OCT for Evaluation of a Universal Adhesive in a Three-Year Clinical Trial.

OBJECTIVES

In parallel with the 36-month clinical evaluation of a universal adhesive, tooth-composite bond failure was assessed by tomography.

METHODS

In 55 patients, three non-carious cervical lesions (NCCLs) each were restored with FiltekTM Supreme XTE (3M) using the universal adhesive Scotchbond™ Universal Adhesive (SBU, 3M) in the self-etch (SE) or selective enamel-etch (SEE) mode or by OptiBond™ FL (OFL, Kerr, reference, randomization). Immediately after restoration placement (T0) and in parallel with the clinical assessments (FDI criteria) at 6, 12, 24, and 36 months (M), the restorations were imaged by optical coherence tomography (OCT) to quantify interfacial adhesive defects (ADs; 14 days, clinical only). Cumulative failure rates (CFRs) and means of ADs were statistically analyzed.

RESULTS

From six to 36M, CFRs were lower in the SBU groups vs. OFL (pi ≤ 0.004). Compared to SBU-SE or OFL, SBU-SEE resulted in reduced marginal staining (≥ 12M; pi: 0.002 - 0.727) and increased marginal adaptation (≥ 12M; pi: 0.001 - 0.629). Increased ADs appeared on the enamel with SBU-SE vs. SBU-SEE and OFL (T0 - 36M; pi ≤ 0.001/0.048) and with OFL vs. SBU-SEE (≥ 6M; pi ≤ 0.025). At dentin/cement less defects appeared using SBU-SEE vs. SBU-SE (≥ 6M) or OFL (≥ T0, pi ≤ 0.0115), and fewer in the SBU-SE vs. OFL group (≥ T0, pi ≤ 0.001). Before restoration loss, the adhesive defects on the dentin/cement were increased (pi ≤ 0.05).

CONCLUSIONS

Clinical assessments and OCT-based analyses were consistent. In terms of bond failure, however, the groups already differed upon restoration placement, with reproducible substrate-specific differences becoming apparent.

CLINICAL SIGNIFICANCE: The universal adhesive Scotchbond™ Universal Adhesive in SEE mode performed most favorably. Interfacial adhesive defects detectable by OCT reliably predict the performance of a restoration system. #DRKS00011084, http://www.drks.de/DRKS00011084, 30.09.2016.