Three-year clinical performance of a HEMA-free one-step self-etch adhesive in non-carious cervical lesions. Clinical effectiveness of a one-step self-etch adhesive in non-carious cervical lesions at 2 years A 13-year clinical evaluation of two three-step etch-and-rinse adhesives in non-carious class-V lesions 3-year clinical effectiveness of one-step adhesives in non-carious cervical lesions. Three-year clinical evaluation of One-Step in non-carious cervical lesions. A three-year clinical evaluation of a one-step self-etch and a two-step etch-and-rinse adhesive in non-carious cervical lesions. A clinical evaluation of a resin composite and a compomer in non-carious Class V lesions. A 3-year follow-up. An 18-months' evaluation of self-etch and etch & rinse adhesive in non-carious cervical lesions Thirteen-year randomized controlled clinical trial of a two-step self-etch adhesive in non-carious cervical lesions. Five-year clinical performance of a HEMA-free one-step self-etch adhesive in noncarious cervical lesions Eighteen-month clinical evaluation of a filled and unfilled dentin adhesive. Clinical evaluation of a nanohybrid and a flowable resin composite in non-carious cervical lesions: 24-month results. Durability of three simplified adhesive systems in Class V non-carious cervical dentin lesions. Clinical evaluation of an all-in-one adhesive in non-carious cervical lesions with different degrees of dentin sclerosis. Correlation between microtensile bond strength data and clinical outcome of Class V restorations. Long-term dentin retention of etch-and-rinse and self-etch adhesives and a resin-modified glass ionomer cement in non-carious cervical lesions. Restoring cervical lesions with flexible composites. Eight-year clinical evaluation of a 2-step self-etch adhesive with and without selective enamel etching. One-year clinical evaluation of five single-step self-etch adhesive systems in non-carious cervical lesions.
Despite the fact that one-step adhesives are currently used routinely in clinical practice , long-term studies on their clinical performance are scarce . The objective of this r and omized controlled clinical trial was to test the hypothesis that a 2-hydroxyethyl methacrylate (HEMA)-free one-step self-etch adhesive performs worse than a conventional multistep etch- and -rinse adhesive .  Two-hundred and seventy-six non-carious cervical lesions in 52 patients were restored with a micro-hybrid composite  ( Gradia Direct ; GC ) . These restorations were bonded in r and om order either with the HEMA-free one-step adhesive G-Bond ( GC ) or with the ' gold-st and ard ' ( control ) three-step adhesive Optibond FL ( Kerr ) . The restorations were evaluated after 6 , 12 , 24 , and 36 months of clinical service regarding retention , marginal adaptation , microleakage , caries occurrence , and sensitivity . After a medium-long period of 3 yr , similar success in clinical performance was observed for the simplified all-in-one adhesive and the conventional three-step adhesive . However , the one-step adhesive exhibited significantly more incisal marginal defects and discolorations . Whereas marginal degradation appeared to arrest for the multistep etch- and -rinse adhesive after 12 months , the enamel margins of the restorations bonded with the one-step self-etch adhesive continued to deteriorate . These incisal marginal defects were , however , small and could easily be removed by polishing . For both adhesives , large and sclerosed lesions appeared to be at higher risk of retention loss A 2-year r and omized , controlled prospect i ve study evaluated the clinical effectiveness of a one-step self-etch adhesive and a “ gold-st and ard ” three-step etch- and -rinse adhesive in non-carious Class-V lesions . The null hypothesis tested was that the one-step self-etch adhesive does perform clinical ly equally well as the three-step etch- and -rinse adhesive .  A total of 161 lesions in 26 patients were restored with Clearfil AP-X ( Kuraray ) .  