Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of a novel restorative protocol to treat non-carious cervical lesion associated with gingival recession: a 2-year follow-up randomized clinical trial

  • Research
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

To compare 2 different resin composites and 2 adhesive systems used in a new restorative protocol (partial restoration) to treat non-carious cervical lesions associated with gingival recession type 1 (RT1).

Material and methods

Eighty combined defects (CDs) were treated with a partial restoration and periodontal plastic surgery for root coverage. The CDs were randomly assigned to one of the following groups: NP + TE (n = 20), nanofilled composite and 2-step total-etch adhesive system; NP + UA (n = 20), nanofilled composite and universal adhesive system; MH + TE (n = 20), microhybrid composite and 2-step total-etch adhesive; MH + UA (n = 20), microhybrid composite and universal adhesive. Restorations were assessed using the United States Public Health Service (USPHS) criteria at 1 week (baseline) and 6, 12, and 24 months. Survival rate, periodontal parameters, dentin hypersensitivity (DH), and aesthetics were also evaluated.

Results

After 24 months, only the MH + TE group did not lose any restoration, with no significant differences between groups. For surface roughness parameter, MH presented 83.3% of the restorations scoring Bravo, whereas NP presented 48.5% of the restorations scoring Bravo. All groups presented restorations with marginal discoloration. All periodontal parameters behaved similarly, regardless of the restorative material. All groups presented significant reductions of dentin hypersensitivity and improved aesthetic perceptions (p < 0.05).

Conclusion

Both resin composites and adhesives tested can be combined for partial restorations to treat CDs.

Clinical relevance

This new restorative-surgical protocol to treat CDs presents satisfactory outcomes. The partial restorations can be successfully executed with both combinations of adhesives and resin composites evaluated in this investigation.

TRN

ClinicalTrial.gov: NCT03215615; registration date July 12, 2017.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability

Data availability is upon request to the corresponding author.

References

  1. Pini-Prato G, Franceschi D, Cairo F et al (2010) Classification of dental surface defects in areas of gingival recession. J Periodontol 81:885–890. https://doi.org/10.1902/jop.2010.090631

    Article  PubMed  Google Scholar 

  2. Santamaría MP, Ambrosano GMB, Casati MZ et al (2011) Connective tissue graft and resin glass ionomer for the treatment of gingival recession associated with noncarious cervical lesions: a case series. Int J Periodontics Restorative Dent 31:e57-63

    PubMed  Google Scholar 

  3. Santamaria MP, Mathias-Santamaria IF, Ferraz LFF et al (2021) Rethinking the decision-making process to treat gingival recession associated with non-carious cervical lesions. Braz Oral Res 35:e096. https://doi.org/10.1590/1807-3107bor-2021.vol35.0096

    Article  PubMed  Google Scholar 

  4. Santamaria MP, Silveira CA, Mathias IF et al (2018) Treatment of single maxillary gingival recession associated with non-carious cervical lesion: randomized clinical trial comparing connective tissue graft alone to graft plus partial restoration. J Clin Periodontol 45:968–976. https://doi.org/10.1111/jcpe.12907

    Article  PubMed  Google Scholar 

  5. Mathias-Santamaria IF, Silveira CA, Rossato A et al (2022) Single gingival recession associated with non-carious cervical lesion treated by partial restoration and coronally advanced flap with or without xenogenous collagen matrix: a randomized clinical trial evaluating the coverage procedures and restorative protocol. J Periodontol 93:504–514. https://doi.org/10.1002/JPER.21-0358

    Article  PubMed  Google Scholar 

  6. Santamaria MP, da Silva FD, Nociti FH et al (2009) Cervical restoration and the amount of soft tissue coverage achieved by coronally advanced flap: a 2-year follow-up randomized-controlled clinical trial. J Clin Periodontol 36:434–441. https://doi.org/10.1111/j.1600-051X.2009.01389.x

    Article  PubMed  Google Scholar 

  7. Santamaria MP, da Silva FD, Casati MZ et al (2013) Randomized controlled clinical trial evaluating connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesion: 2-year follow-up. J Periodontol 84:e1–e8. https://doi.org/10.1902/jop.2013.120447

    Article  PubMed  Google Scholar 

  8. Santamaria MP, Queiroz LA, Mathias IF et al (2016) Resin composite plus connective tissue graft to treat single maxillary gingival recession associated with non-carious cervical lesion: randomized clinical trial. J Clin Periodontol 43:461–468. https://doi.org/10.1111/jcpe.12524

