Influence of Adhesive Type and Placement Technique on Postoperative Sensitivity in Posterior Composite Restorations. Total-etch versus self-etch adhesive: effect on postoperative sensitivity. Four-year clinical evaluation of Class II nano-hybrid resin composite restorations bonded with a one-step self-etch and a two-step etch-and-rinse adhesive. Effect of glass-ionomer cement lining on postoperative sensitivity in occlusal cavities restored with resin composite--a randomized clinical trial. Randomized clinical trial of four adhesion strategies: 18-month results. Eight-year randomized clinical evaluation of Class II nanohybrid resin composite restorations bonded with a one-step self-etch or a two-step etch-and-rinse adhesive Influence of acid etching and enamel beveling on the 6-month clinical performance of a self-etch dentin adhesive. Self-etching adhesives and postoperative sensitivity. The effect of adhesive and flowable composite on postoperative sensitivity: 2-week results. An 18-months' evaluation of self-etch and etch & rinse adhesive in non-carious cervical lesions Experimental and clinical evaluation of a self-etching and an etch-and-rinse adhesive system. A prospective 15-year evaluation of extensive dentin-enamel-bonded pressed ceramic coverages. Clinical performance of a self-etching adhesive at 18 months. A new universal simplified adhesive: 18-month clinical evaluation. Self-etching adhesive on intact enamel, with and without pre-etching. A randomized, controlled clinical trial of one-step self-etching adhesive systems in non-carious cervical lesions. Effect of phosphoric acid etching prior to self-etching primer application on adhesion of resin composite to enamel and dentin. Primary dentin etching time, bond strength and ultra-structure characterization of dentin surfaces. Three-year clinical performance of a HEMA-free one-step self-etch adhesive in non-carious cervical lesions. Long-term dentin retention of etch-and-rinse and self-etch adhesives and a resin-modified glass ionomer cement in non-carious cervical lesions. In Vivo and In Vitro Effects of Chlorhexidine Pretreatment on Immediate and Aged Dentin Bond Strengths. A 12-month clinical evaluation of composite resins in class III restorations. Effect of silver diamine fluoride on microtensile bond strength to dentin.
PURPOSE This double blind , r and omized clinical trial compared the postoperative sensitivity of the placement technique ( incremental and bulk fill ) in posterior composite resin restorations bonded with two different adhesive strategies ( self-etch and etch- and -rinse ) . METHODS Posterior dental cavities of 72 participants ( n=236 ) , with a cavity depth of at least 3 mm , were r and omly divided into four groups . The restorations were bonded using either the etch- and -rinse Tetric N-Bond ( Ivoclar Vivadent ) or the self-etch Tetric N-Bond SE ( Ivoclar Vivadent ) . The composite resin Tetric N-Ceram Bulk Fill ( Ivoclar Vivadent ) was placed either incrementally or using the bulk-fill technique . Two experienced and calibrated examiners evaluated the restorations using World Dental Federation criteria after one week of clinical service . Spontaneous postoperative sensitivity was assessed using a 0 - 4 numerical rating scale and a 0 - 10 and 0 - 100 visual analog scale up to 48 h after the restorative procedure and after one week . RESULTS The risk ( p>0.49 ) and intensity of spontaneous postoperative sensitivity ( p>0.38 ) was not affected by the adhesive strategy or the filling technique . The overall risk of postoperative sensitivity was 20.3 % ( 95 % confidence interval 15.7 - 25.9 ) and typically occurred within 48 hours after the restorative procedure . CONCLUSIONS The overall risk of immediate postoperative sensitivity was 20.3 % and was not affected by either the adhesive strategy ( etch- and -rinse/self-etch ) or the filling technique ( incremental/ bulk ) BACKGROUND Self-etching adhesives are believed to prevent postoperative sensitivity when used under posterior resin-based composite restorations . The authors tested a twofold hypothesis : a self-etch , or SE , adhesive would result in less postoperative sensitivity than a total-etch , or TE , adhesive ; an SE adhesive would result in poorer enamel marginal integrity than a TE adhesive . METHODS Patients were selected on the basis of requiring Class I and II restorations in molars and premolars . The authors placed 30 restorations with the SE material ( Clearfil SE Bond , Kuraray America , New York ) and 36 restorations with Prime & Bond NT ( Dentsply Caulk , Milford , Del. ) , which uses 34 percent phosphoric acid to etch enamel and dentin simultaneously . Preparations were of st and ard design , with all margins in enamel without beveling . Upon rubber dam isolation , the authors conditioned the enamel and dentin walls with the self-etching primer ( for Clearfil SE Bond ) or etched with the proprietary 34 percent phosphoric acid ( for Prime & Bond NT ) , followed by application of the corresponding dentin adhesive . Teeth were restored with the proprietary hybrid resin-based composite indicated for posterior restorations : Clearfil AP-X for Clearfil SE Bond or Esthet-X Micro Matrix Restorative for