M. PEUMANS, J. DE MUNCK, K. VAN LANDUYT, P. LAMBRECHTS, and B. VAN MEERBEEK, Catholic University of Leuven, Belgium
Objectives:: The purpose of this
‘paired-tooth', randomized controlled clinical trial was to test the hypothesis
that using a self-etch adhesive additional acid-etching of enamel is beneficial
in terms of retention, marginal adaptation and clinical microleakage of class-V
restorations. Methods: 29 patients received two or four restorations
randomly following two experimental protocols: (1) The ‘mild' self-etch
adhesive (Clearfil SE, Kuraray) was applied following a self-etch approach on
both enamel and dentin (C-SE non-etch); (2) Similar application of Clearfil SE,
but including beforehand selective acid-etching of the enamel cavity margins
with phosphoric acid (C-SE etch). Clearfil AP-X (Kuraray) was used as
restorative composite for all 100 restorations. Clinical effectiveness was
recorded in terms of retention (R), perfect marginal integrity (MI), absence of
small incisal marginal defects (I-MI), absence of small cervical defects (C-MI),
absence of clinical microleakage (CM), absence of caries recurrence (CR) and
absence of post-operative sensitivity (PS) after 3 years of clinical service. Results:
Only one restoration (C-SE etch) was clinically unacceptable because of partial
loss. Statistically significant difference between both groups was only found
for I-MI* (McNemar p=0.0225). Superficial clinical microleakage (marginal
discoloration) was observed significantly more in smokers (Fisher's exact
p=0.0246), especially in the C-SE non-etch group (p=0.0175).
|
|
R
|
MI
|
I-MI*
|
C-MI
|
CM
|
CR
|
PS
|
|
C-SE
non-etch
|
100%
|
64%
|
67%
|
91%
|
87%
|
100%
|
91%
|
|
C-SE
etch
|
100%
|
73%
|
89%
|
87%
|
96%
|
100%
|
98%
|
Conclusions: The clinical effectiveness
of the mild two-step self-etch adhesive Clearfil SE was excellent after 3 years
of clinical service. A tendency towards more marginal defects at the enamel
side was recorded when enamel was not beforehand etched with phosphoric acid. Also
in this latter group, smoking lead more easily to slight marginal
discoloration. However, these shortcomings were small and of clinical
negligible relevance.
|