Clinical Evaluation of a Nanohybrid and a Flowable Resin Composite in Non-carious Cervical Lesions: 24-Month Results

Purpose: To evaluate the 24-month clinical performance of cervical restorations using a nanohybrid and a flowable resin composite with a one-step self-etching adhesive. Materials and Methods: Twenty-one patients with at least one pair of non-carious cervical lesions participated in this study. A total of 134 non-carious cervical lesions were restored (67 with a nanohybrid resin composite, Grandio; 67 with a flowable resin composite, Grandio Flow) using a one-step self-etching adhesive system, Futura Bond NR, by one dentist. The restorations were evaluated for retention, color match, marginal discoloration, marginal adaptation, surface texture, anatomic form, and secondary caries by two calibrated examiners at baseline and after 6, 12, and 24 months using modified USPHS criteria. The survival rates of the restorations were calculated by the Kaplan-Meier estimator. The comparison of resin composites for each category was performed with the Pearson chi-square test, and the performance of restorations at baseline and after each recall time was evaluated using McNemar's test (p < 0.05). Results: All patients attended the 24-month recall. The retention rates at 6 months were 66% and 58%, and 61% and 57% at 12 months for Grandio and Grandio Flow, respectively. At the 24-month recall, the retention rate was 60% for Grandio and 54% for Grandio Flow. No statistically significant differences were found in retention rates among the restorative materials in any evaluation period (p > 0.05). For marginal discoloration and anatomical form, three Grandio and three Grandio Flow restorations showed Bravo scores at the end of 24 months. The restorations in both groups had Alfa ratings of 100% for the rest of the criteria evaluated. Conclusion: The nanohybrid and flowable resin composites showed similar clinical performances in the restoration of non-carious cervical lesions over 24 months.     

The effect of different types of flowable restorative resins on microleakage of Class V cavities

This study evaluated the microleakage of Class V cavities restored with three different types of flowable resin restorative material and compared the effects of using their respective manufacturer's dentin adhesive or a different brand. Class V cavities with the occlusal margin in enamel and the gingival margin in dentin were prepared on the buccal and lingual surfaces of 48 non-carious human molars. The teeth were randomly assigned to three equal groups of 16. The first eight teeth in each group were restored with one of the flowable restorative materials (Filtek Flow, Dyract Flow, Admira Flow) using the manufacturer's recommended dentin adhesive (Single Bond, Prime & Bond NT, Admira Bond), and the remaining eight molars were restored using a different brand of dentin adhesive (Gluma Comfort Bond). The samples were thermocycled 200 times (5 degrees C-55 degrees C) with a one-minute dwell time. They were then immersed in a 2% basic fuchsin solution for 24 hours, sectioned and analyzed by stereomicroscopy. There was no statistically significant difference at the occlusal margins for either restoration used with its respective dentin adhesive. At the gingival margins, there was a significant difference among all groups. Flowable ormocer (Admira Flow/Admira Bond) displayed the least leakage at the gingival margins. When these flowable restoratives were used with a different brand of dentin adhesive, statistically significant differences were observed both on enamel and dentin. None of the restoratives tested fully prevented leakage at the gingival margins. No significant differences in microleakage were observed among the restorative materials used with respect to the manufacturer's dentin adhesive or a different brand except for Admira Flow restorative at the gingival margins. The gingival margins had significantly more microleakage than the occlusal margins (p < 0.05) except in the Admira Flow group, where microleakage at the occlusal and gingival margins was almost equal.     

