Restoration of cervical lesions: 60-month results of a RCT

A randomized controlled trial represents the best solution for checking the clinical performances. Objectives: The aim of the study was to test two all-in-one bonding systems in cervical abrasion/erosion lesions. Methods: A randomized controlled trial was scheduled on 50 patients, 22 males, 28 females, aged between 30-52, with 3 cervical lesions, respecting the inclusion-exclusion and randomisation criteria for selection of technique and teeth.The material selected were i-Bond(H)(Heraeus Kulzer),AQ bond(S)(Morita)and SBMP(M)(3M-ESPE)as control. The procedure was done according with manufacturer's instructions by 3 operators with 8,4,4-year of experience, all the cavities were restored with Z250 (3M-ESPE),using a layering technique and soft start light-curing with an halogen lamp (Visilux 3000, 3M), with 400 mWcm2,with a final energy density > 8 J/cm2. The diameter, the depth, the type of dentin and the margin location of the lesions were recorded. ANOVA statistical analysis (P=0.05) was performed. The restorations were evaluated by an examiner with an intra-agreement >.80 with a loop (4.5x) according with USPHS modified criteria at baseline, 6,12,18,24,36,60 months. Results:After 60 months 42 patients were assessed: the group S showed 6 restorations lost and 2 rated Charlie for margin infiltration, the group H had 5 restorations rated Charlie for marginal adaptation in cervical regions, the group M had 4 restorations lost.There is a significant difference between the group S and groups H and M (P=.03), no difference between H and M. The group H had 21 restoration rated Bravo for marginal adaptation on the enamel margin, the group M had 10 restorations with the same score in the same position. There is a significant difference for this parameter (P=.025). Conclusion: Within the limits of this clinical trial, one all-in-one bonding systems seems to work as well as a three step bonding agent, the acid etching of enamel margins could guarantee a better long-term seal.