Clinical, double blind, randomized controlled trial of experimental adhesive protocols in caries-affected dentin

• Published in: Clinical oral investigations Vol. 23; no. 4; pp. 1855 - 1864
• Main Authors: Pintado-Palomino, Karen, de Almeida, Cecilia Vilela Vasconcelos Barros, da Motta, Raphael Jurca Gonçalves, Fortes, João Henrique Parise, Tirapelli, Camila
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-04-2019; Springer Nature B.V
• Subjects: Acid Etching, Dental; Adhesive bonding; Adhesives; Adolescent; Adult; Cavities; Ceramics; Composite Resins; Dental Bonding; Dental caries; Dental Caries - therapy; Dental Cements; Dental Etching; Dental Marginal Adaptation; Dental Restoration, Permanent; Dental restorative materials; Dentin; Dentin-Bonding Agents; Dentistry; Double-Blind Method; Double-blind studies; Etching; Female; Humans; Male; Medicine; Middle Aged; Original Article; Powder; Powders; Resin Cements; Young Adult; Caries-affected dentin; Bioactive glasses; Randomized controlled trial
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-018-2615-7

Objective
To evaluate the clinical performance of posterior resin composite restorations regarding experimental and regular adhesive protocols in caries affected-dentin (CAD).
Material and methods
A total of 92 class I and class II cavities with carious lesions were selected and randomly assigned to the following groups: (1) bioactive glass-ceramic powder/two-step etch and rinse system, (2) control/two-step etch and rinse system, (3) bioactive glass-ceramic powder/two-step self-etching system, and (4) control/two-step self-etching system. Two operators carried out the adhesive protocols and restored the cavities with a nano-hybrid resin composite. Participants were followed up at 1 week and 6, 12, and 18 months for clinical evaluation performed by two blinded examiners and calibrated according to FDI criteria. Data were analyzed using Kruskal-Wallis and Dunn tests with a confidence of 95%.
Results
The clinical performance of resin composite restoration was not affected by the experimental use of an adhesive protocol including a bioactive glass-ceramic powder for 18 months post-procedure. However, there was a significant difference between group 2 and group 4 (
p
 < 0.05) for marginal adaptation (18 months). Group 2 was significantly different from group 3 (
p
 < 0.05) for fracture of material/retention (18 months) and marginal adaptation (1 week); group 2 showed a better performance.
Conclusion
Adhesive protocols can alter the clinical performance of posterior restorations in terms of marginal adaptation and the fracture of material/retention in CAD. Clinical significance: Adhesive protocols may influence the success of resin composite restorations in CAD; this is important because failure can lead to caries, re-incidence, and/or clinical re-work.