Self-Etch and Etch-and-Rinse adhesives in class V restorations: Clinical performance over 2-years

Introduction: The cervical dental hard tissues loss is a clinical model for evaluating the performance of adhesive restorations in non-retentive preparations. Objective: The aim of this study was to compare the clinical performance at 2-years, of Self-Etch (SE) and Etch-and-Rinse (ER) adhesives in composite restorations of non-carious cervical lesions (NCCL). Material and Methods: Prospective clinical trial, approved by UFP-FHS Ethics Committee, in 29 adult patients with 77 restorations randomly allocated according to two groups (microhybrid composite/adhesive system); SE Group: 43 restorations, Amaris®/FuturabondNR); ER Group: 34 restorations, Amaris®/SolobondM (Voco GmbH). All restorations were evaluated (aesthetic, functional and biological parameters) at baseline and at 2 years, using USPHS criteria and Hickel and colleagues (2007) recommendations, by three calibrated (ICC≥0.928) examiners. SE and ER efficacy (success rate) was evaluated at 2 years follow-up; Statistical analysis with nonparametric tests (alpha=0.05). Results: At 2 years, the SE (n=40; 7% dropout) and ER (n=34; 0% dropout) restorations showed success rates of 100% (Fisher /Chi-square tests, p>0.05), respectively. No significant differences between SE/ER (p> 0.05) regarding aesthetic, functional and biological restorations performance except for surface staining (p=0.012), for wear (p=0.012), patient's view (p=0.012) and tooth integrity (p=0.009), with less changes for ER restorations. Regarding baseline-2 years follow-up, SE and ER restorations showed significant changes in aesthetic (McNemar/Wilcoxon tests.; p0.020 and p0.008, respectively), functional (p0.012 and p0.014) and biological (p0.001 and p=0.009) parameters. Discussion and Conclusions: The effectiveness of restorations with SE and RE is high and similar at two-years follow-up. Aesthetic, functional and biological performance of restoration with ER appears to be better than with SE adhesive. However, a continuous and longer evaluation of these adhesive restorations longevity is necessary. The adhesives ER and SE in composite restorations of NCCL indicate a clinically acceptance and a comparable performance in the mean-term evaluation. Keywords: self-etch adhesives, etch-and-rinse adhesives, class V restorations, clinical trial, adhesives clinical performance, composite restorations effectiveness