Clinical Performance of Different Adhesive Strategies With a Universal System in Sclerosed Dentin in NCCL: A Double-blind Randomized Clinical Trial.

Non Carious Cervical Lesion Clinical Trial

Official title:

Clinical Performance of Different Adhesive Strategies With a Universal System in Sclerosed Dentin in NCCL: A Double-blind Randomized Clinical Trial.

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05211908
• Other study ID #: UFPara-0013
• Status: Recruiting
• Phase: N/A
• Start date: July 27, 2021
• Est. completion date: December 30, 2023

Study information

• Verified date: May 2022
• Source: Universidade Federal do Para
• Contact: Cecy M Silva, PhD
• Phone: (91)3201-7563
• Email: cecymsilva[@]gmail.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of this randomized, prospective, parallel, double-blind clinical trial will be to evaluate the clinical performance of restorations performed in non-carious cervical lesions (NCCL) using a soft ph universal adhesive system, varying the adhesive strategy (self-etching vs. selective etching of the enamel) and the sclerosis characteristics of the dentinal substrate over 24 months.

Description:

Two hundred restorations will be performed in NCCL of volunteers of both genders, by a single operator, using the Single Bond Universal(3M ESPE) adhesive system. The restorations will be randomly allocated into 4 groups (n-50): D-SE (absence of dentinal sclerosis and self-etching protocol); D-SELETIVE (absence of dentinal sclerosis and selective enamel etching protocol); SD-SE (sclerotic dentin and self-etching protocol); SD-SELETIVE (sclerotic dentin and selective enamel etching protocol). The randomization process within subject was performed by computer-generated tables by a staff member not involved in the research protocol. Details of the allocated group were recorded on cards contained in sequentially numbered, opaque, sealed envelopes. These were prepared by a staff member who was not involved in any of the phases of the clinical trial. The allocation assignment was revealed by opening the envelope on the day of the restorative procedure.The operator was not blinded to group assignment when administering.

The evaluations of the clinical performance of the restorations will be carried out by two previously calibrated examiners, adopting the criteria of the United States Public Health Service (USPHS) for the variables retention, marginal adaptation, marginal staining and postoperative sensitivity . The intragroup statistical analysis will be performed using the McNemar test for the variables retention and postoperative sensitivity; and by Wilcoxon for adaptation and marginal staining. To compare the clinical performance inter groups in the different assessment intervals, Fisher's exact test (retention and postoperative sensitivity) and Kruskal-Wallis (adaptation and marginal staining) will be used.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: December 30, 2023
• Est. primary completion date: March 30, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Good general health status

• Good oral hygiene

• Absence of periodontal disease

• Minimum of 20 teeth in occlusion

• Presence at least one (01) non-carious cervical lesion in a tooth with pulp vitality.

• Non-carious cervical lesion greater than 1mm in depth.

• Non-carious cervical lesion involving enamel and dentin.

Exclusion Criteria:

• Non- carious cervical lesion cavo surface margin involving more than 50% of the enamel.

• NCCL in crack teeth.

• Absence of opposing teeth and/or adjacent to the lesion.

• Presence of occlusal trauma in the NCCL tooth

• Presence of orthodontic appliance or removable partial denture with retention in the tooth where the lesion is located

• Patients that underwent tooth whitening procedures within a period of less than 14 days from the date of restoration

• Patients with high risk of caries (presence of three or more active caries lesions)

