{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T06:03:57Z","timestamp":1773381837775,"version":"3.50.1"},"reference-count":47,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objective: The aim of this randomized split-mouth study-controlled clinical trial was to compare the 2-year clinical performance of resin composite restorations placed at non-caries cervical lesions (NCCL) with one-step self-etch, total-etch, and selective enamel etch and self-etch adhesive techniques. Materials and methods: Thirty-two patients received three resin composite restorations each at NCCLs (Tetric EvoCeram\/Ivoclar\/Vivadent), bonded with a total-etch adhesive agent (ExciTE F\/Ivoclar\/Vivadent) and a self-etch (AdheSE One F\/Ivoclar\/Vivadent) without and with selective enamel etching. All restorations were evaluated by two examiners at baseline, 6-, 12-, 18-, and 24-months with FDI clinical criteria (post-operation regarding retention, caries occurrence, marginal adaptation, and marginal staining). A logistic regression analysis, a Cohen\u2019s kappa statistic, a multifactorial analysis, and X2 were performed with generalized estimating equations. Results: After 2 years, the retention rate was 86.8% for total etch, 92.26% for self-etch, and 93.63% for selective enamel etching and self-etch. No caries was detected on the restorations. Concerning marginal adaptation, the clinically perfect restorations were 26.9% for the total-etch technique, 16% for self-etch, and 25.9% for selective enamel etch and self-etch. The logistic regression model revealed that only time reduced the probability of perfect marginal adaptation. Conclusions: All three adhesive strategies provided restorations with no significant differences in the retention rate or marginal adaptation, whereas the total etch yielded better performance for marginal staining. All restorations were assessed as clinically acceptable after 2 years.<\/jats:p>","DOI":"10.3390\/medicina60061005","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T11:47:17Z","timestamp":1718797637000},"page":"1005","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A 2-Year Randomized Clinical Trial of Three Bonding Techniques in Non-Carious Cervical Lesions"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1631-9871","authenticated-orcid":false,"given":"Eftychia","family":"Pappa","sequence":"first","affiliation":[{"name":"Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7408-4650","authenticated-orcid":false,"given":"Grigoria","family":"Gkavela","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioanna","family":"Sampri","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3606-317X","authenticated-orcid":false,"given":"Konstantinos","family":"Masouras","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4117-3501","authenticated-orcid":false,"given":"Christos","family":"Rahiotis","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afrodite","family":"Kakaboura","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/jerd.12692","article-title":"Adhesive dentistry: Current concepts and clinical considerations","volume":"33","author":"Araujo","year":"2021","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_2","first-page":"214","article-title":"Influence of multi-step etch-and-rinse versus self-etch adhesive systems on the post-operative sensitivity in medium-depth carious lesions: An in vivo study","volume":"28","author":"Scotti","year":"2015","journal-title":"Am. J. Dent."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jdent.2016.05.009","article-title":"Selective enamel etching in cervical lesions for self-etch adhesives: A systematic review and meta-analysis","volume":"53","author":"Szesz","year":"2016","journal-title":"J. Dent."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1111\/j.1834-7819.2010.01218.x","article-title":"One-year clinical evaluation of a two-step self-etch adhesive with and without additional enamel etching technique in cervical lesions","volume":"55","author":"Ozel","year":"2010","journal-title":"Aust. Dent. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2341\/15-130-C","article-title":"Two-year Randomized Clinical Trial of Self-etching Adhesives and Selective Enamel Etching","volume":"41","author":"Pena","year":"2016","journal-title":"Oper. Dent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/j.dental.2010.08.190","article-title":"Eight-year clinical evaluation of a 2-step self-etch adhesive with and without selective enamel etching","volume":"26","author":"Peumans","year":"2010","journal-title":"Dent. Mater."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.dental.2010.10.023","article-title":"State of the art of self-etch adhesives","volume":"27","author":"Yoshihara","year":"2011","journal-title":"Dent. Mater."},{"key":"ref_8","first-page":"187","article-title":"Is There Evidence that Three-step Etch-and-Rinse Adhesives Have Better Retention Rates than One-step Self-etch Adhesives in Noncarious Cervical Lesions? A Systematic Review and Meta-Analysis","volume":"23","author":"Dreweck","year":"2021","journal-title":"J. Adhes. Dent."},{"key":"ref_9","first-page":"327","article-title":"Clinical evaluation of a self-etch adhesive in non-carious cervical lesions","volume":"21","author":"Abdalla","year":"2008","journal-title":"Am. J. Dent."