Comparative evaluation of different adhesive strategies of a universal adhesive in class II bulk-fill restorations: A 48-month randomized controlled trial

• Published in: Journal of dentistry Vol. 117; p. 103921
• Main Authors: Yazici, Ayse Ruya, Uslu Tekce, Aybuke, Kutuk, Zeynep Bilge
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2022; Elsevier Limited
• Subjects: Adaptation; Adhesives; Bulk-fill; Chi-square test; Clinical trial; Composite materials; Composite Resins - therapeutic use; Criteria; Dental Care; Dental caries; Dental Caries - therapy; Dental Cements; Dental Marginal Adaptation; Dental Restoration, Permanent; Dentin; Dentistry; Discoloration; Enamel; Etch-and-rinse; Humans; Oral hygiene; Patients; Recall; Resin Cements - therapeutic use; Resins; Self-etch; Statistical analysis; Statistical tests; Teeth; Universal adhesive; Viscosity; United States > US; Switzerland; Liechtenstein; Universal adhesive; Bulk-fill; Etch-and-rinse; Clinical trial; Self-etch
• ISSN: 0300-5712; 1879-176X
• DOI: 10.1016/j.jdent.2021.103921

To compare the clinical performance of the universal adhesive used in etch-and-rinse (ER) and self-etch (SE) adhesive strategies for 48-month in class II bulk-fill restorations. A total of 84 class II bulk-fill resin composite (Tetric EvoCeram Bulk Fill) restorations were placed in 35 participants by one operator using the universal adhesive's (Adhese Universal VivaPen) etch-and-rinse or self-etch mode randomly. The restorations were evaluated by two calibrated examiners at baseline and after 6-, 12-, 24-, 36- and 48-month using modified USPHS criteria. The comparison of the two adhesive strategies for each evaluation criteria was performed with the chi-square test. The baseline scores were compared with those at the recalls using the Friedman and Cochran's Q-test (p < .05). At 48-month, 74 restorations were evaluated in 30 participants (recall rate: 85.7%). Marginal discoloration was statistically more frequent in SE approach (p < .05), whereas no significant difference was observed between the two strategies in terms of marginal adaptation (p > .05). There were statistically significant differences between the baseline and 48-month recall in the SE group in terms of marginal adaptation and discoloration (p < .05). In ER group, significant differences were found between baseline and 48-month only for marginal adaptation (p < .05). None of the restorations showed post-operative sensitivity. Secondary caries was observed in one restoration from SE group. The tested bulk-fill restorative exhibited better clinical performance only in terms of marginal discoloration when the universal adhesive was used with ER strategy. Though ER approach of the tested universal adhesive appears to be advantageous in terms of marginal discoloration, both adhesive strategies had similar impact on the clinical success of bulk-fill resin restorations.