There is not enough evidence to support one adhesive or bonding strategy over another for treatment of NCCLs .
CLINICAL SIGNIFICANCE Studies with low overall risk of bias demonstrated good clinical performance for adhesives with all four bonding strategies .
However , included studies showed wide variation between adhesives of the same category
OBJECTIVES To establish whether simplified adhesives ( self-etch ) are as clinical ly effective as conventional adhesives ( etch- and -rinse ) with multiple application steps for treatment of non-carious cervical lesions ( NCCLs ) .
NULL HYPOTHESIS there is no difference in the clinical effectiveness of the four different bonding strategies : Three-step etch- and -rinse ; Two-step etch- and -rinse ; Two-step self-etch ; One-step self-etch for treatment of NCCLs .
Restoring cervical lesions with flexible composites.
OBJECTIVES Flexure at the tooth cervix has been suggested to dislodge cervical restorations more rapidly . The objective of this r and omized controlled clinical trial was to test the hypothesis that a higher composite flexibility better withst and s tooth flexure stress . METHODS One hundred and forty-two non-carious cervical lesions were restored with composites with contrasting stiffness . Seventy-one patients r and omly received two cervical restorations  placed following two out of the three experimental groups : ( 1 ) the three-step etch- and -rinse adhesive Permaquick applied with the stiff micro-hybrid composite Amelogen Hybrid ( PMQ/A-Hy , Ultradent ) , ( 2 ) Permaquick applied with the more flexible micro-filled composite Amelogen Microfill ( PMQ/A-Mi , Ultradent ) , or ( 3 ) the ' golden st and ard ' three-step etch- and -rinse adhesive Optibond FL applied with the micro-hybrid composite Prodigy ( O-FL/Pro , Kerr ) . RESULTS The recall rate at 7 years was 80 % . No statistically significant difference was found for any of the parameters evaluated neither between both adhesives , nor between both composites ( McNemar , p>0.05 ) . Eleven percent of the O-FL/Pro restorations were clinical ly unacceptable due to loss of retention ( 5.5 % ) and severe marginal discoloration ( 5.5 % ) . In the PMQ-group , 22 % of the PMQ/A-Mi restorations ( 8 % loss of retention , 5 % severe enamel margin defects , 3 % severe dentin margin defects , 6 % severe marginal discoloration , 3 % extreme sensitivity ) and 19 % of the PMQ/A-Hy restorations ( 13 % loss of retention , 3 % severe enamel margin defects , 3 % severe marginal discoloration ) needed repair or replacement . SIGNIFICANCE The clinical performance of the three adhesive/composite combinations was good and reliable during the 7-year clinical trial . It was concluded that the composite stiffness does not affect the clinical longevity of cervical composite restorations
There is not enough evidence to support one adhesive or bonding strategy over another for treatment of NCCLs .
CLINICAL SIGNIFICANCE Studies with low overall risk of bias demonstrated good clinical performance for adhesives with all four bonding strategies .
However , included studies showed wide variation between adhesives of the same category
OBJECTIVES To establish whether simplified adhesives ( self-etch ) are as clinical ly effective as conventional adhesives ( etch- and -rinse ) with multiple application steps for treatment of non-carious cervical lesions ( NCCLs ) .
NULL HYPOTHESIS there is no difference in the clinical effectiveness of the four different bonding strategies : Three-step etch- and -rinse ; Two-step etch- and -rinse ; Two-step self-etch ; One-step self-etch for treatment of NCCLs .