Which adhesive strategy for non-carious cervical lesions?

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Abstract

Abstracted from Schroeder M, Correa IC, Bauer J, Loguercio AD, Reis A.

Influence of adhesive strategy on clinical parameters in cervical restorations: A systematic review and meta-analysis. J Dent 2017; 62: 36-53.

Question: In the treatment of non-carious cervical lesions does use of self-etch (SE) or etch-and-rinse (ER) affect postoperative sensitivity, retention rates and marginal discoloration?

Data sources Medline, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), Cochrane Library, System for Information on Grey literature in Europe (SIGLE), ProQuest Dissertations and Theses, Periódicos Capes Theses database, Current Controlled Trials (www.controlled-trials.com), International Clinical trials registry platform (http://apps.who.int/trialsearch/), the ClinicalTrials.gov (www.clinicaltrials.gov), Rebec (www.rebec.gov.br) and EU Clinical Trials Register (https://www.clinicaltrialsregister.eu), abstracts of the annual conference of the International Association for Dental Research (IADR) and their regional divisions.

Question: In the treatment of non-carious cervical lesions does use of self-etch (SE) or etch-and-rinse (ER) affect postoperative sensitivity, retention rates and marginal discoloration?

Study selection Two reviewers selected studies; parallel or splitmouth randomised controlled trials (RCTs) comparing adhesive strategies were considered.

Question: In the treatment of non-carious cervical lesions does use of self-etch (SE) or etch-and-rinse (ER) affect postoperative sensitivity, retention rates and marginal discoloration?

Data extraction and synthesis Data were abstracted by two reviewers and into four follow up periods, 1 year; 18 months to 2 years; 3 years and 4 to 5 years. The Cochrane risk of bias tool was used to assess study quality. Data outcomes were dichotomous and summarised using relative risks and random effects meta-analysis.

Question: In the treatment of non-carious cervical lesions does use of self-etch (SE) or etch-and-rinse (ER) affect postoperative sensitivity, retention rates and marginal discoloration?

Results Twenty-nine studies were included in the meta-analysis. Bonding strategy did not influence postoperative sensitivity (risk ratio [RR] 1.04; 95% CI 0.81 to 1.34) or retention rates (RR = 1.04; 95% CI 0.81 to 1.34). The etch-and-rinse approach produced less marginal discoloration at 18 months to 2 years (RR 1.51; 95% CI 1.21 to 1.90) and at 4 to 5 years (RR 1.81; 95% CI 1.28 to 2.55) (p<0.0007).

Question: In the treatment of non-carious cervical lesions does use of self-etch (SE) or etch-and-rinse (ER) affect postoperative sensitivity, retention rates and marginal discoloration?

Conclusions Composite resin restorations placed with self-etch and etch-and-rinse adhesives produce restoration with similar clinical service and POS, however using etch-and-rinse adhesives one can reduce marginal discoloration.

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