    Article  PubMed  Google Scholar 

  9. Lucchesi JA, Santos VR, Amaral CM et al (2007) Coronally positioned flap for treatment of restored root surfaces: a 6-month clinical evaluation. J Periodontol 78:615–623. https://doi.org/10.1902/jop.2007.060380

    Article  PubMed  Google Scholar 

  10. Isler SC, Ozcan G, Ozcan M, Omurlu H (2018) Clinical evaluation of combined surgical/ restorative treatment of gingival recession-type defects using different restorative materials: a randomized clinical trial. J Dent Sci 13:20–29. https://doi.org/10.1016/j.jds.2017.09.004

    Article  PubMed  Google Scholar 

  11. Häfer M, Jentsch H, Haak R, Schneider H (2015) A three-year clinical evaluation of a one-step self-etch and a two-step etch-and-rinse adhesive in non-carious cervical lesions. J Dent 43:350–361. https://doi.org/10.1016/j.jdent.2014.12.009

    Article  PubMed  Google Scholar 

  12. Santamaria MP, Saito MT, Casati MZ et al (2012) Gingival recession associated with noncarious cervical lesions: combined periodontal-restorative approach and the treatment of long-term esthetic complications. Gen Dent 60:306–311

    PubMed  Google Scholar 

  13. Zucchelli G, Gori G, Mele M et al (2011) Non-carious cervical lesions associated with gingival recessions: a decision-making process. J Periodontol 82:1713–1724. https://doi.org/10.1902/jop.2011.110080

    Article  PubMed  Google Scholar 

  14. Cairo F, Cortellini P, Nieri M et al (2020) Coronally advanced flap and composite restoration of the enamel with or without connective tissue graft for the treatment of single maxillary gingival recession with non-carious cervical lesion. A randomized controlled clinical trial. J Clin Periodontol 47:362–371. https://doi.org/10.1111/jcpe.13229

    Article  PubMed  Google Scholar 

  15. Silveira C, Mathias I, da Silva Neves F et al (2017) Connective tissue graft and crown-resin composite restoration for the treatment of gingival recession associated with noncarious cervical lesions: case series. Int J Periodontics Restorative Dent 37:601–607. https://doi.org/10.11607/prd.3044

    Article  PubMed  Google Scholar 

  16. de Sanctis M, Di Domenico G, Bandel A et al (2020) The influence of cementoenamel restorations in the treatment of multiple gingival recession defects associated with noncarious cervical lesions: a prospective study. Int J Periodontics Restorative Dent 40:333–342. https://doi.org/10.11607/prd.4639

    Article  PubMed  Google Scholar 

  17. Reis A, Loguercio AD (2009) A 36-month clinical evaluation of ethanol/water and acetone-based etch-and-rinse adhesives in non-carious cervical lesions. Oper Dent 34:384–391. https://doi.org/10.2341/08-117

    Article  PubMed  Google Scholar 

  18. Loguercio AD, de Paula EA, Hass V et al (2015) A new universal simplified adhesive: 36-month randomized double-blind clinical trial. J Dent 43:1083–1092. https://doi.org/10.1016/j.jdent.2015.07.005

    Article  PubMed  Google Scholar 

  19. Cairo F, Nieri M, Cincinelli S et al (2011) The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study: interproximal CAL for gingival recessions. J Clin Periodontol 38:661–666. https://doi.org/10.1111/j.1600-051X.2011.01732.x

    Article  PubMed  Google Scholar 

  20. Santamaria MP, Fernandes-Dias SB, Araújo CF et al (2017) 2-year assessment of tissue biostimulation with low-level laser on the outcomes of connective tissue graft in the treatment of single gingival recession: a randomized clinical trial. J Periodontol 88:320–328. https://doi.org/10.1902/jop.2016.160391

    Article  PubMed  Google Scholar 

  21. Zucchelli G, Testori T, De Sanctis M (2006) Clinical and anatomical factors limiting treatment outcomes of gingival recession: a new method to predetermine the line of root coverage. J Periodontol 77:714–721. https://doi.org/10.1902/jop.2006.050038

    Article  PubMed  Google Scholar 

  22. de Sanctis M, Zucchelli G (2007) Coronally advanced flap: a modified surgical approach for isolated recession-type defects: three-year results. J Clin Periodontol 34:262–268. https://doi.org/10.1111/j.1600-051X.2006.01039.x

    Article  PubMed  Google Scholar 

  23. Santamaria MP, Rossato A, Miguel MMV et al (2022) Comparison of two types of xenogeneic matrices to treat single gingival recessions: a randomized clinical trial. J Periodontol 93:709–720. https://doi.org/10.1002/JPER.21-0212

