Department of Restorative Dentistry, School of Dentistry, Hacettepe University, 06100, Sıhhıye, Ankara, Turkey.
Clin Oral Investig. 2020 Apr;24(4):1569-1578. doi: 10.1007/s00784-019-03052-2. Epub 2019 Aug 30.
The aim of this clinical trial was to evaluate and compare the performance of a universal adhesive with different adhesive strategies in the restoration of non-carious cervical lesions (NCCLs) over a 36-month period.
One hundred sixty-five NCCLs in 35 patients (13 female, 22 male) with at least 3 lesions each were included in this study. Three groups were formed according to the adhesive strategy used (n = 55): selective-etch mode, etch-and-rinse mode, or self-etch mode of a universal adhesive, Single Bond Universal. The same nanofilled resin composite, Filtek Ultimate, was used for all restorations by a single operator. The restorations were evaluated by two calibrated examiners at baseline and at 6, 12, 18, 24, and 36 months in accordance with the modified USPHS criteria. The chi-square test was used for intergroup comparison and Cochran's Q test for intragroup comparison (∝ = 5%).
At 36 months, the recall rate was 98.1% and three restorations, one from each group, had failed because of retention loss (P > 0.05). The self-etch mode group showed 17 bravo scores for both marginal staining and marginal adaptation after 3 years, which was significantly different from the selective-etch and etch-and-rinse groups (P < 0.05). For all groups, the only statistically significant difference was found when baseline and 36-month evaluations were compared in terms of marginal staining (P = 0.000). When the marginal adaptation values at 36 months were compared with those at the baseline, statistically significant differences were found in the etch-and-rinse and self-etch mode groups (P < 0.05). Neither secondary caries nor postoperative sensitivity was observed at any recall.
All adhesive modes showed similar retention rates. Although all restorations were clinically acceptable, restorations in self-etch mode showed less satisfying performance for marginal staining and marginal adaptation.
At the end of 36 months, the Single Bond Universal adhesive received acceptable scores according to the modified United States Public Health Service (USPHS) criteria. However, clinicians should be aware that its use in self-etch application mode tends to result in marginal staining and marginal deterioration when compared with etch-and-rinse and selective-etch application modes.
本临床试验旨在评估和比较通用粘结剂在 36 个月内使用不同粘结策略修复非龋性颈领（NCCL）的性能。
本研究纳入了 35 名患者（13 名女性，22 名男性）的 165 个 NCCL，每位患者至少有 3 个病变。根据使用的粘结策略将患者分为 3 组（n=55）：选择性蚀刻模式、蚀刻-冲洗模式或通用粘结剂（Single Bond Universal）的自蚀刻模式。所有修复体均由同一位操作员使用相同的纳米填充树脂复合材料（Filtek Ultimate）进行。根据改良美国公共卫生服务（USPHS）标准，在基线和 6、12、18、24 和 36 个月时由两名经过校准的检查者对修复体进行评估。使用卡方检验进行组间比较，使用 Cochran 的 Q 检验进行组内比较（∝=5%）。
在 36 个月时，召回率为 98.1%，3 个修复体（每组 1 个）因固位丧失而失败（P>0.05）。自酸蚀组在 3 年后出现 17 个 Bravo 评分，在边缘染色和边缘适合性方面与选择性蚀刻和蚀刻-冲洗组差异有统计学意义（P<0.05）。对于所有组，仅在基线和 36 个月评估时发现边缘染色方面存在统计学显著差异（P=0.000）。当将 36 个月时的边缘适合性值与基线值进行比较时，在蚀刻-冲洗和自酸蚀模式组中发现了统计学显著差异（P<0.05）。在任何随访中均未观察到继发龋或术后敏感。
所有粘结模式的保留率均相似。尽管所有修复体在临床上均可接受，但自酸蚀模式的修复体在边缘染色和边缘适合性方面表现出较差的性能。
在 36 个月结束时，根据改良的美国公共卫生服务（USPHS）标准，Single Bond Universal 粘结剂获得了可接受的评分。然而，临床医生应该注意到，与蚀刻-冲洗和选择性蚀刻应用模式相比，其在自酸蚀应用模式下使用时往往会导致边缘染色和边缘恶化。
