3-year clinical effectiveness of one-step adhesives in non-carious cervical lesions. Improving clinical retention of one-step self-etching adhesive systems with an additional hydrophobic adhesive layer Five-year clinical performance of a HEMA-free one-step self-etch adhesive in noncarious cervical lesions Clinical evaluation of three adhesive systems for the restoration of non-carious cervical lesions. Clinical evaluation of a nanohybrid and a flowable resin composite in non-carious cervical lesions: 24-month results. The clinical effectiveness of various adhesive systems: an 18-month evaluation. Three-year clinical performance of a HEMA-free one-step self-etch adhesive in non-carious cervical lesions. Two-year clinical comparison of a microfilled and a hybrid resin-based composite in non-carious Class V lesions. A randomized, controlled clinical trial of one-step self-etching adhesive systems in non-carious cervical lesions. A three-year clinical evaluation of a one-step self-etch and a two-step etch-and-rinse adhesive in non-carious cervical lesions. The clinical performance of one- and two-step self-etching adhesive systems at one year. Three-year clinical evaluation of One-Step in non-carious cervical lesions. 3-year clinical evaluation of modified Gluma adhesive systems in cervical abrasion/erosion lesions. An 18-months' evaluation of self-etch and etch & rinse adhesive in non-carious cervical lesions Five-year clinical evaluation of two adhesive systems in non-carious cervical lesions. Clinical evaluation of a resin-modified glass ionomer adhesive system: results at five years. One-year clinical evaluation of five single-step self-etch adhesive systems in non-carious cervical lesions.
OBJECTIVES Despite representing an important component of current dental adhesives , HEMA has been said to negatively influence the long-term stability of adhesion to dentine and enamel . The aim of this r and omised clinical trial was to evaluate the 3-year clinical performance of two one-step self-etch adhesives . METHODS Thirty patients had 175 non-carious cervical lesions restored with composite ( Gradia Direct Anterior , GC ) using either the HEMA-rich adhesive Clearfil Tri-S Bond ( C3S ; Kuraray ) or the HEMA-free adhesive G-Bond ( GB ; GC ) . The restorations were evaluated by two examiners at baseline , 6 , 12 , 24 and 36 months regarding retention , caries recurrence , marginal integrity and discoloration and post-operative sensitivity . The data were statistically analysed with GEE and McNemar tests ( p<0.05 ) . RESULTS The recall rate at 6 and 12 months was 100 % and decreased to 96.7 % at 24 and 36 months . At 3 years , the retention rate was 93.8 % for C3S and 98.8 % for GB ( p=0.14 ) . A pairwise comparison showed no significant differences between the two adhesives for all the parameters evaluated , irrespective of the recall ( p>0.05 ) . After 3 years , both adhesives presented an increase in the percentage of clinical ly acceptable marginal discoloration ( C3S : 32.9 % and GB : 26.8 % ) normally associated to clinical ly acceptable marginal defects ( C3S : 35.8 % and GB : 26.5 % ) . Only 1 dentine margin of a GB restoration presented a severe marginal defect ( 1.2 % ) and 1 C3S restoration presented caries recurrence . The overall 3-year clinical success rate was 92.6 % for C3S and 97.6 % for GB ( p=0.16 ) . CONCLUSION Both one-step self-etch adhesives presented an equally favourable clinical effectiveness at 3 years . CLINICAL SIGNIFICANCE HEMA is a monomer frequently present in dental adhesives in order to increase their wettability and hydrophilicity . However , this monomer negatively influences hydrolytic stability and durability of the adhesive interface complex . In this 3-year clinical trial no significant difference in bonding effectiveness was noticed between a HEMA-rich and HEMA-free one-step adhesive BACKGROUND The durability of restorations bonded with one-step self-etching ( OSSE ) adhesive systems is inferior compared with that of restorations bonded with conventional adhesives . The authors conducted an 18-month r and omized clinical study to evaluate the clinical performance of two OSSE systems in noncarious cervical lesions applied as recommended or with an extra layer of hydrophobic adhesive layer after 18 months of clinical service . METHODS Thirty participants , each of whom had at least two pairs of similar-sized noncarious cervical lesions , took part in this study . The authors placed 120 restorations  , 30 in each of four groups : Clearfil S3 Bond ( Kuraray , Osaka , Japan ) ( CS ) and iBond Gluma inside ( Heraeus Kulzer , Hanau , Germany ) ( IB ) , and Clearfil S3 Bond ( CSB ) and iBond Gluma inside ( IBB ) with an extra layer of hydrophobic adhesive applied on top of them . They placed the restorations incrementally , using a resin-based composite . The authors evaluated the restorations at baseline and at 18 months following modified U.S. Public Health Service criteria . RESULTS At 18 months , the retention rate for the IB group was statistically lower than those for the CS , IBB and CSB groups . Marginal discoloration occurred in all groups and was statistically worse in the IB group . CONCLUSIONS The conversion of the iBond Gluma inside and Clearfil S3 Bond adhesive systems into two-step systems by means of applying an extra hydrophobic adhesive layer improved the clinical performance of these material s after 18 months of clinical service . CLINICAL IMPLICATION S The application of an extra hydrophobic adhesive layer over OSSE adhesive systems , layers improved the OSSE systems clinical performance , mainly in terms of retention rate Objectives The objective of this r and omized controlled trial was to evaluate the clinical performance of a 2-hydroxyethyl methacrylate (HEMA)-free one-step adhesive . Material s and methods Two hundred sixty-seven cervical lesions in 52 patients were restored with the composite Gradia Direct ( GC ) , bonded with either the one-step self-etch adhesive G-Bond ( GC ) or the three-step etch- and -rinse adhesive Optibond FL ( Kerr ) in a r and om order . The restorations were evaluated for retention , marginal integrity , marginal discoloration , and caries occurrence after 5 years . Specific statistics were used to account for the clustered data ( multiple restorations per patient ) . Results The clinical success rate for G-Bond ( 87.4 % ) was not significantly different from that of Optibond FL ( 90.9 % ) . Both adhesives showed progressive marginal deterioration , but G-Bond exhibited more small enamel defects and marginal discoloration , and unlike previous recalls , several restorations failed because of deep microleakage . Large sclerotic lesions were a significant risk factor for retention loss with G-Bond . Irrespective of the adhesive , almost all restorations with retention loss were located in the lower jaw . Conclusion After 5 years of clinical service , restorations bonded with the HEMA-free one-step adhesive did not need repair or replacement more often than those with the three-step etch- and -rinse adhesive , and both adhesives had a high retention rate ( > 90 % ) . There were indications that G-Bond did not (self-)etch enough in some clinical situations , as G-Bond exhibited more incisal defects and marginal discolorations , and sclerotic lesions were at higher risk of retention loss . Clinical relevance The clinical performance of the HEMA-free one-step adhesive was clinical ly acceptable after 5 years The use of adhesive material s to restore non-carious cervical lesions ( NCCL ) has become the st and ard practice . Until recently , the most reliable material for restoring NCCL is glass ionomer cement , but the esthetics can be problematic . This study compared the retention of a self-etching adhesive , Clearfil SE Bond , with Clearfil ST resin composite ( SE ) , with the phosphoric acid-etch single bottle adhesive Single Bond with A110 resin composite ( SB ) and a resin-modified glass ionomer cement , Fuji II LC , ( FJ ) .  Ninety-two restorations in 20 patients ( mean age 61 years ) were placed . The teeth were restored r and omly and manufacturers ' instructions were followed . Patients were recalled at 6 months , 1 , 2 and 3 years and the restorations were evaluated for marginal staining . The restorations were photographed at baseline and at recall periods . At one year , 80 restorations were available for evaluation ; at 2 years , 65 restorations were evaluated and at 3 years , 55 restorations were evaluated . The cumulative retention rates at 1 year , 2 years and 3 years , respectively , were SE : 97 % , 93 % , 90 % ; SB : 86 % , 77 % , 77 % ; FJ : 100 % , 100 % , 97 % . At 3 years , RM-GIC performed the best , followed by Clearfil SE Bond/Clearfil ST . Single Bond/A110 's performance was significantly less than the other 2 material s ( p = 0.012 ) 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 The aim of this clinical trial was to compare the clinical performance of three different adhesive systems over 18 months in