Eighteen-month clinical evaluation of a new universal adhesive applied in the "no-waiting" technique: a randomized clinical trial

Prolonged application time effects on universal adhesives in non-carious cervical lesions: An 18-month split mouth randomized clinical trial

OBJECTIVE

This double-blind, split mouth randomized clinical trial aimed to assess the clinical performance of Clearfil Universal Bond Quick (CBUq) universal adhesive under different application times (no waiting and waiting) compared to Clearfil SE Bond adhesive in non-carious cervical lesions (NCCLs) over 18 months.

METHODS

One hundred and eighty-three restorations were distributed randomly into three groups based on the adhesive system and waiting time: CUBq without waiting time (CUBq-NW), CUBq with a 20 s waiting time (CUBq-W), and CSE with a 20 s waiting time. After placement, restorations were evaluated after 18 months using the International Dental Federation (FDI) and United States Public Health Service (USPHS) criteria. Statistical analyses involved Friedman repeated measures analysis of variance and Wilcoxon tests, with a significance level set at 5 %.

RESULTS

Over the 18-month period, no restorations were lost across the tested groups. Marginal adaptation evaluation indicated minor discrepancies in 21 restorations (8 CUBq-NW, 6 CUBq-W, and 7 CSE). There were no significant differences observed among the three groups following the 18-month clinical assessment (p > 0.05). Only two restorations showed marginal discoloration after 18 months (1 CUBq-NW and 1 CSE).

CONCLUSIONS

The application of Clearfil Universal Bond Quick using either the "waiting" or "no-waiting" technique exhibited excellent clinical results in NCCLs during the 18-month follow-up period, demonstrating comparable performance to Clearfil SE Bond in all assessed outcomes.

CLINICAL SIGNIFICANCE

The findings suggest that the new universal adhesive applied using the no-waiting technique demonstrates promising clinical performance when compared to conventional application methods.

TRIAL REGISTRATION

ClinicalTrials.gov identifer RBR-69p7mpr.

Effect of the Adhesive Strategy on Clinical Performance and Marginal Integrity of a Universal Adhesive in Non-Carious Cervical Lesions in a Randomized 36-Month Study

The effectiveness of a universal adhesive applied in three application modes for the preparation of Class V composite restorations was evaluated both clinically and by quantitative marginal analysis (QMA) over 36 months. In 50 patients, three (n = 21) or four (n = 29) non-carious cervical lesions (NCCL) were restored with Venus® Diamond Flow (Kulzer GmbH, Hanau, Germany). The adhesive iBond® Universal (iBU, Kulzer, Germany) was used in self-etch (SE), etch-and-rinse (ER), or selective-enamel-etch mode (SEE). The etch-and-rinse adhesive OptiBondTM FL served as a control (OFL, Kerr GmbH, Herzogenrath, Germany). The restorations were clinically assessed (FDI criteria) at 14 days (BL), 6, 12, 24, and 36 months. Additionally, QMA was conducted on all restorations of 11 randomly selected patients. FDI criteria and marginal gap and perfect margin were compared between and within groups and recalls using McNemar, Wilcoxon, or Mann-Whitney U-tests (α = 0.05). Starting with 12 months, cumulative failure rates were lower in iBU-SE (0.0%, p = 0.016) and iBU-ER groups (2.1%, p = 0.07) compared to OFL (16.7%). At two years, iBU-SEE also showed fewer failures (0.0% SEE vs. 34.6% OFL, p = 0.016), as did iBU-SE compared to iBU-ER after 36 months (2.2 and 19.6%, p = 0.039). From BL, the iBU-SEE group always had the fewest marginal gaps and the highest percentage of perfect margins. From BL, iBU-SEE (0%, p = 0.008) and iBU-ER (0.2%, p = 0.027) showed significantly fewer marginal gaps compared to OFL (2.5%) and more perfect margins were found with iBU-SEE starting at 6 months (p = 0.054). The SEE and ER modes ensured the most excellent marginal quality, with differences from the control appearing earlier with QMA than clinically. In restoring NCCls, iBU showed superior clinical performance over OFL, especially in modes SE and SEE.