Selective Enamel Etching Research Articles

Clinical Outcomes and Quantitative Margin Analysis of a Universal Adhesive Using a Randomized Clinical Trial over Three Years.

The effectiveness of a universal adhesive applied in different application modes for the preparation of Class V composite restorations was evaluated both clinically and by quantitative marginal analysis (QMA). In each of the 22 patients, four non-carious cervical lesions (NCCL) were restored with Filtek™ Supreme XTE (3M). The adhesive Scotchbond™ Universal (SBU, 3M) was applied in self-etch (SE), selective-enamel-etch (SEE) or etch-and-rinse (ER) modes. The etch-and-rinse adhesive OptiBond™ FL (OFL, Kerr) served as a control. The restorations were clinically evaluated (FDI criteria) after 14 days (BL), 6, 12, 24, and 36 months. Additionally, QMA was conducted on all restorations of 11 randomly selected patients. The FDI criteria and marginal gap were statistically compared between the groups at each recall as well as for the time periods between recalls. The cumulative failure rate was non-significantly higher in the OFL group when compared to all of the SBU groups. Marginal adaptation in the OFL and SBU-SE/ER groups was significantly decreased (BL-36 m, p: 0.004) in comparison to the SBU-SEE group (BL-36 m, p: 0.063). More marginal gaps were found in the OFL group than in the SBU-SEE (BL to 36 m, p: 0.063-0.003) and SBU-ER (24/36 m, p: 0.066/0.005) groups as well as in the SBU-SE group when compared to the SBU-SEE (12-36 m, pi ≤ 0.016) and SBU-ER (24/36 m, p: 0.055/0.001) groups. SBU-SEE performed most effectively. The clinical evaluation and QMA corresponded, yet QMA detected group differences earliest after 6 months and is thus a valuable extension to clinical evaluations.

Universal Adhesives: Evaluation of the Relationship between Bond Strength and Application Strategies—A Systematic Review and Meta-Analyses

Adhesive resins with guided application protocols have been developed with the main goal of reducing the number of clinical steps. Universal Adhesives (UA) can be applied with both Self-Etch (SE) or Etch-and-Rinse (ER) adhesion strategies. This review aims to evaluate the bond strength of UA, applied to dental tissues, by a systematic bibliometric review of in vitro studies. The research question, through the PICO model, aimed to assess the current knowledge of the immediate and long-term bond strength of UA, applied with a direct restorative technique. PubMed and ScienceDirect database searches focused on the bond resistance of UA applied with the ER and SE strategies. Studies assessing shear bond strength and microtensile bond strength, in both enamel and dentin, were included. From 1109 screened articles, 12 fulfilled the inclusion criteria. The bond strength of UA to enamel showed better results with the ER approach, while the adhesion strategy did not significantly affect the bond strength of UA to dentin. Evidence from in vitro studies has tended to suggest that the use of the SE adhesion approach seems to be a better choice to improve the bond strength to the dentin. The selective enamel etching is advisable when applied with the SE adhesion approach to optimize the UA bond strength to the enamel.

Bond strength performance according to the adhesive technique used in universal adhesive systems, literature review

Introduction: Adhesive dentistry faces complex clinical situations, which require the dentist to be able to choose the best adhesive protocol offered by universal adhesives. Objective: To present current information about the performance in bond strength according to the etching technique used in universal adhesives, evaluating the total etching technique, selective enamel etching, self-etch technique and bonding used in special clinical situations. Methodology: A search was carried out in the PubMed electronic database using as keywords “universal adhesive”, “total etch technique”, “selective enamel etching”, “self-etch”. Results: In the total acid etching technique, the acid gel to be used must be considered, as well as the type of adhesive. Selective enamel etching seeks to obtain that strong anchorage to the enamel that can only be obtained using a phosphoric acid gel, allowing the self-etching quality of the adhesive to act on dentin. The use of the self-etch technique will simplify the clinical steps in the adhesive protocol, however adhesion may decrease consequently. If there is any type of alteration in the substrate to be adhered, the resulting adhesive force could be modified, regardless of the adhesive technique used. Conclusion: Universal adhesives will allow the clinician to choose the adhesive protocol, depending on the clinical situation they are facing, as long as the clinician pays attention to aspects such as the acid gel to be used, the adhesive application time and the conditions of the substrate to adhere.