noncarious cervical lesions ( NCCLs ) . Thirty patients , with at least three noncarious cervical lesions , were enrolled in the study . One operator r and omly restored a total of 90 lesions with resin composite ( Herculite XRV ) . The restorations were bonded with either Optibond FL ( OF ) , three-step total-etch ; Optibond Solo Plus ( OS ) , two-step total-etch ; or Optibond All-In-One ( OA ) , one step self-etch . The restorations were clinical ly evaluated at baseline and after six , 12 , and 18 months using the eight United States Public Health Services criteria . Data were analyzed using Friedman and Wilcoxon signed ranks tests ( p<0.05 ) . After 18 months , the retention rate was ( OF ) 96.5 % , ( OS ) 93.1 % , and ( OA ) 89.7 % . Differences among the three adhesive systems for evaluated criteria were not observed in comparison of the mean Alfa score percentages . There was a significant increase in marginal discoloration for ( OA ) adhesive  after 18 months compared with baseline ( p=0.011 ) . Other restoration criteria had no statistically significant differences among the three adhesives ( p>0.05 ) . With the exception of marginal discoloration , the clinical effectiveness of three types of adhesive systems in NCCLs was acceptable after 18 months . However , using the one-step self-etch adhesive may lead to some marginal discolorations Despite the fact that one-step adhesives are currently used routinely in clinical practice , long-term studies on their clinical performance are scarce . The objective of this r and omized controlled clinical trial was to test the hypothesis that a 2-hydroxyethyl methacrylate (HEMA)-free one-step self-etch adhesive performs worse than a conventional multistep etch- and -rinse adhesive .  Two-hundred and seventy-six non-carious cervical lesions in 52 patients were restored with a micro-hybrid composite  ( Gradia Direct ; GC ) . These restorations were bonded in r and om order either with the HEMA-free one-step adhesive G-Bond ( GC ) or with the ' gold-st and ard ' ( control ) three-step adhesive Optibond FL ( Kerr ) . The restorations were evaluated after 6 , 12 , 24 , and 36 months of clinical service regarding retention , marginal adaptation , microleakage , caries occurrence , and sensitivity . After a medium-long period of 3 yr , similar success in clinical performance was observed for the simplified all-in-one adhesive and the conventional three-step adhesive . However , the one-step adhesive exhibited significantly more incisal marginal defects and discolorations . Whereas marginal degradation appeared to arrest for the multistep etch- and -rinse adhesive after 12 months , the enamel margins of the restorations bonded with the one-step self-etch adhesive continued to deteriorate . These incisal marginal defects were , however , small and could easily be removed by polishing . For both adhesives , large and sclerosed lesions appeared to be at higher risk of retention loss The purpose of this double-blind clinical trial was to compare the retention rate in noncarious Class V lesions of two resin-based composite restorative material s with contrasting stiffness . Isolation with retraction cord , pressed paper triangles , and cotton rolls was used to closely mimic the procedures generally used in a practice setting . Thirty pairs of restorations were placed , one using Silux Plus and one using Z100 . The assignment of material was r and omized , and the subjects were unaware of the material used . All restorations were placed with a fourth-generation adhesive liner , Scotchbond Multi- Purpose . Evaluations were performed at baseline , 6 , 12 , 18 , and 24 months by two independent examiners using criteria developed by Cvar and Ryge in a forced consensus model . Examiners were unaware of the restoration 's group identity . No difference between the retention rates for the two groups was found after 24 months , bringing into question the role that a material 's stiffness plays in determining retention in a noncarious Class V lesion PURPOSE To evaluate the clinical effectiveness of two different one-step self-etching adhesives . METHODS Two single-step self-etching adhesive systems , Clearfil Tri-S Bond and G-Bond , were evaluated . As a control , a two-step self-etching adhesive system , Clearfil SE Bond , was used . The teeth to be restored were r and omly assigned . The resin composite used to restore the teeth was Clearfil AP-X. The three adhesive systems were evaluated by Modified USPHS at baseline , 3 months , 6 months , and 12 months . The evaluation consisted of retention rate , color match , marginal discoloration ( interfacial staining ) , marginal adaptation ( integrity ) , wear , post-operative sensitivity , caries recurrence , and other failures . Changes over time and across groups were evaluated statistically using generalized estimating equations . RESULTS During the 12-month study period , no statistical differences were observed among the three groups ( P > 0.05 ) in retention rate , color match , marginal discoloration ( interfacial staining ) , marginal adaptation ( integrity ) . No wear , post-operative sensitivity , caries recurrence , or other failures were detected in any groups . The two one-step self-etching adhesives tested showed good clinical performance at the end of 12 months OBJECTIVES The aim of the study was to assess a one-step self-etch adhesive ( Futurabond M , 1-SE ) and a two-step etch- and -rinse adhesive ( Solobond M , 2-ER ) used in combination with the nano-hybrid composite ( Amaris ) in a prospect i ve clinical study on non-carious cervical lesions . METHODS 110 restorations were placed in 40 patients and grade d over 36 months according to aesthetical , functional and biological criteria ( Clinical Oral Investigations 2007;11:5 ) . The four-step etch- and -rinse adhesive Syntac classic ( 4-ER ) combined with the nano-hybrid composite Tetric EvoCeram was used as a control . Cumulative failure rates ( CFR ) , retention rates and Kaplan-Meier survival curves were calculated for each observation period . RESULTS After 3 years , the CFR of 33.3 % in the 2-ER group was significantly higher compared to those of the 1-SE group ( 9.1 % , p = 0.019 ) and of the 4-ER group ( 8.3 % , p = 0.035 ) . Additionally , retention rates in the 1-SE and the 4-ER groups were higher compared to 2-ER ( p = 0.012 each ) after 36 months . Annual failure rates ranged between 2.8 % for 4-ER , 3.0 % for 1-SE and 11.1 % for 2-ER . During the study , restorations in all groups showed progressive marginal deterioration within the limits of clinical acceptance . After 3 years , restorations in the 2-ER and the 4-ER group showed more small defects at dentin than at enamel margins . CONCLUSIONS The 1-SE group was clinical ly as successful as the 4-ER , with both performing better than the 2-ER group . Futurabond M/Amaris can be recommended for the restoration of sclerotic non-carious cervical lesions . CLINICAL SIGNIFICANCE Number protocol 192/2008 BACKGROUND The author compared the clinical performance of a two-step self-etching adhesive system and a one-step self-etching adhesive system over one year . METHODS Thirty-five patients with noncarious cervical lesions were enrolled in the study . The author restored 163 lesions using a two-step ( Clearfil Protect Bond , Kuraray , Osaka , Japan ) or a one-step ( Xeno III , Dentsply/DeTrey , Konstanz , Germany ) self-etching adhesive system . Enamel margins were not beveled , and no mechanical retentions were placed . The author evaluted the restorations at baseline and at three , six , nine and 12 months after placement using modified Ryge criteria for color-matching ability , marginal discoloration , marginal adaptation , initial caries formation , anatomical form , postoperative sensitivity and retention loss . RESULTS The author assessed the changes in the parameters using the Cochran Q test and the McNemar test at a significance level of .05 . At one year , the retention rates for the restorations in the two-step group were 100 percent ; they were 96 percent for the restorations in the one-step group . Of the retained 75 restorations from the one-step group , two had marginal discoloration and slight anatomical form problems . In both groups , color-matching ability and postoperative sensitivity remained excellent . CONCLUSION The performance of both self-etching adhesive systems was excellent during this one-year clinical trial . However , the two-step system exhibited slightly better retention than the one-step system . CLINICAL IMPLICATION S The one- and two-step self-etching adhesive systems evaluated in this study provided excellent clinical retention in noncarious lesions without mechanical retention 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 PURPOSE To study the clinical performance of two c and i date s for improvement of the original Gluma bonding system . MATERIAL S AND METHODS Eight teeth with cervical buccal abrasion/erosion lesions were identified in 40 patients . The lesions were