BackgroundMultimode adhesives incorporate the versatility of adapting to various clinical situations by its capacity to be used in different protocols. This study aimed to evaluate the clinical behavior of composite resin direct restorations (Class I and II) performed with different universal dentin adhesive application protocols comparing adapted FDI and adapted USPHS criteria.MethodsThe current study is a randomized, double-blind, split-mouth, and convenience sample controlled clinical trial. The participants (age ≥ 18 years) had restorative need of Class I and/or II due to the presence of carious lesions and/or unsatisfactory restorations in at least three dental elements. Each participant received three application protocols for Scotchbond Universal adhesive (3M ESPE), one in each tooth to be restored: ER = etch-and-rinse + adhesive (n = 50); SEE = selective enamel etch + adhesive (n = 50) and SE = self-etch adhesive (n = 50). All teeth were restored in a similar way using Filtek™ Supreme composite resin (3M ESPE). Restorations were evaluated using the adapted FDI and adapted USPHS criteria, at baseline after 7 to 21 (12.02 ± 5.68) days (T1; n = 50 per group) and after 12 to 20 (15.8 ± 2.7) months (T2; n = 46 per group) by two previously calibrated evaluators (Kappa > 0.80). The statistical tests were performed between groups (Friedman), intragroup (Wilcoxon), and between the criteria considering acceptable and not acceptable restorations (McNemar), α = 0.05.ResultsA statistically significant difference was observed only for the property “superficial staining”, between groups at T2 (p = 0.01) for ER (n = 13 with score 2 or more) and SEE (n = 3 with score 2 or more) and intragroup for ER (T1, n = 1 with score 2 or more; T2, n = 13 with score 2 or more, p = 0.001) and SE (T1, n = 0 with score 2 or more; T2, n = 8 with score 2 or more p = 0.007). For the other comparisons between groups, intragroup, and between the adapted FDI and adapted USPHS criteria, there were no statistically significant differences (p ≥ 0.05).ConclusionsIt can be concluded that the different application protocols of the universal adhesive resulted in clinically “acceptable” restorations after 15.8 ± 2.7 months of follow-up. Adapted FDI and adapted USPHS criteria provided similar results to each other.Trial registration. Number in Brazilian Registry of Clinical Trials (ReBEC): RBR-9p3hdp. Registered 24 May 2015.

Se describe y reporta el diagnóstico, tipo de tratamiento y seguimiento de un caso con el síndrome del diente fisurado. Una paciente de 26 años acusaba sensibilidad a los cambios térmicos y a la oclusión en el lado izquierdo de la mandíbula. Al examen clínico se observó dos grietas o fisuras pigmentadas en las superficies bucales y linguales de la pieza 36. La colocación de una restauración directa con resina compuesta resolvió los síntomas y alivió por completo el dolor. Dicha situación persistió incluso en el control realizado 7 años después. El diagnóstico y tratamiento para el caso descrito dio como resultado un completo alivio y mantenimiento de la situación alcanzada siete años después.

This case report describes the immediate dentin sealing (IDS) technique with self-etch dentin bonding agent (DBA) for indirect restorations. To avoid problems related to dentin exposure when preparing teeth for indirect restorations, the sealing of the dentin immediately after preparation and before impression has been recommended. The IDS technique with self-etch DBA prevents the patient from inconveniences associated with dentin demineralization by phosphoric acid in the traditional total-etch technique. The case report presented describes the indirect restoration of the right upper first molar using the IDS technique with a self-etch DBA covered with a low-viscosity composite resin. The lithium disilicate glass ceramic restoration was obtained with a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Selective enamel etching occurred before cementation with resin cement. A follow-up of 15 months revealed success of the treatment and lack of sensitivity. The incorporation of IDS with indirect restoring teeth adhesively may provide better marginal fit, reduce marginal infiltration, protect the dentin-pulp complex, reduce postoperative sensitivity, bring more comfort to the patient, and is long-lasting to the restored teeth. Clinical significance:The IDS technique with a self-etch DBA is an excellent clinical option to avoid some inconveniences of traditional protocols for indirect restorations.