Clinical assessment of thermo-viscous versus conventional bulk-fill resin composites in proximal compound posterior restorations

Objective The purpose of this prospective randomized clinical study was to compare the clinical performance of thermo-viscous bulk-fill resin composite versus conventional bulk-fill resin composite in proximal compound posterior restorations. Materials and Methods: A total of fifty-four Class II cavities were prepared in forty-seven patients. The patients were divided into two groups according to the type of the bulk-fill used (n=27).Group 1 : thermo-viscous bulk fill (Viscalor,Voco) while Group 2: conventional bulk fill (Xtra-fil ,Voco). Both groups received the same adhesive system; selective enamel etching using the single dosed dual cured universal adhesive (Futura-bond U, Voco). All restorations were clinically evaluated at periods of 1 week (initial recall), after six months, and after one year. Assessment was done according to the modified United States Public Health Service (USPHS) criteria. Data were statistically analyzed using Friedman to compare between the tested periods for each group (p < 0.05). Results: There was no significant difference between group 1 and group 2 regarding all tested criteria at different follow up periods; where P > 0.05. Conclusions: Thermo-Viscous Bulk fill composite (Viscalor bulk fill) and conventional packable bulk fill composite resin (X-tra-fil) exhibited comparable acceptable clinical performance after one year of clinical evaluation.

Universal Simplified Adhesive applied under different bonding technique's: 36-month Randomized Multicentre Clinical Trial

To evaluate the clinical performance of a new dual-cure universal adhesive system (Futurabond U, Voco) when applied using different application strategies in non-carious cervical lesions (NCCLs) after 36 months. Futurabond U was applied in NCCLs of 50 subjects using four adhesion strategies (n=50 restorations per group): only self-etch (SEE); selective enamel etching+self-etch (SET); etch-and-rinse with dry dentin (ERDry); and etch-and-rinse with wet dentin (ERWet). All cavities were restored using Admira Fusion composite resin (Voco). Restorations were evaluated after 36 months using the World Federation criteria (FDI) and the modified United States Public Health Service (USPHS) criteria. The after 36-month retention rates were 87% (75-92%) for SEE, 94% (83-98%) for SET, 91% (80-97%) for ERDry, and 94% (83-98%) for ERWet. Forty-three restorations were considered to have minor discrepancies in marginal adaptation at the 36-month recall (18 for SEE, 12 for SET, 7 for ERDry, and 6 for ERWet; p > 0.05). One restoration was detected as a minor marginal discoloration at the 36-month recall (1 for SET; p > 0.05). No restorations showed postoperative sensitivity and caries recurrence at 36 months. The clinical performance of the Futurabond U did not depend on the employed bonding strategy, and it was considered reliable after 36 months of clinical evaluation. However, greater marginal discrepancy was observed in the self-etch groups. NCCLs restorations using a dual-cure universal adhesive in self-etch and etch-and-rinse modes showed satisfactory clinical performance after 36 months.

A randomized, controlled clinical evaluation of two resin cement systems in the adhesion of CAD/CAM-fabricated resin nanoceramic restorations: 18-month preliminary results.

The purpose of this clinical study was to evaluate the performance of two different adhesive resin cement systems in the cementation of inlay/onlay restorations produced from resin nanoceramic blocks using the CAD/CAM system. A total of 70 inlay/onlay restorations made from Cerasmart (GC, Tokyo, Japan) resin nanoceramic blocks using CEREC Omnicam (Sirona Dental, Bensheim, Germany) were placed in 53 patients. The restorations were cemented with RelyX U200 Automix (3M ESPE, Seefeld, Germany) self-adhesive resin cement (RXU) after selective enamel etching or with G-CEM LinkForce (GC, Tokyo, Japan) adhesive resin cement (GCL) in combination with a universal adhesive (G-Premio Bond) in selective etch mode. At baseline and after 6, 12, and 18 months, restorations were examined by two calibrated clinicians according to modified USPHS criteria. The data were analyzed using Chi-square (χ2 ) test and Friedman test (p <0.05). After 18 months, two teeth at RXU group were endodontically treated due to hypersensitivities. At GCL group, three restorations were lost due to debondings (2) and ceramic fracture (1). The survival rates of RXU (94.3%) and GCL group (91.4%) exhibited no statistically significant difference (p =0.661). No significant differences were detected for surface texture, secondary caries, anatomic form, color match, marginal discoloration, marginal integrity, interproximal contacts, and patient satisfaction (p >0.05). The two resin cement systems showed acceptable clinical performance for the cementation of resin nanoceramic CEREC Omnicam inlay/onlay restorations. Resin nanoceramic restorations fabricated using CEREC Omnicam and cemented with either a self-adhesive or a universal adhesive/resin cement system demonstrated clinically acceptable results for posterior teeth in a single visit.