A 24-month follow-up of flowable resin composite as an intermediate layer in non-carious cervical lesions

This study compared the clinical performance of a microhybrid resin composite to lined Class V restorations or to those restorations without a flowable resin composite over a 24-month period. Nineteen patients with at least 2 pairs of equivalent cervical erosion/attrition/abfraction lesions, under occlusion, were enrolled in this study. A total of 74 restorations were placed, half for each group (Single-Bond + Filtek-Flow + Filtek Z250 or Single-Bond + Filtek Z250). According to the manufacturers' instructions, 2 calibrated operators placed all restorations. Two other independent examiners evaluated the restorations at baseline and after 24 months, according to the USPHS criteria and modified criteria for color match. The classic alpha score was divided into A1 for "not detectable" and A2 for "slightly discernible" filling. Statistical analysis was conducted using Fisher's exact test (alpha=0.05). For each group, 8 restorations were lost after 24 months (retention rate of 89.2%). All the restorations showed a trend toward dark yellowing after 24 months (color match A2).     

Polymerization shrinkage and microleakage in Class II cavities of various resin composites

This study investigated the polymerization shrinkage of restorative materials and microleakage in the proximal box of Class II restorations. Twenty caries free extracted human molars were prepared on the mesial and distal, making 40 slot cavities. Groups (n=10) were classified as: Group 1: Single bond/Filtek Z-250; Group 2: Single Bond/Filtek Flow/Filtek Z-250; Group 3: Admira Bond/Admira; Group 4: Ariston Liner/Ariston. Dentin bonding systems and resin composites were applied according to the manufacturer's instructions. The specimens were stored in distilled water for one week at 37 degrees C, thermocycled (5 degrees-55 degrees C x 2000), stained with 50% aqueous silver nitrate, immersed in a diluted developer solution (24 hours), rinsed and sectioned in two pieces with a low speed saw (Isomet). Dye penetration (Score 0-4) was determined separately at the occlusal enamel margin and cementoenamel junction. The volumetric polymerization shrinkage of materials was determined with the apparatus of Watts and Cash (Watts Cash, 1991) for 300 seconds. Polymerization shrinkage results were as follows: Filtek Flow (3.5% +/- 0.1) > Admira (2.1% +/- 0.1) = Ariston AT (2.3% +/- 0.1) > Filtek Z-250 (1.8% +/- 0.1) (One-way Anova, post hoc Bonferroni test at p = 0.05 level). No statistical difference was found at the enamel margins for any of the materials (Score 0-1). At the cemento-enamel junction, all test groups showed significantly higher microleakage when compared to the enamel margins (Kruskal-Wallis test, Mann-Whitney U). Dye penetration results at dentin were as follows: Filtek Flow + Filtek Z-250 = Admira < Ariston AT = Filtek Z-250. microleakage than the ion-releasing and hybrid composites lined only with bonding agent at the cementoenamel junction in Class II cavities.     

Cuspal movement and microleakage in premolar teeth restored with posterior filling materials of varying reported volumetric shrinkage values

OBJECTIVES: To investigate the effect of polymerisation shrinkage stress of various aesthetic posterior filling materials on cuspal movement and cervical gingival microleakage of mesio-occlusal-distal (MOD) restorations placed in increments in extracted maxillary premolar teeth. METHODS: Forty sound extracted upper premolar teeth were subjected to standardised preparation of a large MOD cavity. One curing regimen was used and each posterior filling material was placed in eight increments with the appropriate bonding system. A twin channel deflection-measuring gauge allowed a measurement of individual cusp deflections at each stage of polymerisation. Restored teeth were thermocycled before immersion in 0.2% basic fuchsin dye for 24h. After sagittal sectioning of the restored teeth in a mesio-distal plane, the sectioned restorations were examined to assess cervical gingival microleakage. RESULTS: In general, cuspal deflection measurements were dependent upon the constituent monomers and the associated shrinkage on curing, with significantly increased cuspal movement (P<0.05) being recorded for Z100 (20.03+/-2.92 microm) compared with Filtek Z250 (12.34+/-2.18 microm), P60 (13.41+/-4.43 microm) and Admira (11.2+/-2.58 microm). No significant differences were identified between the posterior filling materials when the cervical gingival microleakage scores were examined. CONCLUSIONS: It would appear that a reduction in the manufacturers' reported volumetric polymerisation shrinkage for Z100 (4.0%) to below 3% for Filtek Z250, P60 and Admira, resulted in a significant reduction in the associated cuspal strain on the MOD cavity. The diluent triethyleneglycol dimethacrylate (TEGDMA) increases the polymerisation shrinkage of Z100 resin-based composite due to an increased concentration of carbon-to-carbon double bonds (CC). The replacement of TEGDMA with urethane dimethacrylate (UDMA) and Bis-EMA in Filtek Z250 and P60, decreases the polymerisation shrinkage stress by increasing the cross-linking of polymer networks. However, no group was identified as producing less gingival microleakage at the cervical dentine cavosurface margin when the cavities were sectioned and examined, regardless of the reported variations in cuspal strain and the associated volumetric polymerisation shrinkage values.     

