Non-carious Cervical Lesions Research Articles

Evaluation of Preheating Methods for Bulk-Fill Thermoviscous Composite in Non-Carious Cervical Lesions: A 24-month Randomized Controlled Trial

This 24-month, double-blind, split-mouth randomized equivalence clinical trial compared the clinical performance of a bulk-fill thermoviscous composite resin using two different preheating methods for the restoration of non-carious cervical lesions (NCCLs). A total of 120 NCCLs were randomized into two groups (n = 60 each). In one group, a bulk-fill thermoviscous composite resin (VisCalor bulk, Voco GmbH) was preheated using a dispenser heater (DH, VisCalor Caps dispenser/warmer), while in the other group, the same resin was preheated with a bench heater (BH, Caps Warmer). In the BH group, the composite underwent preheating at 68 °C using a heating bench for 3 min while in the DH group, the composite was preheated at the same temperature for 30 s using a dispenser heater. Subsequently, the preheated bulk-fill thermoviscous composite resin was directly applied to the NCCLs. The restorations were evaluated at baseline, and after 6, 12, 18, and 24 months of clinical service using the FDI criteria. The total working time was recorded. The study used TOST-P to assess groups equivalence, Kaplan-Meier analysis for retention/fracture rate, log-rank test for secondary outcomes' survival distributions, and paired t-tests for comparing time per clinical step between groups (α = 0.05). After 24 months, 106 restorations were evaluated. Four restorations were lost-two from the DH group and two from the BH group-resulting in similar retention rates for both groups (96.1%, 95% CI 86.8 - 98.9, p > 0.05). The hazard ratio was 0.83 (95% CI 0.26 to 2.72), indicating no significant difference between the groups (p > 0.05). All other FDI parameters were deemed clinically acceptable. However, the total working time for the BH group was significantly longer than that for the DH group (p < 0.001). Both preheating protocols employed for the bulk-fill thermoviscous composite resin demonstrated high and equivalent survival rates after 24 months, the other FDI parameters were deemed clinically acceptable over the same period. Clinicians can choose either method for heating the thermoviscous composite resin for restoration of non-carious cervical lesions, as they do not impact important clinical outcomes after 24 months. The total working time for the bench heater is higher than that for the dispenser heater due to the need for preheating of the bench heater.

Effect of an Additional Hydrophobic Adhesive Layer Application on the Clinical Performance of Class V Resin Composite Restorations: An 18-month Randomized Clinical Trial.

This study aimed to evaluate the 18-month clinical performance of two different one-step adhesives that were applied alone or with an additional hydrophobic adhesive layer to noncarious cervical lesions. One hundred sixty teeth in 31 patients were included in the study. Each patient received at least four restorations. A 2-hydroxyethylmethacrylate (HEMA)-containing one-step self-etch adhesive (Clearfil S3 Bond Plus, Kuraray Noritake, Noritake, Japan) and a HEMA-free universal adhesive (G-Premio Bond) were applied to noncarious cervical lesions with or without additional hydrophobic adhesive (Heliobond) randomly. Teeth were restored with a nanohybrid composite. Restorations were evaluated according to FDI criteria at baseline, 6-, 12-, and 18-month recalls. Data were analyzed with the Kruskal-Wallis and the Friedman analysis of variance (ANOVA) tests (α=0.05). At 18 months, recall rates were 100%, and there was no significant difference between four different adhesive applications in terms of any criteria (p>0.05). The cumulative retention rates were 92.5%, 92.5%, 97.5%, and 100% for the restorations with one-step self-etch, one-step self-etch plus hydrophobic adhesive layer, a universal adhesive, and a universal adhesive plus hydrophobic adhesive layer, respectively. An additional hydrophobic adhesive layer was found to have no significant effect on the 18-month clinical performance of two different one-step adhesive systems with and without HEMA.

