Four-Year Clinical Evaluation of Two Self-Etching Dentin Adhesives

Objectives: Evaluate the performance of two self-etching adhesives clinically.

Methods: Eighty-four Class V restorations were placed in 21 patients in need of 2, 4 or 6 restorations in incisors, canines and premolars. The retention relied only on the adhesive (no mechanical retention). The two evaluated adhesives were iBond NG plus B(IBSE)(Heraeus Kulzer GmbH) and Clearfil SE (CLSE)(Kuraray), and the composite was Venus (Heraeus Kulzer GmbH). One week after placement, the patients were recalled for baseline evaluation. Following the baseline evaluation, the patients were recalled and evaluated after 3 months, 1 year, 2 years and 4 years using similar evaluations.

Results: At the 4-year evaluation, 4 patients did not show up for evaluation. The remaining 17 patients had originally received 66 restorations (33 of each adhesive). Of these restorations, 8 had been lost during the 4 years (4 IBSE and 4 CLSE). A noticeable finding was that two of the restorations (1 IBSE and 1 CLSE) had failed in the same patient, and in both cases, the restorations had fractured leaving a large piece of the composite still bonded to the dentin. Regarding two of the other failed material IBSE restorations, they had been crowned (one after endodontic treatment and one after cusp fracture), while the remaining lost IBSE restoration had debonded. Regarding material CLSE, except for the fractured and partly retained restoration, the remaining three had debonded. Pair-wise comparison of the evaluated parameters (retention, color matching and color stability, marginal integrity, marginal discoloration, incidence of caries, anatomic form, changes in the restorative-tooth interface, changes in surface texture, postoperative sensitivity and maintenance of periodontal health) using chi square statistics revealed no statistically significant (p<0.05) differences between the two materials.

Conclusions: The performance of the two adhesives in vivo was not significantly different during the 4-year period this study lasted.