Jassal M, Mittal S, Tewari S
Oper Dent. 2018 Nov/Dec;43(6):581-592. doi: 10.2341/17-147-C. Epub 2018 May 21.
: To evaluate the clinical effectiveness of two methods of application of a mild one-step self-etch adhesive and composite resin as compared with a resin-modified glass ionomer cement (RMGIC) control restoration in noncarious cervical lesions (NCCLs).
: A total of 294 restorations were placed in 56 patients, 98 in each one of the following groups: 1) G-Bond active application combined with Solare-X composite resin (A-1SEA), 2) G-Bond passive application combined with Solare-X composite resin (P-1SEA), and 3) GC II LC RMGIC. The restorations were evaluated at baseline and after six, 12, and 18 months according to the FDI criteria for fractures/retention, marginal adaptation, marginal staining, postoperative sensitivity, and secondary caries. Cumulative failure rates were calculated for each criterion at each recall period. The effect of adhesive, method of application, and recall period were assessed. The Kruskal-Wallis test for intergroup comparison and Friedman and Wilcoxon signed ranks tests for intragroup comparison were used for each criterion ( α=0.05).
: The retention rates at 18 months were 93.26% for the A-1SEA group, 86.21% for the P-1SEA group, and 90.91% for the RMGIC group. The active application improved the retention rates compared with the passive application of mild one-step self-etch adhesive; however, no statistically significant difference was observed between the groups. Marginal staining was observed in 13 restorations (1 in A-1SEA, 4 in P-1SEA, and 8 in RMGIC) with no significant difference between the groups. The RMGIC group showed a significant increase in marginal staining at 12 and 18 months from the baseline. There was no significant difference between the groups for marginal adaptation, secondary caries, or postoperative sensitivity.
: Within the limitations of the study, we can conclude that mild one-step self-etch adhesive followed by a resin composite restoration can be an alternative to RMGIC with similar retention and improved esthetics in restoration of NCCLs. Agitation could possibly benefit the clinical performance of mild one-step self-etch adhesives, but this study did not confirm that the observed benefit was statistically significant.
评估在非龋性颈部病变（NCCLs）中，与树脂改性玻璃离子水门汀（RMGIC）对照修复体相比，两种应用温和型一步自酸蚀粘结剂和复合树脂方法的临床效果。
共对56例患者进行了294颗修复体修复，以下每组各98颗：1）G-Bond主动应用联合Solare-X复合树脂（A-1SEA），2）G-Bond被动应用联合Solare-X复合树脂（P-1SEA），3）GC II LC RMGIC。根据FDI标准，在基线以及6个月、12个月和18个月后对修复体的折裂/固位、边缘适合性、边缘染色、术后敏感和继发龋进行评估。计算每个回访期各标准的累积失败率。评估粘结剂、应用方法和回访期的影响。每组比较采用Kruskal-Wallis检验，组内比较采用Friedman和Wilcoxon符号秩检验（α = 0.05）。
18个月时，A-1SEA组的固位率为93.26%，P-1SEA组为86.21%，RMGIC组为90.91%。与温和型一步自酸蚀粘结剂的被动应用相比，主动应用提高了固位率；然而，各组之间未观察到统计学上的显著差异。13颗修复体出现边缘染色（A-1SEA组1颗，P-1SEA组4颗，RMGIC组8颗），各组之间无显著差异。RMGIC组在12个月和18个月时边缘染色较基线显著增加。各组在边缘适合性、继发龋或术后敏感方面无显著差异。
在本研究的局限性范围内，我们可以得出结论，对于NCCLs修复，温和型一步自酸蚀粘结剂联合树脂复合修复体可作为RMGIC的替代方法，具有相似的固位效果且美观性更佳。搅拌可能有益于温和型一步自酸蚀粘结剂的临床性能，但本研究未证实观察到的益处具有统计学显著性。