Comparative evaluation of post operative sensitivity in nccl restored with universal adhesive systems in self etch mode and selective enamel etch modes- An in vivo study

Comparative evaluation of post operative sensitivity in nccl restored with universal adhesive systems in self etch mode and selective enamel etch modes- An in vivo study

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

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.

Postoperative sensitivity in posterior resin composite restorations with prior application of a glutaraldehyde-based desensitizing solution: A randomized clinical trial

ObjectivesTo evaluate the effect of a glutaraldehyde-based desensitizer on the postoperative sensitivity (POS) in posterior resin composite restorations up to 12 months using a universal adhesive (Tetric N-Bond Universal) with selective enamel etching (SE) or an etch-and-rinse (ER) strategy. MethodsClass I and class II resin composite restorations (n = 220) at least 3 mm deep were inserted in 55 subjects. The universal adhesive was applied using the SE (self-etch strategy on dentin with selective enamel etching) or the ER strategy, with or without prior application of a glutaraldehyde-based desensitizer (Gluma Desensitizer – GL) to form groups SEGL and ERGL. A bulk-fill resin composite (Tetric NCeram Bulk Fill) was used for all restorations. Spontaneous POS was assessed 7 days after the restorative procedure using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). After 7, 14, and 30 days of completing each restoration, the subjects were reassessed to evaluate POS caused by stimulation with an air blast, horizontal and vertical percussion. In addition, marginal discoloration, marginal adaptation, fracture, and recurrence of caries were evaluated using the FDI (World Dental Federation) criteria after 7 days and at 12 months. ResultsNo significant spontaneous or stimuli-induced POS was observed when restorations with or without GL were compared (p>0.05). A higher risk of spontaneous POS was observed within 7 days (40.0%; 95% CI 28.1 to 53.1), without statistically significant differences among groups. None of the participants reported POS at 12 months, however five restorations were considered clinically unsatisfactory (p > 0.05). ConclusionsThe previous application of GL did not significantly reduce spontaneous or stimuli-induced POS in posterior resin composite restorations at any time, regardless of the adhesive strategy used. Clinical significanceThe use of a glutaraldehyde-based desensitizing agent did not generate lower incidence of postoperative sensitivity in resin composite posterior restorations.

Randomized clinical split-mouth study on the performance of CAD/CAM-partial ceramic crowns luted with a self-adhesive resin cement or a universal adhesive and a conventional resin cement after 39 months

Objectives To determine the clinical performance of partial ceramic crowns (PCCs) luted with a conventional resin cement combined with a universal adhesive without or with selective enamel etching or luted with a self-adhesive resin cement.Methods In a split-mouth design, each three CAD/CAM-PCCs (Vita Mark II, Cerec) were placed in 50 patients. Two PCCs were luted with a conventional resin cement (RelyX Ultimate) combined with a universal adhesive (Scotchbond Universal) without (SB-E) or with (SB+E) selective enamel etching. The third PCC was luted with a self-adhesive resin cement (RelyX Unicem 2; RXU). Chi-square tests (α≤0.05) were applied. Based on clinical failures (complete debonding or need for replacement of the restorations), Kaplan-Meier survival analysis was performed.Results 31 patients were evaluated clinically using FDI criteria at 39 months. Clinically acceptable results were detected over time, except for “fracture of material and retention” (inacceptable fractures and debondings). Within materials, statistically significant differences (p ≤ 0.003) between baseline and 39 months were found for “marginal adaptation” and “marginal staining”. At 39-month, SB+E and SB-E showed significantly better results compared to RXU in “marginal adaptation”(p ≤ 0.021) and “marginal staining”(p ≤ 0.013). Kaplan-Meier analysis showed higher survival rates after 39 months for SB+E (96%) and SB-E (88%) compared to RXU (69%) with statistically significant differences between RXU vs. SB-E (p = 0.022) and RXU vs. SB+E (p ≤ 0.001).Conclusions After 39-months, PCCs luted with the self-adhesive resin cement exhibited a statistically significant inferior survival rate compared to restorations luted with the conventional resin cement combined with a universal adhesive without or with selective enamel etching.Clinical significance Currently, self-adhesive resin cements cannot be recommended for luting partial ceramic crowns. However, the standard adhesive luting procedure comprising a universal adhesive and luting composite yielded good clinical results for more than 3 years irrespectively of application of a selective enamel etching step.