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1007\/s00784-011-0565-4","article-title":"Clinical effectiveness of a one-step self-etch adhesive in non-carious cervical lesions at 2 years","volume":"16","author":"Ermis","year":"2012","journal-title":"Clin. Oral Investig."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.jdent.2013.05.016","article-title":"3-year clinical effectiveness of one-step adhesives in non-carious cervical lesions","volume":"41","author":"Moretto","year":"2013","journal-title":"J. Dent."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.jdent.2012.08.017","article-title":"A 7-year randomized prospective study of a one-step self-etching adhesive in non-carious cervical lesions. The effect of curing modes and restorative material","volume":"40","author":"Pallesen","year":"2012","journal-title":"J. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.dental.2015.01.005","article-title":"Thirteen-year randomized controlled clinical trial of a two-step self-etch adhesive in non-carious cervical lesions","volume":"31","author":"Peumans","year":"2015","journal-title":"Dent. Mater."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1016\/j.dental.2006.10.005","article-title":"Clinical long-term retention of etch-and-rinse and self-etch adhesive systems in non-carious cervical lesions: A 13 years evaluation","volume":"23","author":"Lindberg","year":"2007","journal-title":"Dent. Mater."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"104633","DOI":"10.1016\/j.jdent.2023.104633","article-title":"Bonding performance of universal adhesives to eroded dentine: A 6-year evaluation","volume":"136","author":"Wendlinger","year":"2023","journal-title":"J. Dent."},{"key":"ref_16","first-page":"259","article-title":"FDI World Dental Federation\u2014Clinical Criteria for the Evaluation of Direct and Indirect Restorations. Update and Clinical Examples","volume":"12","author":"Hickel","year":"2010","journal-title":"J. Adhes. Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1007\/s00784-019-03011-x","article-title":"A 2-year clinical evaluation of direct and semi-direct resin composite restorations in non-carious cervical lesions: A randomized clinical study","volume":"24","author":"Caneppele","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jdent.2003.10.009","article-title":"Resin bonding to cervical sclerotic dentin: A review","volume":"32","author":"Tay","year":"2004","journal-title":"J. Dent."},{"key":"ref_19","first-page":"MR000006","article-title":"Publication bias in clinical trials due to statistical significance or direction of trial results","volume":"2010","author":"Hopewell","year":"2009","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1007\/s00784-005-0027-y","article-title":"Reprint of Criteria for the clinical evaluation of dental restorative materials","volume":"10","author":"Cvar","year":"2006","journal-title":"Clin. Oral Investig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s00784-005-0017-0","article-title":"Reprinting the classic article on USPHS evaluation methods for measuring the clinical research performance of restorative materials","volume":"9","author":"Bayne","year":"2005","journal-title":"Clin. Oral Investig."},{"key":"ref_22","first-page":"121","article-title":"Recommendations for conducting controlled clinical studies of dental restorative materials. Science Committee Project 2\/98--FDI World Dental Federation study design (Part I) and criteria for evaluation (Part II) of direct and indirect restorations including onlays and partial crowns","volume":"9","author":"Hickel","year":"2007","journal-title":"J. Adhes. Dent."},{"key":"ref_23","unstructured":"American Dental Association\u2014Council on Scientific Affairs (2001). Dentin and Enamel Adhesive Materials, ADA. Acceptance program; Guidelines."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.dental.2010.06.003","article-title":"Clinical performance of cervical restorations\u2014A meta-analysis","volume":"26","author":"Heintze","year":"2010","journal-title":"Dent. Mater."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1007\/s00784-022-04806-1","article-title":"Evaluation of a novel restorative protocol to treat non-carious cervical lesion associated with gingival recession: A 2-year follow-up randomized clinical trial","volume":"27","author":"Santamaria","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.dental.2023.04.007","article-title":"Five-year clinical evaluation of universal adhesive applied following different bonding techniques: A randomized multicenter clinical trial","volume":"39","author":"Matos","year":"2023","journal-title":"Dent. Mater."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"31","DOI":"10.2341\/20-103-C","article-title":"Five-year Randomized Clinical Trial on the Performance of Two Etch-and-rinse Adhesives in Noncarious Cervical Lesions","volume":"47","author":"Matos","year":"2022","journal-title":"Oper. Dent."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"103747","DOI":"10.1016\/j.jdent.2021.103747","article-title":"Clinical behavior of universal adhesives in non-carious cervical lesions: A randomized clinical trial","volume":"113","author":"Follak","year":"2021","journal-title":"J. Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jdent.2017.05.006","article-title":"Influence of adhesive strategy on clinical parameters in cervical restorations: A systematic review and meta-analysis","volume":"62","author":"Schroeder","year":"2017","journal-title":"J. Dent."