Restorative treatment of cervical lesions with resin composites : 4-year results

Background: Class V restorations continue to have an unpredictable course in terms of long-term success, despite advances in materials and techniques in recent years and despite their increasing popularity. One factor in this uncertainty regarding long-term success of Class V restorations is the peculiar patterns in the etiology of these lesions. The incidence of cervical lesions is increasing in industrialized countries, as more people live longer and retain more of their teeth. The prevalence of abfractions ranges from 31 % to 56% in populations older than 45 years. Different restorative materials have been proposed for the treatment of cervical lesions. Traditional materials such as amalgam and gold foil have excellent longevity but are rarely used for esthetic and functional reasons, as they require an excessive removal of sound tooth structure to obtain macro-mechanical retention in small cavities. Adhesive materials such as resin-based composites, compo-mers, and glass-ionomer cements are now widely used in these lesions. In the past decade, new, flowable resins were introduced. One of these, Ælite Flo, is used for restoration of cervical restorations where the failure rate is typically high, particularly in lesions such as abfractions. The long-term (48 months) clinical behavior of 2 resin-based composites with different Young's modulus (Ælite Flo and Ælite Fil) was evaluated in the restoration of carious and noncarious cervical lesions. Methods: A total of 116 restorations were performed with the Ælite material in 15 patients and followed up for 48 months. Retention rate and USPHS criteria were recorded at 6,12,24,36, and 48 months. Results: The retention rate was 66% for Ælite Fil in both carious and noncarious lesions, and 65% and 47% for Ælite Flow in carious and non-carious lesions, respectively, at 48 months. There was a decrease in the quality of restorations in time with all USPHS criteria, with no statistically significant difference between the materials tested. Conclusions: There was no evidence that a flowable composite material with low Young's modulus will behave better than traditional hybrid resins in the restoration of cervical carious and noncarious lesions.