A three-year clinical evaluation of two-bottle versus one-bottle dentin adhesives.

BACKGROUND: The authors conducted an in vivo investigation to compare the clinical performance of two commercial one-bottle adhesives and a two-bottle adhesive for restoration of noncarious cervical lesions (NCCLs). METHOD: The patient pool consisted of 57 patients and 171 teeth (three teeth per patient), with one NCCL per tooth. Each patient received three resin-based composite restorations, each with a different adhesive: one tooth with a two-bottle, water-based adhesive as the control; another tooth with a one-bottle, ethanol-based adhesive; and a third tooth with a one-bottle, solvent-free adhesive. The authors assessed restorations in terms of retention, marginal integrity, margin discoloration and air sensitivity at baseline, six months, one year, two years and three years after initial placement. RESULTS: The retention rates at 36 months were 88 percent for the first adhesive, 81 percent for the second adhesive and 90 percent for the third adhesive. No statistically significant differences in retention rates could be shown, with 86 percent of restorations retained overall. Measures of marginal integrity, marginal discoloration and sensitivity also had no statistically significant differences between the three adhesives (P > .05). CONCLUSIONS: All three adhesives performed with acceptable outcomes after a 36-month period, with small differences between the one- and two-bottle systems and between the various solvents. Retention rate was moderately high and air sensitivity was markedly reduced; however, superficial marginal discoloration and marginal degradation was notable. Certain lesion, tooth and patient characteristics may predispose restorations to retention failure. CLINICAL IMPLICATIONS: The type of solvent may not be a major factor in retention of Class V restorations in NCCLs. Both single-bottle adhesives and conventional two-bottle adhesives performed acceptably.

One-year clinical evaluation of an ethanol-based and a solvent-free dentin adhesive.

PURPOSE: To analyze the clinical performance of adhesives with various solvents for restoration of non-carious cervical lesions. METHODS: The patient pool consisted of a total of 57 patients and 171 teeth (3 teeth per patient), with one non-carious cervical lesion per tooth. For each patient, one tooth was restored with a water-based, two-bottle adhesive (Scotchbond Multi-Purpose - SM), and another tooth with an ethanol-based, one-bottle adhesive (Single Bond - SB), and the other tooth with a solvent-free, one-bottle adhesive (One Coat Bond - OCB), all with resin-based composites (Silux Plus or Synergy). Restorations were assessed by retention, marginal integrity, margin discoloration and air sensitivity, according to modified USPHS criteria. The evaluations were performed at baseline, 6 months and 12 months after initial placement. RESULTS: The retention rates at 12 months were 98% for the SM adhesive, 91% for the SB adhesive, and 93% for the OCB adhesive. The differences in retention rates were not statistically significant, with 94% restorations retained overall. Measures of marginal integrity, marginal discoloration and sensitivity also had no statistically significant differences between the three adhesives. Overall, for the restorations still retained after 12 months, 80% had non/slightly detectable margins, 80% had no marginal discoloration and 90% had none/mild sensitivity. All three adhesives performed comparably with excellent outcomes after a 12-month period, with no significant differences between the water-based, ethanol-based and solvent-free adhesives, nor between the one-and two-bottle systems. Retention rate was high, air sensitivity was markedly reduced, and marginal integrity was good. Although superficial marginal discoloration was notable, no deep staining was evident. Certain lesion, tooth and patient characteristics may predispose restorations to retention failure.

Wettability, imbibition, and mass change of disinfected low-viscosity impression materials.

STATEMENT OF PROBLEM: There is an ongoing effort by dental manufacturers to create impression materials with improved wetting properties. Disinfection solutions may alter the surface characteristics of these newer materials. PURPOSE: This study compared wettability, imbibition, and mass change of various recently introduced automixed low-viscosity addition silicone and polyether materials before and after immersion disinfection. MATERIAL AND METHODS: The Wilhelmy technique was used for deriving wetting properties of 5 addition silicone materials (Clinician's Choice Affinity, Clinician's Choice Superhydrophilic [experimental], Kerr's Take One, 3M's Imprint II, and Dentsply's Aquasil LV) and 2 polyether materials (ESPE's Permadyne Garant and Impregum Garant). Conditions included a control with no disinfection (0 hours), as well as (1/2) hour of immersion disinfection in a full-strength solution of 2% acid glutaraldehyde disinfectant (Banicide). Weight changes before and after disinfection and weight loss in air were measured over an 18-hour period to detect imbibition and mass change over time. The data were analyzed with a 1-way analysis of variance at alpha=0.05, with n = 3 for advancing (ACA) and receding (RCA) contact angles and n = 2 for imbibition and mass change. RESULTS: Statistical significant differences in wettability (P<.001) were found among nondisinfection control groups, as well as among (1/2)-hour disinfection groups. Polyethers were the most wettable materials overall. Impregum Garant polyether demonstrated significantly lower RCA for the control (48.4 degrees) and at (1/2) hour of disinfection (51.8 degrees). The 2 polyethers and Take One lost mass, whereas Aquasil LV gained mass in air; however, all materials exhibited some degree of imbibition during disinfection. CONCLUSION: Within the limitations of this study, the 2 polyether materials tested exhibited significantly lower ACA's and RCA's compared with the 5 addition silicones tested. Imbibition for the 2 polyether materials was significantly higher (P<.001). Polyether materials lost significantly more (0.6% to 0.8%) and Aquasil LV gained significantly more (0.6%) mass in air.

Characteristics of noncarious cervical lesions: a clinical investigation.

BACKGROUND: The purpose of the authors' in vivo investigation was to analyze the characteristics of noncarious cervical lesions, or NCCLs, in adult patients who had a high incidence of them. METHODS: The patient pool consisted of a total of 57 patients and 171 teeth (three teeth per patient), with one NCCL per tooth. The characteristics the authors evaluated were shape, dimensions, sensitivity, sclerosis and occlusion. RESULTS: In terms of lesion characteristics, 91 percent of the lesions had axial depths of 1 to 2 millimeters, 49 percent had occlusogingival widths of 1 to 2 mm, 74 percent had an angular shape of 45 to 135 degrees, 76 percent had mild or moderate sclerosis, and 73 percent had no or mild sensitivity. In terms of occlusion, 75 percent of teeth had an Angle Class I occlusion on the involved side, 60 percent had group function or mixed excursive guidance, 82 percent had wear facets, and 99 percent had Type 0 or I mobility. In terms of tooth location, 70 percent of NCCLs were on posterior teeth, 65 percent were on maxillary teeth, and 46 percent were on premolars. CONCLUSIONS: The evaluated NCCLs were found mainly to have small dimensions of depth and width (< 2 mm) and to be roughly right-angled in shape, and many had sclerosis and low sensitivity. A majority of the dentitions studied had Class I occlusion, with group function, prevalent wear facets, and little or no mobility. Cervical lesions were more common with posterior maxillary teeth and premolars, especially first premolars, which had the highest prevalence of lesions. Older patients were more likely to exhibit noncarious cervical lesions, but no great difference in incidence was found between men and women. Clinical Implications. A knowledge of the NCCL characteristics and etiologic covariables aids in proper case selection for treatment, aids in selection of appropriate treatment protocols and improves assessment of prognosis.