Two-year randomized clinical trial of different restorative techniques in non-carious cervical lesions and MMP activity in gingival crevicular fluid

Abstract

To evaluate different restorative techniques for non-carious cervical lesions (NCCLs) and the activity of matrix metalloproteinases (MMPs) in gingival crevicular fluid. Two hundred restorations were performed in 50 patients using resin composite restorative system without (I) and with selective enamel conditioning (II) and resin-modified glass-ionomer cement without (III) and with EDTA pretreatment (IV). Gingival crevicular fluid samples were collected in 15 patients. Restorations were evaluated using USPHS criteria at baseline and after 2years. Percentages of MMP activity were assessed by zymography as a surrogate outcome. Equality tests of two proportions, logistic regression analysis, survival analysis, ANOVA repeated measures, and Fisher tests were used. No differences in clinical performance were found among groups. Group I had lower retention at 2years than at baseline. Decreased alpha scores for marginal integrity and marginal discoloration were observed for all groups after 2years. MMP-2 decreased after 1year, and its activity increased back to the initial level after 2years, mainly for groups I, II, and III. MMP-9 increased after 1year, and it was reduced to the initial level after 2years, mainly for group I. All restorative techniques performed similarly in NCCLs after 2years with initial marginal defect alterations. MMP-2 reestablished its initial levels after 2years, and MMP-9 had few alterations over time in crevicular fluid. Clinical relevance The different restorative techniques are equally successful in NCCLs after 2years of clinical functioning and have similar effects on MMPs present in crevicular fluid.