Prime & Bond NT . The restored teeth were evaluated preoperatively and at two weeks , eight weeks and six months postoperatively for sensitivity to cold ( ice ) , air and masticatory forces , as well as for marginal discoloration . RESULTS Analysis of variance revealed no statistically significant differences in postoperative sensitivity between the SE and TE material s at any recall time . Marginal discoloration was rated as " absent " for all restorations at six months . Only one tooth displayed sensitivity to occlusal forces at six months . CONCLUSION The SE adhesive did not differ from the TE adhesive in regard to sensitivity and marginal discoloration . CLINICAL IMPLICATION S Postoperative sensitivity may depend on the restorative technique rather than on the type of dentin adhesive used OBJECTIVE The objective of this prospect i ve clinical trial was to evaluate the 4-year clinical performance of an ormocer-based nano-hybrid resin composite ( Ceram X ; Dentsply/DeTrey ) in Class II restorations placed with a one-step self-etch ( Xeno III ; Dentsply/DeTrey ) and two-step etch- and -rinse adhesive ( Ivoclar Vivadent ) . METHODS Seventy-eight participants received at r and om at least two , as similar as possible , Class II restorations of the nano-hybrid resin composite bonded with either a single step self-etch adhesive or a control 2-step etch- and -rinse adhesive . The 165 restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 4 years . RESULTS 162 restorations were evaluated at 4 years . Postoperative sensitivity was observed in 6 patients ( 3 Xeno III , 3 Exite ) between 1 and 3 weeks . Eleven failed restorations ( 6.8 % ) were observed during the follow up . Seven in the one-step self-etch adhesive group ( 7.7 % ) and four in the 2-step etch- and -rinse group ( 5.6 % ) . This result ed in non-significant different annual failure rates of 1.9 % and 1.4 % , respectively . Fracture of restoration was the main reason for failure . CONCLUSION The ormocer-based nano-hybrid resin composite showed a good clinical performance in Class II cavities during the 4 year evaluation . No significant difference was seen in overall clinical effectiveness between the two adhesives This study investigated the ability of a glass-ionomer cement ( GIC ) lining to reduce postoperative sensitivity in occlusal cavities restored with resin composite . In addition , the effects of a total-etch and self-etch adhesive on postoperative sensitivity were also compared . Patients who had moderate to deep occlusal caries of at least one molar were recruited . Overall , 103 restorations were placed in 70 participants , with an average age of 22.8 + /- 3.8 years . Preoperatively , each tooth was evaluated for cold-stimulated tooth sensitivity using a visual analog scale . If present , tooth sensitivity induced by cold/hot drinks or occlusal function was also noted . Caries was stained with a caries detector dye , then removed using slow-speed burs and h and excavators . The cavity was restored with one of four r and omly allocated restorative procedures : 1 ) bonded with a two-step , total-etch adhesive ( Single Bond 2 ) ; 2 ) lined with a resin-modified GIC liner ( Fuji Lining LC ) , then bonded with total-etch adhesive ; 3 ) bonded with a two-step , self-etch adhesive ( Clearfil SE Bond ) and 4 ) lined with the GIC liner , then bonded with self-etch adhesive . The cavities were incrementally filled with a nanofilled hybrid resin composite . At recall , postoperative sensitivity was evaluated at one week and one month . Overall , postoperative sensitivity in daily function was rare . No significant difference in postoperative sensitivity , either in daily function or in response to a cold stimulus , was observed between the restorative procedures with or without the GIC liner , regardless of the adhesive used ( p > 0.05 ) . In addition , no difference in postoperative sensitivity was noted between use of the self-etch and total-etch adhesive STATEMENT OF THE PROBLEM With Institutional Review Board approval , 39 patients who needed restoration of noncarious cervical lesions ( NCCLs ) were enrolled in this study . A total of 125 NCCLs were selected and r and omly assigned to four groups : 1 ) a three-step etch- and -rinse adhesive , Adper Scotchbond Multi- Purpose ( MP , 3 M ESPE , St Paul , MN , USA ) ; 2 ) a two-step etch- and -rinse adhesive , Adper Single Bond Plus ( SB , 3 M ESPE ) ; 3 ) a two-step self-etch adhesive , Adper Scotchbond SE ( SE , 3 M ESPE ) ; and 4 ) a one-step self-etch adhesive , Adper Easy Bond ( EB , 3 M ESPE ) . A nanofilled composite resin was used for all restorations . Restorations were evaluated at six months and 18 months using modified U.S. Public Health Service ( USPHS ) parameters . RESULTS At six months after initial placement , 107 restorations ( 85.6 % recall rate ) were evaluated . At 18 months , 94 restorations ( 75.2 % recall rate ) were available for evaluation . The 6 mo/18 mo overall retention rates ( % ) were 100/90.9 for MP ; 100/91.7 for SB ; 100/90.9 for SE ; and 96.4/92.3 for EB with no statistical difference between any pair of groups at each recall . Sensitivity to air decreased significantly for all adhesives from the