Restoring cervical lesions with flexible composites. Effect of resin viscosity and enamel beveling on the clinical performance of Class V composite restorations: three-year results. Three-year clinical evaluation of One-Step in non-carious cervical lesions. Five-year clinical evaluation of two adhesive systems in non-carious cervical lesions. Clinical evaluation of resin composite and resin-modified glass ionomer cement in non-carious cervical lesions. Clinical evaluation of a nanohybrid and a flowable resin composite in non-carious cervical lesions: 24-month results. Thirteen-year randomized controlled clinical trial of a two-step self-etch adhesive in non-carious cervical lesions. Noncarious cervical lesions restored with three different tooth-colored materials: two-year results. Two-year clinical evaluation of composite resins in non-carious cervical lesions Five-year clinical evaluation of One-Up Bond F in non-carious cervical lesions. Clinical performance of a resin-modified glass-ionomer and a compomer in restoring non-carious cervical lesions. 5-year results. Restorations in abrasion/erosion cervical lesions: 8-year results of a triple blind randomized controlled trial. Direct tooth-colored materials for noncarious lesions: a 3-year clinical report. Cervical compomer restorations: the role of cavity etching in a 48-month clinical evaluation. A clinical evaluation of a resin composite and a compomer in non-carious Class V lesions. A 3-year follow-up. Clinical performance of a self-etching adhesive at 18 months. Clinical performance of posterior composite resin restorations.
OBJECTIVES Flexure at the tooth cervix has been suggested to dislodge cervical restorations more rapidly . The objective of this r and omized controlled clinical trial was to test the hypothesis that a higher composite flexibility better withst and s tooth flexure stress . METHODS One hundred and forty-two non-carious cervical lesions were restored with composites with contrasting stiffness . Seventy-one patients r and omly received two cervical restorations  placed following two out of the three experimental groups : ( 1 ) the three-step etch- and -rinse adhesive Permaquick applied with the stiff micro-hybrid composite Amelogen Hybrid ( PMQ/A-Hy , Ultradent ) , ( 2 ) Permaquick applied with the more flexible micro-filled composite Amelogen Microfill ( PMQ/A-Mi , Ultradent ) , or ( 3 ) the ' golden st and ard ' three-step etch- and -rinse adhesive Optibond FL applied with the micro-hybrid composite Prodigy ( O-FL/Pro , Kerr ) . RESULTS The recall rate at 7 years was 80 % . No statistically significant difference was found for any of the parameters evaluated neither between both adhesives , nor between both composites ( McNemar , p>0.05 ) . Eleven percent of the O-FL/Pro restorations were clinical ly unacceptable due to loss of retention ( 5.5 % ) and severe marginal discoloration ( 5.5 % ) . In the PMQ-group , 22 % of the PMQ/A-Mi restorations ( 8 % loss of retention , 5 % severe enamel margin defects , 3 % severe dentin margin defects , 6 % severe marginal discoloration , 3 % extreme sensitivity ) and 19 % of the PMQ/A-Hy restorations ( 13 % loss of retention , 3 % severe enamel margin defects , 3 % severe marginal discoloration ) needed repair or replacement . SIGNIFICANCE The clinical performance of the three adhesive/composite combinations was good and reliable during the 7-year clinical trial . It was concluded that the composite stiffness does not affect the clinical longevity of cervical composite restorations This study evaluated the effect of the elastic modulus and margin configuration on the clinical performance of  resin-based composite restorations in Class V non-carious defects . One hundred and five cervical non-carious defects on buccal surfaces of canines and premolars were included in this study . Defects were r and omly divided into three Groups and restored according to the following techniques : Group 1 - -no enamel bevel was placed and the defect was restored with a microfilled resin-based composite ( Durafill VS ) ; Group 2 - -the enamel margin was beveled and the defect restored as in Group 1 ; Group 3-the enamel margin was beveled and the defect was restored with a flowable resin-based composite ( Natural Flow ) . Each group comprised 35 lesions . A total-etch , one-bottle adhesive ( One-Step ) was used in all groups . Retention rate , pre- and post-operative sensitivity , marginal discoloration and secondary caries were determined over a three-year period and the data were analyzed statistically . At six months post-insertion , the restorations placed with beveled enamel margins result ed in 100 % retention regardless of the composite used compared to a 66 % retention of the non-beveled margins . At two and three