The restorations were bonded either with the “ all-in-one ” adhesive Clearfil S3 Bond ( Kuraray ) or with the three-step etch- and -rinse adhesive Optibond FL ( Kerr ) . The restorations were evaluated at baseline and after 6 months , 1 and 2 years , regarding their retention , marginal adapation , marginal discoloration , caries occurrence , preservation of tooth vitality and post-operative sensivity . Retention loss , severe marginal defects and /or discoloration that needed intervention ( repair or replacement ) and the occurrence of caries were considered as clinical failures . The recall rate at 2 years was 93.8 % . Only one Clearfil S3 Bond restoration was lost at the 2-year recall . All other restorations were clinical ly acceptable . The number of restorations with defect-free margins decreased severely during the 2-year study period ( to 6.7 % and 25.3 % for Clearfil S3 Bond and Optibond FL , respectively ) . The Clearfil S3 Bond restorations presented significantly more small marginal defects at the enamel side than the Optibond FL restorations ( Clearfil S3 Bond : 93.3 % ; Optibond FL : 73.3 % ; p = 0.000 ) . Superficial marginal discoloration increased in both groups ( to 53.3 % and 36 % for Clearfil S3 Bond and Optibond FL , respectively ) and was also more pronounced in the Clearfil S3 Bond group ( p = 0.007 ) . After 2 years , the simplified one-step self-etch adhesive Clearfil S3 Bond and the three-step etch- and -rinse adhesive Optibond FL were clinical ly equally successful , even though both adhesives were characterized by progressive degradation in marginal integrity .  Clearfil S3 Bond exhibited more small enamel marginal defects and superficial marginal discolorations This 13-year r and omized clinical trial compared the clinical effectiveness of two three-step etch- and -rinse adhesives in combination with a hybrid , stiffer composite versus a micro-filled , more flexible composite . The influence of composite stiffness on the clinical performance of one of the adhesives was assessed as well . One hundred and forty-two non-carious cervical lesions were restored with composites with contrasting stiffness . Seventy-one patients r and omly received two cervical restorations placed following two out of three adhesive procedures : ( 1 ) the three-step etch- and -rinse adhesive Permaquick applied with the stiff micro-hybrid composite Amelogen Hybrid ( PMQ-H , Ultradent ) , ( 2 ) Permaquick applied with the more flexible micro-filled Amelogen Microfill ( PMQ-M , Ultradent ) , or ( 3 ) the “ gold-st and ard ” three-step etch- and -rinse adhesive Optibond FL applied with the micro-hybrid composite Prodigy ( OFL-P , Kerr ) . The restorations were evaluated after 6 months , 1 , 2 , 3 , 5 , 7 , and 13 years of clinical service regarding their retention , marginal integrity and discoloration , caries occurrence , preservation of tooth vitality , and post-operative sensitivity . Retention loss , severe marginal defects , and /or discoloration that needed intervention ( repair or replacement ) and the occurrence of caries were considered as clinical failures . The recall rate at 13 years was 77 % . Bond degradation after 13 years was mainly characterized by a further increase in the presence of small but clinical ly acceptable marginal defects and superficial marginal discoloration . Twelve percent of the OFL-P restorations were clinical ly unacceptable . In the PMQ group , 22 % of the PMQ-M restorations and 26 % of the PMQ-H restorations needed repair or replacement . Regarding the clinical failure rate , Optibond FL scored significantly better than Permaquick ( McNemar ; p = 0.015 ) . No statistically significant differences were found between the micro-filled and the hybrid composite for each of the parameters evaluated ( McNemar , p > 0.05 ) . After 13 years of clinical functioning , the clinical effectiveness of the three adhesive/composite combinations remained highly acceptable OBJECTIVES Despite representing an important component of current dental adhesives , HEMA has been said to negatively influence the long-term stability of adhesion to dentine and enamel . The aim of this r and omised clinical trial was to evaluate the 3-year clinical performance of two one-step self-etch adhesives . METHODS Thirty patients had 175 non-carious cervical lesions restored with composite ( Gradia Direct Anterior , GC ) using either the HEMA-rich adhesive Clearfil Tri-S Bond ( C3S ; Kuraray ) or the HEMA-free adhesive G-Bond ( GB ; GC ) . The restorations were evaluated by two examiners at baseline , 6 , 12 , 24 and 36 months regarding retention , caries recurrence , marginal integrity and discoloration and post-operative sensitivity . The data were statistically analysed with GEE and McNemar tests ( p<0.05 ) . RESULTS The recall rate at 6 and 12 months was 100 % and decreased to 96.7 % at 24 and 36 months . At 3 years , the