Alexandra Mena-Serrano

A New Universal Simplified Adhesive: 18-Month Clinical Evaluation

PURPOSE To evaluate the 18-month clinical performance of a multimode adhesive (Scotchbond Universal Adhesive, SU, 3M ESPE, St Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. MATERIALS AND METHODS Thirty-nine patients participated in this study. Two-hundred restorations were assigned to four groups: ERm, etch-and-rinse + moist dentin; ERd, etch-and-rinse + dry dentin; Set, selective enamel etching; and SE, self-etch. The composite resin, Filtek Supreme Ultra (3M ESPE), was placed incrementally. The restorations were evaluated at baseline, and at 18 months, using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed using Friedman repeated-measures analysis of variance by rank and McNemar test for significance in each pair (α=0.05). RESULTS Five restorations (SE: 3; Set: 1; and ERm: 1) were lost after 18 months (p>0.05 for either criteria). Marginal staining occurred in four and 10% of the restorations evaluated (p>0.05), respectively, for USPHS and FDI criteria. Nine restorations were scored as bravo for marginal adaptation using the USPHS criteria and 38%, 40%, 36%, and 44% for groups ERm, ERd, Set, and SE, respectively, when the FDI criteria were applied (p>0.05). However, when semiquantitative scores (or SQUACE) for marginal adaptation were used, SE resulted in a significantly greater number of restorations, with more than 30% of the total length of the interface showing marginal discrepancy (28%) in comparison with the other groups (8%, 6%, and 8%, respectively, for ERm, ERd, and Set). CONCLUSIONS The clinical retention of the multimode adhesive at 18 months does not depend on the bonding strategy. The only differences between strategies were found for the parameter marginal adaptation, for which the FDI criteria were more sensitive than the USPHS criteria.

A New Universal Simplified Adhesive: 6-Month Clinical Evaluation

STATEMENT OF THE PROBLEM Multimode adhesives, which can be used as etch-and-rinse or as self-etch adhesives, have been recently introduced without clinical data to back their use. PURPOSE OF THE STUDY To evaluate the 6-month clinical performance of Scotchbond Universal Adhesive (SU; 3M ESPE, St. Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. METHODS/MATERIALS Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-TEm: etch-and-rinse + moist dentin; SU-TEd: etch-and-rinse + dry dentin; SU-SEet: selective enamel etching; and SU-SE: self-etch. The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline and after 6 months using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed with Friedman repeated measures analysis of variance by rank and McNemar test for significance in each pair (α = 0.05). RESULTS Only four restorations (SU-SE: 3 and SU-TEm: 1) were lost after 6 months (p > 0.05 for either criteria). Marginal discoloration occurred in one restoration in the SU-SE group (p > 0.05 for either criteria). Only 2/200 restorations were scored as bravo for marginal adaptation using the USPHS criteria (one for SU-SE and one for SU-SEet, p > 0.05). However, when using the FDI criteria, the percentage of bravo scores for marginal adaptation at 6 months were 32%, 36%, 42%, and 46% for groups SU-TEm, SU-TEd, SU-SEet, and SU-SE, respectively (p > 0.05). CONCLUSIONS The clinical behavior of the multimode adhesive does not depend on the bonding strategy at 6 months. The FDI evaluation criteria are more sensitive than the USPHS criteria. CLINICAL SIGNIFICANCE At 6 months, the clinical behavior of the new multimode adhesive Scotchbond Universal was found to be reliable when used in noncarious cervical lesions and may not depend on the bonding strategy employed.

Effect of 3-year water storage on the performance of one-step self-etch adhesives applied actively on dentine

OBJECTIVES To evaluate the effect of the application method on the immediate and 3-year resin-dentine bond strength (μTBS) and nanoleakage (NL) for 3 one-step self-etch adhesives (Adper Prompt L-Pop; Clearfil S(3) Bond and Xeno III). METHODS The occlusal enamel of 42 human molars were removed to expose a flat dentine surface. The adhesives were applied under inactive or active application. After light-curing (600mW/cm(2) for 10s), composite buildups were constructed incrementally and sectioned to obtain bonded sticks (0.8mm(2)) to be tested in tension immediately or after 3 years of water storage of water storage. For NL, 2 bonded sticks from each tooth at each time were coated with nail varnish, placed in silver nitrate and polished down with SiC paper. The μTBS data was submitted to a two-way repetead mesures ANOVA and Tukeys test for each adhesive (α=0.05). RESULTS The active application showed higher immediate and 3-year μTBS than the inactive application (p<0.05). An increase in the silver nitrate deposition was seen for all conditions after 3 years; however this was more pronounced for all materials under inactive application (p<0.05). CONCLUSIONS The active application improves the immediate bonding performance of the adhesive systems. Reductions of the bond strength were observed for all materials after 3 years, however reduced degradation rate was observed when the materials are applied actively in dentine.