One-year clinical evaluation of a flowable resin liner associated with a microhybrid resin in noncarious cervical lesions

The aim of this study was to compare the clinical performance over 1 year of a microhybrid composite resin for class V restorations both lined and not lined with a flowable composite resin. Nineteen patients having at least two pairs of cervical noncarious lesions under occlusion were enrolled in this study. A total of 38 restorations were placed, half for each group (Single-Bond + Filtek-Flow + Filtek Z250, and Single-Bond + Filtek Z250). Two calibrated operators placed all restorations according to the manufacturers instructions. Two other independent examiners evaluated the restorations at baseline and after a 12-month period according to the USPHS criteria and modified criteria for color match. The classic alpha score was divided into A1 for not detectable and A2 for slightly discernible filling. Statistical analysis was conducted using Fishers exact test and McNemars test (P=0.05). One restoration was lost after 12 months for each group (retention rate 95% for each group). After 12 months, 18 restorations showed a trend towards dark yellowing (color match A2). The use of Filtek Flow as a liner under Filtek Z250 restorations did not improve the clinical performance of class V restorations after 6 and 12 months of evaluation.     

Three-year clinical evaluation of a resin modified glass-ionomer cement and a composite resin in non-carious class V lesions

The purpose of this study was a 3-year clinical evaluation of a resin modified glass-ionomer and a composite resin restorative material in non-carious class V lesions. In 24 patients 98 non-carious class V lesions were restored with either a resin modified glass-ionomer (Vitremer), or a composite resin restoration (Z100). The restorations were clinically evaluated after 6, 12, 24 and 36 months with the US Public Health Service criteria. At 3 years, 88 teeth of 21 patients were evaluated. All restorations were rated clinically acceptable for colour match, marginal discoloration, marginal adaptation and anatomical form. Restoration retention of both groups was high without any statistically significant difference. However, Vitremer restorations showed a lower incidence of Alfa scores for colour match and marginal discoloration than Z100 restorations (P < 0.05).     

Leakage pathway of Class V cavities restored with different flowable resin composite restorations

This study investigated the leakage pathway of facial and lingual Class V cavities restored with different flowable resin composites bonded with one bonding agent by examining the resin/dentin interface. Forty Class V cavities were etched with 37% phosphoric acid gel; Single Bond dental adhesive was applied, then the cavities were randomly divided into four groups (n=10). Three groups were restored with one of three flowable resin composites (Grandio Flow, Filtek Flow and Admira Flow). The fourth group was restored with Z250 (hybrid resin composite) to serve as a control. The specimens were then placed in 50% w/v silver nitrate solution for 24 hours and immersed in a photodeveloping solution for eight hours. Thereafter, the specimens were sectioned bucco-lingually, polished, mounted on stubs, gold sputter coated and examined by scanning electron microscope. Silver particle penetration length with and without gap formation was measured directly on the scanning electron microscope monitor and calculated as a percentage of the total length of the cut dentin surface that was penetrated by silver nitrate. The data were analyzed with one-way ANOVA and Tukey HSD test. The groups restored with Filtek Flow and Admira Flow showed a microleakage pattern where silver nitrate penetration was observed with gap formation at the tooth/restoration interface and Filtek Flow recorded significantly higher leakage than Admira Flow. Grandio Flow showed similar marginal adaptation to Z250 resin composite with no gap formation at the interface. However, silver ions had penetrated beneath the resin-impregnated layer in cavities restored with Grandio Flow and Z250, indicating nanoleakage occurred. This study suggests that volumetric shrinkage in resin composites remains a problem. Although some new technologies are trying to solve the problem of composite shrinkage, the bonding system used in this study did not achieve perfect sealing at the restoration/dentin interface. This might affect durability of the bond to dentin.     