    Article  PubMed  Google Scholar 

  24. Wilson MA, Cowan AJ, Randall RC et al (2002) A practice-based, randomized, controlled clinical trial of a new resin composite restorative: one-year results. Oper Dent 27:423–429

    PubMed  Google Scholar 

  25. Santamaria MP, Mathias IF, Dias SBF et al (2014) Esthetic evaluation of different approaches to treat gingival recession associated with non-carious cervical lesion treatment: a 2-year follow-up. Am J Dent 27:220–224

    PubMed  Google Scholar 

  26. Teixeira DNR, Thomas RZ, Soares PV et al (2020) Prevalence of noncarious cervical lesions among adults: a systematic review. J Dent 95:103285. https://doi.org/10.1016/j.jdent.2020.103285

    Article  PubMed  Google Scholar 

  27. Susin C, Haas AN, Oppermann RV et al (2004) Gingival recession: epidemiology and risk indicators in a representative urban Brazilian population. J Periodontol 75:1377–1386. https://doi.org/10.1902/jop.2004.75.10.1377

    Article  PubMed  Google Scholar 

  28. Santamaria MP, Suaid FF, Casati MZ et al (2008) Coronally positioned flap plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesions: a randomized controlled clinical trial. J Periodontol 79:621–628. https://doi.org/10.1902/jop.2008.070285

    Article  PubMed  Google Scholar 

  29. Mahn E, Rousson V, Heintze S (2015) Meta-analysis of the influence of bonding parameters on the clinical outcome of tooth-colored cervical restorations. J Adhes Dent 17:391–403. https://doi.org/10.3290/j.jad.a35008

    Article  PubMed  Google Scholar 

  30. Lawson NC, Robles A, Fu C-C et al (2015) Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions. J Dent 43:1229–1234. https://doi.org/10.1016/j.jdent.2015.07.009

    Article  PubMed  PubMed Central  Google Scholar 

  31. Peumans M, Politano G, Van Meerbeek B (2020) Treatment of noncarious cervical lesions: when, why, and how. Int J Esthet Dent 15:16–42

    PubMed  Google Scholar 

  32. Al Khuraif AAA (2014) An in vitro evaluation of wear and surface roughness of particulate filler composite resin after tooth brushing. Acta Odontol Scand 72:977–983. https://doi.org/10.3109/00016357.2014.933251

    Article  PubMed  Google Scholar 

  33. Monteiro B, Spohr AM (2015) Surface roughness of composite resins after simulated toothbrushing with different dentifrices. J Int Oral Health JIOH 7:1–5

    PubMed  Google Scholar 

  34. Santamaria MP, Casati MZ, Nociti FH et al (2013) Connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesions: microbiological and immunological results. Clin Oral Investig 17:67–77. https://doi.org/10.1007/s00784-012-0690-8

    Article  PubMed  Google Scholar 

  35. Tuncer D, Yazici A, Özgünaltay G, Dayangac B (2013) Clinical evaluation of different adhesives used in the restoration of non-carious cervical lesions: 24-month results. Aust Dent J 58:94–100. https://doi.org/10.1111/adj.12028

    Article  PubMed  Google Scholar 

  36. Giachetti L, Scaminaci Russo D, Rossi Campani E et al (2011) Comparison of experienced and inexperienced operators on bond strengths of total-etch and self-etch bonding systems. Am J Dent 24:271–276

    PubMed  Google Scholar 

  37. Lührs A, Jacker-Guhr S, Günay H, Herrmann P (2020) Composite restorations placed in non-carious cervical lesions—which cavity preparation is clinically reliable? Clin Exp Dent Res 6:558–567. https://doi.org/10.1002/cre2.310

    Article  PubMed  PubMed Central  Google Scholar 

  38. Soares P, Machado A, Zeola L et al (2015) Loading and composite restoration assessment of various non-carious cervical lesions morphologies - 3D finite element analysis. Aust Dent J 60:309–316. https://doi.org/10.1111/adj.12233

    Article  PubMed  Google Scholar 

  39. Szesz A, Parreiras S, Reis A, Loguercio A (2016) Selective enamel etching in cervical lesions for self-etch adhesives: a systematic review and meta-analysis. J Dent 53:1–11. https://doi.org/10.1016/j.jdent.2016.05.009

    Article  PubMed  Google Scholar 

  40. Jeong J-S, Chang M (2015) Food impaction and periodontal/peri-implant tissue conditions in relation to the embrasure dimensions between implant-supported fixed dental prostheses and adjacent teeth: a cross-sectional study. J Periodontol 86:1314–1320. https://doi.org/10.1902/jop.2015.150322