preoperative to the postoperative stage and was stable thereafter . Interfacial staining did not change statistically from baseline to six months ; however , interfacial staining at the enamel margins was statistically worse at 18 months than at baseline for the two self-etch adhesives EB and SE . Marginal adaptation was statistically worse at 18 months compared with baseline only for EB . This tendency was already significant at the six-month recall . CONCLUSION Although 18-month retention was similar for the different adhesion strategies , enamel marginal deficiencies were more prevalent for the self-etch adhesives Objectives The aim of this study is to observe the durability of Class II nanohybrid resin composite restorations  , placed with two different adhesive systems , in an 8-year follow-up . Methods Seventy-eight participants received at r and om at least two Class II restorations of the ormocer-based nanohybrid resin composite ( Ceram X ) bonded with either a one-step self-etch adhesive ( Xeno III ) or a control two-step etch- and -rinse adhesive ( Excite ) . The 165 restorations were evaluated using slightly modified United States Public Health Services ( USPHS ) criteria at baseline and then yearly during 8 years . Results One hundred and fifty-eight restorations were evaluated after 8 years . Three participants with five restorations ( three Xeno III , two Excite ) were registered as dropouts . Twenty-one failed restorations ( 13.3 % ) were observed during the follow-up . Twelve in the one-step self-etch adhesive group ( 13.5 % ) and nine in the two-step etch- and -rinse group ( 13.0 % ) . This result ed in nonsignificant different annual failure rates of 1.69 and 1.63 % , respectively . Fracture of restoration was the main reason for failure . Conclusion Good clinical performance was shown during the 8-year evaluation and no significant difference in overall clinical performance between the two adhesives . Fracture was the main reason for failure . Clinical relevance The one-step self-etch adhesive showed a good long-term clinical effectiveness in combination with the nanohybrid resin composite in Class II restorations This study tested the hypothesis that beveling and /or etching enamel does not affect the 6-month clinical performance of the self-etch adhesive Clearfil SE Bond in class V noncarious lesions . With Institutional Review Board approval , 34 patients were enrolled in this study . A total of 120 noncarious cervical lesions were selected and assigned to 4 groups : ( 1 ) Clearfil SE Bond was applied without any cavity preparation ; ( 2 ) After the enamel was beveled , Clearfil SE Bond was applied ; ( 3 ) After the enamel was etched for 15 seconds with 35 % phosphoric acid , Clearfil SE Bond was applied ; ( 4 ) After the enamel was beveled and etched with 35 % phosphoric acid for 15 seconds , Clearfil SE Bond was applied . A microfilled composite resin was used for all restorations . Six months after initial placement , 120 restorations ( a 100 % recall rate ) were re-evaluated . Retention rates at 6 months were 100 % for all groups . Sensitivity to air improved from baseline to 6 months , but the overall difference was not statistically significant . The 6-month retention rate of the self etch dentin adhesive system Clearfil SE Bond was not improved by enamel beveling or by enamel etching . For the self-etch material Clearfil SE Bond , instrumentation or etching of enamel may not be critical for its clinical performance at 6 months PURPOSE To test the hypothesis that the prevention of postoperative sensitivity in resin-based composite restorations is better achieved with a self-etching/self-priming ( SE/SP ) dentin bonding system without lining than with an early generation total-etch ( TE ) bonding system . METHODS Over a 4-year period , clinical follow-ups were conducted on patients who had received composite restorations .  The depth of each cavity was categorized as being shallow , medium or deep , and an evaluation was made regarding the need for pulpal protection for each restoration . Three different self-etching/self-priming ( SE/SP ) adhesive systems were compared to three different total-etch ( TE ) adhesive systems . The incidences of postoperative sensitivity ( IPS ) were examined by a st and ardized procedure 1 week after placement of the restoration . Patients ' ages varied between 16 - 83 years . RESULTS The  total number of restorations placed in vital teeth were 330 for 150 patients in the SE/SP group , and 126 for 70 patients in the TE group .  