Two-year clinical evaluation of ormocer and nanofill composite with and without a flowable liner

PURPOSE: The aim of this clinical follow-up study was to determine the clinical performance of ormocer and a new nanofill composite material, lined or not lined with flowable composites, after 2 years. MATERIALS AND METHODS: Occlusal restorations (n = 108) were placed in 54 patients with two symmetric restorations per patient. In one of the two restorations in each patient, cavities were first lined with the flowable composite material Admira Flow or Filtek Flow after applying the two-step total-etch one-bottle adhesive (Admira Bond) or single bond adhesive (Single Bond). Admira or Filtek Supreme was then applied. Restorations were examined using the USPHS modified Ryge criteria for retention, color matching, cavosurface marginal discoloration, anatomic form, marginal adaptation, surface texture, and secondary caries by two previously calibrated dentists. The overall performance of the restorations was evaluated by Wilcoxon signed ranks test. The chi-square test was used to determine differences in the performance of the restorations in which the flowable composite was applied first. RESULTS: There was no secondary caries or postoperative sensitivity in any of the restorations at the 6-month, 1-year, and 2-year follow-up examinations. After 2 years, only one Admira restoration had failed; all other restorations were available for evaluation. There were no statistically significant differences among the materials regardless of the prior use of flowable material (p > 0.05). There was no statistically significant difference between the restorations with and without the prior application of flowable materials (p > 0.05). CONCLUSION: The clinical performance of occlusal restorations using ormocer or nanofill composite did not benefit from the additional use of the flowable composite. Both of the restorative materials exhibited ideal clinical performance.     

Clinical evaluation of a flowable resin composite in non-carious Class V lesions: two-year results

This in vivo study evaluated the clinical performance and appearance of a flowable resin composite and a hybrid resin composite over two years. Twenty-eight (28) pairs of restorations of a flowable resin composite and a conventional hybrid resin composite were placed in non-carious, asymptomatic facial Class V lesions. The restorations were evaluated at baseline, six, twelve, eighteen and twenty-four (6, 12, 18 and 24) months, using modified Ryge/USPHS criteria. No significant difference (p < 0.05) was observed in the performance or appearance of both materials.     

Two-year clinical evaluation of composite resins in non-carious cervical lesions

Objective

The purpose of this double-blind, randomised trial was to compare the clinical performance of a hybrid composite (Clearfil AP-X, Kuraray, Tokyo) and a nanocomposite (Filtek Z350, 3M ESPE, St. Paul, MN) over a period of 2 years in non-carious class V lesions using a modified US Public Health Service (USPHS) system.

Methods

Forty-six patients with at least one pair of equivalent non-carious cervical lesions under occlusion and a mean age of 44.1 years (range 27–66 years; median 45 years) were enrolled in this study. A total of 116 restorations (58 with each material) were placed according to manufacturer's instructions by two calibrated operators. The restorations were evaluated at baseline and at 6, 12 and 24 months after placement using the USPHS criteria for retention, colour match, marginal discolouration, marginal adaptation, anatomic form, surface texture and secondary caries. Statistical analysis was conducted using the Cochran and the McNemar tests at a significance level of 5 % (P?<?0.05).