retention rate was 93.8 % for C3S and 98.8 % for GB ( p=0.14 ) . A pairwise comparison showed no significant differences between the two adhesives for all the parameters evaluated , irrespective of the recall ( p>0.05 ) . After 3 years , both adhesives presented an increase in the percentage of clinical ly acceptable marginal discoloration ( C3S : 32.9 % and GB : 26.8 % ) normally associated to clinical ly acceptable marginal defects ( C3S : 35.8 % and GB : 26.5 % ) . Only 1 dentine margin of a GB restoration presented a severe marginal defect ( 1.2 % ) and 1 C3S restoration presented caries recurrence . The overall 3-year clinical success rate was 92.6 % for C3S and 97.6 % for GB ( p=0.16 ) . CONCLUSION Both one-step self-etch adhesives presented an equally favourable clinical effectiveness at 3 years . CLINICAL SIGNIFICANCE HEMA is a monomer frequently present in dental adhesives in order to increase their wettability and hydrophilicity . However , this monomer negatively influences hydrolytic stability and durability of the adhesive interface complex . In this 3-year clinical trial no significant difference in bonding effectiveness was noticed between a HEMA-rich and HEMA-free one-step adhesive PURPOSE To clinical ly evaluate the 3-year performance of a one-bottle dentin adhesive in the restoration of non-carious cervical lesions ( NCCLs ) with resin composite . MATERIAL S AND METHODS 105 NCCLs were restored with either AElite Flow , Bisco Glaze ( both flowable resin-based composites ) or Silux ( a microfilled resin-based composite ) , using One-Step dentin adhesive . The cavities were cleaned with pumice and water slurry , the dentin lightly roughened with a fine diamond bur , and the restorations placed according to the manufacturer 's instructions . Patients were recalled at 6 months , 1 year , 2 years and 3 years , and restoration integrity and marginal discoloration assessed . RESULTS The overall retention rates were : 6 months , 100 % ; 1 year , 95 % ; 2 years , 87 % ; 3 years , 75 % . Marginal discoloration was negligible , and there was no significant difference among the material s , although there was a trend for it to be greater around the Bisco Glaze restorations OBJECTIVES The aim of the study was to assess a one-step self-etch adhesive ( Futurabond M , 1-SE ) and a two-step etch- and -rinse adhesive ( Solobond M , 2-ER ) used in combination with the nano-hybrid composite ( Amaris ) in a prospect i ve clinical study on non-carious cervical lesions . METHODS 110 restorations were placed in 40 patients and grade d over 36 months according to aesthetical , functional and biological criteria ( Clinical Oral Investigations 2007;11:5 ) . The four-step etch- and -rinse adhesive Syntac classic ( 4-ER ) combined with the nano-hybrid composite Tetric EvoCeram was used as a control . Cumulative failure rates ( CFR ) , retention rates and Kaplan-Meier survival curves were calculated for each observation period . RESULTS After 3 years , the CFR of 33.3 % in the 2-ER group was significantly higher compared to those of the 1-SE group ( 9.1 % , p = 0.019 ) and of the 4-ER group ( 8.3 % , p = 0.035 ) . Additionally , retention rates in the 1-SE and the 4-ER groups were higher compared to 2-ER ( p = 0.012 each ) after 36 months . Annual failure rates ranged between 2.8 % for 4-ER , 3.0 % for 1-SE and 11.1 % for 2-ER . During the study , restorations in all groups showed progressive marginal deterioration within the limits of clinical acceptance . After 3 years , restorations in the 2-ER and the 4-ER group showed more small defects at dentin than at enamel margins . CONCLUSIONS The 1-SE group was clinical ly as successful as the 4-ER , with both performing better than the 2-ER group . Futurabond M/Amaris can be recommended for the restoration of sclerotic non-carious cervical lesions . CLINICAL SIGNIFICANCE Number protocol 192/2008 PURPOSE To compare the clinical performance of a resin composite and a polyacid-modified resin composite ( compomer ) in non-carious cervical lesions using a one-step self-etch adhesive . METHODS Thirty patients , each with two non-carious cervical lesions ( 60 restorations ) , received one composite ( Pertac-II ) restoration and one compomer ( Hytac ) restoration , both used in conjunction with a self-etch adhesive ( Prompt L-Pop ) and placed following the manufacturer 's instructions . Evaluations were at baseline , 6 , 12 and 36 months after placement for retention , margin adaptation , marginal discoloration , anatomic form , secondary caries and postoperative sensitivity . Statistical analysis with the Pearson Chi-square test was undertaken . RESULTS Retention rates were 86.6 % for composite and 86.7 % for compomer at 36 months . 