphoric acid. clinical trials have indicated that self-etch adhesives have higher rates of marginal discoloration than etch-andrinse systems and negatively influence the aesthetic appearance of restorations. In addition, the relatively low enamel bonding strength of self-etch adhesives remains a problem; selective etching of enamel has been suggested as an option to overcome the poor enamel bond strength of self-etch adhesives and improve their clinical success
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