    Article  PubMed  Google Scholar 

  41. Costa TRFD, Loguercio AD, Reis A (2013) Effect of enamel bevel on the clinical performance of resin composite restorations placed in non-carious cervical lesions: effect of enamel bevel on cervical lesions. J Esthet Restor Dent 25:346–356. https://doi.org/10.1111/jerd.12042

    Article  PubMed  Google Scholar 

  42. Schroeder M, Reis A, Luque-Martinez I et al (2015) Effect of enamel bevel on retention of cervical composite resin restorations: a systematic review and meta-analysis. J Dent 43:777–788. https://doi.org/10.1016/j.jdent.2015.02.017

    Article  PubMed  Google Scholar 

  43. Santos VR, Lucchesi JA, Cortelli SC et al (2007) Effects of glass ionomer and microfilled composite subgingival restorations on periodontal tissue and subgingival biofilm: a 6-month evaluation. J Periodontol 78:1522–1528. https://doi.org/10.1902/jop.2007.070032

    Article  PubMed  Google Scholar 

  44. Paolantonio M, D’ercole S, Perinetti G et al (2004) Clinical and microbiological effects of different restorative materials on the periodontal tissues adjacent to subgingival class V restorations. 1-year results. J Clin Periodontol 31:200–207. https://doi.org/10.1111/j.0303-6979.2004.00472.x

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the Ultradent Inc. for the Valo light curing unit donated to Dr. Mathias-Santamaria.

Funding

Dr. Mathias-Santamaria was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazil-Finance Code 001. Dr. Mauro Santamaria is supported by the National Council for Scientific and Technological Development from Brazil, CNPq (grant # 304269/2019–0).

Author information

Authors and Affiliations

  1. Department of General Dentistry, School of Dentistry, University of Maryland, Baltimore, 650 West Baltimore Street, Baltimore, MD, 21201, USA

    Ingrid Fernandes Mathias-Santamaria & Mary Anne Sampaio de Melo

  2. Department of Restorative Dentistry, Institute of Science and Technology, UNESP - São Paulo State University, São José Dos Campos, Brazil

    Ingrid Fernandes Mathias-Santamaria & Eduardo Bresciani

  3. Department of Diagnosis and Surgery, Institute of Science and Technology, UNESP - São Paulo State University, São José Dos Campos, Brazil

    Mauro Pedrine Santamaria, Camila Augusto Silveira & Andrea Carvalho De Marco

  4. Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, USA

    Mauro Pedrine Santamaria

  5. Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Baltimore, MD, USA

    Frederico Canato Martinho

  6. Department of Dentistry, School of Dentistry, Western Paraná State University, Cascavel, Brazil

    Marina Gullo Augusto & Guilherme Schmitt de Andrade

  7. Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, USA

    Jean-François Roulet

Authors
  1. Ingrid Fernandes Mathias-Santamaria
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mauro Pedrine Santamaria
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Camila Augusto Silveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Frederico Canato Martinho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mary Anne Sampaio de Melo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andrea Carvalho De Marco
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marina Gullo Augusto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Guilherme Schmitt de Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jean-François Roulet
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Eduardo Bresciani
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

I.F.M.S. and M.P.S. were the coordinators of the study, created the study design and funding, performed all restorative and surgical procedures, and supervised all stages of the research. E.B. and C.A.S. performed clinical evaluations and collected the data. I.F.M.S. and C.A.S supported the patients with the necessary procedures during and after the trial. M.G.A. and G.S.A. assisted in the procedures. I.F.M.S., M.P.S., and E.B. wrote the main manuscript text. A.C.M., F.C.M., J.F.R., and M.A.S.M. revised the manuscript. All authors reviewed and approved the submission of the manuscript.

Corresponding author

Correspondence to Ingrid Fernandes Mathias-Santamaria.

Ethics declarations

Ethics approval and consent to participate

All the treatment procedures were conducted according to the principles outlined in the Declaration of Helsinki and Ethical Conduct for Research with Human Beings and the Good Clinical Practice Guidelines. Written informed consent was taken from all participants included in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 20.3 KB)

Supplementary file2 (DOCX 20.5 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mathias-Santamaria, I.F., Santamaria, M.P., Silveira, C.A. et al. Evaluation of a novel restorative protocol to treat non-carious cervical lesion associated with gingival recession: a 2-year follow-up randomized clinical trial. Clin Oral Invest 27, 1781–1792 (2023). https://doi.org/10.1007/s00784-022-04806-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-022-04806-1

Keywords

Search

Navigation