3.3 % of composite and 6.7 % of compomer restorations showed a deficiency in marginal adaptation . Both material s showed a slight marginal discoloration of 7.7 % . More deterioration in anatomic form occurred with the compomer ( 11.5 % ) than the composite ( 3.8 % ) . None of the restorations exhibited secondary caries or postoperative sensitivity problems . There was no significant difference in performance between the material s in any of the categories evaluated Objective . In this intra-individual comparison ( an 18-months ' r and omized , controlled prospect i ve study ) , we evaluated the clinical performance of one self-etch and one “ etch & rinse ” adhesive in non-carious cervical lesions . Methods . Twenty-five patients with at least two pairs of similar-sized non-carious cervical lesions participated . Seventy-eight restorations were placed ; 39 with etch & rinse ( Single-Bond ) and 39 with self-etch ( Adper Prompt ) . Both adhesives were combined with the microfilled resin composite Filtek-A110 . The restorations were evaluated at baseline , 6 , 12 , and 18 months according to slightly modified USPHS criteria . Statistical differences between the adhesives was tested with McNemar 's test and clinical degradation over time for each material with the Fisher exact test ( α=0.05 ) . Results . Thirty pairs were evaluated at 12 and 18 months . Two self-etch restorations were lost after 18 months . Nine Adper Prompt and four Single-Bond restorations scored bravo for marginal adaptation at 18 months ( p<0.05 ) . Nine Adper Prompt and three Single-Bond restorations scored bravo for marginal discoloration ( p<0.05 ) . Conclusions . Both adhesive systems showed acceptable clinical retention rates according to the ADA full acceptance criteria for enamel-bonding systems in class V non-carious lesions . The self-etch adhesive showed a faster progressive marginal degradation OBJECTIVE The objective of this r and omized controlled clinical trial was to evaluate the 13-year clinical performance of a mild two-step self-etch adhesive in non-carious cervical lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins . METHODS A total of 100 non-carious cervical lesions in 29 patients were restored with Clearfil AP-X ( Kuraray Noritake ) . The composite restorations were bonded following two different approaches : ( 1 ) application of Clearfil SE Bond ( Kuraray Noritake ) following a self-etch approach ( CSE-NE ) ; ( 2 ) selective phosphoric acid-etching of enamel cavity margins before application of Clearfil SE Bond ( CSE-E ) . The restorations were evaluated after 6 months , 1 , 2 , 3 , 5 , 8 and 13 years of clinical service regarding retention , marginal integrity and discoloration , caries occurrence , preservation of tooth vitality and post-operative sensitivity . RESULTS The patient recall rate at 13 years was 62 % . Six restorations , 4 of the CSE-NE group and 2 of the CSE-E group , were clinical ly unacceptable due to loss of retention ( 1 CSE-NE , 1 CSE-E ) , a severe marginal defect ( 2 CSE-NE , 1 CSE-E ) and caries occurrence in combination with a severe marginal defect ( 1 CSE-NE ) leading to a clinical success rate of 86 % ( CSE-NE ) and 93 % ( CSE-E ) . Ageing of the restorations was characterized by a further increase in the percentage of restorations with a clinical ly acceptable small marginal defect ( CSE-NE : 87 % ; CSE-E : 83 % ) and /or superficial marginal discoloration ( CSE-NE : 53 % ; CSE-E : 56 % ) . The presence of small marginal defects ( CSE-NE : 86 % ; CSE-E : 68 % ) and superficial marginal discoloration ( CSE-NE : 41 % ; CSE-E : 20 % ) at the incisal enamel side was more frequently noticed in the CSE-NE group than in the CSE-E group . The difference , however , was not statistically significant ( McNemar , p>0.05 ) . SIGNIFICANCE After 13 years , the clinical effectiveness of Clearfil SE Bond in non-carious Class-V lesions remained excellent , with selective acid-etching of the enamel cavity margins only having some minor positive effect on marginal integrity and absence of marginal discoloration Objectives The objective of this r and omized controlled trial was to evaluate the clinical