IADR Abstract Archives
Clinical and OCT Evaluation of a Universal Adhesive: 24-Months Effectiveness
Objectives: Investigation of clinical performance and tooth-composite interface (OCT) of a universal adhesive.
Methods: 50 patients with three/four non-carious cervical lesions (NCCL) were included. The lesions were restored with composite (Venus®-Diamond-Flow) combined with the universal adhesive iBond® Universal (iB) applied in three etching modes: self-etch (SE/n=50), selective-enamel-etch (SEE/n=29), etch-and-rinse (ER/H3PO4/ n=50). OptiBond™ FL (OFL/n=50) was used as a positive control. All restorations were examined for both interfacial adhesive defects (AD, %) using OCT and for clinical failure rate using the FDI criteria. Restorations were imaged by spectral domain OCT (Telesto II/Thorlabs/1310nm) directly after restoration (t0), after 14 days (t1), 6 (t2) 12 (t3) and 24 months (t4) and from t1-t4 for clinical failure. Per OCT image stack 25 equally distributed B-scans out of 200-400 were examined. AD at the enamel- and dentin-/cement-composite interface were quantified as percentage of the total interface length. Statistic: Wilcoxon-, Mann-Whitney-U-, McNemar-test (α=0.05).
Results: Patients recall-response at 24-months was 82.8-90%. Clinic: After 24 months cumulative total failure rates were significantly lower in groups SE (0.0%; p<0.001), SEE (0.0%; p=0.016) and ER (4.3%; p=0.002) compared to OFL (27.6-29.8%). In all groups marginal staining increased (pi≤0.016) and marginal adaption decreased (pi≤0.039), without group differences (p>0.077).
OCT: At enamel, more AD appeared with SE than with SEE (t2-t4; p=0.009), ER (t1-t4; p=0.051) and OFL (t0-t3; p≤0.02). At the dentin/cement-composite interface, AD increased in all groups from 12-24 months (pi≤0.004). Additionally significantly, less defects were observed with iB compared to OFL (t1-t4; p≤0.003) and with the application mode SE compared to ER (t2-t4; p≤0.01).
Conclusions: Adhesive performance of iB was the highest with the self-etch strategy, being significantly superior than etch-and-rinse and OFL at the dentin/cement-composite interface of NCCLs. Adhesive defects detected through OCT seem to early predict the clinical performance of both adhesive systems, already at baseline (t1).
Methods: 50 patients with three/four non-carious cervical lesions (NCCL) were included. The lesions were restored with composite (Venus®-Diamond-Flow) combined with the universal adhesive iBond® Universal (iB) applied in three etching modes: self-etch (SE/n=50), selective-enamel-etch (SEE/n=29), etch-and-rinse (ER/H3PO4/ n=50). OptiBond™ FL (OFL/n=50) was used as a positive control. All restorations were examined for both interfacial adhesive defects (AD, %) using OCT and for clinical failure rate using the FDI criteria. Restorations were imaged by spectral domain OCT (Telesto II/Thorlabs/1310nm) directly after restoration (t0), after 14 days (t1), 6 (t2) 12 (t3) and 24 months (t4) and from t1-t4 for clinical failure. Per OCT image stack 25 equally distributed B-scans out of 200-400 were examined. AD at the enamel- and dentin-/cement-composite interface were quantified as percentage of the total interface length. Statistic: Wilcoxon-, Mann-Whitney-U-, McNemar-test (α=0.05).
Results: Patients recall-response at 24-months was 82.8-90%. Clinic: After 24 months cumulative total failure rates were significantly lower in groups SE (0.0%; p<0.001), SEE (0.0%; p=0.016) and ER (4.3%; p=0.002) compared to OFL (27.6-29.8%). In all groups marginal staining increased (pi≤0.016) and marginal adaption decreased (pi≤0.039), without group differences (p>0.077).
OCT: At enamel, more AD appeared with SE than with SEE (t2-t4; p=0.009), ER (t1-t4; p=0.051) and OFL (t0-t3; p≤0.02). At the dentin/cement-composite interface, AD increased in all groups from 12-24 months (pi≤0.004). Additionally significantly, less defects were observed with iB compared to OFL (t1-t4; p≤0.003) and with the application mode SE compared to ER (t2-t4; p≤0.01).
Conclusions: Adhesive performance of iB was the highest with the self-etch strategy, being significantly superior than etch-and-rinse and OFL at the dentin/cement-composite interface of NCCLs. Adhesive defects detected through OCT seem to early predict the clinical performance of both adhesive systems, already at baseline (t1).