Faculty Bibliography

This pilot study evaluated the effect of removing acid-etch-exposed dentin collagen on the clinical performance of composite restorations of noncarious cervical lesions placed using 2 different adhesive systems. Fifty-six restorations were placed in 14 subjects, each subject receiving at least 4 restorations. No cavity preparation or mechanical retention form was used. The variables tested were: 1) dentin treatment prior to application of the adhesive (acid-etch only vs acid-etch and collagen removal) and 2) type of adhesive (acetone- vs ethanol-based). For the acid-etch only groups, enamel and dentin were etched with 37% phosphoric acid for 15 seconds, rinsed and blot dried. Prime & Bond 2.1 (Dentsply Caulk) or Single Bond (3M ESPE) was applied and light-cured according to the manufacturer's instructions. For the acid-etch and collagen removal groups, the enamel and dentin were etched and rinsed in the same manner and a 10% sodium hypochlorite (NaOCl) solution was applied for 60 seconds and rinsed before adhesive application. Filtek Z-250 (3M ESPE) was applied to all specimens and light-cured according to the manufacturer's instructions, and the restorations were finished and polished immediately. The restorations were evaluated for pre- and post-operative sensitivity, retention, marginal staining and secondary caries at baseline, 12 and 24 months after placement, using modified USPHS criteria. Data were analyzed using the Kruskal-Wallis and Wilcoxon statistical tests (p=0.05). At 24 months, the retention rates for Prime & Bond 2.1 with and without NaOCl pretreatment were 80% and 63%, respectively. The corresponding retention rates for Single Bond were 70% and 90%. Marginal staining was minimal. Statistical analyses revealed no significant differences at any time interval between groups for retention or marginal staining. No post-operative sensitivity or secondary caries was detected during the study.