years , no significant difference in retention rate was found among the three groups . Post-operative sensitivity , marginal discoloration and secondary caries were not affected by enamel beveling and restorative material . Beveled enamel margins result ed in significantly better clinical retention in the first six months only . Enamel beveling and composite viscosity appeared to not significantly affect the clinical performance of Class V non-retentive composite restorations after three years PURPOSE To clinical ly evaluate the 3-year performance of a one-bottle dentin adhesive in the restoration of non-carious cervical lesions ( NCCLs ) with resin composite . MATERIAL S AND METHODS 105 NCCLs were restored with either AElite Flow , Bisco Glaze ( both flowable resin-based composites ) or Silux ( a microfilled resin-based composite ) , using One-Step dentin adhesive . The cavities were cleaned with pumice and water slurry , the dentin lightly roughened with a fine diamond bur , and the restorations placed according to the manufacturer 's instructions . Patients were recalled at 6 months , 1 year , 2 years and 3 years , and restoration integrity and marginal discoloration assessed . RESULTS The overall retention rates were : 6 months , 100 % ; 1 year , 95 % ; 2 years , 87 % ; 3 years , 75 % . Marginal discoloration was negligible , and there was no significant difference among the material s , although there was a trend for it to be greater around the Bisco Glaze restorations OBJECTIVE This controlled clinical trial evaluated the 5-year clinical performance of a self-etching primer system including selective enamel-etching with phosphoric acid and a one-bottle adhesive system . METHODS Seventy-two non-carious cervical lesions in 8 patients ( 4 male and 4 female ) with a mean age of 61.3 years ( range 45 - 78 ) participated in the study . An enamel bevel was placed and dentin lightly ground , and cavities restored with clearfil liner bond II ( LB ) or single bond ( SB ) in conjunction with a hybrid resin composite ( Clearfil AP-X ) . In the case of 27 cavities for LB , the enamel was pretreated with 37 % phosphoric acid for 10 s. Each patient received both types of restoration , which were distributed on a r and om basis . All restorations ( 37 restorations for LB and 35 restorations for SB ) were placed by one dentist . The restorations were evaluated blind after 5 years using modified USPHS criteria . The data were statistically analyzed using the Fisher 's exact test . RESULTS All but one restoration ( which was replaced by a crown after the 2-year recall ) were evaluated after 5 years . 100 % retention rates were recorded for both restorative groups . No caries was detected in association with any restorations . The only minor problem was marginal discoloration ; superficial and localized marginal discoloration occurred around 18 % of the restorations , and mainly at the dentin margin . There were no significant differences in the marginal integrity between the LB and SB groups . CONCLUSIONS Restorative material s used in this study demonstrated a good clinical effectiveness in the restoration of non-carious cervical lesions for 5 years BACKGROUND The clinical performance of various tooth-coloured material s used to restore Non-Carious Cervical Lesions ( NCCLs ) has been evaluated . However , most of these evaluations were in western societies where soft diets requiring little mastication were common . The present study sets out to evaluate resin composite and RMGIC in the restoration of NCCLs among a Nigerian sub population group with fibrous diet requiring more rigorous mastication . PATIENTS & METHODS The study included all adult patients that presented at the Dental Hospital , Obafemi Awolowo University Teaching Hospitals Complex , Ile-Ife , Nigeria with non-carious cervical lesions over a period of six months . The teeth with non-carious cervical lesions in each patient were allocated into treatment with either resin composite or resin-modified glass ionomer cement by simple r and om sampling using ballots . The depth of the NCCLs was measured using a graduated flat ash periodontal probe . All the treatment was done by the first author according to the manufacturer 's instructions . Patients were recalled and evaluated at 48- hours , 3- months , 6- months and 12- months using the USPHS criteria . Data analysis was done using SPSS version 15 . The level of significance was put at 0.05 . RESULTS At the end of 12 months , 143 resin composite and 144 RMGIC restorations were evaluated , out of which 37 resin composite and 13 RMGIC restorations were dislodged , giving a retention rate of 74.1 % and 91.0 % respectively . The difference was statistically significant ( p<0.05 ) . For marginal discolouration , marginal