Class V Non-carious Cervical Dental Lesions
Conditions
Keywords
composite resins, dental adhesives, noncarious lesions, abfraction lesions, bonding, dental, clinical study, Scotchbond Universal plus, Scotchbond Universal, Filtek, dental materials
Brief summary
This is a prospective, controlled, within-subject, randomized, single-center study comparing Scotchbond Universal Plus (SBU+) and Scotchbond Universal (SBU) adhesives when used with Filtek restorative. The study will enroll Subjects scheduled to undergo Class-V non-carious cervical lesion (NCCL) restorations.
Detailed description
This is a prospective, controlled, within-subject, randomized, single-center study that will enroll Subjects scheduled to undergo Class-V NCCL restorations on 2 or 4 teeth treated in pairs according to lesion depth. Enough subjects will be enrolled from a single site located in New Orleans, Louisiana, USA to perform a minimum of 110 restorations (estimated 38 subjects). Each study tooth will be restored using only one type of adhesive, either SBU+ or SBU, and Filtek restorative following manufacturer's directions using the "Total Etch/Etch and Rinse Procedure". Any teeth needing treatment that are not included in the study will be treated by the dentist using the standard of care. Subjects will be seen during screening (≤21 days before the restoration procedure), on the day of the restoration procedure, 7 days (± 3 days) after restoration (remote visit for subject self-assessment of baseline hypersensitivity), and follow-up visits at 6 months (± 14 days), 1 year (± 30 days), and 2 years (± 45 days) after restorations. Study teeth will be assessed for selected endpoints based partly on FDI (Fédération Dentaire Internationale) World Dental Federation criteria. Subjects may participate in additional unscheduled visits as required during the study if evaluation of any study tooth is required outside of the scheduled study visits. The entire duration of the study is expected to last approximately 3 years, with individual Subject participation expected to last up to 2 years (± 45 days). To help minimize or avoid bias in the study, randomization of study teeth will occur after teeth preparation but before the initial application of any adhesive. Assessments will be performed by 2 dental examiners that are independent of the dentist that placed the restorations and are blinded to the treatment arms. All examiners will be trained and calibrated for the scoring criteria before any Subject assessment occurs, and examiners will be retrained and recalibrated if any new evaluator is added to the list of assessors. After the second examiner has completed their assessments, the examiners will compare their evaluations and a consensus will be reached for each of the scoring criteria at each visit before the Subject leaves the visit. The consensus assessments will be entered into the Case Report Form (CRF).
Interventions
Eligible teeth with Class-V NCCLs randomized to the SBU+ treatment group underwent restoration(s) using Scotchbond Universal Plus (SBU+) Adhesive using total-etch mode and Filtek Universal Restorative material.
Eligible teeth with Class-V NCCLs randomized to the SBU Control group underwent restoration(s) using Scotchbond Universal Plus (SBU) Adhesive using total-etch mode and Filtek Universal Restorative material.
Sponsors
Study design
Masking description
All assessments were performed by two dental examiners that were independent of the dentist that placed the restorations and were blinded to the treatment arms.
Intervention model description
Each subject had either two restorations (two teeth) or four restorations (four teeth) performed at the beginning of the study, with each tooth restoration using only one type of adhesive. Study teeth were paired according to lesion depth and randomized to treatment in a 1:1 ratio with at least half of the teeth (ie, 1 tooth for Subjects with 2 eligible teeth or 2 teeth for Subjects with 4 eligible teeth) randomized to undergo restoration(s) using Scotchbond Universal Plus Adhesive (SBU+ Treatment group) and the other half of the teeth undergoing restoration(s) using Scotchbond Universal Adhesive (SBU Control group).
