title: Five-year clinical evaluation of two adhesive systems in non-carious cervical lesions. Eighteen-month clinical performance of a self-etching primer in unprepared class V resin restorations. A three-year clinical evaluation of two dentin bonding agents. Clinical evaluation of an all-in-one adhesive in non-carious cervical lesions with different degrees of dentin sclerosis. Two-year clinical evaluation of resinous restorative systems in non-carious cervical lesions. Two-year clinical evaluation of one-step self-etch systems in non-carious cervical lesions. Correlation between microtensile bond strength data and clinical outcome of Class V restorations. A randomized clinical evaluation of a one- and two-step self-etch adhesive over 24 months. Restoring cervical lesions with flexible composites. A 36-month clinical evaluation of ethanol/water and acetone-based etch-and-rinse adhesives in non-carious cervical lesions. A three-year clinical evaluation of two-bottle versus one-bottle dentin adhesives. Three-year clinical performance of a HEMA-free one-step self-etch adhesive in non-carious cervical lesions. Two-year clinical performance of Class V resin-modified glass-lonomer and resin composite restorations. Durability of three simplified adhesive systems in Class V non-carious cervical dentin lesions. A 24-month randomized clinical trial of a two- and three-step etch-and-rinse technique. Two-year clinical performance of two primer adhesives on class V restorations. Clinical evaluation of tooth-colored materials in cervical lesions.
abstract: OBJECTIVE This controlled clinical trial evaluated the 5-year clinical performance of a self-etching primer system including selective enamel-etching with phosphoric acid and a one-bottle adhesive system . METHODS Seventy-two non-carious cervical lesions in 8 patients ( 4 male and 4 female ) with a mean age of 61.3 years ( range 45 - 78 ) participated in the study . An enamel bevel was placed and dentin lightly ground , and cavities restored with clearfil liner bond II ( LB ) or single bond ( SB ) in conjunction with a hybrid resin composite ( Clearfil AP-X ) . In the case of 27 cavities for LB , the enamel was pretreated with 37 % phosphoric acid for 10 s. Each patient received both types of restoration , which were distributed on a r and om basis . All restorations ( 37 restorations for LB and 35 restorations for SB ) were placed by one dentist . The restorations were evaluated blind after 5 years using modified USPHS criteria . The data were statistically analyzed using the Fisher 's exact test . RESULTS All but one restoration ( which was replaced by a crown after the 2-year recall ) were evaluated after 5 years . 100 % retention rates were recorded for both restorative groups . No caries was detected in association with any restorations . The only minor problem was marginal discoloration ; superficial and localized marginal discoloration occurred around 18 % of the restorations , and mainly at the dentin margin . There were no significant differences in the marginal integrity between the LB and SB groups . CONCLUSIONS Restorative material s used in this study demonstrated a good clinical effectiveness in the restoration of non-carious cervical lesions for 5 years This study evaluated the clinical performance of unprepared Class V resin composites , placed using a self-etching primer and a single-bottle adhesive , over a period of 18 months . Thirty-eight pairs of restorations of Renew hybrid resin composite ( BISCO , Inc ) were placed using adhesives from the same manufacturer in caries-free cervical erosion/abfraction lesions . Based on insensitivity to air , the dentin in 76 % of these lesions was considered to be sclerotic . The restorations were placed without abrasion of tooth surfaces , except for cleaning with plain pumice . One of each pair was placed using Tyrian , a self-etching primer and the other was placed using One-Step , a single-bottle adhesive placed after acid etching . Both the etchant and self-etching primer were applied for 20 seconds . The restorations were clinical ly evaluated at baseline , 6 , 12 and 18 months , using modified Ryge/USPHS criteria . For both adhesives , very low retention of 50 % to 56 % of the restorations was observed over 18 months , leading to the