performance of a 2-hydroxyethyl methacrylate (HEMA)-free one-step adhesive . Material s and methods Two hundred sixty-seven cervical lesions in 52 patients were restored with the composite Gradia Direct ( GC ) , bonded with either the one-step self-etch adhesive G-Bond ( GC ) or the three-step etch- and -rinse adhesive Optibond FL ( Kerr ) in a r and om order . The restorations were evaluated for retention , marginal integrity , marginal discoloration , and caries occurrence after 5 years . Specific statistics were used to account for the clustered data ( multiple restorations per patient ) . Results The clinical success rate for G-Bond ( 87.4 % ) was not significantly different from that of Optibond FL ( 90.9 % ) . Both adhesives showed progressive marginal deterioration , but G-Bond exhibited more small enamel defects and marginal discoloration , and unlike previous recalls , several restorations failed because of deep microleakage . Large sclerotic lesions were a significant risk factor for retention loss with G-Bond . Irrespective of the adhesive , almost all restorations with retention loss were located in the lower jaw . Conclusion After 5 years of clinical service , restorations bonded with the HEMA-free one-step adhesive did not need repair or replacement more often than those with the three-step etch- and -rinse adhesive , and both adhesives had a high retention rate ( > 90 % ) . There were indications that G-Bond did not (self-)etch enough in some clinical situations , as G-Bond exhibited more incisal defects and marginal discolorations , and sclerotic lesions were at higher risk of retention loss . Clinical relevance The clinical performance of the HEMA-free one-step adhesive was clinical ly acceptable after 5 years OBJECTIVE The purpose of this study was to evaluate the performance of a filled ( OptiBond Solo ) and an unfilled ( Prime & Bond 2.1 ) " one-bottle " adhesive in Class V restorations after 18 months of clinical service . METHODS Thirty-three patients with non-carious cervical lesions were enrolled in the study . A total of 101 lesions were restored using one of the adhesives and a hybrid composite resin . Enamel was not beveled , nor was any mechanical retention placed . The restorations were evaluated at baseline , and at 6 and 18 months after placement using modified USPHS criteria . RESULTS Cumulative 18-month retention rates were 93.6 % for OptiBond Solo and 98.0 % for Prime & Bond 2.1 . The difference in retention rates was not statistically significant . For OptiBond Solo , the only notable problems were interfacial staining and marginal adaptation , both of which were less than ideal in 9 % of restorations . Marginal problems were slightly less frequent for Prime & Bond 2.1 restorations , but the difference was not significant . CONCLUSIONS Both adhesives provided Class V retention rates exceeding the 18-month , full acceptance guidelines set by the American Dental Association . Any additional benefit provided by the use of a filled adhesive was not detected in this 18-month clinical trial PURPOSE To evaluate the 24-month clinical performance of  cervical restorations  using a nanohybrid and a flowable resin composite with a one-step self-etching adhesive . MATERIAL S AND METHODS Twenty-one patients with at least one pair of non-carious cervical lesions participated in this study . A total of 134 non-carious cervical lesions were restored ( 67 with a nanohybrid resin composite , Gr and io ; 67 with a flowable resin composite , Gr and io Flow ) using a one-step self-etching adhesive system , Futura Bond NR , by one dentist . The restorations were evaluated for retention , color match , marginal discoloration , marginal adaptation , surface texture , anatomic form , and secondary caries by two calibrated examiners at baseline and after 6 , 12 , and 24 months using modified USPHS criteria . The survival rates of the restorations were calculated by the Kaplan-Meier estimator . The comparison of resin composites for each category was performed with the Pearson chi-square test , and the performance of restorations at baseline and after each recall time was evaluated using McNemar 's test ( p < 0.05 ) . RESULTS All patients attended the 24-month recall . The retention rates at 6 months were 66 % and 58 % , and 61 % and 57 % at 12 months for Gr and io and Gr and io Flow , respectively . At the 24-month recall , the retention rate was 60 % for Gr and io and 54 % for