title: The Thickness of the Adhesive Layer Increases the Misdiagnosing of the Radiolucent Zones and Restoration Replacement Indication.
abstract: OBJECTIVE
  To evaluate the influence of the thickness of the adhesive layer and demineralized dentin on the decision to replace composite restoration.
  
  
  METHODS
  Eighty human third molars with occlusal preparations (Class I) were randomly assigned to eight groups (n = 10): adhesive system (Clearfil SE Bond [CSE] or Scotchbond Universal Adhesive [SBU]); the number of adhesive layers (one or two); and substrate (sound or demineralized dentin). A blinded examiner evaluated radiographs of each restored tooth. Obtained scores for the presence or absence of radiolucent zone under restoration were submitted to a relative risk (RR) calculus and Z-test, and the scores for the decision to replace restorations were submitted to Fisher's exact test (p < 0.05).
  
  
  RESULTS
  The relative risk of identifying a radiolucent zone under restoration in sound and demineralized dentin were, respectively, 2 and 1.85 times higher when two layers of adhesive were applied. Demineralized dentin did not increase the probability of identifying a radiolucent zone. A higher relative (1.6, p = 0.01) was observed when two layers of SBU were applied. The number of layers did not influence the relative risk for CSE (RR = 1.3, p = 0.13).
  
  
  CONCLUSIONS
  Thicker layers of SBU increase the relative risk of identifying a radiolucent layer under restoration and the decision to replace a/composite restoration, irrespective of the substrate. The presence of demineralized dentin did not increase the probability of identifying a radiolucent zone when compared to sound dentin.
  
  
  CONCLUSIONS
  The results of this in vitro study suggest that thicker layers of a particular adhesive under resin composite restorations can negatively influence the decision to replace them. (J Esthet Restor Dent 29:193-200, 2017).
authors.affiliation: Post Graduate Program in Dental Sciences, Federal University of Santa Maria, Brazil, Rua Marechal Floriano Peixoto, 1184, Santa Maria, RS, 97015-270, Brazil.
authors.forename: Tatiana Tambara
authors.initials: TT
authors.lastname: Fröhlich
authors.affiliation: Post Graduate Program in Dental Sciences, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil.
authors.forename: Gabriel Ferreira
authors.initials: GF
authors.lastname: Nicoloso
authors.affiliation: Post Graduate Program in Dental Sciences, Federal University of Santa Maria, Brazil, Rua Marechal Floriano Peixoto, 1184, Santa Maria, RS, 97015-270, Brazil.
authors.forename: Tathiane Larissa
authors.initials: TL
authors.lastname: Lenzi
authors.affiliation: Department of Restorative Dentistry, Federal University of Santa Maria, Brazil, Rua Marechal Floriano Peixoto, 1184, Santa Maria, RS, 97015-270, Brazil.
authors.forename: Fabio Zovico Maxnuck
authors.initials: FZM
authors.lastname: Soares
authors.affiliation: Department of Stomatology, Federal University of Santa Maria, Brazil, Rua Marechal Floriano Peixoto, 1184, Santa Maria, RS, 97015-270, Brazil.
authors.forename: Rachel
authors.identifier: http://orcid.org/0000-0001-7737-2257
authors.initials: R
authors.lastname: De Oliveira Rocha
mesh_terms: D001840:Dental Bonding / Q000379:methods; D003793:Dental Restoration, Permanent / Q000379:methods*; D017220:Dentin-Bonding Agents / Q000737:chemistry*; D003951:Diagnostic Errors; D006801:Humans; D066298:In Vitro Techniques; D008422:Materials Testing; D008964:Molar, Third / Q000000981:diagnostic imaging; D011897:Random Allocation; D019279:Resin Cements; D019233:Retreatment; D013499:Surface Properties
chemical_list: C438313:Clearfil SE Bond; D017220:Dentin-Bonding Agents; D019279:Resin Cements; C041330:Scotchbond