Incidences of IPS in the total number of restorations stratified for depth were 14 % in deep cavities , 6 % in medium depth cavities and 5 % in shallow cavities in the SE/SP group , and 35 % in deep cavities , 16 % in medium and 4 % in shallow cavities in the TE group . Fisher 's exact test showed the incidence of IPS was significantly higher in cases of deep ( P < 0.05 ) and medium ( P < 0.05 ) cavities . The test also revealed that in restorations placed with the SE/SP adhesive systems , the presence or absence of a protective liner or base made no significant difference in the IPS in medium and shallow cavities , while the use of such protective layers produced a significantly higher IPS ( 21 % ) , compared with no protection ( 0 % ) , in deep cavities ( P < 0.05 ) . The absence of protective liners or bases did not result in postoperative sensitivity in deep cavities , when the SE/SP dentin bonding systems were used OBJECTIVE To measure 2-week postoperative sensitivity in Class II composite restorations placed with a self-etching adhesive ( Clearfil SE Bond ) or a total-etch adhesive ( Prime&Bond NT ) with or without a flowable composite as cervical increment . METHOD AND MATERIAL S Upon approval by the University of Guarulhos Committee on Human Subjects , 100 restorations were inserted in 46 patients who required Class II restorations in their molars and premolars . Enamel and dentin walls were conditioned with a self-etching primer ( for Clearfil SE Bond ) or etched with 34 % phosphoric acid ( for Prime&Bond NT ) . A 1- to 2-mm-thick increment of a flowable composite ( Filtek Flow ) was used in the proximal box in 50 % of the restorations of each adhesive . Preparations were restored with a packable composite ( Surefil ) . The restorations were evaluated preoperatively and 2 weeks postoperatively for sensitivity to cold , air , and masticatory forces using a visual analog scale . Marginal integrity of the accessible margins was also evaluated . Statistical analysis used a mixed linear model with subject as a r and om effect . RESULTS Ninety-eight teeth from 44 subjects were observed at 2 weeks . The type of adhesive and use of flowable composite had no significant effects or interaction for any of the four outcomes of interest , ie , change from baseline to 2 weeks in sensitivity and response time for the cold or air stimulus . For the air stimulus , the overall average change from baseline was not significant for either sensitivity or response time . For the cold stimulus , the overall average change from baseline was significant for both sensitivity and response time . No case of sensitivity to masticatory forces was observed . CONCLUSION No differences in postoperative sensitivity were observed between a self-etch adhesive and a total-etch adhesive at 2 weeks . The use of flowable composite did not decrease postoperative sensitivity Objective . In this intra-individual comparison ( an 18-months ' r and omized , controlled prospect i ve study ) , we evaluated the clinical performance of one self-etch and one “ etch & rinse ” adhesive in non-carious cervical lesions . Methods . Twenty-five patients with at least two pairs of similar-sized non-carious cervical lesions participated . Seventy-eight restorations were placed ; 39 with etch & rinse ( Single-Bond ) and 39 with self-etch ( Adper Prompt ) . Both adhesives were combined with the microfilled resin composite Filtek-A110 . The restorations were evaluated at baseline , 6 , 12 , and 18 months according to slightly modified USPHS criteria . Statistical differences between the adhesives was tested with McNemar 's test and clinical degradation over time for each material with the Fisher exact test ( α=0.05 ) . Results . Thirty pairs were evaluated at 12 and 18 months . Two self-etch restorations were lost after 18 months . Nine Adper Prompt and four Single-Bond restorations scored bravo for marginal adaptation at 18 months ( p<0.05 ) . Nine Adper Prompt and three Single-Bond restorations scored bravo for marginal discoloration ( p<0.05 ) . Conclusions . Both adhesive systems showed acceptable clinical retention rates according to the ADA full acceptance criteria for enamel-bonding systems in class V non-carious lesions . The self-etch adhesive showed a faster progressive marginal degradation PURPOSE To assess the one-step self-etching adhesive iBond Gluma inside ( 1-SE ) and the two-step etch- and rinse adhesive Gluma Comfort Bond ( 2-ER ) , both used in combination with the fine particle hybrid composite Venus , in a laboratory and in a prospect i ve clinical study . MATERIAL S AND METHODS In the in vitro study , tooth-composite interaction , microleakage , and adhesive failure of 8 Class V restorations per system were evaluated by light and scanning electron microscopy . In the in vivo study , 90 paired Class III/IV restorations were scored over 48 months ( modified USPHS criteria ) . Cumulative failure rates ( CFR ) were calculated . RESULTS In vitro , microleakage and adhesive failure at enamel margins were significantly increased with 1-SE in comparison with 2-ER . With 1-SE , micromechanical interlocking at enamel was reduced and pores within the adhesive layer arose . In vivo , after 48 months with 1-SE , decreased marginal integrity and an increased number of dark marginal color lines were observed . CONCLUSION Because the results of the 4-year clinical study showed lower esthetics and marginal integrity for the 1-SE adhesive , its use should be viewed critically , which is in line with the reduced enamel-adhesive-composite interaction found in vitro OBJECTIVES The purpose of this study was to investigate the durability of extensive dentin-enamel-bonded posterior ceramic coverages  in a 15 years follow-up . METHODS All extensive dentin-enamel-bonded posterior partial and complete all-ceramic coverages placed during the period November 1992-December 1998 