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.
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
M
M
Peumans
J
J
De Munck
K L
KL
Van Landuyt
A
A
Poitevin
P
P
Lambrechts
B
B
Van Meerbeek
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