Eligibility
Inclusion criteria
Subjects may be included that meet the following criteria: 1. Subject is at least 18 years of age at the time of consent 2. Subject is able to provide their own informed consent 3. Subject has a minimum of two teeth that: * have non-carious Class V lesions that are at least 1.5 mm deep * are not devitalized * have not undergone root canal treatment 4. Subject has an Approximal Plaque Index score ≤ 40% as assessed via explorer and without the use of plaque-disclosing agents 5. Subject is able and willing to return for all scheduled study visits 6. Subject meets the Level-I or Level-II classification criteria of the American Society of Anesthesiologists (ASA) Physical Status Classification System For Dental Patient Care
Exclusion criteria
Subjects may not be included that meet any of the following criteria: 1. Subject has any of the following: * rampant caries * chronic periodontitis * salivary gland dysfunction 2. Subject is unable, for any reason, to tolerate the procedure time required to place the restorations 3. Subject has unacceptable oral hygiene (eg, chronic moderate to heavy plaque accumulation along the gumline) 4. Subject has known sensitivity to the study product components (ie, acrylate) 5. Subject is planned to be enrolled in another investigational trial that requires additional interventions at any time during the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Retention of Restorative Material | 24 months post-restoration | The percentage of restorations with partial or complete loss of the restorative materials. |
| Marginal Adaptation | 24 months post-restoration | Marginal adaptation of restorations graded on a scale of 1-5 with a score of 1 being Excellent/very good and a score of 5 being Poor. Grading scale is based on modified FDI (Fédération Dentaire Internationale) World Dental Federation criteria. Scoring categories for marginal adaptation: 1. Excellent/very good: No clinically detectable gap. 2. Good: Marginal integrity deviates from the ideal but could be upgraded to ideal by polishing. 3. Sufficient/Satisfactory: Leakage/discoloration is present but limited to the marginal area. 4. Unsatisfactory: Localized gap larger than 250 µm, may result in exposure of dentine or base. 5. Poor: Generalized gap larger than 250 µm or the restoration is loose but in situ, re-placement necessary. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Retention of Restorative Material | 6 months post-restoration | The percentage of restorations with partial or complete loss of the restoration material. |
| Marginal Adaptation | 6 months post restoration | Marginal adaptation of restorations graded on a scale of 1-5 with a score of 1 being Excellent/very good and a score of 5 being Poor. Grading scale is based on modified FDI World Dental Federation criteria. Scoring categories for marginal adaptation: 1. Excellent/very good: No clinically detectable gap. 2. Good: Marginal integrity deviates from the ideal but could be upgraded to ideal by polishing. 3. Sufficient/Satisfactory: Leakage/discoloration is present but limited to the marginal area. 4. Unsatisfactory: Localized gap larger than 250 µm, may result in exposure of dentine or base. 5. Poor: Generalized gap larger than 250 µm or the restoration is loose but in situ, re-placement necessary. |
| Fracture of Restorative Material | 6 months post-restoration | Fractures on study teeth graded on a 0-4 grading scale with a score of 1 being Excellent/very good and a score of 4 being Unsatisfactory. Grading scale is based on modified FDI World Dental Federation criteria. Scoring categories for the fracture of restorative material are defined as follows: 1. Excellent/very good: No fractures/cracks 2. Good: Small hairline cracks 3. Sufficient/Satisfactory: Two or more or larger hairline cracks and/or material chip fracture not affecting the marginal integrity or approximal contact 4. Unsatisfactory: Material chip fractures which damage marginal quality or approximal contacts |
| Secondary Caries | 6 months post-restoration | Secondary caries in study teeth scored on scale 1-5. 1. Excellent/Very Good: No secondary or primary caries 2. Good: Small and localized areas of demineralization 3. Sufficient/Satisfactory: Larger areas of demineralization 4. Unsatisfactory: Caries with cavitation and suspected undermining caries 5. Poor: Deep caries or exposed dentin not accessible for repair of restoration. |
Countries
United States
Contacts
Louisiana State University HSC Health, School of Dentistry
Participant flow
Recruitment details
The patient population was selected from current patients under clinical treatment at Louisiana State University (LSU), School of Dentistry. Patients were between the ages of 18 and 70 years old at time of consent, of either sex, and of any ethnic background. Eligible patients needed to have at least two teeth with Class V non-carious cervical lesions (NCCL) at least 1.5 mm deep, in vital teeth that had not undergone root canal treatment.
Pre-assignment details
Subjects were required to meet all inclusion and none of the exclusion criteria to be eligible. A total of 38 subjects were screened and of those, 32 subjects were treated. Two or four Class V restorations were placed per patient, randomized in a 1:1 ratio with half of the teeth (i.e., 1 tooth for Subjects with 2 eligible teeth, or 2 teeth for Subjects with 4 eligible teeth) randomized to the SBU+ Adhesive Treatment group and the other half to the SBU Adhesive Control group.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 60 years STANDARD_DEVIATION 12 |
| Age, Customized <=18 years | 0 years |
| Age, Customized >=65 years | 14 years |
| Age, Customized Between 18 - 65 years | 17 years |
| Race/Ethnicity, Customized Ethnicity: Hispanic or Latino | 1 participants |
| Race/Ethnicity, Customized Ethnicity: Not Hispanic or Latino | 11 participants |
| Race/Ethnicity, Customized Ethnicity: Unknown or Not Reported | 19 participants |
| Race/Ethnicity, Customized Race: Asian | 4 participants |
| Race/Ethnicity, Customized Race: Black or African American | 6 participants |
| Race/Ethnicity, Customized Race: White | 21 participants |
| Region of Enrollment United States | 31 participants |
| Sex/Gender, Customized Female | 18 participants |
| Sex/Gender, Customized Male | 13 participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 32 | 0 / 32 |
| other Total, other adverse events | 2 / 32 | 2 / 32 |
| serious Total, serious adverse events | 2 / 32 | 2 / 32 |