Acidic/abrasive challenges on simulated non-carious cervical lesions development and morphology

This in vitro investigation assessed how frequency of erosive challenges and duration of toothbrushing abrasion influenced non-carious cervical lesions (NCCLs) development and morphology. Experimental units were prepared using extracted human premolars assigned to four erosive-abrasive frequency protocols (n=16): F0. No acid exposure (negative control), F2.5 K. Acid exposure (1 % citric acid at natural pH) every 2500, F5K. 5000 and F15K. 15000 brushing-strokes. All groups were brushed for 55000 total brushing-strokes. Three-dimension images of the teeth were captured at baseline, after 15000, 35000 and 55000 brushing-strokes, using an intraoral scanner (TRIOS4, 3Shape). WearCompare software (Leeds Digital Dentistry) was used to analyze volumetric tooth loss (mm3) by superimposition followed by subtraction analysis. Lesion angle was measured (ImageJ, NIH) and morphology visually classified. Data were analyzed using ANOVA and Fisher's Exact tests adopting two-sided 5 % significance level. Tooth loss increased with brushing-strokes overall (p<0.001) and for each erosive-abrasive protocol (p<0.001). Acid exposure significantly increased tooth loss (p<0.001), regardless of brushing interval (p<0.001), however by 35000 strokes no tooth loss difference was observed among acid-exposed groups (p>0.05). Control had significantly sharper mean lesion angle (59°) than all acid-exposed groups (∼145°) (p<0.001), and significantly different lesion shape with 94 % wedge-shaped lesions versus 0 %, respectively (p<0.001). In contrast to the control, acid exposure was associated to more striated lesions. Simulated NCCLs developed and progressed differently and more rapidly in the presence of acidic challenges, regardless of their frequency. Exposure to acid impacted the morphology of lesions.

Marginal Degradation of Universal Adhesive Restorations in NCCLs: A Systematic Review and Meta-analysis

Purpose This systematic review aimed to answer the PICO question: do adhesive protocols used for non-carious cervical lesions (NCCLs) using a universal adhesive system influence marginal degradation, marginal staining, and retention of these restorations? The self-etching adhesive strategy and selective enamel etching were compared with the etch-and-rinse strategy as a control. Materials and Methods The study searched various databases, including PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Scopus, Embase, and grey literature, to find randomized clinical trials (RCTs) comparing self-etching (SE) or selective enamel etching (SEE) to the etch and rinse (ER) strategy. The risk of methodological bias was assessed using the Cochrane RoB 2 tool. Data were dichotomized and analyzed using RevMan v 5.3, adopting the Mantel-Haenszel method. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results Twenty RCTs were included in the meta-analysis. Results showed that using universal adhesives with the SE strategy resulted in clinical signs of marginal degradation at 12 months, 24 months, and 36 months of follow-up, and marginal staining at 24 months. The adhesive strategy did not interfere with the retention of restorative material used for NCCLs over 36 months, as assessed based on both the United States Public Health Service (USPHS) and World Dental Federation (FDI) criteria. Conclusion With moderate certainty of evidence, after 24 months of follow-up, the SE strategy results in the detection of clinical signs of marginal degradation and staining. The adhesive strategy adopted did not influence the retention rate of the restorations over 36 months of follow-up.

Periodontal Evaluation for a New Alkasite Restorative Material in Noncarious Cervical Lesions: A Randomized-Controlled Clinical Trial.

This study aims to evaluate the periodontal condition adjacent to Cention N (CN) restorations applied for noncarious cervical lesions (NCCL) compared with resin-modified glass ionomer cement (RM-GIC) restorations in terms of plaque accumulation, attachment loss, and gingival inflammation. This is a double-blind split-mouth three-armed randomized-controlled clinical trial. The study arms are RM-GIC (FUJI II LC), CN + adhesive system, and CN + retentive groove. The study included 25 restorations per arm. Follow-ups were performed at 1 week, 3, 6, and 9 months after the application of the restorations. The periodontal condition was evaluated using the plaque index (PI), the bleeding on probing index (BOP), and the probing depth (PD). Appropriate tests were used to perform statistical analyses (α = 0.05). There was no significant difference between Cention N and RM-GIC regarding the studied variables. However, after the application of the restorations, it was noted that the PI and the PD mean values increased. The average increase after 9 months was 0.06 and 0.34 for PI and PD, respectively, with that of PD being significant. It was also noted that the percentage of positive BOP sites increased at the 1-week follow-up for all study groups and afterward dropped to near preintervention values at the 3-month and later follow-ups. The two ion-releasing materials Cention N and RM-GIC have a comparable and clinically acceptable effect on the gingival tissue when restoring NCCLs. The combined effect of the gingival retraction cord and the rubber dam clamp on the periodontal tissues might be more important to consider, especially in relation to the probing depth. Future long-term studies are needed to evaluate the effect of Cention N on the subgingival biofilm in comparison with nonion-releasing restorative materials, and subsequently, its effect on gingival inflammation. This clinical trial was registered in clinicaltrial.gov clinical registry under protocol #NCT05593159.