Bonding to dentine: an update on universal adhesives

The ability to successfully bond restorations to dentine is central to minimally invasive restorative dentistry. While dentine bonding agents have gone through a variety of ‘generations’, it is the purpose of this article to describe the latest clinical and laboratory research on universal adhesives. Results from the latest laboratory and clinical research indicates that universal adhesives are a step forward in the quest for the ultimate bond to tooth substance and ease of use of the adhesive. The wide variety of studies that indicates the effectiveness of universal adhesives are discussed, along with research that indicates that selective enamel etching is a beneficial procedure when using these materials. CPD/Clinical Relevance: Universal adhesives appear to hold promise in the quest for a reliable bond to dentine.

Update on Enamel Bonding Strategies

Optimal strategies for the application of an adhesive differ between enamel and dentin because of the differences in their composition. The development of adhesive systems has mainly focused on the bonding of dentin, rather than on the enamel, by etching with phosphoric acid (PA). Dental adhesive technologies continue to rapidly advance, and various adhesive systems have been developed since the study of Buonocore in 1955. He introduced the enamel acid-etch technique. Then, the etch-and-rinse (ER) system was developed, and subsequently, the self-etch (SE) system. Universal adhesives are a new generation of one-bottle SE adhesives that can be applied with either ER mode or SE mode, or a combined system involving selective enamel etching mode. Since the combination of PA etching and the SE system differs from conventional ER systems, the enamel bonding strategy should be carefully considered. This concise review of the literature on reliable enamel bonding strategies should prove helpful to clinicians to choose an appropriate adhesive system to achieve optimal clinical outcomes.

Bonding and wear properties of self-adhesive flowable restorative materials.

The purpose of this study was to evaluate the bonding and wear properties of self-adhesive flowable restorative materials. Five self-adhesive flowable restorative materials were used. The study parameters were: (i) shear bond strengths; (ii) microleakage; (iii) occlusal wear; and (iv) qualitative evaluation of the bonding interface. The range of shear bond strengths of the materials was as follows: 7.4-12.2MPa to ground enamel, 22.5-32.5MPa to etched enamel, and 1.3-4.2MPa to dentin. The microleakage scores of the materials did not show any statistically significant differences regardless of the presence or absence of etching. The wear facets on the materials showed 0.099-0.447mm3 of volume loss and 148.6-365.3µm maximum depth, with statistically significant differences between materials. Scanning electron microscopic images of the interfaces of the materials showed good adaptation regardless of substrate. The bonding and wear properties of self-adhesive flowable restorative materials were still limited and showed lower values than previously reported results for nanofilled composites with an adhesive system. Selective enamel etching can improve the bonding performance of these materials.

Effectiveness of a Selective Etching Technique in Reducing White Spots Formation around Lingual Brackets: A Prospective Cohort Clinical Study

The risk of developing white spot lesions (WSLs) after orthodontic treatment with lingual brackets is generally considered lower than with labial ones, even if plaque accumulation is frequently higher due to the increased difficulty level in oral hygiene maintenance. In this prospective clinical study, selective enamel etching technique effectiveness in reducing plaque accumulation and WSLs was tested. Thirty patients were bonded with a split-mouth approach: two randomly selected opposite quadrants were used as the test sides, using customized plastic etching guides, and the other two as control sides, applying traditional direct etching methods. The plaque presence around the braces was recorded after 1, 3, 6, and 12 months according to a lingual plaque accumulation index (LPAI), as was the presence of WSLs. PAI measured values were significantly higher in the control sides during the observation period. Test and control sides differed significantly for new WSL onset only after 12 months of treatment. Therefore, the present research demonstrated that this guided enamel etching technique allowed for significant reduction in plaque accumulation around the lingual brackets and reduced onset of white spots after one year of treatment.

