Class V Resin-Composite Restorations Using Two Different Adhesives: Prospective RCT

Objectives: Aims of this work were prospective clinical evaluation and in vitro analysis of an etch & rinse/two-steps adhesive and a self-etch/one-step adhesive in class V resin-composite restorations. Methods: 52 teeth with cervical lesions were selected from 14 patients and randomly divided in two groups: group A assigned to a beginner operator, group B to a dentist with 15-year experience. Groups were then randomly divided in two subgroups: etch & rinse adhesive was used in subgroups A1 and B1 (Gluma Comfort Bond, Heraeus Kulzer), while self-etch adhesive was used in subgroups A2 and B2 (iBond, Heraeus Kulzer). Class V cavity’s margins were placed on both enamel and cement. All the restorations were performed using the same resin-composite and evaluated at baseline and 12-month, following Hickel’s criteria. Further follow-up will be performed at 24 and 36-month. Micro-tensile laboratory tests were performed to evaluate the bond strenght of the two adhesives, thus comparing in vitro Vs in vivo results. Wilcoxon and Mann-Whitney statistical tests were used to compare the adhesives performance and the operators, respectively. Results: Clinical evaluation at baseline and 12-month follow-up demonstrated no statistical difference between the clinical performance of the adhesives and the two operators. On the other hand, there was a statistical significant difference between baseline and 12-month follow-up (decrease) , in both groups, for the following: polishing procedure, post-operative sensitivity and marginal adaptation . Under laboratory conditions, the etch & rinse adhesive gave better results than the self-etch adhesive, even if statistically significant differences could only be found on enamelparticularly in terms of adhesion on enamel. Conclusions: This study suggests that both etch & rinse and self-etch adhesives can be recommended for clinical use in class V resin-composite restorations, either for a beginner operator than for an expert one. The 36-month follow-up results are needed to confirm these preliminary data.