Three-year clinical evaluation of universal adhesives in non-carious cervical lesions

PURPOSE: To compare the performance of universal adhesives containing different monomers, namely 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) and dipentaerythritol penta-acrylate monophosphate (PENTA), in the restoration of non-carious cervical lesions (NCCLs). METHODS: This was a randomized controlled clinical trial involving 63 subjects in need of restorations of 203 NCCLs. Notch-shaped lesions were restored with Kalore (GC Corporation) after application of Scotchbond Universal (SU) or Prime&Bond Elect (PBE) following the etch-and-rinse (ER) or self-etch (SE) technique. Restorations were assessed after 1 week, 18 and 36 months. Logistic regression was performed for each outcome separately with compound symmetric variance-covariance structure assumed to consider a correlation of restorations within subjects. All analyses were conducted using SAS 9.4 (SAS). RESULTS: 150 teeth in 41 subjects were assessed at 36 months. Three restorations in the PBE_SE group failed the retention criterium. Statistically significant differences were reached for the following comparisons: restorations with SU_SE were 75% less likely to maintain a score of Alfa for marginal discoloration than PBE_SE; restorations with PBE_SE were 83% less likely to maintain a score of Alfa for marginal adaptation than PBE_ER. CLINICAL SIGNIFICANCE: More than 20% of restorations restored with universal adhesives developed marginal degradation after 36 months. The impact of phosphoric acid on the restoration seems to be material-dependent.