conditioned with an oxalic acid solution followed by either a HEMA-glutaraldehyde bonding agent or a formamide-containing bonding agent . The lesions were restored with a hybrid composite . Each patient received the same number of restorations with the two different bonding formulations . All restorations were made by the same operator ( JK ) . Evaluations were based on the USPHS system . RESULTS No difference between the two groups as to retention , marginal adaptation and discoloration was observed after 3 years . Eight restorations were lost and a slight increase in marginal discoloration was seen during the observation period Objective . In this intra-individual comparison ( an 18-months ' r and omized , controlled prospect i ve study ) , we evaluated the clinical performance of one self-etch and one “ etch & rinse ” adhesive in non-carious cervical lesions . Methods . Twenty-five patients with at least two pairs of similar-sized non-carious cervical lesions participated . Seventy-eight restorations were placed ; 39 with etch & rinse ( Single-Bond ) and 39 with self-etch ( Adper Prompt ) . Both adhesives were combined with the microfilled resin composite Filtek-A110 . The restorations were evaluated at baseline , 6 , 12 , and 18 months according to slightly modified USPHS criteria . Statistical differences between the adhesives was tested with McNemar 's test and clinical degradation over time for each material with the Fisher exact test ( α=0.05 ) . Results . Thirty pairs were evaluated at 12 and 18 months . Two self-etch restorations were lost after 18 months . Nine Adper Prompt and four Single-Bond restorations scored bravo for marginal adaptation at 18 months ( p<0.05 ) . Nine Adper Prompt and three Single-Bond restorations scored bravo for marginal discoloration ( p<0.05 ) . Conclusions . Both adhesive systems showed acceptable clinical retention rates according to the ADA full acceptance criteria for enamel-bonding systems in class V non-carious lesions . The self-etch adhesive showed a faster progressive marginal degradation 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 One hundred non-carious , non-undercut cervical lesions were restored with Silux Plus or Estio LC and bonded with Fuji Bond LC . The restorations were evaluated yearly for retention and marginal discoloration . After five years , the overall retention rate was 96 % . Of the 41 restorations examined at five years , five had clinical ly evident marginal discoloration This study evaluated the clinical performance of five single-step self-etch adhesive systems over a one-year follow-up period in 98 restorations . Independent evaluations were performed at baseline ( one week ) , after three months , six months , and one year , by two trained examiners using the modified US Public Health Service rating criteria . Color match , marginal integrity , anatomical form , surface roughness , marginal or interfacial staining , postoperative sensitivity , and secondary caries were evaluated . Results were analyzed using the Kruskal-Wallis test at a significance level of p<0.05 . After one year , the restorations were re-evaluated and 100 % retention rate was recorded . No caries were detected in association with any of the restorations . Marginal adaptation was the only measure that showed a slight deterioration over time , and there were no significant differences in this factor among the adhesive systems tested ( p=0.464 )
RESULTS Comparison of retention of class-V adhesive restorations as a measure to determine clinical bonding effectiveness of adhesives revealed that glass-ionomers most effectively and durably bond to tooth tissue .
Three-step etch- and -rinse adhesives and two-step self-etch adhesives showed a clinical ly reliable and predictably good clinical performance .
The clinical effectiveness of two-step etch- and -rinse adhesives was less favourable , while an inefficient clinical performance was noted for the one-step self-etch adhesives .
SIGNIFICANCE Although there is a tendency towards adhesives with simplified application procedures , simplification so far appears to induce loss of effectiveness .
OBJECTIVES The purpose of this paper was to review current literature on the clinical effectiveness of contemporary adhesives when used to restore cervical non-carious class-V lesions .
Restoration retention in function of time was recorded in order to find out if adhesives with a simplified application procedure are as clinical ly effective as conventional three-step adhesives .