Influence of viscosity and chemical composition of composite resins in non-carious cervical restorations: 12-month randomized clinical trial

Objective: The objective of this double-blind, randomized controlled clinical trial was to evaluate the clinicalperformance of two methacrylate-based flowable composite and ormocer-based flowable composite in non-cariouscervical lesions (NCCLs) of adult patients. Material and Methods: 183 restorations were performed on NCCLsusing the Futurabond U adhesive system, applied in the selective enamel etching mode in all cavities. After theadhesive application, the cavities were restored with one out of the three evaluated flowable composites (n = 61per group): ormocer-based flowable composite (Admira Fusion Flow, ORM), low viscosity methacrylate-basedcomposite (GrandioSO Flow, LV) and high viscosity methacrylate-based composite (GrandioSO Heavy Flow, HV).After 12 months of clinical performance, these restorations were evaluated according to FDI and USPHS criteriain the following items: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity andcaries recurrence. Results: eight restorations were lost/fractured after 12 months of clinical evaluation (1 inthe ORM and 7 in the HV group). The retention rates for 12- months (95% confidence interval) were 98.4%(91.3%-99.7%) for the ORM group, 100% (94.5%-100%) for the LV group and 88.5% (78.1%-94.3%) for theHV group, with no statistical difference identified between any pair of groups (p &gt; 0.05). Five restorationspresented small marginal adaptation defects at the 12-months evaluation recall, and all of them were consideredclinically acceptable. Conclusion: The clinical performance of the universal adhesive associated to ormocer-basedor methacrylate-based flowable composite were found to be promising after 12-month of clinical evaluation.KEYWORDSDental bonding; Dental restoration; Clinical trial.

Influence of selective etching on the enamel and dentin leakage of three low shrinkage composites in class V restoration

This study determined if prior selective enamel etching affected leakage of enamel/dentin margins in Class V low-shrinkage resin-based composite restorations. Round cavities, centered on the cemento/enamel junction, 2 mm in diameter and 2 mm in depth were prepared on the buccal, palatal or lingual surfaces of premolar teeth to have a total of 60 cavities. One side of the tooth received selective enamel etching and both sides were restored using one of 3 restorative materials (n = 10): Aelite LS posterior/All-bond SE, Estelite Sigma Quick/Bond Force, or Filtek P90/P90 System Adhesive. The teeth were fatigued for 5000 thermal cycles, and the marginal sealing was challenged with 50% ammoniacal silver nitrate. The interface was analyzed and the leakage score was calculated. Two-way ANOVA revealed that Filtek P90 (25.5±17.4) had lower leakage than Estelite Sigma Quick (63.1±34.5) and Aelite LS Posterior (64.2±41.8) with self-etching. With selective etching, the three materials showed reduced leakage in enamel. A significant difference (P &lt;0.05) was found between leakage in enamel and dentin for the Aelite LS Posterior selective etch group and for Estelite Sigma Quick. Selective etching reduced enamel leakage for all materials in one-step self-etch materials. Two-step self-etch adhesives bond better to enamel and dentin than one-step resin-based adhesives.

Composite restorations placed in non-carious cervical lesions-Which cavity preparation is clinically reliable?

The purpose of this in‐vivo study was to evaluate the clinical performance of restorations placed in non‐carious cervical lesions (NCCLs), using different cavity preparation designs, after 7.7 years. A total of 85 NCCLs with coronal margins in enamel and cervical margins in dentin were randomly assigned to the following treatment protocols: dentin surface cleaning, dentin surface roughening with round bur plus flowable composite, dentin surface roughening/cervical groove preparation with round bur, dentin surface roughening/cervical groove preparation with round bur plus flowable composite. After enamel beveling and selective enamel etching, the defects were restored with composite. The restorations were assessed by two independent, calibrated and blinded investigators, using modified USPHS criteria. At 7 years (7.7 (± 0.35)), a total of 64 restorations (75.3%) were available for follow‐up examination. The total retention rate, irrespective of the test groups, was 82.8%. Restorations placed without any preparation showed the highest loss rate (27.8%). Esthetic appearance, marginal adaptation, anatomic form and marginal discoloration did not differ significantly between the groups. Composites are long‐term stable materials for restoring NCCLs. Restorations placed without any dentin preparation (cavity cleaning only) showed the highest loss rate.

