10-year Clinical Evaluation of a Self-etching Adhesive System

This study evaluated the long-term clinical performance of a self-etching adhesive system, Clearfil Liner Bond 2. Two operators placed a total of 87 restorations among 42 patients. Carious dentin was identified with the help of Caries Detector and was removed using only a low speed round bur. Clearfil Liner Bond 2 was applied following the manufacturer's directions, and the resin composite was then placed. The number of restorations placed by cavity classification were: 8-Class I, 11-Class II, 21-Class III, 2-Class IV and 45-Class V. The restorations were evaluated in 5 categories according to modified USPHS criteria: pulpal response, marginal integrity, marginal discoloration, retention and secondary caries. Assessments were done at baseline, immediately after placement and at 6-months and 1, 5, 7 and 10 years. Recall rates at each assessment period were 83.9% (6-months), 82.8% (1 year), 59.8% (5 years), 77.0% (7 years) and 50.6% (10 years). In terms of assessment categories, there were no recorded sensitivity, retention loss or secondary caries at any of the five recall periods. At the 10-year assessment, 40 out of 44 restorations (90.9%) were rated Bravo for marginal integrity and 39 restorations (88.6%) were rated Bravo for marginal discoloration (Wilcoxon signed-ranks test p < 0.05). This data demonstrates the retention rate and pulpal response of the self-etching adhesive system Clearfil Liner Bond 2 was excellent at 10 years. Most cases showed slight marginal changes during clinical function; however, these changes were not clinically severe by USPHS criteria. These data demonstrate that placement of the Clearfil Liner Bond 2 self-etching adhesive system was demonstrated to be acceptable for the clinical restoration of human teeth following 10 years of clinical function.