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OBJECTIVE: To evaluate non-carious cervical lesions (NCCLs) restored with different adhesion strategies. METHODOLOGY: This is a prospective, randomized, double-blind, split-mouth study. An adhesive restorative system (Single Bond Universal/Filtek Z350XT - SBU) was evaluated both without and with selective enamel conditioning (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic acid pretreatment (EDTA; E-RMGIC). In total, 200 restorations, placed in 50 patients, were evaluated at baseline and at a 3-year follow-up using the modified United States Public Health Service (USPHS) criteria. Data were analyzed using the two-proportion equality test, multinomial logistic regression, Wilcoxon test, and Kaplan-Meier survival curves. RESULTS: In total, 42 (84%) patients returned for the 3-year follow-up. SBU showed restoration losses statistically different from RMGIC. Retention was also statistically different in SBU between baseline and the 3-year follow-up. Marginal defects and surface texture were statistically significant for all groups in the period studied, except for the surface texture of SBU and the marginal integrity in E-RMGIC. We observed no statistically significant difference in wear, secondary caries, anatomical form, surface staining, and color over time. Recession degree was the only factor to influence retention rates. Cumulative survival (%) was 89, 98, 98, and 95.3, for SBU, SE-SBU, RMGIC, and E-RMGIC, respectively, without significant differences among them. There was a statistically significant difference between survival curves; however, multiple comparison procedures found no statistical differences. CONCLUSION: Selective enamel etching affected the retention of non-carious cervical restorations. Adhesion using EDTA and resin-modified glass-ionomer cements delayed marginal defects over time. The degree of gingival recession influenced retention rates. Resin composite restorations showed initial marginal defects, and ionomer restorations, reduced surface luster. EDTA pre-treatment followed by resin-modified glass-ionomer cements may be a promising adhesion strategy for NCCL restorations.

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Abstract: Objective: To evaluate non-carious cervical lesions (NCCLs) restored with different adhesion strategies. Methodology: This is a prospective, randomized, double-blind, split-mouth study. An adhesive restorative system (Single Bond Universal/Filtek Z350XT - SBU) was evaluated both without and with selective enamel conditioning (E-SBU), resin-modified glass-ionomer cements (Vitremer; RMGIC), and ethylenediaminetetraacetic acid pretreatment (EDTA; E-RMGIC). In total, 200 restorations, placed in 50 patients, were evaluated at baseline and at a 3-year follow-up using the modified United States Public Health Service (USPHS) criteria. Data were analyzed using the two-proportion equality test, multinomial logistic regression, Wilcoxon test, and Kaplan-Meier survival curves. Results: In total, 42 (84%) patients returned for the 3-year follow-up. SBU showed restoration losses statistically different from RMGIC. Retention was also statistically different in SBU between baseline and the 3-year follow-up. Marginal defects and surface texture were statistically significant for all groups in the period studied, except for the surface texture of SBU and the marginal integrity in E-RMGIC. We observed no statistically significant difference in wear, secondary caries, anatomical form, surface staining, and color over time. Recession degree was the only factor to influence retention rates. Cumulative survival (%) was 89, 98, 98, and 95.3, for SBU, SE-SBU, RMGIC, and E-RMGIC, respectively, without significant differences among them. There was a statistically significant difference between survival curves; however, multiple comparison procedures found no statistical differences. Conclusion: Selective enamel etching affected the retention of non-carious cervical restorations. Adhesion using EDTA and resin-modified glass-ionomer cements delayed marginal defects over time. The degree of gingival recession influenced retention rates. Resin composite restorations showed initial marginal defects, and ionomer restorations, reduced surface luster. EDTA pre-treatment followed by resin-modified glass-ionomer cements may be a promising adhesion strategy for NCCL restorations.

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O objetivo deste estudo clínico controlado, prospectivo, randomizado e com avaliadores cegos foi avaliar o desempenho clínico de restaurações cervicais não cariosas frente às diferentes estratégias de adesão ao substrato dental. Métodos: foram utilizados um sistema restaurador adesivo (Single Bond Universal/Z350XT) com e sem condicionamento seletivo do esmalte e um cimento de ionômero de vidro modificado por resina (Vitremer) com e sem tratamento prévio com EDTA, seguindo as instruções do CONSORT. Um total de 200 restaurações foram realizadas por dois operadores em 50 pacientes voluntários. Previamente à execução das restaurações e em cada tempo de avaliação foram avaliados os índices de sangramento gengival, placa visível e CPOD. Todas as restaurações foram avaliadas por meio do sistema de avaliação do USPHS modificado. Dois examinadores calibrados, cegos e diferentes dos operadores realizaram as avaliações nos seguintes intervalos de tempo: inicial imediato (baseline), 6, 12 e 24 meses. Ao final de 24 meses os dados foram analisados pelos testes estatísticos de Friedman, Qui-quadrado, Kappa, Cochran, Wilcoxon e análise de regressão logística múltipla, adotando-se nível de significância a 5%. Resultados: a amostra foi composta de 34 homens e 16 mulheres com idade média de 61,8 anos. Em relação ao CPOD, houve um aumento gradativo e significante ao longo do tempo, havendo diferença entre os quatro tempos de avaliação (p≤0,001). Não teve diferença entre os tempos para o índice de placa visível (p=0,28). No entanto, houve uma redução significativa do índice de sangramento gengival entre o baseline e os demais tempos (p≤0,001). Não houve diferença estatisticamente significante entre os 4 grupos em cada tempo de avaliação em nenhum dos critérios avaliados (p>0,05), assim como não houve entre os 4 tempos de avaliação para todos os grupos (p>0,05). Em relação à regressão logística, embora não tenha apresentado nenhuma variável isolada como estatisticamente significante, o modelo como um todo apresentou-se estatisticamente significante (p=0,034). Conclusão: As quatro diferentes estratégias de adesão em restaurações cervicais não cariosas apresentaram similar desempenho clínico após 24 meses de acompanhamento(AU)

