title: Does operatory field isolation influence the performance of direct adhesive restorations?
abstract: OBJECTIVE
  To evaluate the influence of different adhesive strategies (etch-and-rinse and self-etching adhesives) and type of field isolation (absolute or relative) on the clinical performance of restorations of noncervical carious lesions (NCCLs).
  
  
  METHODS
  One hundred forty NCCLs were selected from 38 patients, according to previously established inclusion/exclusion criteria, and assigned to one of four groups (n = 35): etch-and-rinse/rubber-dam (ERR), etch-and-rinse/cotton roll (ERC), self-etching/rubber-dam (SER) and self-etching/cotton roll (SEC). The adhesive systems used were: Adper Single Bond 2 (3M ESPE) and Adper SE Plus (3M ESPE), with restorations made using a composite resin (Z350, 3M ESPE). Using the USPHS modified criteria, 140 restorations were evaluated by two calibrated examiners at 5 different times: immediately after placement, at 7 days, and 2, 6, and 12 months. In order to evaluate the presence of gingival recession after the use of the #212 rubber-dam clamp, the clinical crowns of the teeth from groups ERR and SER were measured at six different periods (baseline, immediately, and at 7 days, 2, 6, and 12 months). Data were subjected to McNemar's, chi-square, and Student's t-tests.
  
  
  RESULTS
  Both adhesive strategies reduced tooth sensitivity beyond the second period of evaluation (7 days); tooth sensitivity disappeared after the third period of evaluation (2 months). There were no statistically significant differences between the adhesive techniques or isolation techniques, except for a Bravo score for marginal discoloration in group SEC at 6 months, which was significantly different from the other groups. The rubber-dam isolation technique was more uncomfortable for the patient and resulted in short-term gingival recession.
  
  
  CONCLUSIONS
  No significant differences were found between the types of isolation or adhesive strategy in this clinical evaluation, with the exception of 2 restorations in group SEC that showed marginal discoloration, possibly due to inadequate enamel etching by the self-etching adhesive. Class V restorations perform equally well placed with or without rubber-dam.
authors.affiliation: Department of Operative Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil. edudaudt@hotmail.com
authors.forename: Eduardo
authors.initials: E
authors.lastname: Daudt
authors.forename: Guilherme Carpena
authors.initials: GC
authors.lastname: Lopes
authors.forename: Luiz Clovis
authors.initials: LC
authors.lastname: Vieira
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003188:Composite Resins; D003738:Dental Cements; D003793:Dental Restoration, Permanent / Q000009:adverse effects / Q000379:methods*; D003807:Dentin Sensitivity / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019279:Resin Cements; D016733:Rubber Dams / Q000009:adverse effects; D018709:Statistics, Nonparametric; D019237:Tooth Cervix; D057085:Tooth Wear / Q000628:therapy; D055815:Young Adult
chemical_list: C554641:Adper single bond 2; D003188:Composite Resins; D003738:Dental Cements; D019279:Resin Cements