Two-year clinical evaluation of a proanthocyanidins-based primer in non-carious cervical lesions: A double-blind randomized clinical trial

J Dent. 2020 May:96:103325. doi: 10.1016/j.jdent.2020.103325. Epub 2020 Mar 20.

Abstract

Objectives: This double-blind randomized clinical trial evaluated the influence of pre-treatment with proanthocyanidins (PA) from grape seed extract on the clinical behavior of a simplified etch-and-rinse adhesive placed in non-carious cervical lesions (NCCLs) over 6- and 24-months.

Materials and methods: A total of 135 restorations were randomly inserted in 45 subjects. The NCCLs were etched with 37 % phosphoric acid for 15 s and distributed into 3 groups: Control (PA0) - adhesive ExciTE F applied as per the manufacturer's recommendations; PA2 and PA5 groups - 2 wt% and 5 wt% PA solution, respectively, were applied for 60 s and washed for 30 s prior to application of the adhesive. The resin composite was placed incrementally and light-cured. The restorations were evaluated at baseline, 6 months (6 m) and 24 months (24 m) using both the FDI and USPHS criteria. Statistical analyses were carried out using Friedman repeated-measures analysis of variance by rank and the Wilcoxon test (α = 0.05).

Results: The retention rates were 98 % (PA0), 98 % (PA2) and 83 % (PA5) after 6 m and 93 % (PA0), 89 % (PA2) and 70 % (PA5) after 24 m. Only PA5 resulted in a significant lower retention rate at 6 m and at 24 m compared with that of baseline (p = 0.03). All groups resulted in a significantly worse marginal adaptation and marginal staining for the FDI criteria when the baseline vs. the 24 m recall data were compared. These differences were considered clinically acceptable under the FDI criteria.

Conclusions: The application of PA as a primer did not result in clinical advantages after 24 m of clinical service, regardless of the concentration used.

Clinical relevance: It has been reported that PA, a collagen crosslinking agent, increases the durability of the dentin-resin interface. However, no effects were found clinically after 24 months.

Keywords: Clinical study; Dentin-bonding agents; Non-carious cervical lesions; Proanthocyanidins.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Composite Resins
  • Dental Bonding*
  • Dental Marginal Adaptation
  • Dental Restoration, Permanent
  • Dentin-Bonding Agents
  • Humans
  • Proanthocyanidins*
  • Resin Cements
  • Tooth Cervix

Substances

  • Composite Resins
  • Dentin-Bonding Agents
  • Proanthocyanidins
  • Resin Cements