IADR edition:88th General Session location:Barcelon date:14-17 July 2010
Journal of Dental Research 89B: n°3565
Objectives: The objective of this randomized controlled clinical trial was to evaluate the 8-year clinical performance of a mild two-step self-etch adhesive in non-carious Class-V lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins. Methods: A total of 100 non-carious Class-V lesions in 29 patients were restored with Clearfil AP-X (Kuraray). The composite restorations were bonded following two different approaches: 1. application of Clearfil SE (Kuraray) following a self-etch approach (control group; C-SE non-etch); 2. selective phosphoric acid-etching of the enamel cavity margins before application of Clearfil SE (experimental group; C-SE etch). The restorations were evaluated after 6 months, 1, 2, 3, 5 and 8 years of clinical service regarding retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. Results: The recall rate at 8 years was 76%. Only two restorations, one of the C-SE non-etch group and one of the C-SE etch group, were clinically unacceptable due to loss of retention leading to a retention rate and a clinical success rate of 97% in both groups. Aging of the restorations was characterized by an increase in the percentage of restorations with a clinically acceptable but small marginal defect (C-SE non-etch:92%; C-SE etch:84%) and/or superficial marginal discoloration (C-SE non-etch:44%; C-SE etch:28%). At the enamel side, the presence of small marginal defects (C-SE non-etch:86%; C-SE etch:65%) and superficial marginal discoloration (C-SE non-etch:36%; C-SE etch:11%) was more frequently noticed in the control group than in the experimental group. The difference, however, was only statistically significant for the presence of superficial marginal discoloration (McNemar, p=0.01). Conclusion: After 8 years of clinical functioning, the clinical effectiveness of Clearfil SE remained excellent, with selective acid-etching of the enamel cavity margins only having some minor positive effect on marginal integrity and absence of marginal discoloration at enamel.