adaptation , abrasion wear resistance , post operative sensitivity , and secondary caries , there were no statistically significant differences in the performance of resin composite and RMGIC . There was more retention failure of both resin composite and RMGIC restorations in NCCLs in m and ibular teeth than in maxillary teeth . The differences were statistically significant ( p<0.05 ) . CONCLUSION RMGIC demonstrated a higher retention rate in the restoration of non-carious cervical lesions than resin composite over a period of 12 month PURPOSE To evaluate the 24-month clinical performance of  cervical restorations  using a nanohybrid and a flowable resin composite with a one-step self-etching adhesive . MATERIAL S AND METHODS Twenty-one patients with at least one pair of non-carious cervical lesions participated in this study . A total of 134 non-carious cervical lesions were restored ( 67 with a nanohybrid resin composite , Gr and io ; 67 with a flowable resin composite , Gr and io Flow ) using a one-step self-etching adhesive system , Futura Bond NR , by one dentist . The restorations were evaluated for retention , color match , marginal discoloration , marginal adaptation , surface texture , anatomic form , and secondary caries by two calibrated examiners at baseline and after 6 , 12 , and 24 months using modified USPHS criteria . The survival rates of the restorations were calculated by the Kaplan-Meier estimator . The comparison of resin composites for each category was performed with the Pearson chi-square test , and the performance of restorations at baseline and after each recall time was evaluated using McNemar 's test ( p < 0.05 ) . RESULTS All patients attended the 24-month recall . The retention rates at 6 months were 66 % and 58 % , and 61 % and 57 % at 12 months for Gr and io and Gr and io Flow , respectively . At the 24-month recall , the retention rate was 60 % for Gr and io and 54 % for Gr and io Flow . No statistically significant differences were found in retention rates among the restorative material s in any evaluation period ( p > 0.05 ) . For marginal discoloration and anatomical form , three Gr and io and three Gr and io Flow restorations showed Bravo scores at the end of 24 months . The restorations in both groups had Alfa ratings of 100 % for the rest of the criteria evaluated . CONCLUSION The nanohybrid and flowable resin composites showed similar clinical performances in the restoration of non-carious cervical lesions over 24 months OBJECTIVE The objective of this r and omized controlled clinical trial was to evaluate the 13-year clinical performance of a mild two-step self-etch adhesive in non-carious cervical lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins . METHODS A total of 100 non-carious cervical lesions in 29 patients were restored with Clearfil AP-X ( Kuraray Noritake ) . The composite restorations were bonded following two different approaches : ( 1 ) application of Clearfil SE Bond ( Kuraray Noritake ) following a self-etch approach ( CSE-NE ) ; ( 2 ) selective phosphoric acid-etching of enamel cavity margins before application of Clearfil SE Bond ( CSE-E ) . The restorations were evaluated after 6 months , 1 , 2 , 3 , 5 , 8 and 13 years of clinical service regarding retention , marginal integrity and discoloration , caries occurrence , preservation of tooth vitality and post-operative sensitivity . RESULTS The patient recall rate at 13 years was 62 % . Six restorations , 4 of the CSE-NE group and 2 of the CSE-E group , were clinical ly unacceptable due to loss of retention ( 1 CSE-NE , 1 CSE-E ) , a severe marginal defect ( 2 CSE-NE , 1 CSE-E ) and caries occurrence in combination with a severe marginal defect ( 1 CSE-NE ) leading to a clinical success rate of 86 % ( CSE-NE ) and 93 % ( CSE-E ) . Ageing of the restorations was characterized by a further increase in the percentage of restorations with a clinical ly acceptable small marginal defect ( CSE-NE : 87 % ; CSE-E : 83 % ) and /or superficial marginal discoloration ( CSE-NE : 53 % ; CSE-E : 56 % ) . The presence of small marginal defects ( CSE-NE : 86 % ; CSE-E : 68 % ) and superficial marginal discoloration ( CSE-NE : 41 % ; CSE-E : 20 % ) at the incisal enamel side was more frequently noticed in the CSE-NE group than in the CSE-E group . The difference , however , was not statistically significant ( McNemar , p>0.05 ) . SIGNIFICANCE After 13 years , the clinical effectiveness of Clearfil SE Bond in non-carious Class-V lesions remained excellent , with selective acid-etching of the enamel cavity margins only having some minor positive effect on marginal integrity and absence of marginal discoloration INTRODUCTION The aim of this two-year prospect i ve clinical study was to evaluate and compare the clinical