Randomized clinical trial of five adhesive systems in occlusal restorations: One-year results

THREE YEARS CLINICAL ASSESSMENT OF LOW CONCENTRATION DIMETHYL SULFOXIDE PRIMER IN NON CARIOUS CERVICAL LESIONS: A RANDOMIZED CONTROLLED TRIAL

OBJECTIVES

to evaluate the clinical effectiveness of 1% dimethyl-sulfoxide (DMSO/H2O) dentin pretreatment on the clinical performance of 2-step etch-rinse adhesive after 36-months of a follow-up.

METHODS

Twenty-nine patients with 82 non carious-cervical lesions NCCLs were eligible for the study. NCCLs were randomly distributed into 2 equal groups. Both groups were acid etched then bonded with (Single-bond2, 3M-ESPE) and restored with a nanohybrid composite (Z350XT, 3M-ESPE) under rubber-dam isolation. Only for the intervention group 1% DMSO/H2O was applied for 60s then blot dried after etching and before bonding. The restorations were evaluated at baseline, 12-, 24-, and 36-months using FDI criteria for evaluation of the restoration. For the statistical analysis, intergroup comparison between interventions was performed using Chi-Square-test (P ≤ .05), intragroup comparison within each intervention was performed using the Cochran's Q-test (P ≤ .0083).

RESULTS

In the current study, intergroup comparison between both groups at baseline and after 12, 24 and 36 months showed no statistically significant differences for all tested outcomes (P > .05), except for marginal discoloration at 36 months, where there was statistically significant difference (P < .05) favoring DSMO. Intragroup comparison within control revealed statistically significant deterioration through time (P < .001) for all tested parameters, also within DSMO there was statistically significant change through time (P < .0083).

CONCLUSION

The clinical performance of a 2-step etch-rinse adhesive in combination with 1% DMSO pretreatment was better than the control without pretreatment. Longer follow-up and higher concentrations of DMSO pretreatment should be evaluated in the future.

CLINICAL SIGNIFICANCE

Several laboratory studies showed that DMSO pretreatment improves the hybrid layer quality and integrity. However, this clinical trial gave the proof of the clinical effectiveness of this protocol after 36-months follow-up.

Three-year clinical performance of direct restorations using low-shrinkage Giomer vs. nano-hybrid resin composite

Objectives

The objective of this investigation was to compare the clinical performance of a nano-hybrid resin composite and a low-shrinkage Giomer resin composite.

Material and methods

In total, 35 pairs of restorations were performed using either low-shrinkage Giomer (Beautifil II LS, Shofu Inc.) or nano-hybrid (Clearfil Majesty Posterior) resin composite in 35 patients by two operators using the relevant adhesives, i.e., FL-Bond II (Shofu Inc.) and Clearfil SE Bond (Kuraray), with the self-etching technique according to each manufacturer's instructions. Two clinicians assessed the restorations 2 weeks (baseline); 6 months; and 1, 2, and 3 years after the restorative procedures using FDI (World Dental Federation) criteria (Scores 1-5). Data were analyzed using the marginal homogeneity and McNemar tests. The survival rate was calculated using Kaplan-Meier survival analysis and the survival of the two groups was compared with the log-rank test (p = 0.05).

Results

The mean observation period was 37.7 ± 6.8 months. All restorations completed their 3-year follow-up. The criteria were mainly rated with high (1 or 2) scores for quality in both groups. Only one restoration in the low-shrinkage Giomer resin composite group was accepted as a failure at the 2-year recall due to retention loss.

Conclusion

At the 3-year follow-up, the performance of the restorations using the Giomer and the nano-hybrid resin composite were similar and clinically acceptable.

Clinical relevance

The low-shrinkage Giomer resin composite exhibited a similar clinical performance to the nano-hybrid resin composite after 3 years in service with both materials displaying minor surface deteriorations at the 3-year recall.

Clinical Trial Registration

https://clinicaltrials.gov, identifier: NCT02823769.

