Longer polymerization time tied to better long-term restoration retention in non-carious cervical lesions

A study was done to evaluate the effect of prolonged (P) polymerization time of a universal adhesive system applied in etch-and-rinse (ER) or self-etch (SE) strategies on the clinical performance of restorations in non-carious cervical lesions (NCCLs), after 36 months of clinical service. A total of 140 restorations were randomly placed in 35 subjects according to the polymerization time groups: ER (10 s); ER-P (40 s); SE (10 s); and SE-P (40 s) at 1,200 mW/cm2. Composite resin was placed incrementally. The restorations were evaluated immediately and after 6, 12, 18, and 36 months using the FDI criteria. Data were analyzed using the Kaplan-Meier survival test for retention loss, and the Kruskal-Wallis’ test for secondary outcomes (α = 0.05). Results: After 36 months, 19 restorations were lost: ER 6, ER-P 2, SE 9, SE-P 2. The retention rates were 82.3% for ER; 94.1% for ER-P; 73.5% for SE; and 94.1% for SE-P, with a significant difference between ER vs. ER-P and SE vs. SE-P, as well as ER vs. SE-P and ER-P vs. SE (p < 0.0001). Minor defects were observed in 18 restorations for the marginal staining criteria: ER 5, ER-P 2, SE 8, SE-P 3; and in 33 restorations for the marginal adaptation criteria: ER 11, ER-P 4, SE 12, and SE-P 6 (p > 0.05). No restorations showed a recurrence of caries or postoperative sensitivity. A prolonged polymerization time of 40 seconds improves the clinical performance of the universal adhesive for both adhesive strategies evaluated, even after 36 months. Prolonging the polymerization time of a universal adhesive from 10 s to 40 s has been shown to improve its clinical performance when used in NCCLs.

Reference:

Romina Ñaupari-Villasante, André de Freitas, Viviane Hass, Thalita P. Matos, Sibelli O. Parreiras, Alessandra Reis, Mario F. Gutiérrez, Alessandro D. Loguercio. Prolonged polymerization of a universal adhesive in non-carious cervical lesions: 36-month double-blind randomized clinical trial. Journal of Dentistry, 2023, 104823, ISSN 0300-5712. https://doi.org/10.1016/j.jdent.2023.104823.