Five-year clinical evaluation of a universal adhesive: A randomized double-blind trial.

OBJECTIVE: To evaluate the five-year clinical performance of Scotchbond Universal Adhesive (SU; 3M Oral Care, St. Paul, MN, USA) in non-carious cervical lesions (NCCLs) using two evaluation criteria. METHODS: Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-ERm: etch-and-rinse + moist dentin; SU-ERd: etch-and-rinse + dry dentin; SU-Set: selective enamel etching; and SU-SE: self-etch. A nanofilled composite resin was placed incrementally. The restorations were evaluated at baseline and after 5 years using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. The survival rates (retention/fractures) were calculated with the Kaplan-Meier and the log-rank test. For the secondary outcomes, Friedman repeated measures analysis of variance by rank was applied (α = 0.05). RESULTS: After 5 years the recall rate was 86%. The retention/fracture rates were 93% for Erm and ERd, 88.4% for SEet and 81.4% for SE. A significant difference was observed for SE vs. ERd and SE vs. ERm (p = 0.01). Also, marginal discoloration and adaptation showed significant differences with ERm and ERd resulting in fewer marginal discrepancies than SE (p < 0.05). SIGNIFICANCE: After 5 years, the clinical behavior of the universal adhesive in the etch-and-rinse strategy was better when compared to the self-etch strategy. The use of selective enamel etching is highly recommended for the self-etch strategy. The FDI and USPHS evaluation criteria showed similar results after 5 years.

Longevity of indirect restorations cemented with self-adhesive resin luting with and without selective enamel etching. A Systematic review and meta-analysis.

OBJECTIVE: To investigate the influence of the selective etching in the survival rates of indirect restorations cemented with self-adhesive resin luting. MATERIALS AND METHODS: The eligibility criteria were formulated based on PICOS strategy. The search without restrictions was performed in PubMed/Medline, the Cochrane Library, Web of Science, Scopus, LILACS databases and gray literature until May 2018. Cochrane Collaboration's tool was performed for assessing the risk of bias. According to the bias risk analysis, the studies were classified as low risk of bias and high quality of evidence. The systematic review was conducted according to PRISMA and registered in PROSPERO (CRD42018091202). The meta-analysis was performed using RevMan 5.3 software (RevMan, Copenhagen, Denmark) and the risk ration and confidence interval was obtained (p < 0.05). RESULTS: After database screening, removal of duplicates and eligibility criteria application, two studies were selected for this systematic review, with 65 participants (34 in one and 31 in the other). The pooled meta-analysis demonstrated no statistically significant difference in clinical longevity for selective etching in indirect restorations (P > .05; I2 = 0%) and risk ratio of 0.46 [0.19-1.09]. CONCLUSIONS: Based on the findings, the results of this systematic review suggest that the selective enamel etching prior to application of self-adhesive luting cements systems for indirect restoration do not influence the clinical longevity of indirect restorations. CLINICAL SIGNIFICANCE: The knowledge of the clinical steps of adhesive procedures is fundamental to the success of adhesive restorations and their longevity. Self-adhesive resin cements simplify the luting procedure of indirect restorations. However, adding a step that could significantly improve long-term survival would be of great value. Thus, the results of this systematic review will provide data so that the decision making regarding materials used for adhesive cementation is conducted based on scientific evidence.

Selective enamel etching in cervical lesions for self-etch adhesives: A systematic review and meta-analysis.

OBJECTIVES: To identify if selective etching of enamel (SEE) margins improves the retention rates and marginal discoloration of cervical composite restorations in non-carious cervical lesions (NCCLs) of adult patients. SOURCE: MEDLINE, Scopus, Web of Science, LILACS, BBO Library, Cochrane Library and SIGLE were searched without restrictions, as well as IADR abstracts and gray literature via trial registries. Dissertations and theses were searched using the ProQuest Dissertations and Periódicos Capes Theses databases. STUDY SELECTION: We included randomized clinical trials that compared the clinical effectiveness of SEE using the self-etch adhesive for direct composite resin restorations in NCCLs in the permanent dentition. DATA: After removal of duplicates, 2689 articles were identified. Following screening of abstracts, 10 studies remained in the qualitative synthesis. Seven were considered to be at "low" risk of bias. The report of the studies varied from 1 to 5 years. Except for one-year follow-up, there was a significantly lower marginal discoloration and marginal adaptation during all follow-up periods. Significantly less loss of retention of restorations at the 3-year follow-up was observed with the selective enamel etching technique. CONCLUSIONS: Selective enamel prior to application of self-etch adhesive systems in NCCLs might improve clinical performance of resin-composite cervical restorations, although further long-term research is required to confirm this. CLINICAL SIGNIFICANCE: Selective enamel etching prior to application of self-etch adhesive systems in NCCLs can produce composite restorations with higher longevity.

Tensile bond strength and SEM analysis of enamel etched with Er:YAG laser and phosphoric acid: a comparative study In vitro

Er:YAG laser has been studied as a potential tool for restorative dentistry due to its ability to selectively remove oral hard tissue with minimal or no thermal damage to the surrounding tissues. The purpose of this study was to evaluate in vitro the tensile bond strength (TBS) of an adhesive/composite resin system to human enamel surfaces treated with 37 percent phosphoric acid, Er:YAG laser (lambda=2.94 mum) with a total energy of 16 J (80 mJ/pulse, 2Hz, 200 pulses, 250 ms pulse width), and Er:YAG laser followed by phosphoric acid etching. Analysis of the treated surfaces was performed by scanning electron microscopy (SEM) to assess morphological differences among the groups. TBS means (in MPa) were as follows: Er:YAG laser + acid (11.7 MPa) > acid (8.2 MPa) > Er:YAG laser (6.1 MPa), with the group treated with laser+acid being significantly from the other groups (p=0.0006 and p= 0.00019, respectively). The groups treated with acid alone and laser alone were significantly different from each other (p=0.0003). The SEM analysis revealed morphological changes that corroborate the TBS results, suggesting that the differences in TBS means among the groups are related to the different etching patterns produced by each type of surface treatment. The findings of this study indicate that the association between Er:YAG laser and phosphoric acid can be used as a valuable resource to increase bond strength to laser-prepared enamel.

A tecnologia a laser tem sido estudada como uma ferramenta potencial para uso em odontologia devido à sua habilidade em remover tecido ósseo com um mínimo ou nenhum dano aos tecidos vizinhos. O objetivo deste estudo é comparar in vitro a resistência à tração do sistema adesivo em esmalte tratado com ácido fosfórico a 37 por cento, laser Er:YAG (lambda=2,94 mim) com energia total de 16 J (80 mJ/pulso, 2 Hz, 200 pulsos e largura de pulso de 250 ms) e com a combinação laser Er:YAG seguido por ácido fosfórico. O teste de resistência à tração foi usado para comparar a resistência à tração em cada grupo. Foi também realizada microscopia eletrônica de varredura para permitir a análise das diferenças morfológicas entre os grupos. Foram obtidos os seguintes valores médios de resistência para os grupos tratados com: laser (6,1 MPa), ácido fosfórico (8,2 MPa) e laser mais ácido (11,7 Mpa). Amostras tratadas com laser e ácido apresentaram valores maiores de resistência do que amostras com laser ou ácido isoladamente. A análise da microscopia eletrônica revelou diferenças que corroboram os resultados, demonstrando que diferenças de resistência entre os grupos são devidas às diferenças entre os padrões superficiais resultantes. Nossos resultados sugerem que a combinação do laser Er:YAG com ácido fosfórico pode ser usada como um método para aumentar a resistência à tração do sistema esmalte resina.