Gr and io Flow . No statistically significant differences were found in retention rates among the restorative material s in any evaluation period ( p > 0.05 ) . For marginal discoloration and anatomical form , three Gr and io and three Gr and io Flow restorations showed Bravo scores at the end of 24 months . The restorations in both groups had Alfa ratings of 100 % for the rest of the criteria evaluated . CONCLUSION The nanohybrid and flowable resin composites showed similar clinical performances in the restoration of non-carious cervical lesions over 24 months PURPOSE To investigate the durability of three simplified systems in Class V non-carious abrasion/erosion lesions . METHODS 144 non-carious cervical dentin lesions were restored either with Clearfil Liner Bond 2 , a 2-step self-etching primer ( n = 46 ) , One Coat Bond , a one bottle total-etch system applied with one coat ( n = 46 ) , or Prompt-L-Pop , a 1-step self-etching primer ( " all-in-one " ) ( n = 52 ) , in 90 individuals . Ninety-eight of the lesions showed sclerotic dentin and 46 were non-sclerotic . Sixty-one were slightly roughened with a diamond bur before conditioning . The restorations were evaluated every 6 months during a 2-year period with slightly modified USPHS criteria . RESULTS All except three restorations were evaluated over 2 years . The cumulative loss rates for Clearfil Liner Bond 2 , One Coat Bond and Prompt-L-Pop were at 6 months : 4.3 , 2.2 and 3.9 % , at 18 months : 4.3 , 10.9 and 15.4 % and at 24 months : 8.7 , 13.0 and 21.2 % , respectively . The cumulative loss rates of the material s in sclerotic lesions ( 15.7 % ) versus non-sclerotic lesions ( 14.0 % ) were not significanty different . Restorations placed with a diamond bur-roughened lesions showed a loss rate of 14.5 % , while for the non-roughened lesions the frequency was 14.8 % This r and omized clinical trial compared the performance of an all-in-one adhesive ( iBond ) applied in sclerotic and non-sclerotic non-carious cervical lesions with that of a three-step etch-prime-bond adhesive ( Gluma Solid Bond , SB ) .  One-hundred and five lesions were r and omly assigned to four groups according to adhesive , sclerosis scale and technique : 1 ) SB applied to lesions with sclerosis scale 1 and 2 ( n=26 ) ; 2 ) iBond applied to lesions with sclerosis scale 1 and 2 ( n=28 ) ; 3 ) iBond applied to lesions with sclerosis scale 3 and 4 ( n=25 ) and 4 ) iBond applied with prior acid-etching to lesions with sclerosis scale 3 and 4 ( n=26 ) . A microfilled composite ( Durafill VS ) was used as the restorative material . The restorations were evaluated for retention , color match , marginal adaptation , anatomic form , cavosurface margin discoloration , secondary caries , pre- and post-operative sensitivity , surface texture and fracture at insertion ( baseline ) , 6 , 18 months and at 3 years using modified USPHS evaluation criteria ( Alfa = excellent ; Bravo= clinical ly acceptable ; Charlie= clinical ly unacceptable ) . There was a high percentage of Bravo scores for marginal adaptation ( 4%-32 % ) and marginal discoloration ( 18%-60 % ) in Groups 2 , 3 and 4 , but all groups had < 5 % Charlie scores at 6 months and < 10 % Charlie scores at 18 months for retention and marginal discoloration , respectively . However , it should be noted that 13 % of the restorations in Group 4 were not retained at three years OBJECTIVE To determine if the results of  resin-dentin microtensile bond strength ( μTBS ) is correlated with the outcome parameters of clinical studies on non-retentive Class V restorations . METHODS  Resin-dentin μTBS data were obtained from one test center ; the in vitro tests were all performed by the same operator . The μTBS testing was performed 8 h after bonding and after 6 months of storing the specimens in water . Pre-test failures ( PTFs ) of specimens were included in the analysis , attributing them a value of 1MPa . Prospect i ve clinical studies on cervical restorations ( Class V ) with an observation period of at least 18 months were search ed in the literature . The clinical outcome variables were retention loss , marginal discoloration and marginal integrity . Furthermore , an index was formulated to be better able to compare the laboratory and clinical results . Estimates of adhesive effects in a linear mixed model were used to summarize the clinical performance of each adhesive between 12 and 36 months . Spearman correlations