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"173","DOI":"10.4103\/0972-0707.73376","article-title":"Clinical effectiveness of contemporary dentin bonding agents","volume":"13","author":"Krithikadatta","year":"2010","journal-title":"J. Conserv. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1007\/s00784-014-1220-7","article-title":"Retention of tooth-colored restorations in non-carious cervical lesions\u2014A systematic review","volume":"18","author":"Santos","year":"2014","journal-title":"Clin. Oral Investig."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2495","DOI":"10.1007\/s00784-023-05007-0","article-title":"Effect of different adhesive systems on dental defects and sensitivity to teeth in composite resin restoration: A systematic review and meta-analysis","volume":"27","author":"Fang","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/j.dental.2014.07.007","article-title":"Clinical effectiveness of contemporary adhesives for the restoration of non-carious cervical lesions. A systematic review","volume":"30","author":"Peumans","year":"2014","journal-title":"Dent. Mater."},{"key":"ref_34","first-page":"391","article-title":"Meta-Analysis of the Influence of Bonding Parameters on the Clinical Outcome of Tooth-colored Cervical Restorations","volume":"17","author":"Mahn","year":"2015","journal-title":"J. Adhes Dent"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e503","DOI":"10.1016\/j.dental.2021.08.017","article-title":"Is clinical behavior of composite restorations placed in non-carious cervical lesions influenced by the application mode of universal adhesives? A systematic review and meta-analysis","volume":"37","author":"Josic","year":"2021","journal-title":"Dent. Mater."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/j.1600-0722.2005.00256.x","article-title":"Three-year clinical effectiveness of a two-step self-etch adhesive in cervical lesions","volume":"113","author":"Peumans","year":"2005","journal-title":"Eur. J. Oral Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/j.1600-0722.2011.00855.x","article-title":"Three-year clinical performance of a HEMA-free one-step self-etch adhesive in non-carious cervical lesions","volume":"119","author":"Peumans","year":"2011","journal-title":"Eur. J. Oral Sci."},{"key":"ref_38","first-page":"7","article-title":"Bonding Performance of Universal Adhesives: An Updated Systematic Review and Meta-Analysis","volume":"21","author":"Rosa","year":"2019","journal-title":"J. Adhes. Dent."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.dental.2004.07.005","article-title":"Self-etch vs etch-and-rinse adhesives: Effect of thermo-mechanical fatigue loading on marginal quality of bonded resin composite restorations","volume":"21","author":"Frankenberger","year":"2005","journal-title":"Dent. Mater."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1590\/S1678-77572009000400009","article-title":"Bond strength and morphology of enamel using self-etching adhesive systems with different acidities","volume":"17","author":"Moura","year":"2009","journal-title":"J. Appl. Oral Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.jdent.2008.06.005","article-title":"A randomized controlled clinical trial of a HEMA-free all-in-one adhesive in non-carious cervical lesions at 1 year","volume":"36","author":"Peumans","year":"2008","journal-title":"J. Dent."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/S0300-5712(03)00107-6","article-title":"Clinical evaluation of a self-etching and a one-bottle adhesive system at two years","volume":"31","author":"Turkun","year":"2003","journal-title":"J. Dent."},{"key":"ref_43","first-page":"99","article-title":"Influence of selective enamel etching on the bonding effectiveness of a new \u201call-in-one\u201d adhesive","volume":"26","author":"Goracci","year":"2013","journal-title":"Am. J. Dent."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1016\/j.jdent.2009.06.020","article-title":"Bonding effectiveness of two contemporary self-etch adhesives to enamel and dentin","volume":"37","author":"Mine","year":"2009","journal-title":"J. Dent."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.dental.2010.09.005","article-title":"Correlation between microtensile bond strength data and clinical outcome of Class V restorations","volume":"27","author":"Heintze","year":"2011","journal-title":"Dent. Mater."},{"key":"ref_46","first-page":"133","article-title":"Three-year Clinical Performance of a Universal Adhesive in Non-Carious Cervical Lesions","volume":"25","author":"Peumans","year":"2023","journal-title":"J Adhes Dent."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"104407","DOI":"10.1016\/j.jdent.2022.104407","article-title":"A randomized clinical study of the performance of self-etching adhesives containing HEMA and 10-MDP on non-carious cervical lesions: A 2-year follow-up study","volume":"130","author":"Alves","year":"2023","journal-title":"J. Dent."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/6\/1005\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:01:22Z","timestamp":1760108482000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/6\/1005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,19]]},"references-count":47,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["medicina60061005"],"URL":"https:\/\/doi.org\/10.3390\/medicina60061005","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,19]]}}}