3-Year Clinical Effectiveness of One-step Adhesives in Non-carious Cervical Lesions

One-step adhesives are either HEMA-rich or HEMA–poor/free. For both kinds, some concerns regarding bond durability have been raised. Objectives: To evaluate the clinical performance of two one-step self-etch adhesives in a randomized controlled clinical trial. Methods: Thirty patients had 175 non-carious cervical lesions restored with composite (Gradia Direct Anterior, GC) using either the HEMA-rich adhesive Clearfil Tri-S Bond (C3S; Kuraray) or the HEMA-free adhesive G-Bond (GB; GC). The restorations were evaluated by two calibrated examiners at baseline and after 6, 12, 24 and 36 months of clinical service regarding retention, caries recurrence, marginal integrity and discoloration and post-operative sensitivity. Retention loss, caries recurrence or any severe marginal defect/discoloration requiring clinical intervention (repair or replacement) were considered as clinical failures. The data were statistically analyzed with Mann-Whitney U and Friedmann ANOVA tests (p<0.05). Results: The recall rate at 6 and 12 months was 100% and decreased to 96.7% at 24 and 36 months. At 3 years, the retention rate was 93.8% for C3S and 98.8% for GB (p=0.08). No significant differences were observed between the two adhesives for all the parameters evaluated, irrespective of the recall (p>0.05). After 2 and 3 years of clinical service, both adhesives presented an increase in the percentage of small, though still clinically acceptable marginal defects up to 27.6% for C3S [18.4% for enamel (E) and 9.2% for dentin (D)] and 23.2% for GB (15.9% E; 7.3% D). The percentage of severe marginal defects was 2.6% (1.3% E; 1.3% D) and 3.6% (1.2% E; 2.4% D) for C3S and GB respectively. At 3 years, C3S presented marginal discoloration in 31.3% and GB 26.8%. The overall 3-year clinical success rate was 89.0% and 94.0% for C3S and GB, respectively. Conclusion: Both one-step self-etch adhesives presented an equally favorable clinical effectiveness at 3 years.