Does the isolation method influence the performance of direct restorations?

Objectives: The aim of this study was to evaluate and compare the clinical performance of restorations of non-carious cervical lesions (N.C.C.L) with different adhesive strategies (total-etch versus self etching) an different isolation methods (rubber dam versus cotton rolls) for 180 days. Methods: One hundred and forty lesions in 38 patients were selected according to previously established inclusion and exclusion criteria and divided into four groups (n=35): G1 and G2 total-etch with Adper Single Bond 2. G3 and G4 self etching with Adper SE Plus. Rubber dam and cotton rolls were used in alternate order in all groups. All the restorations were made using an incremental technique with the same composite (Z 350) by the same operator. All restorations were evaluated using a modified-USPHS criteria by two previously calibrated examiners in 4 distinct periods: immediate (up to 24hrs after the completion of the restoration) 7, 30 and 180 days. McNemar test was used to identify alterations in the alfa index within groups throughout the evaluated periods. Qui-square test was used to detect interactions among groups in each period. 5% Significance level was used for all investigated criteria. Results: Both adhesive strategies promoted good sensitivity control throughout the study. In the Marginal discoloration criteria 4, G4 restorations demonstrated bravo scores. Conclusion: Regardless of the adhesive strategy or the isolation method, the sensitivity ceased from the third evaluation period. The self-etch approach in association with the cotton rolls was more susceptible to develop marginal discoloration.