were included . In 121 patients , 252 coverages ( IPS Empress ) were placed . The adhesive bonding to dentin and enamel was performed with three 3-step and one 2-step etch and rinse bonding . In 106 restorations the classic Syntac was used in combination with the dual-cured resin composite Variolink . The other restorations were luted with the chemically cured resin composite Bisfil 2B and bonded with 3-step etch and rinse systems , classic Gluma ( 37 ) , Allbond 2 ( 57 ) , Syntac ( 32 ) or the 2-step etch and rinse system , One step ( 20 ) . The ceramics were evaluated yearly by modified USPHS criteria during 15 years . RESULTS Postoperative sensitivity was registered in 4 patients during bite forces lasting for 2 - 4 weeks . Fifty-five of 228 coverages ( 24.1 % ) failed . The mean observation period of the acceptable coverages was 12.6 years ( range 11 - 15 years ) . The main reasons for failure were lost restorations ( 18 ) , ceramic fracture ( 16 ) , and secondary caries ( 11 ) . Significant differences in failure rate were observed between the dentin bonding agents but not between the two luting agents . Ceramic  coverages placed on non-vital teeth failed in 39 % and on vital teeth in 20.9 % ( p=0.014 ) . Logistic regression indicated three significant predictors for failure of the coverages : gender and parafunctional habits of the patient and non-vitality of the tooth . SIGNIFICANCE The technique investigated showed advantages like less destruction of healthy tissue , and avoiding of endodontic treatment and /or deep cervical placement of restoration margins to obtain retention PURPOSE To test the null hypothesis that beveling and /or etching enamel would not affect the 18-month clinical performance of the self-etching adhesive Clearfil SE Bond ( CSEB ) in noncarious cervical lesions ( NCCL ) . METHODS With Institutional Review Board approval , 34 patients were enrolled in this study . A total of 120 NCCL was selected and assigned to four groups : ( 1 ) CSEB was applied without any cavity preparation ; ( 2 ) CSEB was applied after beveling enamel ; ( 3 ) CSEB was applied after etching enamel for 15 seconds with 35 % phosphoric acid ; ( 4 ) CSEB was applied after beveling and etching enamel . A microfilled composite resin was used for all restorations . RESULTS At 6 months after initial placement , 120 restorations ( a 100 % recall rate ) were evaluated . At 18 months , 87 restorations ( a 72.5 % recall rate ) were available for evaluation . A survival rate of 100 % was measured for all groups at both 6 and 18 months . Sensitivity to air decreased significantly only for Group 3 ( no bevel+acid etch ) from baseline to 18 months without statistical changes from 6 months to 18 months . None of the other parameters result ed in significant differences for any of the four groups . However , when data were pooled , both the overall marginal discoloration and the overall marginal adaptation were significantly worse at 18 months than at baseline , while sensitivity to air decreased significantly from baseline to 18 months . The 18-month survival rate of the self-etching adhesive Clearfil SE Bond was not improved by enamel bevel or by enamel etching . Both overall marginal adaptation and overall marginal discoloration were worse at 18 months than at baseline . PURPOSE To evaluate the 18-month clinical performance of a multimode adhesive ( Scotchbond Universal Adhesive , SU , 3 M ESPE , St Paul , MN , USA ) in noncarious cervical lesions ( NCCLs ) using two evaluation criteria . MATERIAL S AND METHODS Thirty-nine patients participated in this study . Two-hundred restorations were assigned to four groups : ERm , etch- and -rinse + moist dentin ; ERd , etch- and -rinse + dry dentin ; Set , selective enamel etching ; and SE , self-etch . The composite resin , Filtek Supreme Ultra ( 3 M ESPE ) , was placed incrementally . The restorations were evaluated at baseline , and at 18 months , using both the World Dental Federation ( FDI ) and the United States Public Health Service ( USPHS ) criteria . Statistical analyses were performed using Friedman repeated- measures analysis of variance by rank and McNemar test for significance in each pair ( α=0.05 ) . RESULTS Five restorations ( SE : 3 ; Set : 1 ; and ERm : 1 ) were lost after 18 months ( p>0.05 for either criteria ) . Marginal staining occurred in four and 10 % of the restorations evaluated ( p>0.05 ) , respectively , for USPHS and FDI criteria . Nine restorations were scored as bravo for marginal adaptation using the USPHS criteria and 38 % , 40 % , 36 % , and 44 % for groups ERm , ERd , Set , and SE , respectively , when the FDI criteria were applied ( p>0.05 ) . However , when semiquantitative scores ( or SQUACE ) for marginal adaptation were used , SE result ed in a significantly greater number of restorations , with more than 30 % of the total length of the interface showing marginal discrepancy ( 28 % ) in comparison with the other groups ( 8 % , 6 % , and 8 % , respectively , for ERm , ERd , and Set ) . CONCLUSIONS The clinical retention of the multimode adhesive at 18 months does not depend on the bonding strategy . The only differences between strategies were found for the parameter marginal adaptation , for which the FDI criteria were more sensitive than the USPHS criteria OBJECTIVE Bond strengths of composite resin to enamel using self-etch adhesive ( SEA ) Clearfil SE bond system on intact enamel and enamel pre-etched with phosphoric acid were compared . The objective was to determine if the pre-etching would increase the bond strengths of the SEA systems to intact enamel and to evaluate the effect of pre-etching on bond formation of self-etch adhesives on intact enamel . MATERIAL S AND METHOD Labial surfaces of 40 caries free permanent upper central and lateral incisors were cleaned , sectioned of their roots . All specimens were mounted on acrylic block and divided r and omly into four groups . In two groups the application of self-etch adhesive , Clearfil SE bond was carried as per manufacturer 's instructions , composite cylinders were built , whereas in the other two groups , 37 % phosphoric acid etching was done before the application of self-etching adhesives . Then the resin tags were analyzed using scanning electron microscope and shear bond strength was measured using Instron universal testing machine . RESULTS When phosphoric acid was used , there was significant increase in the depth of penetration of resin tags and in the Shear Bond Strength of composite to enamel . CONCLUSION The results indicate that out of both treatment groups , pre-etching the intact enamel with 37 % phosphoric acid result ed in formation of longer resin tags and higher depth of penetration of resin tags of the Clearfil SE bond , and attaining higher bond strength of the Clearfil SE bond to intact enamel PURPOSE To evaluate the clinical effectiveness of two different one-step self-etching adhesives . METHODS Two single-step self-etching adhesive systems , Clearfil Tri-S Bond and G-Bond , were evaluated . As a control , a two-step self-etching adhesive system , Clearfil SE Bond , was used . The teeth to be restored were r and omly assigned . The resin composite used to restore the teeth was Clearfil AP-X. The three adhesive systems were evaluated by Modified USPHS at baseline , 3 months , 6 months , and 12 months . The evaluation consisted of retention rate , color match , marginal discoloration ( interfacial staining ) , marginal adaptation ( integrity ) , wear , post-operative sensitivity , caries recurrence , and other failures . Changes over time and across groups were evaluated statistically using generalized estimating equations . RESULTS During the 12-month study period , no statistical differences were observed among the three groups ( P > 0.05 ) in retention rate , color match , marginal discoloration ( interfacial staining ) , marginal adaptation ( integrity ) . No wear , post-operative sensitivity , caries recurrence , or other failures were detected in any groups . The two one-step self-etching adhesives tested showed good clinical performance at the end of 12 months PURPOSE To investigate the effect of phosphoric acid etching prior to the application of self-etching primer on the adhesion of resin composite to tooth substrates . MATERIAL S AND METHODS Bovine teeth were r and omly divided in four groups of 20 sample s each . Tooth surface conditions were as follows : Group 1 : enamel ground with 600-grit SiC paper ; Group 2 : ground enamel was etched with 35 % phosphoric acid gel for 15 seconds , water-rinsed and completely dried ; Group 3 : ground dentin ; Group 4 : dentin etched using the same method as Group 2 . The sample s in each group were divided in two subgroups of 10 each . UniFil Bond ( UB ) and Clearfil SE Bond ( SE ) were applied as adhesive systems with self-etching primers , and a layer of resin composite ( AP-X ) was placed and light-cured for 40 seconds . The tensile bond strengths ( TBS ) were measured and the resin-tooth interfaces were observed with scanning electron microscopy . RESULTS The mean TBS values were 11.2 MPa ( Group 1-UB ) , 14.3 MPa ( Group 1-SE ) , 16.3 MPa ( Group 2-UB ) , 20.5 MPa ( Group 2-SE ) , 13.4 MPa ( Group 3-UB ) , 16.7 MPa ( Group 3-SE ) , 9.3 MPa ( Group 4-UB ) and 12.6 MPa ( Group 4-SE ) . Two-way ANOVA and Scheffe 's F test showed that the enamel etching significantly increased the TBS values but dentin etching significantly decreased the TBS values OBJECTIVES To evaluate the effect of shortening the etching time on roughness , microhardness and bond strength of three adhesive systems to primary tooth dentin . METHODS Flat dentin surfaces from primary molars were r and omly assigned to six experimental groups . Three different adhesive systems were used : an etch- and -rinse adhesive ( Single Bond ) , a two-step self-etching ( Clearfil SE Bond ) , and a one-step self-etching ( One-Up Bond F ) adhesive . In half of the specimens , the recommended etching time was used , in the other half the etching time was 50 % reduced . After applying the adhesive , resin composite build-ups were constructed and stored in a humid environment for 24h at 37 degrees C. Specimens were sectioned into 1mm(2 ) beams and tested for microtensile bond strength ( MTBS ) . Debonded surfaces were analyzed by scanning electron microscopy ( SEM ) . Additional surfaces were conditioned for microhardness measurements ( KHN ) and