A new universal simplified adhesive

STATEMENT OF THE PROBLEM Multimode adhesives, which can be used as etch-and-rinse or as self-etch adhesives, have been recently introduced without clinical data to back their use. PURPOSE OF THE STUDY To evaluate the 6-month clinical performance of Scotchbond Universal Adhesive (SU; 3M ESPE, St. Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. METHODS/MATERIALS Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-TEm: etch-and-rinse + moist dentin; SU-TEd: etch-and-rinse + dry dentin; SU-SEet: selective enamel etching; and SU-SE: self-etch. The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline and after 6 months using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed with Friedman repeated measures analysis of variance by rank and McNemar test for significance in each pair (α = 0.05). RESULTS Only four restorations (SU-SE: 3 and SU-TEm: 1) were lost after 6 months (p > 0.05 for either criteria). Marginal discoloration occurred in one restoration in the SU-SE group (p > 0.05 for either criteria). Only 2/200 restorations were scored as bravo for marginal adaptation using the USPHS criteria (one for SU-SE and one for SU-SEet, p > 0.05). However, when using the FDI criteria, the percentage of bravo scores for marginal adaptation at 6 months were 32%, 36%, 42%, and 46% for groups SU-TEm, SU-TEd, SU-SEet, and SU-SE, respectively (p > 0.05). CONCLUSIONS The clinical behavior of the multimode adhesive does not depend on the bonding strategy at 6 months. The FDI evaluation criteria are more sensitive than the USPHS criteria. CLINICAL SIGNIFICANCE At 6 months, the clinical behavior of the new multimode adhesive Scotchbond Universal was found to be reliable when used in noncarious cervical lesions and may not depend on the bonding strategy employed.

Effect of EDTA conditioning on cervical restorations bonded with a self-etch adhesive: A randomized double-blind clinical trial

OBJECTIVE To compare the 18-month retention rates of composite restorations in non-carious cervical lesions [NCCLs] bonded with a self-etch adhesive with and without preliminary conditioning with EDTA. METHODS Forty-eight patients with two similar-sized NCCL were selected and randomly allocated to one of two groups. Two calibrated operators placed 96 restorations with a one-step self-etch adhesive (Adper Easy One, 3M ESPE). Half of the restorations were placed according to the manufacturers instructions while, for the other half, the surfaces of the lesions were conditioned with 17% EDTA for 2 min prior to adhesive application. Two blinded and independent examiners evaluated the restorations at baseline, 6, 12, and 18 months, according to the FDI criteria. The comparison between groups in each period was conducted with the Fishers exact test, and the performance of each group at the different periods was evaluated by McNemars test (α=0.05). RESULTS After 18 months, significantly higher retention rates (95% CI) were observed for the EDTA group (95.5 [84.9-98.7]) than the control group (79.6% [65.5-88.9]) (p=0.02). Significant deterioration of the marginal adaptation and marginal discoloration were observed for both groups over the 18-month evaluation. CONCLUSIONS The preliminary conditioning with EDTA before application of a one-step self-etch adhesive significantly improved the retention rates of composite restorations in cervical lesions. CLINICAL SIGNIFICANCE Conditioning with EDTA is an alternative that improves the 18-month retention rate of cervical restorations bonded with a self-etch adhesive.

Ethanol-wet bonding technique: Clinical versus laboratory findings

OBJECTIVES This study evaluated the microtensile bond strength (μTBS) and nanoleakage (NL) of dentin bonded interfaces produced with ethanol-wet and water-wet bonding protocols under clinical and laboratory conditions. METHODS The sample was composed of forty primary second molars in advanced exfoliation process. Occlusal cavities were prepared leaving a flat dentin surface on the pulpal floor. In half of the teeth, the water-wet protocol was followed using a three-step etch-and-rinse adhesive. In the other half, dentin was dehydrated with ascending ethanol solutions (50%, 70%, 80%, 95% and 3×100%), 15s each for the ethanol-bonding protocol. An experimental hydrophobic primer was used, followed by the neat adhesive application. Resin build-ups were prepared, stored for 24h, sectioned into sticks and tested in tensile mode (0.5mm/min). NL was performed for all groups. The μTBS and NL data were submitted to two-way ANOVA and Kruskall-Wallis tests, respectively (α=0.05). RESULTS Under clinical conditions, the highest μTBS was observed for the water-wet bonding while under the laboratory setting, the highest μTBS was obtained for the ethanol-wet bonding. Increased NL was observed in the water-wet bonding groups irrespective of the bonding condition. SIGNIFICANCE The immediate benefits of the ethanol-bonding observed in the laboratory setting was not confirmed when the same protocol was performed in vivo. However, as reduced nanoleakage was seen in adhesive interfaces produced with the ethanol-wet bonding technique, suggests that the hybrid layer may be more resistant to degradation.