Effects of occlusal adjustment on the clinical performance of resin composite restorations in non-carious cervical lesions: A randomized, controlled, double-blind clinical trial
{"title":"Effects of occlusal adjustment on the clinical performance of resin composite restorations in non-carious cervical lesions: A randomized, controlled, double-blind clinical trial","authors":"Jullyana Mayara Preizner Dezanetti Hermeling , Brenda Giselle Sanchez Leyton , Sergio Aparecido Ignacio , Rodrigo Nunes Rached , Evelise Machado de Souza","doi":"10.1016/j.jdent.2025.106084","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the clinical performance of a conventional and flowable composite resin in the restoration of non-carious cervical lesions (NCCLs), with and without occlusal adjustment, over a period of up to 18 months.</div></div><div><h3>Methods</h3><div>Eighteen participants with abfraction lesions and occlusal interferences were recruited. A total of 145 teeth with NCCL were divided into four groups: FWA (flowable composite with occlusal adjustment), FNA (flowable composite without occlusal adjustment), CWA (conventional composite with occlusal adjustment), and CNA (conventional composite without occlusal adjustment). Two independent examiners evaluated the restorations at 7 days, 6, 12, and 18 months, according to the modified USPHS and the FDI criteria. Mann-Whitney U, Kruskal-Wallis, Dunn and Friedman tests were used (α=5%).</div></div><div><h3>Results</h3><div>Two restorations of CWA were considered clinically unacceptable due to loss of retention after 18 months. At 6 months, FWA showed a significantly higher index of marginal staining compared to CNA (p=0.000), FNA (p=0.001), and CWA (p=0.015) following USPHS criteria. Using FDI, in 6 months, marginal staining scores were significantly higher in the FWA group compared to CNA (p=0.000), FNA (p=0.001), and CWA (p=0.001), and at 12 months between the FNA and CWA (p=0.005). Abfraction recurrence assessed with FDI at 18 months was significantly higher in the CNA compared to CWA (p=0.004), FWA (p=0.005), and FNA (p=0.031).</div></div><div><h3>Conclusions</h3><div>After 18 months, both conventional and flowable resin composites performed clinically well, although the flowable resin showed higher marginal discoloration rates. Conventional composites should be avoided when occlusal balance cannot be fully achieved, to minimize the risk of recurrent abfraction lesions.</div></div><div><h3>Clinical Relevance</h3><div>The diagnosis and treatment of occlusal interferences may influence the clinical longevity of restorations with conventional composite resin in abfraction lesions.</div></div>","PeriodicalId":15585,"journal":{"name":"Journal of dentistry","volume":"162 ","pages":"Article 106084"},"PeriodicalIF":5.5000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of dentistry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0300571225005305","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
This study aimed to evaluate the clinical performance of a conventional and flowable composite resin in the restoration of non-carious cervical lesions (NCCLs), with and without occlusal adjustment, over a period of up to 18 months.
Methods
Eighteen participants with abfraction lesions and occlusal interferences were recruited. A total of 145 teeth with NCCL were divided into four groups: FWA (flowable composite with occlusal adjustment), FNA (flowable composite without occlusal adjustment), CWA (conventional composite with occlusal adjustment), and CNA (conventional composite without occlusal adjustment). Two independent examiners evaluated the restorations at 7 days, 6, 12, and 18 months, according to the modified USPHS and the FDI criteria. Mann-Whitney U, Kruskal-Wallis, Dunn and Friedman tests were used (α=5%).
Results
Two restorations of CWA were considered clinically unacceptable due to loss of retention after 18 months. At 6 months, FWA showed a significantly higher index of marginal staining compared to CNA (p=0.000), FNA (p=0.001), and CWA (p=0.015) following USPHS criteria. Using FDI, in 6 months, marginal staining scores were significantly higher in the FWA group compared to CNA (p=0.000), FNA (p=0.001), and CWA (p=0.001), and at 12 months between the FNA and CWA (p=0.005). Abfraction recurrence assessed with FDI at 18 months was significantly higher in the CNA compared to CWA (p=0.004), FWA (p=0.005), and FNA (p=0.031).
Conclusions
After 18 months, both conventional and flowable resin composites performed clinically well, although the flowable resin showed higher marginal discoloration rates. Conventional composites should be avoided when occlusal balance cannot be fully achieved, to minimize the risk of recurrent abfraction lesions.
Clinical Relevance
The diagnosis and treatment of occlusal interferences may influence the clinical longevity of restorations with conventional composite resin in abfraction lesions.
期刊介绍:
The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis.
Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research.
The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.