conclusion that tooth surfaces must receive some additional treatment prior to restoration with these adhesives . No statistically significant difference ( p=0.75 ) between the two adhesives was observed in overall performance , and dentinal sclerosis and axial depth did not appear to be important factors in the study BACKGROUND A new restorative called a " giomer composite " has been introduced . The authors conducted a study to determine retention , anatomical form , caries , staining , marginal discoloration , marginal adaptation , surface roughness and sensitivity of giomer  compared with those of a microfilled composite . METHODS The authors placed 40 sets of restorations r and omly in canines and premolars in vivo . They used a giomer composite and a microfilled composite in erosion/abrasion/abfraction Class V lesions that were not altered with rotary instruments . They placed the restorations according to manufacturer 's recommendations , and two calibrated examiners evaluated the restorations independently using modified U.S. Public Health Service criteria at baseline and at six , 18 and 36 months . The lesions receiving the restorations did not differ from each other in the amount of circumferential enamel present , the percentage of the surface area of dentin or lesion type . RESULTS There were no differences in the restorations at baseline , an evaluation made two weeks after placement . At 36 months , the giomer and microfilled composite restorations were not significantly different from one another in any of the eight criteria evaluated . The percentage agreement between examiners was at least 83 percent for each criterion in each evaluation period . CONCLUSIONS Both the giomer and the microfilled composite used in this study meet the clinical portion of the Acceptance Program Guidelines for Dentin and Enamel Adhesives Material s established by the American Dental Association . CLINICAL IMPLICATION S Both the giomer and the microfilled composite used in this study can be used with confidence in Class V lesions This r and omized clinical trial compared the performance of an all-in-one adhesive ( iBond ) applied in sclerotic and non-sclerotic non-carious cervical lesions with that of a three-step etch-prime-bond adhesive ( Gluma Solid Bond , SB ) .  One-hundred and five lesions were r and omly assigned to four groups according to adhesive , sclerosis scale and technique : 1 ) SB applied to lesions with sclerosis scale 1 and 2 ( n=26 ) ; 2 ) iBond applied to lesions with sclerosis scale 1 and 2 ( n=28 ) ; 3 ) iBond applied to lesions with sclerosis scale 3 and 4 ( n=25 ) and 4 ) iBond applied with prior acid-etching to lesions with sclerosis scale 3 and 4 ( n=26 ) . A microfilled composite ( Durafill VS ) was used as the restorative material . The restorations were evaluated for retention , color match , marginal adaptation , anatomic form , cavosurface margin discoloration , secondary caries , pre- and post-operative sensitivity , surface texture and fracture at insertion ( baseline ) , 6 , 18 months and at 3 years using modified USPHS evaluation criteria ( Alfa = excellent ; Bravo= clinical ly acceptable ; Charlie= clinical ly unacceptable ) . There was a high percentage of Bravo scores for marginal adaptation ( 4%-32 % ) and marginal discoloration ( 18%-60 % ) in Groups 2 , 3 and 4 , but all groups had < 5 % Charlie scores at 6 months and < 10 % Charlie scores at 18 months for retention and marginal discoloration , respectively . However , it should be noted that 13 % of the restorations in Group 4 were not retained at three years This controlled clinical trial evaluated the 2-year clinical performance of a one-bottle etch- and -rinse adhesive and resin composite system ( Excite/Tetric Ceram ) compared to a resin-modified glass ionomer cement ( RMGIC ) ( Vitremer/3 M ) in non-carious cervical lesions . Seventy cervical restorations ( 35 resin composite - RC- restorations and 35 RMGIC restorations ) were placed by a single operator in 30 patients under rubber dam isolation without mechanical preparation . All restorations were evaluated blindly by 2 independent examiners using the modified USPHS criteria at baseline , and after 6 , 12 and 24 months . Data were analyzed statistically by Fisher 's exact and McNemar tests . After 