Risk Factors Associated with Noncarious Cervical Lesions: A Case–Control Study

Risk Factors Associated with Noncarious Cervical Lesions: A Case–Control Study

Evaluation of the Effect of Occluso-gingival Distance and different shapes of Non-Carious Cervical Lesions on the Clinical Performance of Recent Types of Restorative Materials. (An In Vivo Study).

Evaluation of the Effect of Occluso-gingival Distance and different shapes of Non-Carious Cervical Lesions on the Clinical Performance of Recent Types of Restorative Materials. (An In Vivo Study).

Comparative Evaluation of Micro-tensile Bond Strength in Non-carious Lesions After Different Pre-surface Treatments.

Non-carious cervical lesions (NCCLs) present themselves as smooth saucer lesions with variable height and depth. Treatment of choice for these lesions should be aimed at conservative management by restoring the teeth. The present study aims to evaluate the micro-tensile bond strength in NCCLsafter various surface pre-treatments. Sixty-six human permanent maxillary first premolars were subjected to artificial wedge-shaped lesions on the buccal aspect of the cervical regions of all the teeth. Samples were divided into two groups (n = 33 per group). Group 1 received a 37% orthophosphoric acid treatment for 30 seconds and a 17% ethylene diamine tetraacetic acid (EDTA) application for 10 seconds. Group 2 received a 10% citric acid treatment for 30 seconds, followed by a 17% EDTA application for 10 seconds. These groups were further subdivided according to the bonding agent applied as subgroup A: 3M™ Single Bond™; Subgroup B:Prime & Bond Universal group; and Subgroup C:Tetric N-Bond Universal. Samples were subjected to incremental restoration and then segmented to fit into Geraldelli jig with cyanoacrylate adhesive. A universal testing machine was used to assess the micro-tensile bond strength and the data obtained were subjected to statistical analysis. In this study, statistically significant differences in micro-tensile strength were observed between the pre-treatment groups and the effect of the bonding agent. Consequently, the null hypothesis was rejected, and the research hypothesis was accepted. The micro-tensile strength for both groups was compared with various pre-conditioning methods. It was noted that the micro-tensile strength was maximum when Tetric N Bond was used along with 37% orthophosphoric acid followed by Prime Bond with highly statistically significant values (p = 0.000). Contrary to this, in the 10% citric acid group, the micro-tensile strength was equally comparable in the 3M ESPE and Tetric N bond groups compared to the Prime Bond group, with highly statistically significant differences (p = 0.000). Surface pre-treatment in NCCLs improves the bonding strength of the restoration used. Analysis using scanning electron microscopy and long-term assessment of the failure of restoration should be carried out in future studies.

Novel 3-dimensional classification of cervical abrasion using CBCT: A comprehensive analysis

IntroductionTooth cervical abrasion (CA) is a prevalent non-carious cervical lesion that poses challenges for accurate diagnosis from periapical radiographs due to difficulties in assessing the lesion's extent, associated bone loss, and pulpal involvement. The presence of overlying bone structures on the palatal side when lesions are located on the buccal side, or vice versa, further complicates radiographic interpretation. So it is important to define the lesions in all three dimensions. ObjectiveTo provide a three-dimensional descriptive classification for cervical abrasion lesions using Cone Beam Computed Tomography (CBCT). MethodA total of 50 patients with cervical abrasion were selected for the study. From these patients, teeth (n = 10) from each of the four different quadrants were chosen. A CBCT scan with a 6 × 6 cm field of view (FOV) was performed, and the DICOM files of the cervical lesions were transferred to 3-D imaging software. The CBCT images of the cervical abrasion lesions were assessed at the level of the deepest point of the lesion along the long axis of the tooth in both axial and sagittal planes. The height (A), buccolingual dimension (B), circumferential spread (C), and remaining dentine thickness (D) were evaluated and classified using new scoring criteria for each dimension. The reliability and reproducibility of the classification were assessed to ensure its clinical applicability. ConclusionCBCT can be utilized to classify tooth cervical abrasion in endodontics, enhancing diagnosis, analysis, and treatment outcomes. This three-dimensional view facilitates easier communication among clinicians, allows for tailored treatment approaches, and opens new avenues for research.

