Marginal Integrity of Simplified Adhesive Strategies in Primary Teeth

• Published in: International dental journal Vol. 73; no. 6; pp. 881 - 888
• Main Authors: de Boer, Mia, Zimmermann, Marcus, Attin, Thomas, Tauböck, Tobias T., Hamza, Blend
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.12.2023; Elsevier
• Subjects: Primary teeth; Selective enamel etch; Self-etch; Shortened application time; Universal adhesives; Selective enamel etch; Shortened application time; Primary teeth; Self-etch; Universal adhesives
• ISSN: 0020-6539; 1875-595X
• DOI: 10.1016/j.identj.2023.06.002

The aim of this research was to investigate the effect of simplified adhesive strategies (self-etch vs selective enamel etch and 10- vs 20-second adhesive application time) on the marginal integrity in primary molars. Forty deep class-II cavities were prepared in 40 extracted primary molars. The molars were divided into 4 groups based on the applied universal adhesive strategy as follows: groups 1 and 2: selective enamel etch with 20- or 10-second application time and groups 3 and 4: self-etch with 20- or 10-second application time. All cavities were restored with a sculptable bulk-fill composite restoration. The restorations underwent a thermomechanical loading (TML, 5–50 °C, 2-minute dwelling time, ×1000; 400,000 loading cycles, 1.7 Hz, 49 N). Marginal analysis before and after TML was conducted with scanning electron microscopy and the marginal integrity of each restoration was calculated as a percentage of continuous margins. A beta regression model was adopted to statistically analyse the data with a consequent pairwise comparison. The mean marginal integrity (% ± SD) of the restorations for each tested adhesive strategy after TML was as follows: selective enamel etch/20 seconds = 85.4 ± 3.9, self-etch/20 seconds = 85.3 ± 5.2, self-etch/10 seconds = 80.1 ± 8.2, and selective enamel etch/10 seconds = 80.0 ± 8.5. The difference between both adhesive strategies was not statistically significant at the same application time. The difference between both application times within the same adhesive strategy was statistically significant (P ≤ .01). Universal adhesives applied either in selective enamel etch or in self-etch mode result in comparable marginal integrities when restoring class-II cavities in primary molars. Shortened adhesive application time (10 seconds) could lead to a reduction in the marginal integrity in comparison to the recommended application time of 20 seconds.