title: A randomized controlled 5-year prospective study of two HEMA-free adhesives, a 1-step self etching and a 3-step etch-and-rinse, in non-carious cervical lesions.
abstract: OBJECTIVE
  The aim of this study was to evaluate the 5 year clinical dentin bonding effectiveness of two HEMA-free adhesives in Class V non-carious cervical lesions.
  
  
  METHODS
  A total of 169 Class V restorations were placed in 67 patients with a self-etching adhesive (G-Bond; 67), a 3-step HEMA and TEGDMA free etch-and-rinse (cfm; 51) and a control HEMA-containing etch-and-rinse adhesive (XP Bond; 51) in non-carious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline and yearly during a 5 year follow-up with modified USPHS criteria. Dentin bonding efficiency was determined by the percentage of lost restorations.
  
  
  RESULTS
  During the 5 years, 159 restorations could be evaluated. Good short time dentin retention was observed for the three adhesives, there all adhesives fulfilled at 18 months the full acceptance ADA criteria. At 5 years a cumulative number of 22 lost restorations (13.8%) was observed. The HEMA-free adhesives showed significantly higher dentin retention compared to the HEMA-containing one. Loss of retention was observed for 5 G-Bond (7.9%), 4 cfm (8.3%) and 13 XP Bond (27.1%) restorations (p<0.05). No post-operative sensitivity was reported by the participants. No secondary caries was observed.
  
  
  CONCLUSIONS
  The durability in non-carious cervical lesions of the HEMA-free adhesives was successful after 5 years. Despite concerns which have been raised, showed the 1-step SEA one of the best reported clinical dentin bonding effectiveness.
authors.affiliation: Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden. Electronic address: Jan.van.Dijken@odont.umu.se.
authors.forename: Jan W V
authors.initials: JW
authors.lastname: van Dijken
mesh_terms: D003738:Dental Cements; D003793:Dental Restoration, Permanent; D006801:Humans; D008689:Methacrylates; D011446:Prospective Studies; D019237:Tooth Cervix / Q000473:pathology*
chemical_list: D003738:Dental Cements; D008689:Methacrylates; C005044:hydroxyethyl methacrylate
keywords: Adhesion; Cervical; Clinical; Composite resin; Dental resin; Restoration; Self-etch