performance of three different adhesive esthetic material s in noncarious cervical lesions . MATERIAL AND METHODS A total of 90 restorations ( 30 per material ) were placed in 30 patients who ranged in age between 18 and 50 years and of both genders , by a single operator with no previous preparation . The restoration of noncarious cervical lesions was done with either a microfilled composite ( Esthet . X/Dentsply/De Trey , Konstanz , Germany , and Prime&Bond NT/Dentsply/De Trey ) , a nanohybrid composite ( TetricEvoCeram/Vivadent , Schaan , Liechtenstein , and AdheSE/Vivadent ) , or a compomer ( Dyract eXtra/Dentsply/De Trey and Xeno III Dentsply/De Trey ) . All restorations were evaluated by independent examiners using a modified US Public Health Service criteria at baseline and after 12 and 24 months for six clinical categories . Data were analyzed statistically by Pearson 's chi-square or the Fisher 's exact test at 5 % significance level ( p<0.05 ) . RESULTS Results showed that most of the restorations were clinical ly satisfactory after 12 and 24 months , with no statistically significant differences among the three groups for all evaluated criteria . CONCLUSION Treatment of noncarious cervical lesions using composite and compomer material s , combined with the appropriate adhesive systems and properly implemented restorative procedures , gives satisfactory results after a two-year evaluation period Objective The purpose of this double-blind , r and omised trial was to compare the clinical performance of a hybrid composite ( Clearfil AP-X , Kuraray , Tokyo ) and a nanocomposite ( Filtek Z350 , 3 M ESPE , St. Paul , MN ) over a period of 2 years in non-carious class V lesions using a modified US Public Health Service ( USPHS ) system . Methods Forty-six patients with at least one pair of equivalent non-carious cervical lesions under occlusion and a mean age of 44.1 years ( range 27–66 years ; median 45 years ) were enrolled in this study . A total of 116 restorations ( 58 with each material ) were placed according to manufacturer 's instructions by two calibrated operators . The restorations were evaluated at baseline and at 6 , 12 and 24 months after placement using the USPHS criteria for retention , colour match , marginal discolouration , marginal adaptation , anatomic form , surface texture and secondary caries . Statistical analysis was conducted using the Cochran and the McNemar tests at a significance level of 5 % ( P < 0.05 ) . Results No surface texture changes or secondary caries were detected in association with any restorations . The retention rates for Clearfil AP-X ( 100 % ) and for Filtek Z350 ( 91.38 % ) did not differ significantly ( P > 0.05 ) . Two Z350 restorations were completely lost after 2 years . No significant differences were observed in the colour match , marginal discolouration , marginal adaptation or anatomic form . Conclusions There were no significant differences in the clinical performances between the material s. Clinical relevance Both restorative material s exhibited acceptable clinical performance in class V non-carious lesions 2 years post-restoration PURPOSE To evaluate the retention and marginal staining of restorations placed in non-carious cervical lesions using the all-in-one self-etching system , One-Up Bond F and Palfique Estelite resin composite . METHODS Fifty-one non-undercut non-carious cervical lesions received restorations with One-Up Bond F and Palfique Estelite in 15 subjects ( mean age 57.7 years ) by one operator . Teeth were cleaned with pumice and water , restored following the manufacturer 's instructions and evaluated at 6 months , 1 , 2 , 4 and 5 years for retention and presence of marginal staining . RESULTS At 1 year , 42 restorations were evaluated , and all were intact with three restorations showing slight marginal staining . At 2 years , 37 restorations were evaluated from 11 subjects , and all were intact . Marginal staining was observed around nine restorations . At 4 years , 27 restorations and at 5 years , 24 restorations could be evaluated . Marginal staining showed a significant increase at the enamel and cervical margins over the 5 years of the study , with two restorations showing severe , nine mild and 13 no staining . Although a number of restorations could not be evaluated , the retention rate of 92 % at 5 years showed One-Up Bond F/Palfique Estelite resin composite for the restoration of non-carious cervical lesions produced an excellent outcome . Marginal staining was limited to a small number of subjects and is unlikely to be a problem if margins are refurbished at recall visits PURPOSE To evaluate the 5-yr clinical performance of a resin-modified glass-ionomer cement and a polyacid-modified resin composite in restoring non-carious cervical