between these clinical performances and the μTBS values were calculated subsequently . RESULTS Thirty-six clinical studies with 15 adhesive/restorative systems for which μTBS data were also available were included in the statistical analysis . In general 3-step and 2-step etch- and -rinse systems showed higher bond strength values than the 2-step/3-step self-etching systems , which , however , produced higher values than the 1-step self-etching and the resin modified glass ionomer systems . Prolonged water storage of specimens result ed in a significant decrease of the mean bond strength values in 5 adhesive systems ( Wilcoxon , p<0.05 ) . There was a significant correlation between μTBS values both after 8 h and 6 months of storage and marginal discoloration ( r=0.54 and r=0.67 , respectively ) . However , the same correlation was not found between μTBS values and the retention rate , clinical index or marginal integrity . SIGNIFICANCE As μTBS data of adhesive systems , especially after water storage for 6 months , showed a good correlation with marginal discoloration in short-term clinical Class V restorations , longitudinal clinical trials should explore whether early marginal staining is predictive for future retention loss in non-carious cervical restorations OBJECTIVES The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems . METHODS A total of 270 Class V restorations of four etch- and -rinse , one self-etch adhesive system and a resin-modified glass ionomer cement were placed in non-carious cervical lesions without intentional enamel involvement . The restorations were evaluated at baseline , 6 , 12 , 18 , and 24 months and then every year during a 13-year follow-up . Dentin bonding efficiency was determined by the percentage of lost restorations . RESULTS During the 13 years , 215 restorations could be evaluated . The cumulative loss rate at 13 years was 53.0 % , with significant different failures rates for the different systems varying between 35.6 and 86.8 % . Four systems fulfilled the ADA 18-month full acceptance retention criteria . Two systems showed at 18 months and earlier high debonding rates . The annual failure rates for the etch- and -rinse systems were Optibond 3.1 % , Permagen 13.0 % , Scotchbond MP 4.8 % , Syntac classic 2.8 % ; for the self-etch system P&S 4.4 % ; and the resin-modified glass ionomer cement Vitremer 2.7 % . CONCLUSION It can be concluded that all systems showed a continuous degradation of the bond with a wide variation , which was independent of the adhesion strategy . Three bonding systems showed a cumulative failure rate after 13 years between 36 and 41 % with the best retention for the resin-modified glass ionomer cement and a four-step etch- and -rinse system OBJECTIVES Flexure at the tooth cervix has been suggested to dislodge cervical restorations more rapidly . The objective of this r and omized controlled clinical trial was to test the hypothesis that a higher composite flexibility better withst and s tooth flexure stress . METHODS One hundred and forty-two non-carious cervical lesions were restored with composites with contrasting stiffness . Seventy-one patients r and omly received two cervical restorations  placed following two out of the three experimental groups : ( 1 ) the three-step etch- and -rinse adhesive Permaquick applied with the stiff micro-hybrid composite Amelogen Hybrid ( PMQ/A-Hy , Ultradent ) , ( 2 ) Permaquick applied with the more flexible micro-filled composite Amelogen Microfill ( PMQ/A-Mi , Ultradent ) , or ( 3 ) the ' golden st and ard ' three-step etch- and -rinse adhesive Optibond FL applied with the micro-hybrid composite Prodigy ( O-FL/Pro , Kerr ) . RESULTS The recall rate at 7 years was 80 % . No statistically significant difference was found for any of the parameters evaluated neither between both adhesives , nor between both composites ( McNemar , p>0.05 ) . Eleven percent of the O-FL/Pro restorations were clinical ly unacceptable due to loss of retention ( 5.5 % ) and severe marginal discoloration ( 5.5 % ) . In the PMQ-group , 22 % of the PMQ/A-Mi restorations ( 8 % loss of retention , 5 % severe enamel margin defects , 3 % severe dentin margin defects , 6 % severe marginal discoloration , 3 % extreme sensitivity ) and 19 % of the PMQ/A-Hy restorations ( 13 % loss of retention , 3 % severe enamel margin defects , 3 % severe marginal discoloration ) needed repair or replacement . SIGNIFICANCE The clinical performance of the three adhesive/composite combinations was good and reliable during the 7-year clinical trial . It was concluded that the composite stiffness does not affect the clinical longevity of cervical composite restorations OBJECTIVES The objective of this r and omized controlled clinical trial was to evaluate the 8-year clinical performance of a mild 2-step self-etch adhesive in non-carious Class-V lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins . METHODS A total of 100 non-carious Class-V lesions in 29 patients were restored with Clearfil AP-X ( Kuraray ) .  