Etiologies of non-surgical root canal treatment and its association with risk factors in a selected Thai population

BackgroundThe aim of this study was to investigate the etiologies of non-surgical root canal treatment (NS-RCT) in a Thai population and examine their association with risk factors.MethodsA cross-sectional observational study was performed to examine the etiologies of NS-RCT and risk factors among Thai-nationality patients treated at a tertiary care dental hospital in Thailand from 2019–2023. Treatment records and radiographs were retrospectively reviewed to identify NS-RCT etiologies, and associated contributing factors were analyzed. Statistical analysis used univariate logistic regression followed by multivariate logistic regression, with a significance level set at P < 0.05.ResultsThe data from 1500 teeth were analyzed, comprising 59.1% females and 40.9% males, with ages ranging from 7–91 years (mean = 48.56 years). The most prevalent age group was 61–70 years-old. Among the treated teeth, the mandibular first molar was the most frequently involved (13.9%), followed by the maxillary first molar (9.9%) and mandibular second premolar (9.7%). The primary etiologies of NS-RCT were dental caries (53.7%), old and large restorations (7.9%), and attrition (5.9%). Analysis of etiology of NS-RCT due to caries revealed that the most commonly affected sites were the occlusal (32.6%), distal (31.6%), and mesial (17.2%) surfaces. In immature teeth requiring NS-RCT, the predominant etiologies were dens evaginatus (32.1%), dental caries (28.6%), and traumatic injury (21.4%). The association between the etiology of NS-RCT and investigated associated factors were identified.ConclusionsThe etiologies of NS-RCT in the selected Thai population were mainly attributed to dental caries, with additional factors being old and large restorations and attrition. Notably, due to the aging society, the elderly population experiences a higher demand for NS-RCT, particularly due to attrition, non-carious cervical lesions, and erosion. In contrast, in immature teeth, the most common etiologies leading to NS-RCT comprise dens evaginatus, dental caries, and traumatic injuries. The distinct etiological patterns observed in different age groups emphasize the importance of specific oral health prevention programs to address individual needs.

Influence of different viscosity and chemical composition of flowable composite resins: A 48-month split-mouth double-blind randomized clinical trial

ObjectivesTo evaluate the clinical performance of two flowable composites based on methacrylate and one based on ormocer in treating non-carious cervical lesions (NCCLs) after 48-month evaluation in a split-mouth double-blind clinical study design. MethodsA total of 183 restorations were performed on NCCLs using a universal adhesive system (Futurabond U, Voco GmbH) with selective enamel etching on 27 participants: two participants received twelve restorations each, three received nine restorations each, and 22 participants received six restorations each. Three different flowable composites were employed (n = 61): a low-viscosity methacrylate-based composite (GrandioSO Flow, LVM), a high-viscosity methacrylate-based composite (GrandioSO Heavy Flow, HVM), and an ormocer-based flowable composite (Admira Fusion Flow, ORM). All restorations were evaluated using FDI and USPHS criteria after 48 months. Statistical analysis was conducted using Kaplan-Meier Survival analysis and Kruskal-Wallis analysis of variance rank (α = 0.05). ResultsAfter 48 months, 17 restorations were lost: LVM 6, HVM 9, ORM 2. The retention rates (95 % confidence interval) were 89.4 % for LVM, 80.4 % for HVM, and 95.6 % for ORM, with a significant difference between HVM vs. LVM and HVM vs. ORM (p < 0.05). Minor defects were observed in 30 restorations for marginal staining criteria (LVM 12, HVM 10, ORM 8) and in 71 restorations for marginal adaptation criteria (LVM 24, HVM 20, ORM 27) without significant difference between groups (p > 0.05). No restorations showed postoperative sensitivity or recurrence of caries. SignificanceThe increased viscosity of flowable composites could reduce the clinical longevity in NCCLs after 48 months. Ormocer-based and low-viscosity methacrylate-based flowable composites showed a successful clinical performance in NCCLs after 48 months.

Exploring access cavity through non-carious cervical lesions: Impacts on instrumentation, obturation, and fracture resistance in mandibular incisors.