lesions . MATERIAL S AND METHODS Non-carious cervical lesions in 46 incisors , canines , and premolars were restored either with Fuji II LC  ( n=18 ) or with  Dyract ( n=28 ) in 16 healthy patients . The lesions were restored without cavity preparation strictly according to the manufacturer 's instructions . The restorations were clinical ly evaluated single blind after 5 yrs using modified USPHS criteria . RESULTS The percentage of Alfa ratings were as follows ( Dyract/Fuji II LC ) : color match 81.3%/28.6 % , surface texture 93.8%/21.4 % , anatomic form 75.0%/28.6 % , marginal integrity ( enamel ) 62.5%/42.9 % , marginal integrity ( dentin ) 68.8%/28.6 % , marginal discoloration ( enamel ) 56.3%/42.9 % , marginal discoloration ( dentin ) 68.8%/21.5 % . Five-yr data revealed a significant difference between the clinical ratings of Dyract and Fuji II LC for all criteria except marginal integrity and marginal discoloration in enamel . A total of five Dyract restorations and four Fuji II LC restorations failed within the study period . CLINICAL SIGNIFICANCE A considerably high and almost similar overall failure rate was found for both restorative material s in restoring non-carious cervical lesions . However , retained Dyract restorations presented superior clinical performance compared to Fuji II LC restorations PURPOSE An equivalence r and omized controlled trial within the subject was organized to evaluate the clinical long-term success of a new 2-step etch & rinse adhesive and a new nano-filled ormocer . METHODS 50 subjects , 21 males and 29 females aged between 21 and 65 , were r and omized to receive 150 restorations , 100 with the new restorative material , 50 with the composite as control , placed in non-carious cervical lesions with the same bonding system . The main outcome measure was the cause of failure at 8 years . R and omization was number table-generated , with allocation concealment by opaque sequentially numbered sealed and stapled envelopes . Subjects , examiner , and analyst were blinded to group assignment . Two interim analyses were performed . Data were analyzed by ANOVA and Cox test ( P < 0.05 ) . RESULTS After 8 years , 40 subjects and 120 teeth were included in the analysis of the primary outcome . There were eight failures in the experimental group and four failures in the control group . The cumulative loss rate was 7 % for both restorative material s , with the annual failure lower than 1 % , without any statistically significant difference . There were two key elements of failure : the presence of sclerotic dentin and the relationship between lesion and gingival margin One hundred fifty-nine noncarious cervical lesions were restored with glass-ionomer cement , resin composite used with a dentinal bonding agent , or the laminate ( s and wich ) restoration , which combines both these material s. These restorations were evaluated at baseline , 1 year , and 3 years for color match , cavosurface marginal discoloration , anatomic form , marginal adaptation , and retention . There was a general deterioration of the restorations with time . Lesions restored with resin composite and a dentinal bonding agent exhibited the highest percentage of lost restorations Compomers are defined as polyacid-modified resin composites . They are supposed to combine the advantages of traditional glass-ionomer cements with resin composites . This study clinical ly evaluated a compomer in cervical cavities . Sixty cervical cavities in premolars and molars ( 24 with cervical caries and 36 with abrasions ) r and omly divided into two groups of 30 teeth ( Group 1 and Group 2 ) were restored with Dyract  ( DeTrey-Dentsply , York , PA 17405 - 0872 ) . The cavities of Group 2 were etched for 30 seconds with orthophosphoric acid before compomer application , while the Group 1 cavities received no treatment . All the restorations were evaluated every six months , up to 48 months : characteristics assessed according to USPHS-modified st and ards were retention , secondary caries , post-operative sensitivity , marginal adaptation and discoloration , color and wear . The Kaplan-Meier 's survival analysis was performed . In both groups , retention was high without any statistically significant difference . No difference was found between the two groups for caries , post-operative sensitivity and wear -- that all had a low incidence . Color was not perfectly matched , however , there was no statistically significant difference between the two groups . Marginal discoloration and marginal adaptation loss were significantly higher in non-etched group ( p < 0.05 ) . Clinical ly relevant failure required 17.2 % of restorations in the non-etched group and 10 % in the etched group to be replaced : this difference was not statistically