Patients´ satisfaction concerning direct anterior dental restoration

The objective of this study was to observe patients' satisfaction with their in-service direct anterior dental restorations and to compare it with clinical evaluation using FDI (Federation Dental International) criteria. Patients scored their own anterior dental restorations regarding satisfaction (satisfactory /dissatisfactory). If dissatisfaction was mentioned, then, they would be interviewed about the complaint. In the same session, the dental restorations were clinically evaluated by two dentists using FDI criteria (1-5 score) concerning esthetic, functional, and biological domains. Descriptive statistics were used for frequencies of scores attributed by patients and clinicians. In order to compare patients' to clinicians' frequencies, the Chi-square test was applied (p ≤ 0.05). A total of 106 restorations were evaluated by patients and clinicians. Patients reported 52.8% of restorations satisfactory and 47.8% dissatisfactory. Overall, clinicians reported the same restorations as 82,3% satisfactory and 17,6% dissatisfactory. Patients' most frequent complaints referred to color, followed by anatomical form, fracture of material and retention, and approximal anatomical form. Comparing patients' satisfaction and dissatisfaction rates to clinicians' evaluation per criteria, there was no difference regarding esthetics. The frequency of dissatisfactory restorations by clinicians was significantly lower when functional and biological properties were compared with patients' opinions. Direct anterior dental restorations were more frequently reported as satisfactory by patients and clinicians, being the main complaints related to esthetic issues. When clinicians and patients' evaluations were compared, it was observed that the frequencies of satisfactory restoration by patients and clinicians were similar regarding esthetic properties, and significantly different regarding functional and biological properties.

Evaluation of the efficacy of a 2-step etch-and-rinse, 2-step self-etch and 1-step self-etch adhesive systems, in class II primary molars restorations. An one year prospective, randomized clinical trial

PURPOSE

To evaluate the clinical efficacy at 6 months (6 M) and 12 months (12 M) of 3 adhesive strategies (two-step etch-and-rinse; two-step self-etch; one step self-etch) used in composite resin restorations in primary molars.

METHODS

This randomized clinical study involved 101 class II restorations in primary molars of 34 children (4-8 years old), distributed by 3 groups according to the 3 tested adhesive systems: GI- Clearfil^TMS³Bond Plus (CSB); GII- Clearfil^TMSE Protect Bond (CSEPB); GIII- Prime&Bond®XP (PBXP). Restorations were evaluated according to FDI criteria, immediately after execution, at 6 M and 12 M. All ethical and legal requirements were met. Statistical analysis was performed using IBM®SPSS®v26 and MS Excel® (5% significance level).

RESULTS

The aesthetic, biological and most of the functional parameters evaluated remained without significant changes over time. Statistically significant differences were only found regarding the "marginal adaptation" parameter at 12 M, with worsening of scores for the three groups (p < 0.001). Comparing the groups, no significant differences were detected between any of the evaluated parameters (aesthetics properties: p = 0.721; functional properties: p = 0.122).

CONCLUSIONS

After a one-year period, the self-etch adhesives tested presented a clinical efficacy similar to the etch-and-rinse adhesive in restoring class II cavities in primary molars.

TRIAL REGISTRATION NUMBER

ISRCTN11458186.

The Retention Effect of Resin-Based Desensitizing Agents on Hypersensitivity-A Randomized Controlled Trial

Recently, the development of dental materials has increased the availability of various hyperesthesia desensitizers. However, there are no studies on the duration of retreatment in terms of adherence rates. Thus, the adhesion rates of resin-based desensitizers were investigated. We used a conventional desensitizer and a recently developed desensitizer containing calcium salt of 4-methacryloxyethyl trimellitic acid (C-MET) and 10-methacryloyloxydecyl dihydrogen calcium phosphate (MDCP). These colored agents were applied to the surfaces of premolars and molars, and the area was measured from weekly oral photographs. Areas were statistically analyzed and mean values were calculated using 95% confidence intervals. A p-value of <0.05 was considered statistically significant. These rates were significantly higher on the buccal side of the maxilla and lower on the lingual side of the maxilla. In addition, the desensitizer containing C-MET and MDCP displayed significantly higher adhesion rates. It is suggested that this will require monthly follow-ups and reevaluation because both agents cause less than 10% adherence and there is almost no sealing effect after 4 weeks. In addition, the significantly higher adhesion rate of the desensitizer containing C-MET and MDCP indicated that the novel monomer contributed to the improvement in the adhesion ability.

