Class V resin-composite restorations using two different adhesives: prospective RCT

Aim. To prospectively evaluate, and in vitro analyse, an etch & rinse/two-steps (E&R) adhesive and a self-etch/one-step (SE) adhesive in class V composite restorations. Methods. 52 teeth with cervical lesions were selected from 14 patients and randomly divided in two groups: A assigned to a beginner operator, B to a dentist with 15 years experience. Groups were then randomly divided in two subgroups: E&R adhesive was used in subgroups A1 and B1 (Gluma Comfort Bond, Heraeus Kulzer), while SE in A2 and B2 (iBond, Heraeus Kulzer). Cavity margins were placed on both enamel and cement. All restorations were performed using the same composite and evaluated at baseline and 24-month (Hickel’s criteria). Micro-tensile laboratory tests were performed to test the bond strength of the two adhesives, comparing in vitro Vs in vivo. Results. No statistical difference between the clinical performance of the adhesives and the two operators. There was a statistically significant difference between baseline and 24-month follow-up, in both groups, for polishing procedure, post-op sensitivity and marginal adaptation. Under laboratory conditions, the E&R adhesive gave better results than the SE adhesive, even if statistically significant differences could only be found in terms of adhesion on enamel. Conclusions. This study suggests that both E&R and SE adhesives can be recommended for clinical use in class V composite restorations, either for a beginner operator than for an expert one.