The composite restorations were bonded following two different approaches : ( 1 ) application of Clearfil SE ( Kuraray ) following a self-etch approach ( control group ; C-SE non-etch ) , ( 2 ) selective phosphoric acid-etching of the enamel cavity margins before application of Clearfil SE ( experimental group ; C-SE etch ) . The restorations were evaluated after 6 months , 1 , 2 , 3 , 5 and 8 years of clinical service regarding their retention , marginal integrity and discoloration , caries occurrence , preservation of tooth vitality and post-operative sensitivity . RESULTS The recall rate at 8 years was 76 % . Only two restorations , one of the C-SE non-etch group and one of the C-SE etch group , were clinical ly unacceptable due to loss of retention leading to a retention rate and a clinical success rate of 97 % in both groups . Aging of the restorations was characterized by an increase in the percentage of restorations with a small but clinical ly acceptable marginal defect ( C-SE non-etch : 92 % ; C-SE etch : 84 % ) and /or a superficial marginal discoloration ( C-SE non-etch : 44 % ; C-SE etch : 28 % ) . At the enamel side , the presence of small marginal defects ( C-SE non-etch : 86 % ; C-SE etch : 65 % ) and superficial marginal discoloration ( C-SE non-etch : 11 % ; C-SE etch% ) was more frequently noticed in the control group than in the experimental group . The difference , however , was only statistically significant for the presence of superficial marginal discoloration ( McNemar , p=0.01 ) . SIGNIFICANCE After 8 years of clinical functioning , the clinical effectiveness of Clearfil SE remained excellent , with selective acid-etching of the enamel cavity margins only having some minor positive effect on marginal integrity and absence of marginal discoloration at enamel This study evaluated the clinical performance of five single-step self-etch adhesive systems over a one-year follow-up period in 98 restorations . Independent evaluations were performed at baseline ( one week ) , after three months , six months , and one year , by two trained examiners using the modified US Public Health Service rating criteria . Color match , marginal integrity , anatomical form , surface roughness , marginal or interfacial staining , postoperative sensitivity , and secondary caries were evaluated . Results were analyzed using the Kruskal-Wallis test at a significance level of p<0.05 . After one year , the restorations were re-evaluated and 100 % retention rate was recorded . No caries were detected in association with any of the restorations . Marginal adaptation was the only measure that showed a slight deterioration over time , and there were no significant differences in this factor among the adhesive systems tested ( p=0.464 )
RESULTS Comparison of retention of class-V adhesive restorations as a measure to determine clinical bonding effectiveness of adhesives revealed that glass-ionomers most effectively and durably bond to tooth tissue .
Three-step etch- and -rinse adhesives and two-step self-etch adhesives showed a clinical ly reliable and predictably good clinical performance .
The clinical effectiveness of two-step etch- and -rinse adhesives was less favourable , while an inefficient clinical performance was noted for the one-step self-etch adhesives .
SIGNIFICANCE Although there is a tendency towards adhesives with simplified application procedures , simplification so far appears to induce loss of effectiveness .
OBJECTIVES The purpose of this paper was to review current literature on the clinical effectiveness of contemporary adhesives when used to restore cervical non-carious class-V lesions .
Restoration retention in function of time was recorded in order to find out if adhesives with a simplified application procedure are as clinical ly effective as conventional three-step adhesives .