To compare the effects of Cervical Access Cavity (CervAC) and Traditional Access Cavity (TradAC) on root canal preparation, root canal filling, and fracture resistance in mandibular incisors. Twenty recently extracted and intact mandibular incisors were initially scanned using a micro-CT device. The specimens were anatomically matched to create two groups (n = 10). A wedge-shaped non-carious cervical lesion (NCCL) was created on the buccal aspect of all teeth using a double-faced segmented diamond disc. In group 1, a TradAC was prepared, whilst in group 2, access was created through the simulated NCCL using a round diamond bur 1012. After root canal preparation with Rotate instruments sizes 15/0.04, 20/0.04, and 25/0.04, the teeth were scanned again and evaluated for root canal volume and surface area, static voxels, volume of removed dental tissue, and dentine thickness. After that, the root canals were filled using the single-cone technique, teeth were restored with composite resin, and subsequently rescanned to calculate the volume of filling materials and voids. Then, the restored teeth were subjected to fracture resistance tests using a universal testing machine. Statistical comparisons between groups were performed with the Mann-Whitney test or the Student's t-test, with a statistical significance level of 5%. Statistical comparisons indicated no significant differences between groups in terms of root canal volume, surface area, static voxels, removed root dentine, root canal filling volume, percentage of voids, or fracture resistance load (p > .05). Conversely, teeth prepared with TradAC showed a significantly higher percentage of dental tissue removed from the crown (p = .001) and a greater volume of filling material remnants in the pulp chamber (p < .001) compared to the CervAC group. A significantly lower percentage reduction in dentine thickness was observed only on the mesial aspect of root at Level 1 in TradAC group (p = .008). CervAC can be considered a viable alternative approach in the presence of NCCL in mandibular incisors.

Comparing the Efficacy of 5% EMLA Cream and 20% Benzocaine Gel on Gingival Tissue Surrounding Non-Carious Cervical Lesions for Reduction of Pain Following Rubber Dam Clamp Placement: A Split-Mouth Randomized Clinical Trial.

Aim The aim of this study was to evaluate the effectiveness of 5% eutectic mixture of local anesthetics (EMLA) cream and 20% benzocaine gel in reduction of pain during rubber dam clamp placement in the treatment of non-carious cervical lesions (NCCLs). Methodology In this split-mouth single-blind randomized clinical trial, 50 adult participants were selected from the outpatient department. The test group was treated using 5% EMLA cream for three minutes, and visual analog scale (VAS) scores were recorded. The comparison group was treated using 20% benzocaine gel and procedure was repeated as that in the test group. After recording the VAS scores, NCCLs in both the groups were restored using composite restoration. Results In the included 50 participants, 70% were males, with an age group of 31-67 years. The mean VAS score at 3 minutes in EMLA group was significantly lower than that in benzocaine group. Conclusion Application of 5% EMLA cream for 3 minutes showed greater pain reduction during rubber dam clamp placement as compared to 20% benzocaine gel in adult patients with NCCLs.

Risk factors for noncarious cervical lesions: A case-control study.

Noncarious cervical lesions (NCCLs) are multifactorial and can be caused by the anatomical structure of the teeth, erosion, abrasion and abnormal occlusion. The aim of this case-control study was to explore the risk factors for NCCLs. Cone-beam computed tomography was used to determine whether a wedge-shaped defect existed at the cementoenamel junction. We compared 63 participants with NCCLs with 63 controls without NCCLs, matched for sex, age (±1 year) and toothbrushing-related factors (e.g., type of bristle and brushing patterns, frequency and strength). All participants were asked to complete a questionnaire about self-administered daily diet habits and health condition. Univariate and multivariate logistic regression analyses were conducted to determine the risk factors for NCCLs. Significant variables in the univariate analysis (i.e., p < .2) included frequency of carbonated beverage consumption, sella-nasion-point B angle (SNB) and Frankfort-mandibular plane angle (FMA). Multivariate logistic regression demonstrated that the consumption frequency of carbonated beverages (odds ratio [OR] = 3.147; 95% confidence interval [CI], 1.039-9.532), FMA (OR = 1.100; 95% CI, 1.004-1.204) and SNB (OR = 0.896; 95% CI, 0.813-0.988) was independent influencing factors. The area under the receiver operating characteristic curve (AUC) value of regression Model 1 (established with the frequency of carbonated beverage consumption, FMA, SNB and sleep bruxism) was 0.700 (95% CI, 0.607-0.792; p < .001), and that of regression Model 2 (established using the frequency of carbonated beverage consumption, FMA and SNB) was 0.704 (95% CI, 0.612-0.796; p < .001). The consumption frequency of carbonated beverages and FMA was risk factors for NCCLs; the higher the frequency of carbonated beverage consumption and FMA, the higher was the probability of NCCLs. SNB was a protective factor for NCCL occurrence; the larger the SNB, the lower was the probability of NCCL occurrence. These findings have further clarified the aetiology of NCCLs and provided clinicians with valuable insights into strategies for preventing the loss of dental tissue.

