Does operatory field isolation influence the performance of direct adhesive restorations?

Area of Science:

• Restorative Dentistry
• Dental Materials Science

Background:

• Noncervical carious lesions (NCCLs) require effective restorative treatments.
• Adhesive strategies and isolation techniques are crucial for successful dental restorations.

Purpose of the Study:

• To compare the clinical performance of etch-and-rinse versus self-etching adhesives.
• To evaluate the impact of absolute (rubber-dam) versus relative (cotton roll) isolation on NCCL restorations.

Main Methods:

• 140 NCCLs were treated using four groups: etch-and-rinse/rubber-dam, etch-and-rinse/cotton roll, self-etching/rubber-dam, and self-etching/cotton roll.
• Restorations were evaluated using modified USPHS criteria over 12 months.
• Gingival recession associated with rubber-dam use was measured.

Main Results:

• Both adhesive strategies effectively reduced tooth sensitivity within two months.
• No significant differences in clinical performance were observed between adhesive or isolation techniques.
• A marginal discoloration was noted in one self-etching group, potentially due to etching inadequacy.

Conclusions:

• Etch-and-rinse and self-etching adhesives demonstrate comparable clinical outcomes for NCCLs.
• Rubber-dam isolation and cotton roll isolation yield similar long-term results for these restorations.
• Class V restorations can be successfully placed using either isolation method.