Omoto Érika Mayumi, Dos Santos Paulo Henrique, Shinohara Mirela Sanae, de Andrade Carvalho Paulo Roberto Marão, Catelan Anderson, Fagundes Ticiane Cestari
Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University. José Bonifácio St. 1193, Araçatuba, SP, Brazil.
Faculty of Dentistry, University of Toronto. 124 Edward St, Toronto, ON, Canada.
J Dent. 2025 Feb;153:105529. doi: 10.1016/j.jdent.2024.105529. Epub 2024 Dec 12.
To evaluate the retention rate and other clinical criteria of four different restorative techniques for non-carious cervical lesions (NCCLs) after 4 years.
This is a prospective, randomized, double-blind, and split-mouth study evaluating four different adhesion strategies in non-carious cervical lesion restorations: adhesive restorative system (Scotchbond Universal Adhesive/Filtek Z350XT) without (SBU) and with selective enamel acid-etching (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic as acid pretreatment (E-RMGIC). In total, 200 restorations were placed in 50 patients. Good health, no allergies to dental products, adequate oral hygiene were inclusion criteria. Pregnancy, active caries, use of desensitizers/fluoride, orthodontic appliances, and severe bruxism were exclusion criteria. All restorations were scored regarding retention, marginal integrity, marginal discoloration, surface texture, wear, secondary caries, anatomical form, surface staining, color match, and inflammation of gingival tissue marginal adaptation, using modified United States Public Health Service (USPHS) criteria at baseline and after 1, 2, 3 and 4 years. Kruskal-Wallis, Friedman, and Wilcoxon were used (p < 0.05).
In total, 40 patients returned for the follow-up. RMGIC and E-RMGIC presented more alteration in surface texture than SBU and E-SBU. SBU had lower retention at four years than at baseline. Decreased alpha scores for marginal integrity and marginal discoloration were observed for all groups after four years when compared to baseline. Survival curves, related to retention, presented no statistical differences among groups (p = 0.315).
NCCLs restored with ionomer had more reduction in surface luster than resin composite restorations. The use of selective enamel etching promoted less loss of retention for universal adhesive. The increase of initial marginal defects occurred for all types of adhesion strategies.
The use of selective enamel etching cause less loss of retention for universal adhesive used in NCCL. Initial marginal defects occur for all types of adhesion strategies after four years.
评估4种不同修复技术用于非龋性颈部病变（NCCLs）4年后的保留率及其他临床指标。
这是一项前瞻性、随机、双盲、口内对照研究，评估非龋性颈部病变修复中4种不同的粘结策略：不进行选择性釉质酸蚀（SBU）和进行选择性釉质酸蚀（E-SBU）的粘结修复系统（Scotchbond通用粘结剂/Filtek Z350XT）、树脂改性玻璃离子水门汀（Vitremer；RMGIC）以及乙二胺四乙酸作为酸预处理（E-RMGIC）。共为50例患者置入200个修复体。纳入标准为身体健康、对牙科产品无过敏、口腔卫生良好。排除标准为妊娠、活动性龋、使用脱敏剂/氟化物、正畸矫治器以及重度磨牙症。在基线以及1、2、3和4年后，采用改良的美国公共卫生服务（USPHS）标准，对所有修复体的保留情况、边缘完整性、边缘变色、表面质地、磨损、继发龋、解剖形态、表面染色、颜色匹配以及牙龈组织边缘适应性炎症进行评分。采用Kruskal-Wallis、Friedman和Wilcoxon检验（p<0.05）。
共有40例患者返回进行随访。RMGIC和E-RMGIC的表面质地改变比SBU和E-SBU更多。SBU在4年后的保留率低于基线。与基线相比，4年后所有组的边缘完整性和边缘变色的α评分均降低。与保留情况相关的生存曲线在各组间无统计学差异（p=0.315）。
与树脂复合修复体相比，用玻璃离子修复的NCCLs表面光泽度降低更多。选择性釉质酸蚀的使用使通用粘结剂的保留率损失更少。所有类型的粘结策略均出现初始边缘缺陷增加。
选择性釉质酸蚀的使用使NCCL中使用的通用粘结剂的保留率损失更少。4年后所有类型的粘结策略均出现初始边缘缺陷。
