Clinical effectiveness of a one-step self-etch adhesive in non-carious cervical lesions at 2 years

Abstract

A 2-year randomized, controlled prospective study evaluated the clinical effectiveness of a one-step self-etch adhesive and a "gold-standard" three-step etch-and-rinse adhesive in non-carious Class-V lesions. The null hypothesis tested was that the one-step self-etch adhesive does perform clinically equally well as the three-step etch-and-rinse adhesive. A total of 161 lesions in 26 patients were restored with Clearfil AP-X (Kuraray). The restorations were bonded either with the "all-in-one" adhesive Clearfil S3 Bond (Kuraray) or with the three-step etch-and-rinse adhesive Optibond FL (Kerr). The restorations were evaluated at baseline and after 6 months, 1 and 2 years, regarding their retention, marginal adapation, marginal discoloration, caries occurrence, preservation of tooth vitality and post-operative sensivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. The recall rate at 2 years was 93.8%. Only one Clearfil S3 Bond restoration was lost at the 2-year recall. All other restorations were clinically acceptable. The number of restorations with defect-free margins decreased severely during the 2-year study period (to 6.7% and 25.3% for Clearfil S3 Bond and Optibond FL, respectively). The Clearfil S3 Bond restorations presented significantly more small marginal defects at the enamel side than the Optibond FL restorations (Clearfil S3 Bond: 93.3%; Optibond FL: 73.3%; p = 0.000). Superficial marginal discoloration increased in both groups (to 53.3% and 36% for Clearfil S3 Bond and Optibond FL, respectively) and was also more pronounced in the Clearfil S3 Bond group (p = 0.007). After 2 years, the simplified one-step self-etch adhesive Clearfil S3 Bond and the three-step etch-and-rinse adhesive Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation in marginal integrity. Clearfil S3 Bond exhibited more small enamel marginal defects and superficial marginal discolorations.

Shear bond strength of self-etch and total-etch adhesives to bovine enamel and dentin

“…However, the authors mentioned that these defects are clinically acceptable because they did not require intervention and could be easily removed by refinishing and repolishing. At the dentin margin, the adhesives behaved equally, in agreement with our study (12).…”

“…Adper Easy One (pH ≈ 3.5) is an "ultramild" self-etch adhesive that only superficially interacts with enamel (12), which explains the lower bond strength values for specimens bonded with this material. Also for this group, all failure modes were classified as adhesive failures, confirming the poor performance of this adhesive system when bonded to enamel.…”

Two-year Clinical Performance of Self-etching Adhesive Systems in Composite Restorations of Anterior Teeth

“…20 Corroborating the current results, Zhou and others 24 and Brackett and others, 21 at one-year and two-year recalls, respectively, evaluated the clinical performance of two-bottle and one-bottle self-etching adhesives and observed no statistically significant differences between the systems. Van Landuyt and others 23 and Ermis and others, 22 after one-year and two-year clinical evaluations, respectively, found that a one-step self-etch adhesive and a three-step etch-and-rinse adhesive were equally clinically successful. Fron and others 1 observed that the effectiveness of a one-step self-etch adhesive was very good after two years of clinical service.…”

“…9,10 However, the current results showed good clinical performance of 1-SEAs compared with a 2-ERA, as also observed by Van Landuyt and others 23 and Ermis and others. 22 At the one-year recall, alpha scores for marginal integrity were 97.0% for restorations bonded with Single Bond 2. At the two-year recall, alpha scores for marginal integrity (marginal adaptation) were 97.5% for restorations bonded with Single Bond 2, Clearfil S3 Bond, and Optibond All-in-One.…”

“…However, clinical studies evaluating the clinical performance of the 1-SEAs are scarce. 1,2,[21][22][23][24] Because of those concerns, the objective of this study was to evaluate the clinical behavior of anterior composite restorations bonded with three 1-SEAs compared with their bonding behavior in a two-step etch-and-rinse adhesive system (2-ERA).…”