for atomic force microscopy ( AFM ) analysis . Intertubular and total surface roughness ( Ra ) were recorded . Results were analyzed with ANOVA and Student-Newman-Keuls tests ( P<0.05 ) . RESULTS Single Bond and Clearfil SE Bond showed higher MTBS than One-Up Bond F. Bond strength and intertubular roughness increased when Single Bond and One-Up Bond F were used with a reduced etching time . For Clearfil SE Bond no differences in MTBS were detected when reducing the etching time . The application of phosphoric acid , Clearfil SE Bond primer and One-Up Bond F decreases dentin microhardness . CONCLUSIONS Shortening One-Up Bond F application time and reducing the etching time of phosphoric acid to one-half of the manufacturer 's recommended etching time when using Single Bond are recommended when bonding to primary dentin Despite the fact that one-step adhesives are currently used routinely in clinical practice , long-term studies on their clinical performance are scarce . The objective of this r and omized controlled clinical trial was to test the hypothesis that a 2-hydroxyethyl methacrylate (HEMA)-free one-step self-etch adhesive performs worse than a conventional multistep etch- and -rinse adhesive .  Two-hundred and seventy-six non-carious cervical lesions in 52 patients were restored with a micro-hybrid composite  ( Gradia Direct ; GC ) . These restorations were bonded in r and om order either with the HEMA-free one-step adhesive G-Bond ( GC ) or with the ' gold-st and ard ' ( control ) three-step adhesive Optibond FL ( Kerr ) . The restorations were evaluated after 6 , 12 , 24 , and 36 months of clinical service regarding retention , marginal adaptation , microleakage , caries occurrence , and sensitivity . After a medium-long period of 3 yr , similar success in clinical performance was observed for the simplified all-in-one adhesive and the conventional three-step adhesive . However , the one-step adhesive exhibited significantly more incisal marginal defects and discolorations . Whereas marginal degradation appeared to arrest for the multistep etch- and -rinse adhesive after 12 months , the enamel margins of the restorations bonded with the one-step self-etch adhesive continued to deteriorate . These incisal marginal defects were , however , small and could easily be removed by polishing . For both adhesives , large and sclerosed lesions appeared to be at higher risk of retention loss OBJECTIVES The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems . METHODS A total of 270 Class V restorations of four etch- and -rinse , one self-etch adhesive system and a resin-modified glass ionomer cement were placed in non-carious cervical lesions without intentional enamel involvement . The restorations were evaluated at baseline , 6 , 12 , 18 , and 24 months and then every year during a 13-year follow-up . Dentin bonding efficiency was determined by the percentage of lost restorations . RESULTS During the 13 years , 215 restorations could be evaluated . The cumulative loss rate at 13 years was 53.0 % , with significant different failures rates for the different systems varying between 35.6 and 86.8 % . Four systems fulfilled the ADA 18-month full acceptance retention criteria . Two systems showed at 18 months and earlier high debonding rates . The annual failure rates for the etch- and -rinse systems were Optibond 3.1 % , Permagen 13.0 % , Scotchbond MP 4.8 % , Syntac classic 2.8 % ; for the self-etch system P&S 4.4 % ; and the resin-modified glass ionomer cement Vitremer 2.7 % . CONCLUSION It can be concluded that all systems showed a continuous degradation of the bond with a wide variation , which was independent of the adhesion strategy . Three bonding systems showed a cumulative failure rate after 13 years between 36 and 41 % with the best retention for the resin-modified glass ionomer cement and a four-step etch- and -rinse system This study evaluated the effect of 2 % chlorhexidine ( CHX ) pretreatment of dentin on the immediate and aged microtensile bond strength ( μTBS ) of different adhesives to dentin in vivo and in vitro . Class I cavities were prepared in 80 caries-free human third molars of 40 patients in a split-mouth fashion . In each tooth pair , one tooth received 2 % CHX pretreatment after which both teeth were r and omly assigned to one of the following groups with respect to the type of adhesive system applied : Adper Single Bond 2 ( etch- and -rinse ) , Clearfil SE Bond ( two-step self-etch ) , Clearfil S(3 ) Bond ( one-step self-etch ) , and Adper Prompt-L-Pop ( all-in-one self-etch ) . The teeth were restored with resin composite and extracted for μTBS testing either immediately or after six months in function . In vitro specimen pairs were prepared as with the clinical protocol in intact , freshly extracted human molars , and thereafter , subjected to testing immediately or after 5000 × thermocycling . Data were analyzed with four-way analysis of variance ( ANOVA ) . Bonferroni test was utilized for pair-wise comparisons . The immediate bond strength values were significantly higher than " aged " ones for all tested adhesives ( p=0.00 ) . The in vitro immediate bond strength values were statistically higher than in vivo bond