• Xerostomia

• Bruxism

• Pregnant women

• Patients who do not accept the study conditions

Related Conditions & MeSH terms

• Non Carious Cervical Lesion

Intervention

Procedure:
• Composite resin restoration with Self Etch adhesive protocol and absence of sclerotic dentin
The adhesive system Single Bond Universal (3M Oral Care; Brazil) and a nanoparticulate composite resin Z350 XT (3M Oral Care; Brazil), shade A3B, will be the materials used in the restorative procedures. For the D-SE group, the universal adhesive system will be applied with a disposable microbrush, actively, for 20s and then a gentle stream of air will be used for 5s to solvent evaporation, followed by light curing for 10s using the Valo Cordless light curing (Ultradent Products Inc.), in Standard mode (1000mW /cm2). All groups will receive the restorations made following the incremental technique of insertion of composite resin (2mm per increment), which will be light cured according to the manufacturer's recommendations.
• Composite resin restoration with Seletive enamel etch adhesive protocol and absence of sclerotic dentin
The adhesive system Single Bond Universal (3M Oral Care; Brazil) and a nanoparticulate composite resin Z350 XT (3M Oral Care; Brazil), shade A3B, will be the materials used in the restorative procedures. For the D-SELETIVE group a 37% phosphoric acid will be applied only at the enamel margin for 15s, then rinsed with water for 20s, and slightly dry. The universal adhesive system will be applied with a disposable microbrush, actively, for 20s and then a gentle stream of air will be used for 5s to solvent evaporation, followed by light curing for 10s using the Valo Cordless light curing (Ultradent Products Inc.), in Standard mode (1000mW /cm2). All groups will receive the restorations made following the incremental technique of insertion of composite resin (2mm per increment), which will be light cured according to the manufacturer's recommendations.
• Composite resin restoration with Self Etch adhesive protocol and presence of sclerotic dentin
The adhesive system Single Bond Universal (3M Oral Care; Brazil) and a nanoparticulate composite resin Z350 XT (3M Oral Care; Brazil), shade A3B, will be the materials used in the restorative procedures. For the SD-SE group, the universal adhesive system will be applied with a disposable microbrush, actively, for 20s and then a gentle stream of air will be used for 5s to solvent evaporation, followed by light curing for 10s using the Valo Cordless light curing (Ultradent Products Inc.), in Standard mode (1000mW /cm2). All groups will receive the restorations made following the incremental technique of insertion of composite resin (2mm per increment), which will be light cured according to the manufacturer's recommendations.
• Composite resin restoration with Seletive enamel etch adhesive protocol and presence of sclerotic dentin
The adhesive system Single Bond Universal (3M Oral Care; Brazil) and a nanoparticulate composite resin Z350 XT (3M Oral Care; Brazil), shade A3B, will be the materials used in the restorative procedures. For the SD-SELETIVE group a 37% phosphoric acid will be applied only at the enamel margin for 15s, then rinsed with water for 20s, and slightly dry. The universal adhesive system will be applied with a disposable microbrush, actively, for 20s and then a gentle stream of air will be used for 5s to solvent evaporation, followed by light curing for 10s using the Valo Cordless light curing (Ultradent Products Inc.), in Standard mode (1000mW /cm2). All groups will receive the restorations made following the incremental technique of insertion of composite resin (2mm per increment), which will be light cured according to the manufacturer's recommendations.

Locations

Country	Name	City	State
Brazil	Universidade Federal do Pará	Belém	PA

Sponsors (1)

Lead Sponsor	Collaborator
Universidade Federal do Para

Country where clinical trial is conducted

Brazil, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Retention	The restorations retention will be evaluated according to the criteria established by the United States Public Health Service (USPHS), classifying them in the following scores: Alpha - retained Bravo - partially retained Charlie - restoration lost For evaluation of clinical performance, beta and charlie scores will be considered as failure.	1 year
Primary	Retention	The restorations retention will be evaluated according to the criteria established by the United States Public Health Service (USPHS), classifying them in the following scores: Alpha - retained Bravo - partially retained Charlie - restoration lost For evaluation of clinical performance, beta and charlie scores will be considered as failure.	2 years
Secondary	Marginal adaptation	Marginal adaptation will be evaluated according to the criteria established by the United States Public Health Service (USPHS), classifying them in the following scores: Alpha - Restoration is continuous with existing anatomic form. Bravo - Detectable V-shaped defect in enamel only. Catches explorer going both ways Charlie - Detectable V-shaped defect to dentin-enamel junction	1 year
Secondary	Marginal adaptation	Marginal adaptation will be evaluated according to the criteria established by the United States Public Health Service (USPHS), classifying them in the following scores: Alpha - Restoration is continuous with existing anatomic form. Bravo - Detectable V-shaped defect in enamel only. Catches explorer going both ways Charlie - Detectable V-shaped defect to dentin-enamel junction	2 years
Secondary	Marginal staining	Marginal staining will be evaluated according to the criteria established by the United States Public Health Service (USPHS), classifying them in the following scores: Alpha - No discoloration along the margin Bravo - Slight and superficial staining (removable, usually localized). Charlie - Deep staining cannot be polished away	1 Year
Secondary	Marginal staining	Marginal staining will be evaluated according to the criteria established by the United States Public Health Service (USPHS), classifying them in the following scores: Alpha - No discoloration along the margin Bravo - Slight and superficial staining (removable, usually localized). Charlie - Deep staining cannot be polished away	2 Years