Eight-year clinical evaluation of a 2-step self-etch adhesive with and without selective enamel etching.
OBJECTIVE
The objective of this randomized controlled clinical trial was to evaluate the 8-year clinical performance of a mild 2-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 their 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 small but clinically acceptable marginal defect (C-SE non-etch: 92%; C-SE etch: 84%) and/or a 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: 11%; C-SE etch%) 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).


CONCLUSIONS
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.
Peumans
M
M
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. marleen.peumans@med.kuleuven.be
De Munck
J
J
Van Landuyt
K L
KL
Poitevin
A
A
Lambrechts
P
P
Van Meerbeek
B
B
D000134:Acid Etching, Dental / Q000379:methods*; D003188:Composite Resins; D003743:Dental Enamel; D018772:Dental Marginal Adaptation; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent; D003807:Dentin Sensitivity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010756:Phosphoric Acids; D019279:Resin Cements; D018709:Statistics, Nonparametric; D019237:Tooth Cervix; D014075:Tooth Discoloration; D016896:Treatment Outcome
C438313:Clearfil SE Bond; D003188:Composite Resins; D010756:Phosphoric Acids; D019279:Resin Cements; C030242:phosphoric acid