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 .
Three-year clinical performance of a HEMA-free one-step self-etch adhesive in non-carious cervical lesions.
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
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 .