Universal Adhesives and Adhesion Modes in Non-Carious Cervical Restorations: 2-Year Randomised Clinical Trial.

Patricia Manarte-Monteiro,Sandra Gavinha,Joana Domingues,Liliana Teixeira,Maria Conceição Manso

doi:10.3390/polym14010033

Abstract

This prospective, double-blind, six-arm parallel randomised controlled trial aimed to compare the performance of two universal adhesives (UAs) in non-carious cervical lesions (NCCLs), using the FDI criteria, and analysed if participants/NCCLs’ characteristics influenced the outcome. Thirty-eight 18- to 65-year-old participants were seeking routine dental care at a university clinic. At baseline, 210 NCCLs were randomly allocated to six groups (35 restorations’ each). The UAs tested were FuturabondU (FBU) and AdheseUniversal (ADU) applied in either etch-and-rinse (ER) and self-etch (SE) modes. FuturabondDC (FBDC) in SE and in SE with selective enamel etching (SE-EE) modes were controls. NCCLs were restored with AdmiraFusion. The analysis included nonparametric tests, Kaplan-Meier and log-rank tests (α = 0.05). At 2-years, of 191 restorations, ten were missed due to retention loss (all groups, p > 0.05). FBDC (p = 0.037) and FBU (p = 0.041) performed worse than ADU in SE mode. FBDC and FBU also showed worse functional success rate (p = 0.012, p = 0.007, respectively) and cumulative retention rates (p = 0.022, p = 0.012, respectively) than ADU. Some participants/NCCLs’ characteristics influenced (p < 0.05) the outcomes. FBU did not perform as well as ADU, especially in SE mode and due to functional properties. Participants’ age and NCCLs’ degree of dentin sclerosis and internal shape angle influenced FBU performance.

Highlights

Universal adhesives (UAs) are contemporary dental materials that can be applied alone by a simplified self-etch (SE) procedure or with phosphoric acid in selective enamel etching (SE-EE) or etch-and-rinse (ER) modes on dental hard tissues [1,2]
We calculated the sample size based on the primary outcome, using rules of thumb, considering the little or no information on the clinical performance of adhesion modes and all adhesives tested in this study
We found regarding participants’ and non-carious cervical lesions (NCCLs)’ characteristics (Table 2) at baseline

Summary

Introduction

Universal adhesives (UAs) are contemporary dental materials that can be applied alone by a simplified self-etch (SE) procedure or with phosphoric acid in selective enamel etching (SE-EE) or etch-and-rinse (ER) modes on dental hard tissues [1,2]. Clinicians must choose the suitable application protocol according to the dental hard tissues’ condition to optimize the final result of the procedure [3]. These universal solutions are similar to the prior one-step SE adhesives (1SAs) but with pH adjustment [4]. That was the main change proposed by manufacturers to improve these materials. It is still challenged whether or not UAs are suitable for all adhesive procedures, since the durability and stability of the bonded interfaces continues to be questionable [5,6]

Methods

Results

Discussion

Conclusion