strength values ( p<0.05 ) . While the bond strength of in vitro aged , CHX-treated sample s were higher than their in vivo counterparts ( p<0.05 ) , no difference was observed in non-CHX treated groups ( p>0.05 ) . In the absence of CHX pretreatment , all adhesives showed significantly higher immediate bond strength values than CHX-treated groups , while all " aged " , non-pretreated adhesives exhibited significantly lower bond strength values ( both p<0.05 ) . By contrast , chlorhexidine pretreatment result ed in significantly higher aged bond strengths , regardless of the adhesive system and testing condition . Aging-associated decline in dentin bond strength of etch- and rinse and self-etch adhesives can be counteracted by chlorhexidine application PURPOSE This paired-tooth r and omized controlled prospect i ve clinical study compared the clinical performance of three composite resins in Class III cavities after 12 months . MATERIAL S AND METHODS Three material s were evaluated : a microfilled composite resin ( Durafill VS ) , a hybrid composite resin ( Filtek Z250 ) , and a nanofilled composite resin ( Filtek Supreme ) .  Thirty-eight patients having at least three Class III restorations were enrolled in this study . A total of 114 restorations were placed by two calibrated operators according to the manufacturers ' instructions . The adhesive system ( Clearfil SE Bond ) was either applied according to manufacturer 's instructions ( CSE non-etch ) or enamel margins were first etched with phosphoric acid ( CSE etch ) . One week later , the restorations were finished and polished . Two other independent examiners evaluated the restorations at baseline according to the USPHS criteria and USPHS modified criteria for the items color match and surface appearance . The restoration location was taken into consideration during the analysis of each item . A nonparametric analysis of variance ( Friedman test ) and the Wilcoxon test were used for statistical analysis ( alpha = 0.05 ) . RESULTS The restoration location did not influence the evaluated items . Filtek Z250 showed the best color match at baseline , and after 6 and 12 months . No significant difference in the item surface appearance was detected at baseline ; however , after 6 and 12 months , Filtek Z250 showed the worst performance on this item . No significant difference was found between CSE non-etch and CSE etch groups . CONCLUSION The hybrid composite resin showed an excellent immediate and 12-month color match , which was superior to the nanofilled and microfilled composites tested . On the other h and , the nanofilled and microfilled composites showed the best surface appearance after 12 months . Additional etching of the enamel cavity margins did not influence the clinical performance of the adhesive Clearfil SE Bond The aim of this in vitro study was to investigate the effect of the cariostatic and preventive agent silver diamine fluoride ( SDF ) on the microtensile bond strength of resin composite to dentin . Forty-two caries-free , extracted molars were flattened occlusally and apically using a diamond saw , and the exposed occlusal dentin was polished with a series of silicon carbide papers , all under water irrigation . The teeth were then r and omly divided into six groups of seven teeth each that were treated as follows : 1 ) Peak SE self-etch bonding agent ; 2 ) 12 % SDF + Peak SE ; 3 ) 38 % SDF + Peak SE ; 4 ) Peak LC etch- and -rinse bonding agent ; 5 ) 12 % SDF + Peak LC ; and 6 ) 38 % SDF + Peak LC . Four-millimeter buildups of Amelogen Plus were incrementally placed on all teeth ; after a 24-hour storage period in distilled water , the specimens were sectioned perpendicular to the adhesive interface to produce beams of cross-sectional surface area measuring approximately 1 mm(2 ) . The beams were placed on a microtensile testing machine , which utilized a single-speed pump motor and force gauge at 20 kgf × 0.01 second to record maximum tensile force before failure occurred . Two-way analysis of variance and post hoc Tukey tests were performed to compare the effects of the SDF  on microtensile bond strength , with statistical significance set at α = 0.05 . None of the experimental groups treated with different concentrations of SDF showed a significant difference in bond strength compared to the control groups , and there was no significant difference in bond strength between self-etch and etch- and -rinse groups . However , the effect of SDF  on self-etch bonded teeth compared to etch- and -rinse bonded teeth was statistically significant ( p=0.0363 ) , specifically at the 12 % concentration . SDF does not adversely affect the bond strength of resin composite to noncarious dentin
No overall effect was revealed in the meta-analyses , meaning that no influence of the  ER or SE strategy on POS .
SIGNIFICANCE The type of adhesive strategy ( ER or SE ) for posterior resin composite restorations does not influence the risk and intensity of POS .
OBJECTIVES A systematic review and meta- analysis were performed on the risk and intensity of postoperative sensitivity ( POS ) in posterior resin composite restorations bonded with self-etch ( SE ) and etch- and -rinse ( ER ) adhesives .