Introduction: the aim of this study, prospective, randomized controlled clinical trial and with blind evaluators was to evaluate the clinical performance of non-carious cervical restorations to different strategies of adhesion for the dental substrate. Methods: we used a restorative adhesive system (Universal/Z350XT Single Bond) with and without selective etching of enamel and a modified glass ionomer luting cement for resin (Vitremer) with and without previous treatment with EDTA, following the instructions of the CONSORT. 200 in total restorations were performed by two operators in 50 patients. Prior to the execution of the restorations and each time, we evaluated the evaluation indexes of gum bleeding, visibly Board and CPOD. All restorations were evaluated using the evaluation system USPHS modified. Two calibrated examiners, blind and different operators, performed the evaluations in the following time intervals: immediate initial (baseline), 6, 12 e 24 months. At the end of 24 months data were analyzed by statistical tests Friedman, Qui-quadrado, Kappa, Cochran, Wilcoxon and multiple logistic regression analysis, adopting the significance level 5%. Results: the sample was composed of 34 men and 16 women with an average age of 61.8 years. Concerning the CPOD, there was a gradual and significant increase over time, difference between the four evaluation times (p≤0,001). There was no difference between the time the visible card index (p=0,28). However, there was a significant reduction of gingival bleeding index between the baseline and other times (p≤0,001). There was no statistically significant difference among the 4 groups in each time any of the assessment criteria evaluated (p>0,05), just as happened with the 4 times of evaluation for all groups (p>0,05). With regards to the logistic regression, although it has not presented any isolated variable as statistically significant, the model as a whole showed statistically significant (p=0,034). Conclusion: The four different adhesive strategies in non-carious cervical restorations showed similar clinical performance after 24 months of follow-up(AU)

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Objetivo: Avaliar a biocompatibilidade do paramonoclorofenolcanforado na proporção 3,5:6,5 (PMCC) e do paramonoclorofenolcanforado associado ao hidróxido de cálcio (PMCC+Ca(OH)2) notecido subcutâneo de ratos, e o potencial antimicrobiano dessesmedicamentos frente a alguns microrganismos.Método: Dez ratos Wistar receberam, após a anestesia,administração endovenosa de corante Evan’s Blue, seguida deinoculação de 0,1mL dos respectivos fármacos na região dorsal. Aquantidade de corante extravasada, ligadas às proteínas do plasmafoi avaliada por meio de espectrofotometria. A atividadeantimicrobiana foi realizada através do teste de difusão em ágar,(foi avaliada pela medida dos halos de inibição) contra osmicrorganismos: S. aureus, S. mutans, B. subtilis e C. albicans.Resultados: Os valores médios de densidade óptica para o PMCCforam de 0,325±0,025 (reação moderada) e para o PMCC+Ca (OH)20,211±0,040 (discreta). Os halos de inibição detectados foram de:PMCC – 7,29mm e PMCC+Ca(OH)2 – 7,29mm para S. aureus; PMCC– 8,57mm e PMCC+Ca(OH)2 – 7,0mm para S. mutans; PMCC –8,57mm e PMCC+Ca(OH)2 – 7,43mm para B. subtilis e de PMCC –8,71mm e PMCC+Ca(OH)2 – 8,29mm para C. albicans.Conclusões: Os dados obtidos indicaram que o PMCC mostrousemais irritante que o PMCC+Ca (OH)2, enquanto que a atividadeantimicrobiana não apresentou resultados estatisticamentediferentes (ANOVA) entre as substâncias testadas.

Objective: To evaluate the biological behavior of the camphorated paramonochlorofenol in the proportion 3.5:6.5 (PMCC) and of the camphorated paramonochlorofenol associated to the calcium hydroxide (PMCC+Ca(OH)2), and evaluates the antimicrobial potential of those medications against some microorganisms. Methods: Ten Wistar mice that were anesthetized and received endovenous administration of "Evans Blue" ink. Soon after was inoculated with 0.1mL of each medication, in the dorsal area. The amount of ink linked to the proteins of the plasm released was evaluated by means of spectrophotometer. The antibacterial activities were (analysis, accomplished) in agar plates diffusion (was) evaluated by the measure of the inhibition halos against: S. aureus, S. mutans B subtilis and C. albicans. Results: The values of optic density for PMCC were 0.325±0.025 (moderated reaction) and for PMCC+Ca(OH)2, 0.211±0.040 (discrete). The haloes of inhibition (results) found in the evaluations of antimicrobial activities against those microorganisms respectively were PMCC ­ 7.29mm and PMCC+Ca(OH)2 ­ 7.29mm to S. aureus; PMCC ­ 8.57 and PMCC+Ca(OH)2 ­ 7.0mm to S. mutans; PMCC ­ 8.57mm and PMCC+Ca(OH)2 ­ 7.43mm to B. subtilis and PMCC ­ 8.71mm and PMCC+Ca(OH)2 ­ 8.29mm to C. albicans. Conclusions: The results indicated that the PMCC was shown more irritating than PMCC+Ca(OH)2; and the antimicrobial activity didn't show statistically significant differences among the two tested medications.

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