Clinical decision-making in anterior resin composite restorations: a multicenter evaluation

OBJECTIVE

This study investigated whether a sample of anterior resin composite restorations could be differently evaluated in different centers of evaluation by clinical and lay evaluators.

METHODS

Anterior resin composite restorations on high-quality intraoral digital photography were evaluated using FDI criteria (1-5 score) by pairs of clinical and lay evaluators in Brazil (BR), France (FR), Peru (PE), and the United States of America (USA). Scores were allocated as maintenance (1, 2, 3), repair (4) and replacement (5) when comparing clinical evaluators and, as acceptable (1, 2, 3) and unacceptable (4, 5) when comparing clinical vs. lay evaluators and lay vs. lay evaluators. The Chi-square test compared the frequencies of scores among the centers.

RESULTS

The frequencies of maintaining, repairing, or replacing anterior resin composite restorations given by clinical evaluators varied depending on the evaluation center. BR and PE showed the highest frequencies for repair and replacement, while FR and USA showed the highest frequencies for maintenance. The comparison of frequencies of anterior resin composite restorations accepted or unaccepted by the clinical vs lay evaluators in the same centers showed a significantly higher frequency of acceptable dental restorations coming from clinical evaluators. Comparison between lay evaluators from different centers showed significant higher frequency of unacceptable dental restorations by BR, compared to other centers.

CONCLUSIONS

In the evaluation of anterior resin composite restorations, the maintenance, repair, or replacement trends can vary among different centers. The unacceptable rate came more frequently from lay than from clinical evaluators. Lay evaluators from different centers differed significantly.

CLINICAL SIGNIFICANCE

Clinical and lay evaluators in distant evaluation centers can present different trends when assessing anterior resin composite restoration. Multicenter evaluations can help to understand such differences and it is important because clinical decision-making based on scientific evidence comes from clinical studies done in different research centers.

Polyphenols and Brazilian red propolis incorporated into a total-etching adhesive system help in maintaining bonding durability

Objectives

The aim of this study was to evaluate the degree of conversion and bond strength of a commercial dental adhesive modified by the incorporation of quercetin, resveratrol (RES), and Brazilian red propolis (BRP).

Methods

BRP markers were identified using ultra-performance liquid chromatography coupled with a diode array detector, and the antioxidant activity (AAO) of the three substances was analyzed. Single Bond 2 adhesive (3M ESPE) was modified by adding BRP, quercetin, and RES, separately, at 20 μg/mL, 250 μg/mL, and 500 μg/mL, respectively. The degree of conversion (DC) was measured using near-infrared spectroscopy 24 h after photopolymerization. Measurements of the resin-dentin microtensile bond strength (μTBS) were carried out after 1 day and 1 year. Student's t test and ANOVA with Tukey's test were used for data analysis (α = 0.05).

Results

The markers daidzein, liquiritigenin, pinobanksin, isoliquiritigenin, formononetin, pinocembrin, and biochanin A were found in the ethanolic extract of BRP. Quercetin, RES, and BRP showed high AAO. The DC of the tested adhesives remained adequate for this category of material, with a slight increase in the DC of adhesives with quercetin and BRP (P > 0.05). Comparisons between μTBS measurements made at 1 day and 1 year showed that, contrary to the control group, μTBS values for all modified adhesives were maintained after 1 year in distilled water (P > 0.05).

Conclusions

These findings suggest that quercetin, RES, or BRP might be useful in adhesive dentistry to help improve hybrid layer resistance.

Clinical significance

Dentin bonding agents with quercetin, RES, and BRP have potential to increase the longevity of composite restorations.