Comportamento clínico de restaurações classe I e II de resina composta realizadas com sistema adesivo universal em diferentes protocolos de aplicação - estudo clínico randomizado

Abstract

The objective of this study was to evaluate the clinical behavior of direct composite resin restorations (Class I and II), varying the universal dental adhesive application protocol, using the FDI and USPHS evaluation criteria. It was a randomized, double-blind, mouth5 divided, and sample-based randomized controlled trial. The selected participants should have a Class I and/or II restorative need for at least three dental elements or multiples of three resulting from the presence of carious lesions and/or unsatisfactory restorations. Three protocols for the application of the Single Bond Universal adhesive (3M ESPE) were tested (n=150): CAT (control) = etch-and-rinse + adhesive (n=50); CASE = selective etching in enamel + adhesive (n=50) and Ac = self-etch (n=50). The three groups were similarly restored using Filtek Z350 XT composite resin (3M ESPE) by means of the oblique incremental technique. Clinical evaluations were performed by two evaluators at the baseline (T1) and after 15.8 (±2.7 months) (T2), using the FDI and USPHS criteria. Friedman (between groups at different times), Wilcoxon (between times for each group) and McNemar (between FDI and USPHS criteria) were performed, α=0.05. The Kappa test showed excellent inter-examiner agreement (κ>0.80). For the "superficial staining" property, a statistically significant difference was observed in T2 between the CAT and CASE groups (p=0.01) with higher values for CAT and, when T1 and T2 were compared for each group, there were differences in the CAT group (p=0.001) and in the Ac group (p=0.007) for T2. For the other comparisons between groups and times there were no statistically significant differences, even when the FDI and USPHS criteria were compared (p≥0.05). It can be concluded that the different protocols of universal adhesive application (CAT, CASE and Ac) did not influence the clinical behavior of the restorations evaluated in 15.8 months of evaluation. The FDI and USPHS criteria provided comparable results.