Influência da estratégia de adesão sobre a performance clínica de restaurações de resina composta à base de Silorano : estudo clínico randomizado controlado

Abstract

Introduction: The demand for aesthetic restorations turned using composite resins into a routine. The type of treatment in the dentin surface to establish the ideal adhesive technique has been studied comprehensively. Objective: To evaluate the clinical performance of composite silorane-based resins made under different adhesion strategy. Methods: controlled, randomized and longitudinal clinical trial, carried out with patients of a dental school clinic. Each restoration received one of four treatment groups: G1 (control 1) - Surface treatment with self-etching adhesive system P90® 3M / ESPE + Filtek P90® 3M / ESPE; G2 (test) - surface treatment with phosphoric acid 37% + P90® self-etching adhesive system 3M / ESPE + Filtek P90® 3M / ESPE; G3 (test) - Surface treatment by blasting with aluminum oxide + P90® self-etching adhesive system 3M / ESPE + Filtek P90® 3M / ESPE; G4 (control 2) - Surface treatment with self-etching adhesive system Adper SE Plus® 3M / ESPE + Filtek P60® 3M / ESPE. Immediately after the treatment (baseline) and after one year, two trained examiners evaluated the restorations using Direct Method. The normality of the data distribution was verified by the Kolmogorov-Smirnov test for each response variable (p = 0.05). The Kruskal-Wallis test compared the performance of the groups at baseline, and after one year. The Wilcoxon test compared the performance of each group in the same periods, both at a 5% significance level. Results: Twenty-six patients, aged 18-62 years (mean = 32.15 years, SD ± 11.81), had made 141 restorations and were evaluated at baseline. After one year, the loss was around 12%. No statistical difference was found when the adhesion strategies were compared, according to each criterion, in both evaluation moments (p> 0.05). When each adhesion strategy was compared with each other over one year, a statistically significant difference (p = 0.005) was observed in the Marginal Adaptation criterion for the adhesive strategy that used conditioning with additional phosphoric acid and self-adhesive system P90® 3M / ESPE. Conclusions: No significant difference was found when the adhesive strategies were compared. There was loss of quality in marginal adaptation of restorations whose adhesive strategy used acid conditioning prior to the silorane resin adhesive system. The use of additional conditioning and air abrasion with aluminum oxide did not improve the clinical performance of the restorations and so their use is unjustified.