significant . Dyract has an acceptable clinical behavior when used in cervical cavities . Its marginal adaptation is enhanced by etching PURPOSE To compare the clinical performance of a resin composite and a polyacid-modified resin composite ( compomer ) in non-carious cervical lesions using a one-step self-etch adhesive . METHODS Thirty patients , each with two non-carious cervical lesions ( 60 restorations ) , received one composite ( Pertac-II ) restoration and one compomer ( Hytac ) restoration , both used in conjunction with a self-etch adhesive ( Prompt L-Pop ) and placed following the manufacturer 's instructions . Evaluations were at baseline , 6 , 12 and 36 months after placement for retention , margin adaptation , marginal discoloration , anatomic form , secondary caries and postoperative sensitivity . Statistical analysis with the Pearson Chi-square test was undertaken . RESULTS Retention rates were 86.6 % for composite and 86.7 % for compomer at 36 months . 3.3 % of composite and 6.7 % of compomer restorations showed a deficiency in marginal adaptation . Both material s showed a slight marginal discoloration of 7.7 % . More deterioration in anatomic form occurred with the compomer ( 11.5 % ) than the composite ( 3.8 % ) . None of the restorations exhibited secondary caries or postoperative sensitivity problems . There was no significant difference in performance between the material s in any of the categories evaluated PURPOSE To test the null hypothesis that beveling and /or etching enamel would not affect the 18-month clinical performance of the self-etching adhesive Clearfil SE Bond ( CSEB ) in noncarious cervical lesions ( NCCL ) . METHODS With Institutional Review Board approval , 34 patients were enrolled in this study . A total of 120 NCCL was selected and assigned to four groups : ( 1 ) CSEB was applied without any cavity preparation ; ( 2 ) CSEB was applied after beveling enamel ; ( 3 ) CSEB was applied after etching enamel for 15 seconds with 35 % phosphoric acid ; ( 4 ) CSEB was applied after beveling and etching enamel . A microfilled composite resin was used for all restorations . RESULTS At 6 months after initial placement , 120 restorations ( a 100 % recall rate ) were evaluated . At 18 months , 87 restorations ( a 72.5 % recall rate ) were available for evaluation . A survival rate of 100 % was measured for all groups at both 6 and 18 months . Sensitivity to air decreased significantly only for Group 3 ( no bevel+acid etch ) from baseline to 18 months without statistical changes from 6 months to 18 months . None of the other parameters result ed in significant differences for any of the four groups . However , when data were pooled , both the overall marginal discoloration and the overall marginal adaptation were significantly worse at 18 months than at baseline , while sensitivity to air decreased significantly from baseline to 18 months . The 18-month survival rate of the self-etching adhesive Clearfil SE Bond was not improved by enamel bevel or by enamel etching . Both overall marginal adaptation and overall marginal discoloration were worse at 18 months than at baseline . Two formulations of posterior composite resin ( P-30 and Bisfil-P ) were evaluated and compared to a high-copper , dispersed-phase amalgam ( Dispersalloy ) .  One hundred twenty-eight restorations were placed in 27 patients so that each patient received at least one of each material . After 3 years of clinical service , all three restorative material s produced clinical ly acceptable restorations , according to US Public Health Service and Leinfelder criteria . The amalgam restorations , however , underwent less wear ( 44 microns ) than did the posterior composite resin restorations ( 60 to 74 microns ) . Stratification of data by type of tooth , class of restoration , and size of restoration produced the same ranking of wear from lowest to highest : Dispersalloy , Bisfil-P , and P-30 . Resin restorations showed 45 % more wear in molars than in premolars , and more wear was associated with moderately sized restorations than with conservative restorations . The surface texture of restorations of composite resin with porous strontium glass filler was nearly as smooth as that of enamel and was significantly smoother than that of the restorations of composite resin with zinc glass filler or of unpolished amalgam
There is not enough evidence to support the bevelled technique over non-bevelled for NCCLs over longer periods of time .
OBJECTIVES To identify if enamel bevelling , compared to no treatment , improves the retention rates and marginal discolouration of cervical composite restorations in non-carious cervical lesions ( NCCLs ) of adult patients , through a systematic review of the literature and meta- analysis .