Two-year clinical evaluation of two dentine-adhesive systems in cervical lesions

Two commercially available dentine-adhesive systems, Tenure and Tripton, were tested in two different cavity designs by placing 132 Class V composite restorations in cervical lesions of 35 patients. In Group A, the cervical restorations were placed totally in dentine without any intentional enamel involvement. In Group B, they were placed in dentine with adjacent enamel margins bevelled and acid etched. The retention rate, the evidence of clinical microleakage, and the marginal integrity were monitored over a 2-year period. The results of this clinical investigation indicate a high failure rate when only dentinal bonding was involved. A loss rate of 30% for Tenure and 55% for Tripton was noted in Group A after 2 years of clinical service. However, both adhesive systems used in combination with micromechanical retention on the enamel border (Group B) performed extremely well with only one restoration each having debonded over the 2-year period. Identically, marginal integrity and evidence of clinical microleakage more severely deteriorated with time for the Group A restorations in comparison with their Group B counterparts. In summary, the overall results were more positive for Tenure than for Tripton. It is concluded that micromechanical retention by acid etching of the enamel margin is still indispensable for the clinical success of cervical Class V composite restorations, primarily for retention and clinical microleakage and also, but to a lesser degree, for marginal adaptation.