A 12-Year Clinical Evaluation of a Three-Step Dentin Adhesive in Noncarious Cervical Lesions

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ABSTRACT

Background

The authors conducted a study to evaluate the clinical performance of a dual-cured, three-step dentin adhesive (OptiBond Dual Cure, Kerr, a subsidiary of Sybron Dental Specialties, Orange, Calif.; no longer on the market) at 12 years.

Methods

The authors restored 100 noncarious cervical lesions without use of macromechanical retention or enamel bevels. In one-half of the lesions (group A), the authors etched only the enamel; in the other half (group B), they etched both enamel and dentin. After etching, they applied a light-cured primer and dual-cured adhesive to enamel and dentin in both groups. They restored the preparations with a resin-based composite. They performed direct evaluations by using modified U.S. Public Health Service criteria at insertion (baseline) and at one year and 12 years after insertion.

Results

The 12-year retention rates were 93 percent in group A and 84 percent in group B, for an overall retention rate of 89 percent. Except for marginal discoloration in both groups and retention in group B, the restorations in both groups had Alfa ratings of 88 percent or greater in all of the direct clinical evaluation categories.

Conclusions

The 12-year clinical performance, including retention rate, of a dual-cured dental adhesive was excellent and was not affected by dentin acid-etching.

Clinical Implications

This clinical study provides additional evidence for the long-term durability of a three-step etch-and-rinse adhesive in non-carious cervical lesions.

Section snippets

Subject selection

We selected 53 subjects on the basis of their need for restoration of noncarious cervical lesions. We randomly assigned them to two groups on the basis of the etching method used; this led to the placement of 26 subjects in group A (etching of enamel only) and of 27 subjects in group B (etching of both enamel and dentin). We excluded subjects who had fewer than 20 teeth. We randomized the sample to exclude possible bias caused by factors of age, sex, race or national origin.

We recruited

RESULTS

We noted no statistically significant differences between groups A and B in terms of subjects' age and sex, overall lesion characteristics and operators (P = .05). As stated earlier, operators placed the 50 restorations in group A in 26 subjects and the 50 restorations in group B in 27 subjects. They placed 35 percent of the baseline restorations in anterior teeth and 65 percent in posterior teeth. Male and female subjects received approximately equal numbers of restorations. Although operators

DISCUSSION

Investigators have published a review of the five-year clinical performance of 11 three-step etch-and-rinse adhesive systems in noncarious cervical lesions.16 At five years, the three-step etch-and-rinse adhesives (including OptiBond Dual Cure) and the two-step self-etch adhesives exhibited the highest retention rates (76 percent and 77 percent, respectively). The retention rate at five years was lower among the two-step etch-and-rinse adhesives (69 percent) and lowest among the one-step

CONCLUSIONS

At 12 years, the retention rate of Class V composite restorations bonded by using the three-step adhesive system OptiBond Dual Cure was nearly 90 percent and not affected by dentin acid-etching. Marginal discoloration was fairly common in both groups, but we generally rated other restoration characteristics as Alfa, the highest rating possible under the evaluation system used.

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      Citation Excerpt :

      The lower 13-year retention rate (59%) for Optibond FL in the study of van Dijken et al. [33] is probably also due to fact that the restorations were only bonded to dentin and not to the incisal enamel (no enamel involvement). High retention rates (93–97%) were noticed for Optibond FL in 3 other long-term clinical trials [34–36]. Two of these studies were excluded from this review because the recall rate was too low [36] or because only 1 adhesive was tested [34].

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    Disclosures. Dr. Swift holds a research contract with 3M ESPE (St. Paul, Minn.) and has received honoraria for consultation and continuing education from Dentsply (Milford, Del.), Kerr, a subsidiary of Sybron Dental Specialties (Orange, Calif.) and Clinician's Choice (New Milford, Conn.). In the past, Dr. Heymann has been a paid consultant for Procter and Gamble (Cincinnati), Colgate (New York City) and Clinician's Choice, and his son works for Kerr. None of the other authors reported any disclosures.

    Portions of the article were presented as an abstract at the 86th General Session and Exhibition of the International Association for Dental Research, held July 2–5, 2008, in Toronto.

    1

    Dr. Wilder is a professor, Department of Operative Dentistry, School of Dentistry, University of North Carolina, 439 Brauer Hall, Chapel Hill, N.C. 27599-7450

    2

    Dr. Swift is professor and the chair, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill.

    3

    Dr. Heymann is a professor, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill.

    4

    Dr. Ritter is an associate professor, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill.

    5

    Dr. Sturdevant is an associate professor, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill.

    6

    Dr. Bayne is professor and the chair, Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor.

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