2 years , 59 out of 70 restorations were evaluated . As much as 78.8 % retention rate was recorded for RC restorations , while 100 % retention was obtained for RMGIC restorations . Fisher 's exact test showed significant differences ( p=0.011 ) for retention . However , there were no significant differences for marginal integrity , marginal discoloration , anatomic form and secondary caries between the RC and RMGIC restorations . The McNemar test detected significant differences for Excite/TC between baseline and the 2-year recall for retention ( p=0.02 ) , marginal integrity ( p=0.002 ) and anatomic form ( p=0.04 ) . Therefore , the one-bottle etch- and -rinse bonding system/resin composite showed an inferior clinical performance compared to the RMGIC OBJECTIVES This r and omized controlled clinical trial evaluated the 2-year clinical performance of S3 Bond ( S3 ) and G-Bond ( GB ) in 108 non-carious cervical lesions . METHODS Twenty-three patients , 12 male and 11 female ( mean age : 61.8 years , range : 30 - 79 years ) regularly visiting the Nagasaki University Hospital of Medicine and Dentistry , participated in the study . Each patient received both material s r and omly . All restorations ( 53 restorations for S3 and 55 restorations for GB ) were placed by one dentist . The restorations were blindly evaluated by two examiners at baseline , 6 months , 1 and 2 years using modified USPHS criteria . The data were statistically analyzed using the Cochran Q test and Fisher 's exact test . RESULTS One restoration of each material was lost during 2 years . The only minor clinical problem was the integrity of the enamel margin . Slight marginal staining occurred adjacent to 11 restorations of both S3 and GB . There was no significant difference in the clinical performance between S3 and GB for each variable . CONCLUSIONS Under the protocol used in this study , S3 and GB have demonstrated an acceptable clinical performance up to 2 years OBJECTIVE To determine if the results of  resin-dentin microtensile bond strength ( μTBS ) is correlated with the outcome parameters of clinical studies on non-retentive Class V restorations . METHODS  Resin-dentin μTBS data were obtained from one test center ; the in vitro tests were all performed by the same operator . The μTBS testing was performed 8 h after bonding and after 6 months of storing the specimens in water . Pre-test failures ( PTFs ) of specimens were included in the analysis , attributing them a value of 1MPa . Prospect i ve clinical studies on cervical restorations ( Class V ) with an observation period of at least 18 months were search ed in the literature . The clinical outcome variables were retention loss , marginal discoloration and marginal integrity . Furthermore , an index was formulated to be better able to compare the laboratory and clinical results . Estimates of adhesive effects in a linear mixed model were used to summarize the clinical performance of each adhesive between 12 and 36 months . Spearman correlations between these clinical performances and the μTBS values were calculated subsequently . RESULTS Thirty-six clinical studies with 15 adhesive/restorative systems for which μTBS data were also available were included in the statistical analysis . In general 3-step and 2-step etch- and -rinse systems showed higher bond strength values than the 2-step/3-step self-etching systems , which , however , produced higher values than the 1-step self-etching and the resin modified glass ionomer systems . Prolonged water storage of specimens result ed in a significant decrease of the mean bond strength values in 5 adhesive systems ( Wilcoxon , p<0.05 ) . There was a significant correlation between μTBS values both after 8 h and 6 months of storage and marginal discoloration ( r=0.54 and r=0.67 , respectively ) . However , the same correlation was not found between μTBS values and the retention rate , clinical index or marginal integrity . SIGNIFICANCE As μTBS data of adhesive systems , especially after water storage for 6 months , showed a good correlation with marginal discoloration in short-term clinical Class V restorations , longitudinal clinical trials should explore whether early marginal staining is predictive for future retention loss in non-carious cervical restorations