InquiryRetaining noncarious cervical lesion restorations
Section snippets
Background
Noncarious cervical lesions (NCCLs) are pervasive and their prevalence increases as patients age. A slow, gradual loss of mineralized dental tissue without dental caries is characteristic of NCCLs, which appear as saucer or wedge-shaped defects along the cementoenamel junction (CEJ). Evidence indicates that a multifactorial etiology is at work, including abrasion, erosion, and abfraction. Restorations placed for NCCLs must address the problems of hypersensitivity, poor esthetics, food
Methods
The articles reviewed were culled from the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE (OVID), the Latin American and Caribbean Health Sciences Literature database (LILACs), and Medline (OVID) electronic files. The search for articles covered 1990 to 2013 and identified 27 randomized clinical trials that met the inclusion criteria. Follow-up ranged from 3 to 13 years, and number of patients per study varied from 8 to 119 patients age 18 to 88 years (mean 53 years). However,
Results
The most often used systems were the three-step etch-and-rinse and the two-step etch-and-rinse adhesive systems. In 11 studies a single adhesive system was used for all study groups, in 11 studies two different adhesive systems were used, and in 5 studies three different adhesive systems were used. Most used resin composite for restoration, but PMRC, RMGI, and GI were also used. A third of the studies used rubber dam isolation, with the rest using cotton roll isolation and a saliva ejector.
Discussion
Few of the studies tested the same adhesive systems, so quantitative comparisons using meta-analysis were limited. Findings indicate that use of GI cement to restore NCCLs produces a lower risk of restoration loss compared to the use of a three-step etch-and-rinse adhesive system with a composite restorative material. There is a much lower risk with the GI cement than with a two-step etch-and-rinse adhesive system with composite restorative material. The comparisons do not differentiate between
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Santos MJMC, Ari N, Steele S, et al: Retention of tooth-colored restorations in non-carious cervical lesions—a systematic review. Clin Oral Invest 18:1369-1381, 2014
Reprints available from MJMC Santos, Schulich Medicine & Dentistry, Western Univ, London, ON, Canada; e-mail: [email protected]