Evaluation of Efficacy of Self-etch Adhesives in the Restoration of Noncarious Cervical Lesions: A Controlled Clinical Trial

Evaluation of Efficacy of Self-etch Adhesives in the Restoration of Noncarious Cervical Lesions: A Controlled Clinical Trial

Effects of occlusal wear on 16-year progression of non-carious cervical lesions-Results of the study of health in Pomerania (SHIP-START).

It is still discussed whether occlusal wear (OW) affects the formation of non-carious cervical lesions (NCCLs). To estimate effects of OW on the presence and development of NCCLs, using 16-year follow-up data from a cohort study. Occlusal and cervical defects were measured in 728 cast models (one from the upper jaw and one from the lower jaw) of 364 participants. Adjusted mixed-effects ordinal logistic models analysing estimated cross-sectional (N = 1308 teeth/291 subjects) and longitudinal (N = 718 teeth/226 subjects) associations of OW with NCCLs using tooth level data. OW size was cross-sectionally (OR = 1.74; 95% CI: 1.27-2.38 for OW size; OR = 0.97; 95% CI: 0.94-0.99 for squared OW size), but not longitudinally (OR = 1.14; 95% CI: 0.99-1.30) associated with odds of higher NCCL sizes. For cross-sectional analyses, predicted probabilities of an NCCL size of 0 decreased from about 0.996 to 0.010 for OW sizes of 0 to 25. Results suggest an association between OW and NCCL size. However, as longitudinal results were non-significant, while consistent in direction, large-scaled cohort studies are demanded to more precisely estimate effect strength.

Investigation of the presence of Non-carious cervical lesions (NCCLs) in ancient adult skulls: analyzing data from prehistoric and historical samples through a systematic review and meta-analysis

ObjectivesHistorically, the prevalence of caries has undergone significant changes, particularly increasing with the industrialization of sugar consumption. When examining ancient populations, lower caries rates are discovered, attributed in part to dietary factors. These populations consumed abrasive foods, leading to occlusal wear and reduced non-axial occlusal forces, potentially influencing Non-Carious Cervical Lesions (NCCLs). Although some attribute NCCLs to abfraction, the mechanism remains debated. This systematic review aims to evaluate the presence of NCCLs in ancient populations, shedding light on the factors contributing to their occurrence.Materials and MethodsThe present systematic review was registered on PROSPERO, and the manuscript was prepared following PRISMA guidelines.ResultsAfter the literature search and article screening, data from 6 studies were included in the meta-analysis, with only 2 reporting NCCLs in ancient skulls, encopassing 17 subjects in 805 examined skulls, suggesting their presence even before the widespread use of toothbrushes. This finding indicates a potential etiopathogenic mechanism linked to abfraction, but the cause is complex and involves abrasive and erosive factors closely tied to dietary habits.ConclusionsIn summary, NCCLs were present in ancient populations, albeit with a much lower prevalence. Their occurrence cannot be solely attributed to wear mechanisms but must be connected to abrasive factors related to diet or practices with religious and cultural significance, such as the use of labrets. Clinical relevance: Th the knowledge of NCCLs presence in acient sculls is crucial today for better understand the associated risk factors. In this context, the analysis of ancient skulls allows us to discern the role that tooth brushing and diet played in the formation of NCCLs, over the past century.

A depth-resolved quantitative evaluation method for non-carious cervical lesions treatment with optical coherence tomography

ObjectivesThe aim of this study is prognostic assessment of surface smoothness and the presence of internal bubbles after treatment of non-cancerous cervical lesions (NCCLs) using optical coherence tomography (OCT). MethodsAfter treatment with NCCLs, cross-sectional images of the lesion parts of the sample were non-invasively acquired and analyzed. The surface smoothness between tooth and resin, resin and cemento-enamel junction, and the presence bubble inside resin was confirmed. In addition, using an algorithm that distinguishes between resin and dental structure based on OCT cross-sectional images, we quantitatively analyzed the amount of resin used in treating NCCLs and acquired 3D images. ResultsThe inner structure of the resin in each sample was checked, and the presence of bubbles was confirmed. In addition, the resin sections were separated from the tomographic images acquired by OCT to visualize 3D images. The volume of resin used in the treatment part of each NCCLs samples was quantitatively analyzed as 3.7216 ∼ 14.889 mm3. ConclusionsOCT is able to measure not only the surface abrasion provided by existing intraoral scanner, but also the size and depth location of interal bubbles, which is distinctive advantage of our method. Based on our results, OCT is a significant tool for qualitative and quantitative analysis of dental NCCLs treatment before and after treatment. Clinical significanceThe study used OCT, a non-destructive diagnostic, to reveal the structure of the resin and the location and size of bubbles after NCCLs treatment. These findings could be golden standard in determining the prognosis of NCCLs treatment.

