Three-year Clinical Performance of a Universal Adhesive in Non-Carious Cervical Lesions.

PURPOSE: The aim of this randomized controlled clinical trial was to evaluate the 3-year clinical performance of a universal adhesive (Clearfil Universal Bond Quick (CUBQ); Kuraray Noritake) when restoring non-carious cervical lesions (NCCLs) using two different application modes (etch-and-rinse vs self-etch with prior selective enamel etching). MATERIALS AND METHODS: Fifty-one patients participated in this study. A total of 251 NCCLs (n = 251) were assigned to two groups: 1) CUBQ applied in etch-and-rinse mode (n = 122; CUBQ-ER) and 2) CUBQ applied in self-etch mode with prior selective etching of enamel with phosphoric acid (n = 129; CUPQ-SEE). The same resin composite, Clearfil Majesty ES-2 (Kuraray Noritake), was used for all restorations. The restorations were evaluated at baseline, 1 and 3 years using FDI criteria: marginal staining, fracture and retention, marginal adaptation, post-operative sensitivity and recurrence of caries. Statistical analysis was performed using a logistic regression model with generalized estimating equations (2-way GEE model). RESULTS: The patient recall rate at 3 years was 90%. After 3 years, both groups presented an increase in the percentage of small but still clinically acceptable marginal defects (CUBQ-ER: 67%, CUBQ-SEE: 63.2%) and marginal staining (CUBQ-ER: 32.6%, CUBQ-SEE: 31.7%). The overall success rate was 82.6% and 83.8% for CUBQ-ER and CUBQ-SEE, respectively. In total, 38 restorations (19 CUBQ-ER, 19 CUBQ-SEE) failed because of loss of retention, fracture, severe marginal defect and/or marginal discoloration. A retention rate of 87.2% and 86.3% was recorded for CUBQ-ER and CUBQ-SEE, respectively. No significant difference was observed between the two bonding-mode groups for any of the evaluated parameters. CONCLUSION: After 3 years of clinical service, Clearfil Universal Bond Quick performed similarly in etch-and-rinse and self-etch modes with prior selective enamel etching.

Six-year Clinical Performance of a 2-step Self-etch Adhesive in Noncarious Cervical Lesions.

PURPOSE: Mild and intermediately strong 2-step self-etch adhesives (2SEa) have been shown to bond efficiently to dentin. In general, their bonding efficiency to enamel is inferior to that of etch & rinse adhesives (E&Ra). On the other hand, their application procedure is less elaborate, and consequently leaves less room for application mistakes. The aim of this randomized controlled trial was to evaluate the clinical performance of an intermediately strong 2SEa, as compared with that of a 3-step E&Ra after 6 years of clinical functioning. MATERIALS AND METHODS: 239 non-carious cervical lesions in 50 patients were restored with the nanohybrid composite Herculite XRV (Kerr), bonded in random order either with the 2SEa Optibond XTR ('O-XTR', Kerr) or the gold-standard control 3E&Ra Optibond FL ('O-FL', Kerr). The restorations were recalled after 1, 2 and 6 years of clinical service and examined for retention, marginal adaptation, marginal discoloration, caries occurrence, and postoperative sensitivity. Statistical analysis was performed using a logistic regression model with generalized estimating equations (2-way GEE model). RESULTS: The patient recall rate at 6 years was 94%. The overall clinical success rate was 81.9% and 80.9% for O-XTR and O-FL, respectively. In total, 42 restorations (21 O-XTR, 21 O-FL) failed because of retention loss, severe abfraction/abrasion/erosion, severe marginal defects and/or discoloration, and/or caries. A retention rate of 92.9% and 88.9% was recorded for O-XTR and O-FL, respectively. Progressive marginal deterioration was observed over the 6-year period. Small clinically acceptable marginal defects were recorded in about 70% of the restorations (O-XTR: 69.9%; O-FL: 74.1%). Regarding marginal discoloration, 37% of the O-XTR and 30.2% of the O-FL restorations showed superficial clinically acceptable marginal discoloration. Six O-XTR and 4 O-FL restorations exhibited caries at the restoration margin. No significant difference was observed between the two groups for any of the evaluated parameters (p > 0.05). CONCLUSION: After 6 years of clinical service, Class-V restorations bonded with the 2SEa performed clinically equally well as those bonded with the 3E&Ra.