Results

No surface texture changes or secondary caries were detected in association with any restorations. The retention rates for Clearfil AP-X (100 %) and for Filtek Z350 (91.38 %) did not differ significantly (P?>?0.05). Two Z350 restorations were completely lost after 2 years. No significant differences were observed in the colour match, marginal discolouration, marginal adaptation or anatomic form.

Conclusions

There were no significant differences in the clinical performances between the materials.

Clinical relevance

Both restorative materials exhibited acceptable clinical performance in class V non-carious lesions 2 years post-restoration.     

An 18-months' evaluation of self-etch and etch & rinse adhesive in non-carious cervical lesions

OBJECTIVE. In this intra-individual comparison (an 18-months' randomized, controlled prospective study), we evaluated the clinical performance of one self-etch and one "etch & rinse" adhesive in non-carious cervical lesions. METHODS. Twenty-five patients with at least two pairs of similar-sized non-carious cervical lesions participated. Seventy-eight restorations were placed; 39 with etch & rinse (Single-Bond) and 39 with self-etch (Adper Prompt). Both adhesives were combined with the microfilled resin composite Filtek-A110. The restorations were evaluated at baseline, 6, 12, and 18 months according to slightly modified USPHS criteria. Statistical differences between the adhesives was tested with McNemar's test and clinical degradation over time for each material with the Fisher exact test (a=0.05). RESULTS. Thirty pairs were evaluated at 12 and 18 months. Two self-etch restorations were lost after 18 months. Nine Adper Prompt and four Single-Bond restorations scored bravo for marginal adaptation at 18 months (p<0.05). Nine Adper Prompt and three Single-Bond restorations scored bravo for marginal discoloration (p<0.05). CONCLUSIONS. Both adhesive systems showed acceptable clinical retention rates according to the ADA full acceptance criteria for enamel-bonding systems in class V non-carious lesions. The self-etch adhesive showed a faster progressive marginal degradation.     

A 7-year randomized prospective study of a one-step self-etching adhesive in non-carious cervical lesions. The effect of curing modes and restorative material

Objective

The aim of this study was to evaluate the clinical retention of a one-step self-etching adhesive system (Xeno III) in Class V non-carious cervical lesions and the effect of restorative material and curing techniques on longevity of the restorations.

Materials and methods

A total of 139 Class V restorations were placed with the self-etching primer Xeno III and a resin composite (Tetric Ceram) or a poly-acid modified resin composite (Dyract AP) in non-carious cervical lesions without intentional enamel involvement. The materials were cured with a conventional continuous light, a soft-start or a pulse-delay curing mode. The restorations were evaluated at baseline, 6, 12, 18 and 24 months and then yearly during a 7 year follow-up with modified USPHS criteria. Dentine bonding efficiency was determined by the percentage of lost restorations.

Results

During the 7 years, 135 restorations could be evaluated. No post-operative sensitivity was reported by the participants. Overall relative cumulative loss rate frequencies for the adhesive system at 6 and 18 months and 7 years, independent of curing technique and restorative material, were 0.8%, 6.9% and 23.0%, respectively. The self-etching adhesive fulfilled at 18 months the full acceptance ADA criteria. Tetric Ceram showed at 7 years a 20.9% loss of retention and Dyract AP a 25.0% loss rate (Log rank p = 0.48). The loss rates for the 3 curing techniques: continuous, soft start and pulse delay were 17%, 27.9% and 24.4%, respectively (Log rank p = 0.52). No secondary caries was observed.

Significance

The single-step self-etching adhesive showed acceptable clinical long-time retention rates to dentine surfaces independent of restorative material and curing technique used.     

Two-year clinical performance of Class V resin-modified glass-lonomer and resin composite restorations

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 clinically 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 materials. 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.     

