A randomized five-year clinical study of a two-step self-etch adhesive with or without selective enamel etching

Area of Science:

• Dental Materials Science
• Clinical Dentistry
• Restorative Dentistry

Background:

• Non-carious cervical sclerotic lesions present a clinical challenge for restorative treatment.
• Two-step self-etch adhesives offer a simplified bonding protocol.
• The necessity of selective enamel etching with self-etch adhesives in these specific lesions requires further clinical evaluation.

Purpose of the Study:

• To assess the five-year clinical performance of a two-step self-etch adhesive in non-carious cervical sclerotic lesions.
• To compare the outcomes of using the adhesive with and without selective enamel etching of the margins.
• To evaluate restoration retention, marginal adaptation, and secondary caries development.

Main Methods:

• A prospective clinical study involving 104 cervical restorations in 22 patients.
• Restorations were placed using a two-step self-etch adhesive (AdheSE) with two protocols: non-etch and selective enamel etch.
• Clinical evaluations were performed at baseline and up to five years using USPHS criteria, with data analyzed by McNemar's test.

Main Results:

• Cumulative five-year retention rates were 82.6% for the non-etch group and 86.1% for the etch group.
• No statistically significant differences were found between the groups regarding retention rates, marginal adaptation at the dentin side, or secondary caries.
• The overall clinical performance of the adhesive was deemed acceptable after five years in both application methods.

Conclusions:

• The evaluated two-step self-etch adhesive provides acceptable five-year clinical performance for non-carious cervical sclerotic lesions.
• Selective enamel etching of margins did not significantly improve the clinical outcomes compared to the non-etch approach.
• The findings support the use of this two-step self-etch adhesive with or without selective enamel etching in treating such lesions.