Five-year clinical evaluation of a universal adhesive: A randomized double-blind trial

ObjectiveTo evaluate the five-year clinical performance of Scotchbond Universal Adhesive (SU; 3M Oral Care, St. Paul, MN, USA) in non-carious cervical lesions (NCCLs) using two evaluation criteria. MethodsThirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-ERm: etch-and-rinse + moist dentin; SU-ERd: etch-and-rinse + dry dentin; SU-Set: selective enamel etching; and SU-SE: self-etch. A nanofilled composite resin was placed incrementally. The restorations were evaluated at baseline and after 5 years using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. The survival rates (retention/fractures) were calculated with the Kaplan-Meier and the log-rank test. For the secondary outcomes, Friedman repeated measures analysis of variance by rank was applied (α = 0.05). ResultsAfter 5 years the recall rate was 86%. The retention/fracture rates were 93% for Erm and ERd, 88.4% for SEet and 81.4% for SE. A significant difference was observed for SE vs. ERd and SE vs. ERm (p = 0.01). Also, marginal discoloration and adaptation showed significant differences with ERm and ERd resulting in fewer marginal discrepancies than SE (p < 0.05). SignificanceAfter 5 years, the clinical behavior of the universal adhesive in the etch-and-rinse strategy was better when compared to the self-etch strategy. The use of selective enamel etching is highly recommended for the self-etch strategy. The FDI and USPHS evaluation criteria showed similar results after 5 years.

A New Dual-cure Universal Simplified Adhesive: 18-month Randomized Multicenter Clinical Trial.

Non-carious cervical lesion restorations using a dual-cure universal adhesive in self-etch and etch-and-rinse mode showed satisfactory clinical performance after 18 months. Objectives: The objective of this multicenter, double-blind, split-mouth randomized clinical trial was to evaluate the clinical performance of a new dual-cure universal adhesive system (Futurabond U, Voco GmBH) when applied using different strategies over a period of 18 months.Methods and Materials: Fifty patients participated in this study. Two hundred non-carious cervical lesions were restored using the adhesive Futurabond U according to four adhesive strategies (n=50 per group): only self-etch (SEE), selective enamel etching + self-etch (SET), etch-and-rinse with dry dentin (ERDry), and etch-and-rinse with wet dentin (ERWet). After the adhesive application, cavities were restored using Admira Fusion composite resin. These restorations were evaluated according to FDI World Dental Federation criteria for the following characteristics: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity, and caries recurrence.Results: After 18 months, only four patients (12 months: one patient, n=4 restorations; and 18 months: three patients, n=12 restorations) were not evaluated. Fourteen restorations were lost after 18 months of clinical evaluation (four for SEE, three for SET, three for ERDry, and four for ERWet). The retention rates for 18 months (95% confidence interval) were 92% (81%-97%) for SEE, 94% (83%-97%) for SET, 94% (83%-97%) for ERDry, and 92% (81%-97%) for ERWet (p>0.05). Thirty-eight restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall (13 for SEE, 13 for SET, six for ERDry, and six for ERWet; p>0.05). Fourteen restorations were detected as a minor marginal discoloration at the 18-month recall (six for SEE, six for SET, one for ERDry, and one for ERWet; p>0.05). However, all were considered clinically acceptable. No restorations showed postoperative sensitivity or caries recurrence at the time.Conclusion: The clinical performance of the Futurabond U did not depend on the bonding strategy used, and it was considered reliable after 18 months of clinical evaluation, although more marginal discrepancy was observed in the self-etch group.

Clinical evaluation of a universal adhesive in non-carious cervical lesions.

To compare the clinical performance of a universal adhesive in class V non-carious cervical lesions (NCCLs) using two surface treatment protocols (self-etch [SfE] vs selective-enamel-etch [SelE]). Thirty-three adults, each with ≥2 NCCLs, received one resin composite restoration utilizing a SfE universal adhesive and another utilizing the adhesive and SelE with 37% phosphoric acid. Restorations were evaluated for sensitivity, retention, marginal discoloration, marginal adaptation, and clinical acceptability through 24 months using Cochran-Mantel-Haenszel tests for stratified, ordered categorical outcomes. Sixty-six restorations (35 SfE, 31 SelE; 27 volunteers) were evaluated at 24 months. There were no significant differences between SfE and SelE for sensitivity, retention, marginal adaptation, or clinical acceptability. One SfE restoration was lost. Marginal adaptation was significantly worse at 24 months than baseline for SelE (P = 0.01), but not for SfE. Marginal discoloration was significantly worse for SfE (P = 0.02), but not for SelE. Sensitivity improved from baseline to 24 months for both groups (SelE P = 0.004, SfE P = 0.002). Twenty-four-month data indicated significantly reduced sensitivity for both groups, worse marginal discoloration for SfE, and worse marginal adaptation for SelE. No changes in retention or clinical acceptability were observed in either group. All retained restorations were clinically acceptable at 24 months. Both self-etch and selective enamel etch techniques with a universal adhesive produced clinically acceptable results in resin composite restorations for NCCLs over 2 years.