Determination of changes on tooth-colored cervical restorations in vivo using a three-dimensional laser scanning device

The present study aimed at the determination of changes of tooth-colored cervical restorations in vivo using an optical 3-dimensional laser scanning device. The study was performed on 197 cervical restorations placed on incisors, canines, and premolars. Four different tooth-colored restoration materials, a composite, a polyacid-modified resin composite, and two resin-modified glass ionomer cements, were used for the restoration of the lesions. For the determination of changes, images were taken at baseline and 15, 24 and 36 months after the placement of the fillings using a 3D-laser scanning device. The images were superimposed automatically, and digital subtraction was made by a specially developed image analysis software. The total substance loss on the entire filling surface at 36 months for the resin-modified glass ionomer Photac-Fil was 44 (+/-23) microm, for Fuji II LC 45 (+/-26) microm, for Dyract 71 (+/-47) microm and for Tetric 18 (+/-12) microm. Differentiating between the class of lesion, a higher wear rate was observed at 36 months on restorations which had been placed in erosion/non-carious cervical cavities (66 (+/-33) microm). In conclusion, the composite material demonstrated a distinctly lower surface wear rate over time in comparison to the resin-modified glass ionomer cements and the polyacid-modified resin composite.     

A 12-month clinical evaluation of composite resins in class III restorations

PURPOSE: This paired-tooth randomized controlled prospective clinical study compared the clinical performance of three composite resins in Class III cavities after 12 months. MATERIALS AND METHODS: Three materials were evaluated: a microfilled composite resin (Durafill VS), a hybrid composite resin (Filtek Z250), and a nanofilled composite resin (Filtek Supreme). Thirty-eight patients having at least three Class III restorations were enrolled in this study. A total of 114 restorations were placed by two calibrated operators according to the manufacturers' instructions. The adhesive system (Clearfil SE Bond) was either applied according to manufacturer's instructions (CSE non-etch) or enamel margins were first etched with phosphoric acid (CSE etch). One week later, the restorations were finished and polished. Two other independent examiners evaluated the restorations at baseline according to the USPHS criteria and USPHS modified criteria for the items color match and surface appearance. The restoration location was taken into consideration during the analysis of each item. A nonparametric analysis of variance (Friedman test) and the Wilcoxon test were used for statistical analysis (alpha = 0.05). RESULTS: The restoration location did not influence the evaluated items. Filtek Z250 showed the best color match at baseline, and after 6 and 12 months. No significant difference in the item surface appearance was detected at baseline; however, after 6 and 12 months, Filtek Z250 showed the worst performance on this item. No significant difference was found between CSE non-etch and CSE etch groups. CONCLUSION: The hybrid composite resin showed an excellent immediate and 12-month color match, which was superior to the nanofilled and microfilled composites tested. On the other hand, the nanofilled and microfilled composites showed the best surface appearance after 12 months. Additional etching of the enamel cavity margins did not influence the clinical performance of the adhesive Clearfil SE Bond.     

Effect of light-activation methods and water storage on the flexural strength of two composite resins and a compomer

The present study evaluated the flexural strength of three composite resins recommended for direct esthetic restorations: a polyacid modified composite (Dyract AP), a unimodal composite resin (Filtek Z250) and a hybrid composite resin (Point 4). The variation factors, apart from the type of composite resin, were the light activation method and the water storage period. The composite resins were light-cured in continuous mode (40 s, 500 mW/cm2) or in ramp mode (0-800 mW/cm2 for 10 s followed by 30 s at 800 mW/cm2) and stored for 24 hours or 30 days in distilled water at 37 degrees C. The data were analyzed by ANOVA and Tukey test for multiple comparisons (alpha = 0.05). The composite resin Z250 presented the highest mean flexural strength (166.74 MPa) and Dyract AP presented the lowest one (129.76 MPa). The storage for 30 days decreased the flexural strength in ramp mode (24 h: 156.64 MPa; 30 days: 135.58 MPa). The light activation method alone did not lead to different flexural strength values.     

