title: 3-year clinical effectiveness of one-step adhesives in non-carious cervical lesions.
abstract: OBJECTIVE
  Despite representing an important component of current dental adhesives, HEMA has been said to negatively influence the long-term stability of adhesion to dentine and enamel. The aim of this randomised clinical trial was to evaluate the 3-year clinical performance of two one-step self-etch adhesives.
  
  
  METHODS
  Thirty patients had 175 non-carious cervical lesions restored with composite (Gradia Direct Anterior, GC) using either the HEMA-rich adhesive Clearfil Tri-S Bond (C3S; Kuraray) or the HEMA-free adhesive G-Bond (GB; GC). The restorations were evaluated by two examiners at baseline, 6, 12, 24 and 36 months regarding retention, caries recurrence, marginal integrity and discoloration and post-operative sensitivity. The data were statistically analysed with GEE and McNemar tests (p<0.05).
  
  
  RESULTS
  The recall rate at 6 and 12 months was 100% and decreased to 96.7% at 24 and 36 months. At 3 years, the retention rate was 93.8% for C3S and 98.8% for GB (p=0.14). A pairwise comparison showed no significant differences between the two adhesives for all the parameters evaluated, irrespective of the recall (p>0.05). After 3 years, both adhesives presented an increase in the percentage of clinically acceptable marginal discoloration (C3S: 32.9% and GB: 26.8%) normally associated to clinically acceptable marginal defects (C3S: 35.8% and GB: 26.5%). Only 1 dentine margin of a GB restoration presented a severe marginal defect (1.2%) and 1 C3S restoration presented caries recurrence. The overall 3-year clinical success rate was 92.6% for C3S and 97.6% for GB (p=0.16).
  
  
  CONCLUSIONS
  Both one-step self-etch adhesives presented an equally favourable clinical effectiveness at 3 years.
  
  
  CONCLUSIONS
  HEMA is a monomer frequently present in dental adhesives in order to increase their wettability and hydrophilicity. However, this monomer negatively influences hydrolytic stability and durability of the adhesive interface complex. In this 3-year clinical trial no significant difference in bonding effectiveness was noticed between a HEMA-rich and HEMA-free one-step adhesive.
authors.affiliation: KU Leuven - BIOMAT, Department of Oral Health Sciences, Catholic University of Leuven, Belgium.
authors.forename: S G
authors.initials: SG
authors.lastname: Moretto
authors.forename: E M A
authors.initials: EM
authors.lastname: Russo
authors.forename: R C R
authors.initials: RC
authors.lastname: Carvalho
authors.forename: J
authors.initials: J
authors.lastname: De Munck
authors.forename: K
authors.initials: K
authors.lastname: Van Landuyt
authors.forename: M
authors.initials: M
authors.lastname: Peumans
authors.forename: B
authors.initials: B
authors.lastname: Van Meerbeek
authors.forename: M V
authors.initials: MV
authors.lastname: Cardoso
mesh_terms: D000328:Adult; D000368:Aged; D003116:Color; D003188:Composite Resins / Q000737:chemistry; D001840:Dental Bonding; D003731:Dental Caries / Q000209:etiology; D018772:Dental Marginal Adaptation; D003764:Dental Materials / Q000737:chemistry; D003793:Dental Restoration, Permanent / Q000379:methods*; D003804:Dentin / Q000473:pathology; D003807:Dentin Sensitivity / Q000209:etiology; D017220:Dentin-Bonding Agents / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008689:Methacrylates / Q000737:chemistry; D008875:Middle Aged; D012008:Recurrence; D019279:Resin Cements / Q000737:chemistry; D013499:Surface Properties; D019237:Tooth Cervix / Q000473:pathology*; D014075:Tooth Discoloration / Q000209:etiology; D057085:Tooth Wear / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C515604:Clearfil Tri-S Bond; D003188:Composite Resins; D003764:Dental Materials; D017220:Dentin-Bonding Agents; C498353:G-Bond; D008689:Methacrylates; D019279:Resin Cements; C005044:hydroxyethyl methacrylate
keywords: Adhesive; Non-carious cervical lesion; Randomized clinical trial; Resin composite; Self-etch