OBJECTIVE To evaluate the performance of All Bond SE used in a one- or two-step protocol in a 24-month r and omized clinical study . METHODS Thirty-three patients with two similarly sized non-carious cervical lesions participated in this study . A total of 66 restorations were placed , half using the one-step All Bond SE protocol ( SE-1 ) and the other half using the two-step All Bond SE protocol ( SE-2 ) . The restorations were evaluated at baseline and after 6 , 12 and 24 months following the modified USPHS criteria and analyzed by the McNemar 's test and Fisher 's exact test ( alpha = 0.05 ) . RESULTS After 24 months , six SE-1 and four SE-2 restorations were rated as Bravo in marginal discoloration The retention rates for SE-1 and SE-2 were 84.8 % and 90.9 % , respectively , after 24 months . Compared to baseline , the retention rate for SE-1 was statistically lower . CONCLUSIONS All Bond SE used in the one- or two-step protocol result ed in high retention rates after 24 months OBJECTIVES Flexure at the tooth cervix has been suggested to dislodge cervical restorations more rapidly . The objective of this r and omized controlled clinical trial was to test the hypothesis that a higher composite flexibility better withst and s tooth flexure stress . METHODS One hundred and forty-two non-carious cervical lesions were restored with composites with contrasting stiffness . Seventy-one patients r and omly received two cervical restorations  placed following two out of the three experimental groups : ( 1 ) the three-step etch- and -rinse adhesive Permaquick applied with the stiff micro-hybrid composite Amelogen Hybrid ( PMQ/A-Hy , Ultradent ) , ( 2 ) Permaquick applied with the more flexible micro-filled composite Amelogen Microfill ( PMQ/A-Mi , Ultradent ) , or ( 3 ) the ' golden st and ard ' three-step etch- and -rinse adhesive Optibond FL applied with the micro-hybrid composite Prodigy ( O-FL/Pro , Kerr ) . RESULTS The recall rate at 7 years was 80 % . No statistically significant difference was found for any of the parameters evaluated neither between both adhesives , nor between both composites ( McNemar , p>0.05 ) . Eleven percent of the O-FL/Pro restorations were clinical ly unacceptable due to loss of retention ( 5.5 % ) and severe marginal discoloration ( 5.5 % ) . In the PMQ-group , 22 % of the PMQ/A-Mi restorations ( 8 % loss of retention , 5 % severe enamel margin defects , 3 % severe dentin margin defects , 6 % severe marginal discoloration , 3 % extreme sensitivity ) and 19 % of the PMQ/A-Hy restorations ( 13 % loss of retention , 3 % severe enamel margin defects , 3 % severe marginal discoloration ) needed repair or replacement . SIGNIFICANCE The clinical performance of the three adhesive/composite combinations was good and reliable during the 7-year clinical trial . It was concluded that the composite stiffness does not affect the clinical longevity of cervical composite restorations UNLABELLED This double-blind r and omized clinical trial compared different ethanol/water and acetone-based systems in non-carious cervical lesions over 36 months . MATERIAL S AND METHODS Eighty-four patients having at least one non-carious cervical lesion [ NCCL ] under occlusion were enrolled in this study . A total of 84 restorations were placed , half for each group ( Adper Single Bond [ SB ] + FiltekA110 or One Step [ OS ] + MicroNew ) . All the material s were placed by two calibrated operators . Two other independent examiners evaluated the restorations at baseline , 6 , 12 , 18 and 36 months , according to slightly modified USPHS criteria . Statistical analysis between material s in each period was conducted using the Fisher 's exact test ( alpha=0.05 ) , and performance of the material s in the baseline in comparison to each period was evaluated by McNemar 's test ( alpha=0.05 ) . RESULTS The 12- , 18- and 36-month retention rates for SB were 95.2 % ( 12 and 18 months ) and 92.3 % ( 36 months ) . For OS , the retention rates were 83.3 % , 73.8 % and 56.4 % , respectively , for each recall period . After 36 months , 10 OS restorations ( 25.7 % ) and seven SB restorations ( 17.9 % ) were rated as Bravo in the marginal discoloration item . CONCLUSIONS The ethanol/water-based adhesive ( Single Bond ) that was evaluated showed a higher retention rate than the acetone-based system ( One Step ) after 36 months of clinical service 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 IMPLICATION S 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 Despite the fact that one-step adhesives are currently used routinely in clinical practice , long-term studies on their clinical performance are scarce . The objective of this r and omized controlled clinical trial was to test the hypothesis that a 2-hydroxyethyl methacrylate (HEMA)-free one-step self-etch adhesive performs worse than a conventional multistep etch- and -rinse adhesive .  