Performance of self-cured versus light-cured universal adhesive in patients with non-carious cervical lesions: 18-month randomized clinical trial

ObjectiveTo evaluate the clinical performance of self versus light-cured universal adhesive in non-carious cervical lesions (NCCLs) after 18 months.Materials and methodsSixty-eight NCCLs in 28 patients were divided into two equal groups; G1: self-cured universal adhesive (Palfique,Tokuyama,Japan) and G2: light-cured universal adhesive (Single Bond Universal,3 M ESPE,USA). Nanohybrid resin composite (Z350XT, 3 M ESPE, USA) was used as a final restoration. Evaluation for fracture, loss of retention, marginal adaptation and discoloration were done after 1 week, 6,12, and 18 months using FDI criteria. Postoperative sensitivity was assessed after 1 week. Chi-Square and Mann-Whitney tests with statistical significance at (P ≤ 0.05) were used for intergroup comparison,while the intragroup one was performed using the Cochran’s Q and Friedman’s tests. Survival rate was analyzed using Kaplan-meier and Log-rank test.ResultsBoth groups exhibited fracture and retention loss, however, there was statistically significant difference favoring the control group at 6 months (p = 0.0114,0.0016). For secondary outcomes, marginal adaptation and discoloration revealed no significant differences. For postoperative sensitivity, there was a significant difference favoring the control group (p = 0.0007, 0.0011). Palfique had 1.5 Relative-Risk (RR) after 6 months (95% CI 0.5659–4.2617; P = 0.3928) and 20% less risk of failure after 18 months (RR 0.8) (95% CI 0.4618–1.3858; P = 0.4260). Tested adhesives showed equal survival rate (P = 0.5685).ConclusionsBoth adhesives revealed similar clinical performance in restoring the NCCLs after 18 m, however, the early failure was more frequent in the self-cured universal adhesive.

Clinical performance of preheating thermoviscous composite resin for non-carious cervical lesions restoration: A 24-month randomized clinical trial

ObjectivesThis 24-month, double-blind, split-mouth randomized clinical trial aimed to compare the retention rates of a preheated thermoviscous composite resin (PHT) compared to a non-heated composite resin (NHT) in non-carious cervical lesions (NCCLs). MethodsA total of 120 restorations were restored on NCCLs using a preheated (VisCalor bulk, Voco GmbH) and a non-heated (Admira Fusion, Voco GmbH) composite resins with 60 restorations per group. A universal adhesive in the selective enamel conditioning was applied. In the PHT group, composite was heated at 68 °C for using a bench heater. In the NHT group, no heating was employed. Both restorative materials were dispensed into caps and inserted into the NCCLs. The restorations were evaluated at baseline, 6, 12, 18, and after 24 months of clinical service using the FDI criteria. Statistical analysis was performed with Kaplan–Meier estimation analysis for retention/fracture rate and Chi-square test for the other FDI parameters (α=0.05). ResultsAfter 24 months 108 restorations were assessed. Seven restorations were lost (two for PHT group and five for NHT group), and the retention rates (95 % confidence interval [CI]) were 96.7 % (81.5–99.9) for PHT group and 90.8 % (81.1–96.0) for NHT group, with no statistical differences between them (p > 0.05). The hazard ratio (95 % CI) was 0.52 (0.27 to 1.01), with no significant difference within groups. In terms of all other FDI parameters that were assessed, all restorations were deemed clinically acceptable. ConclusionsBoth composites showed high rates of retention rates after 24 months. Clinical significanceThe clinical performance of the new preheated thermoviscous was found to be as good as the non-heated composite after 24-month of clinical evaluation in non-carious cervical lesions. Registration of clinical trialsRBR-6d6gxxz