In vitro wear evaluation of dental materials in primary teeth

PURPOSE: To evaluate the effect of dental materials on primary enamel wear. METHODS: Four composites (Filtek Z250, Heliomolar, Point 4, SureFil), two compomers (Dyract AP, F2000) and a resin-modified glass-ionomer (Vitremer) were placed into box-shaped preparations in buccal surfaces of primary molars and stored for 24 hours in water at 37 degrees C. The specimens (n = 6) were subjected to abrasive three-body wear against a primary enamel cusp. Material wear, enamel wear (adjacent to the material), and wear on enamel cusps were estimated by profilometry and video-analysis software. Results were compared with ANOVA and Tukey's tests (P < 0.05). RESULTS: Vitremer showed the highest wear (P < 0.05), followed by Dyract AP and F2000, which were not statistically different (P > 0.05). There was no significant difference between Filtek Z250 and Dyract AP (P > 0.05). Filtek Z250, Heliomolar, Point 4 and SureFil, showed the lowest wear values and there was no difference among them (P > 0.05). The highest wear values on the enamel adjacent to the material were found with Dyract AP (P < 0.05) and the lowest next to Point 4 and SureFil (P < 0.05). There was no difference in the wear of the enamel next to Vitremer, F2000, Heliomolar and Filtek Z250 (P > 0.05). Vitremer and F2000 caused the highest wear on enamel cusps (P < 0.05), and there was no statistically significant difference (P > 0.05) between them; SureFil caused the lowest wear (P < 0.05) on the opposing enamel. There was a correlation (r = 0.85) between wear of materials and wear on the enamel cusps, but not (r = 0.53) for the wear on enamel besides the restoration and wear on enamel cusps. SEM micrographs showed different surface characteristics of the materials after the wear test.     

5-year clinical performance of resin composite versus resin modified glass ionomer restorative system in non-carious cervical lesions

AIM: To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions. METHOD AND MATERIALS: One operator placed 70 restorations (35 resin modified glass ionomer restorations and 35 resin composite restorations) in 30 patients under rubber dam isolation without mechanical preparation. The restorations were directly assessed by 2 independent examiners, using modified USPHS criteria at baseline and 6, 12, 24 and 60 months. RESULTS: Twenty-two patients were available for recall after 5 years (73.3% recall rate) and 55 out of 70 restorations were evaluated. Excellent agreement was registered for all criteria between examiners (kappa > or = 0.85). Sixteen composite restorations were dislodged (51.5% retention) and 1 ionomer restoration was lost (96.4% retention). The McNemar test detected significant differences in resin composite restorations between baseline and 5-year recall for marginal integrity (p<0.001) and retention (p=0.004). For resin modified glass ionomer restorations, no significant differences were identified for all criteria (p>0.05). When comparing both materials, the Fisher exact test pointed out significant differences in retention (p=0.002) after 5 years of clinical service. CONCLUSIONS: After 5 years of evaluation, the clinical performance of resin modified glass ionomer restorations was superior to resin composite restorations.     

Clinical evaluation of self-etch adhesives in Class V non-carious lesions

PURPOSE: To evaluate the clinical performance of two self-etching and one total-etch adhesives in Class V non-carious cervical lesions (NCCL). METHODS: Two self-etching primers, Clearfil SE Bond and Hybrid Bond, and one total etch adhesive, Admira Bond, were placed in 195 NCCL. Restorations were evaluated at baseline, 1 and 2 years using the USPHS criteria. RESULTS: No restoration was lost after 1 and 2 years for all materials. There was no significant difference between the baseline and 2-year results for Admira Bond and Clearfil SE Bond restorations. In contrast, Hybrid Bond restorations showed significant deterioration in marginal adaptation and cavosurface marginal discoloration after 2 years. Also, there was no significant difference between Admira Bond and Clearfil SE Bond at each recall period.