A randomized controlled clinical trial of a HEMA-free all-in-one adhesive in non-carious cervical lesions at 1 year.
OBJECTIVE
One-step self-etch adhesives are the most recent generation of adhesives introduced onto the market. The objective of this randomized controlled clinical trial was to test the hypothesis that a one-step self-etch adhesive performs equally well as a conventional three-step etch&rinse adhesive (gold standard).


METHODS
Fifty-two patients had 267 non-carious cervical lesions restored with Gradia Direct Anterior (GC). These composite restorations were bonded either with the 'all-in-one' adhesive G-Bond (GC) or with the three-step etch&rinse adhesive Optibond FL (Kerr). The restorations were evaluated after 6 and 12 months clinical service regarding their retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. A logistic regression analysis with generalized estimating equations was used to account for the clustered data (multiple restorations per patient).


RESULTS
The recall rate at 1 year was 98%. The statistical analysis revealed a relatively low patient factor, indicating that supplementary information could be obtained from the additional restorations placed per patient. The retention rate for G-Bond was 98.5% compared to 99.3% for Optibond FL, due to the retention loss of two and one restorations, respectively. There were no significant differences between the two adhesives regarding the evaluated parameters except for the presence of small enamel marginal defects with G-Bond.


CONCLUSIONS
After 12 months, the simplified one-step G-Bond and the three-step Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation of marginal adaptation, and G-Bond exhibited more small enamel marginal defects.
Van Landuyt
K L
KL
Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Kapucijnenvoer 7, B-3000 Leuven, Belgium.
Peumans
M
M
Fieuws
S
S
De Munck
J
J
Cardoso
M V
MV
Ermis
R B
RB
Lambrechts
P
P
Van Meerbeek
B
B
D000134:Acid Etching, Dental / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003188:Composite Resins / Q000737:chemistry / Q000627:therapeutic use*; D018772:Dental Marginal Adaptation; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000379:methods*; D017220:Dentin-Bonding Agents / Q000737:chemistry / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008689:Methacrylates / Q000737:chemistry / Q000627:therapeutic use; D008875:Middle Aged; D019279:Resin Cements / Q000737:chemistry / Q000627:therapeutic use; D019237:Tooth Cervix / Q000473:pathology*; D055815:Young Adult
D003188:Composite Resins; D017220:Dentin-Bonding Agents; C498353:G-Bond; C470230:Gradia; D008689:Methacrylates; C469607:OptiBond FL; D019279:Resin Cements; C005044:hydroxyethyl methacrylate