Two-hundred and seventy-six non-carious cervical lesions in 52 patients were restored with a micro-hybrid composite  ( Gradia Direct ; GC ) . These restorations were bonded in r and om order either with the HEMA-free one-step adhesive G-Bond ( GC ) or with the ' gold-st and ard ' ( control ) three-step adhesive Optibond FL ( Kerr ) . The restorations were evaluated after 6 , 12 , 24 , and 36 months of clinical service regarding retention , marginal adaptation , microleakage , caries occurrence , and sensitivity . After a medium-long period of 3 yr , similar success in clinical performance was observed for the simplified all-in-one adhesive and the conventional three-step adhesive . However , the one-step adhesive exhibited significantly more incisal marginal defects and discolorations . Whereas marginal degradation appeared to arrest for the multistep etch- and -rinse adhesive after 12 months , the enamel margins of the restorations bonded with the one-step self-etch adhesive continued to deteriorate . These incisal marginal defects were , however , small and could easily be removed by polishing . For both adhesives , large and sclerosed lesions appeared to be at higher risk of retention loss While a one-year report had been previously published , this study was undertaken to evaluate the clinical performance and appearance of a resin-modified glass ionomer and a resin composite over two years . Thirty-seven pairs of restorations of FujI II LC and Z 250/Single Bond were placed in caries-free cervical erosion/abfraction lesions without tooth preparation . Restorations were clinical ly evaluated at baseline , 6 , 12 , 18 and 24 months using modified Ryge/USPHS criteria . No statistically significant difference ( p = 0.13 ) was observed in the overall performance of the material s. Retention was 96 % for the resin-modified glass ionomer and 81 % for the resin composite , with no additional restorations of either material lost after one year . As previously reported , retention of the Z 250 restorations at six months was below the minimum specified in the ADA Acceptance Program for Dentin and Enamel Adhesives . The resin composite restorations generally had a better appearance , with a 100 % alpha rating in color match , versus 85 % for the resin-modified glass ionomer PURPOSE To investigate the durability of three simplified systems in Class V non-carious abrasion/erosion lesions . METHODS 144 non-carious cervical dentin lesions were restored either with Clearfil Liner Bond 2 , a 2-step self-etching primer ( n = 46 ) , One Coat Bond , a one bottle total-etch system applied with one coat ( n = 46 ) , or Prompt-L-Pop , a 1-step self-etching primer ( " all-in-one " ) ( n = 52 ) , in 90 individuals . Ninety-eight of the lesions showed sclerotic dentin and 46 were non-sclerotic . Sixty-one were slightly roughened with a diamond bur before conditioning . The restorations were evaluated every 6 months during a 2-year period with slightly modified USPHS criteria . RESULTS All except three restorations were evaluated over 2 years . The cumulative loss rates for Clearfil Liner Bond 2 , One Coat Bond and Prompt-L-Pop were at 6 months : 4.3 , 2.2 and 3.9 % , at 18 months : 4.3 , 10.9 and 15.4 % and at 24 months : 8.7 , 13.0 and 21.2 % , respectively . The cumulative loss rates of the material s in sclerotic lesions ( 15.7 % ) versus non-sclerotic lesions ( 14.0 % ) were not significanty different . Restorations placed with a diamond bur-roughened lesions showed a loss rate of 14.5 % , while for the non-roughened lesions the frequency was 14.8 % PURPOSE This 24-month r and omized paired tooth clinical study evaluated the performance of All Bond 3 used in the simplified ( 2-step ) and full ( 3-step ) versions . METHODS 33 patients , with at least two similar sized non-carious cervical lesions participated in this study . A total of 66 restorations  were placed , half using the 2-step All Bond 3 ( AB3 - 2 ) and the other half using 3-step All Bond 3 ( AB3 - 3 ) . The restorations were placed incrementally using the composite resin Aelite . The restorations were evaluated at baseline and after 6 , 12 and 24 months following the modified USPHS criteria . Statistical differences between the adhesive were tested using with McNemar 's test and clinical performance over time for each material with the Fisher 's exact test ( alpha = 0.05 ) . RESULTS After 24 months , six AB3 - 2 and four AB3 - 3 were rated as bravo for marginal discoloration but did not differ from each other significantly ( P > 0.05 ) . The retention rates at 24 months of AB3 - 2 and AB3 - 3 were 90.9 % and 97.0 % , respectively ( P > 0.05 ) The prime purpose of this clinical trial was to examine the clinical quality and retention rate of resin composite in connection with two recently developed acetone-based primer adhesives in Class V lesions according to ADA Clinical Protocol Guidelines for Dentin and Enamel Adhesive Material s. All cavities were nonretentive and predominantly in dentin ( mixed Class V lesions ) . Total bonding was not limited either by sub-base or by base material s. All the trial restorations were placed under rubber dam .  Group 1 ( Version 16 - 135 - 1 ) and group 2 ( Version 17 - 17 - 1 )  consisted of 42 patients with 46 trials and 38 patients with 43 fillings , respectively . The mean follow-up period and the recall response at the end of the study of group 1 were 22.8 months and 92.9 % and of group 2 were 22.4 months and 94.7 % . The trial restorations of both groups maintained their predominantly rated USPHS-Code Alpha level within the follow-up period . The cumulative failure rate of two trials in group 1 and four in group 2 determined a failure percentage of 4.4 % and 9.3 % , respectively , which is within the ADA-18 month limit of < 10 % Charlie . The Version KL 16 - 135 - 1 came into the market as Prime & Bond(R ) 2.1 , and the other one turned out to be Dyract Adhesive(R ) PSA , which was primarily introduced as a single-component adhesive for compomer restorative Dyract(R ) ( Dentsply DeTrey , Germany ) PURPOSE To determine the 18-month clinical performance of four tooth-colored restoratives in non-carious cervical lesions . MATERIAL S AND METHODS Buccal abrasion lesions in 83 teeth were restored with each of the following material s : Fuji Cap II , Fuji II LC , APH/Universal Bond 3 , Lite Fil II A/Imperva Bond . Baseline and an 18-month recall was carried out using the Ryge ( USPHS ) method for retention , color match , marginal adaptation , cavosurface marginal discoloration , anatomic form and secondary caries . RESULTS The USPHS results ( % alfa ) for the four products were , respectively : color match ( 9 % , 48 % , 57 % , 55 % ) , marginal discoloration ( 71 % , 76 % , 52 % , 50 % ) , marginal adaptation ( 24 % , 24 % , 33 % , 15 % ) , anatomic form ( 67 % , 86 % , 95 % , 45 % ) and retention ( 100 % , 95 % , 100 % , 65 % ) . Results indicated that ( 1 ) Fuji Cap II exhibited a poor color match at baseline ( 2 ) Color matching of Fuji II LC was comparable to the resin composites and ( 3 ) seven Lite Fil II/Imperva Bond restorations ( 35 % ) were dislodged after 1 1/2 years
target: There is not enough evidence to support one adhesive or bonding strategy over another for treatment of NCCLs .
  CLINICAL SIGNIFICANCE Studies with low overall risk of bias demonstrated good clinical performance for adhesives with all four bonding strategies .
  However , included studies showed wide variation between adhesives of the same category
background: OBJECTIVES To establish whether simplified adhesives ( self-etch ) are as clinical ly effective as conventional adhesives ( etch- and -rinse ) with multiple application steps for treatment of non-carious cervical lesions ( NCCLs ) .
  NULL HYPOTHESIS there is no difference in the clinical effectiveness of the four different bonding strategies : Three-step etch- and -rinse ; Two-step etch- and -rinse ; Two-step self-etch ; One-step self-etch for treatment of NCCLs .