Three-year evaluation of different adhesion strategies in non-carious cervical lesion restorations: a randomized clinical trial

Abstract

Objective: To evaluate non-carious cervical lesions (NCCLs) restored with different adhesion strategies. Methodology: This is a prospective, randomized, double-blind, split-mouth study. An adhesive restorative system (Single Bond Universal/Filtek Z350XT -SBU) was evaluated both without and with selective enamel conditioning (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic acid pretreatment (EDTA; E-RMGIC). In total, 200 restorations, placed in 50 patients, were evaluated at baseline and at a 3-year follow-up using the modified United States Public Health Service (USPHS) criteria. Data were analyzed using the two-proportion equality test, multinomial logistic regression, Wilcoxon test, and Kaplan-Meier survival curves. Results: In total, 42 (84%) patients returned for the 3-year follow-up. SBU showed restoration losses statistically different from RMGIC. Retention was also statistically different in SBU between baseline and the 3-year follow-up. Marginal defects and surface texture were statistically significant for all groups in the period studied, except for the surface texture of SBU and the marginal integrity in E-RMGIC. We observed no statistically significant difference in wear, secondary caries, anatomical form, surface staining, and color over time. Recession degree was the only factor to influence retention rates. Cumulative survival (%) was 89, 98, 98, and 95.3, for SBU, SE-SBU, RMGIC, and E-RMGIC, respectively, without significant differences among them. There was a statistically significant difference between survival curves; however, multiple comparison procedures found no statistical differences. Conclusion: Selective enamel etching affected the retention of non-carious cervical restorations. Adhesion using EDTA and resin-modified glass-ionomer cements delayed marginal defects over time. The degree of gingival recession influenced retention rates. Resin composite restorations showed initial marginal defects, and ionomer restorations, reduced surface luster. EDTA pre-treatment followed by resin-modified glass-ionomer cements may be a promising adhesion strategy for NCCL restorations.

Morphological and Optical Coherence Tomography Aspects of Non-Carious Cervical Lesions

“…From 2018 to now, more than 150 studies have been published in PubMed indexed journals regarding this form of dental wear. Most of the studies focused on the etiology of NCCLs [ 43 , 44 , 45 , 46 ], but there is currently no established consensus regarding this of for potential treatments, due to the frequent failures recorded in the practical studies [ 4 , 47 , 48 , 49 ].…”

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

“…In the current study, however, 20% of OFL restorations were lost after 24 and 36 months. To our knowledge, the composition of the batches of OptiBond FL used in the present study compared to those in previous studies was changed, and the adhesive was applied according to the manufacturer’s instructions [ 24 ]. The operator (PS) in this study had many years of professional experience with OptiBond FL and was extensively calibrated prior to the study.…”

“…However, in light of the well-known discrepancies that occur when transferring in vitro results to a clinical situation and the conflict between system simplification on the one hand and the desired acceptable clinical results on the other, the possibilities and limitations of universal adhesives can also be viewed critically [ 21 ]. Nevertheless, a few short- and medium-term clinical studies have been published in the last decade [ 10 , 22 , 23 , 24 , 25 ].…”

“…Nevertheless, following this short observation period, the authors concluded that the subtle interfacial adhesive defects found in the OFL group versus those in the SBU groups might well affect the clinical performance of OFL throughout the study period. In sum, it is still not clear which application modes should be used and when [ 24 , 25 ]. It has rarely been the case that the universal adhesives have been tested in all three modes on the one hand and, according to FDI, against a reference standard on the other.…”

12 Month’s Assessment of Clinical Efficacy of Resin Modified Glass Ionomer Cement and Flowable Composites in Restoration of Non-Carious Cervical Lesions, a Randomized Clinical Trial

“…Therefore, flowable composites have been proposed as an alternative owing to their low modulus of elasticity to reduce problem of debonding. 8,9,10,13,16 Good chemical bond to tooth structure and fluoride release by Glass-ionomer cements have shown a good replacement. However, compromised aesthetics, inconvenient setting time and low resistance to abrasive forces have lowered their worth for cervical lesions.…”