Clinical performance of posterior resin composite restorations bonded with universal adhesive system using three different application modes: a 26-month randomized clinical trial

Authors

DOI:

https://doi.org/10.1590/

Keywords:

Universal adhesives, Randomized clinical trial, Dental restorations, Clinical longevity

Abstract

Objective  This study aimed to evaluate the clinical performance of posterior resin composite restorations (Class I and II), bonded with a universal adhesive using three application modes over 26 months, comparing the adapted FDI and USPHS criteria. Methodology  In total, 138 Class I and II cavities were restored using Scotchbond Universal adhesive (3M ESPE) in three application modes: etch-and-rinse (ER); selective enamel etch (SEE), and self-etch (SE). All cavities were restored with FiltekTM Supreme composite resin (3M ESPE). The restorations were evaluated by two trained and calibrated evaluators using FDI and adapted USPHS criteria at baseline (12.02±5.68 days) and after 26 (± 2.36) months. The obtained data were subjected to statistical analysis between the groups using the Friedman and Wilcoxon test for intra-group analysis and the McNemar test for comparisons between FDI and USPHS criteria (α=0.05). Results  No statistically significant differences were observed between the ER, SEE, and SE groups after 26 months, except for marginal discoloration between the ER and SE groups (p≤0.05). Conclusion  Class I and II resin composite restorations performed with Scotchbond Universal adhesive using ER, SEE, and SE modes showed acceptable clinical performance over a 26-month evaluation period. Moreover, the adapted FDI and adapted USPHS criteria yielded comparable results. Brazilian Clinical Trials Registry (Rebec) — RBR-9p3hdp

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References

- Perdigão J, Loguercio AD. Universal or multi-mode Adhesives: Why and how?. J Adhes Dent. 2014;16(2):193-4. doi: 10.3290/j.jad.a31871

» https://doi.org/10.3290/j.jad.a31871

- Lawson NC, Robles A, FU CC, Lin CP, Sawlani K, Burgess JO. Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions. J Dent. 2015; 43(10):1229-34. doi: 10.1016/j.jdent.2015.07.009

» https://doi.org/10.1016/j.jdent.2015.07.009

- Saini RS, Vyas R, Vaddamanu SK, Quadri SA, Mosaddad SA, Heboyan A. Efficacy of different adhesive systems in bonding direct resin composite restorations: a systematic review and meta-analysis. Evid Based Dent. 2025;26(2):115. doi: 10.1038/s41432-024-01095-3

» https://doi.org/10.1038/s41432-024-01095-3

- Hong X, Huang Z, Tong Z, Jiang H, Su M. Clinical effects of different etching modes for universal adhesives: a systematic review and meta-analysis. Ann Palliat Med. 2021;10(5):5462-73. doi: 10.21037/apm-21-890

» https://doi.org/10.21037/apm-21-890

- Carvalho AA, Leite MM, Zago JK, Nunes CA, Barata TJ, Freitas GC, et al. Influence of different application protocols of universal adhesive system on the clinical behavior of Class I and II restorations of composite resin - a randomized and double-blind controlled clinical trial. BMC Oral Health. 2019;19:252. doi:10.1186/s12903-019-0913-3

» https://doi.org/10.1186/s12903-019-0913-3

- Carrilho E, Cardoso M, Ferreira MM, Marto CM, Paula A, Coelho AS. 10-MDP based dental adhesives: adhesive interface characterization and adhesive stability-a systematic review. Materials (Basel). 2019;12(5):790. doi: 10.3390/ma12050790

» https://doi.org/10.3390/ma12050790

- Oliveira RP, Paula BL, Alencar CM, Alves EB, Silva CM. 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. J Dent. 2023;130:104407. doi: 10.1016/j.jdent.2022.104407

» https://doi.org/10.1016/j.jdent.2022.104407

- Perdigão J, Dutra-Corrêa M, Saraceni CH, Ciaramicoli MT, Kiyan VH, Queiroz CS. Randomized clinical trial of four adhesion strategies: 18-month results. Oper Dent. 2012;37(1):3-11. doi: 10.2341/11-222-C

» https://doi.org/10.2341/11-222-C

- Perdigão J, Kose C, Mena-Serrano AP, Da Paula EA, Tay LY, Reis A, et al. A new universal simplified adhesive: 18-month clinical evaluation. Oper Dent. 2014;39(2):113-27. doi: 10.2341/13-045-C

» https://doi.org/10.2341/13-045-C

- Loguercio AD, De Paula EA, Hass V, Luque-Martinez I, Reis A, Perdigão J. A new universal simplified adhesive: 36-Month randomized double-blind clinical trial. J Dent. 2015;43(9):1083-92. doi: 10.1016/j.jdent.2015.05.007

» https://doi.org/10.1016/j.jdent.2015.05.007

- Çakir NN, Demirbuga S. The effect of five different universal adhesives on the clinical success of Class I restorations: 24-month clinical follow-up. Clin Oral Investig. 2019;23(6):2767-76. doi:10.1007/s00784-018-2708-3

» https://doi.org/10.1007/s00784-018-2708-3

- Perdigão J, Ceballos L, Giráldez I, Baracco B, Fuentes MV. Effect of a hydrophobic bonding resin on the 36-month performance of a universal adhesive-a randomized clinical trial. Clin Oral Investig. 2020;24(2):765-76. doi:10.1007/s00784-019-02940-x

» https://doi.org/10.1007/s00784-019-02940-x

- Paris Matos T, Perdigão J, Paula E, Coppla F, Hass V, Scheffer RF, et al. Five-year clinical evaluation of a universal adhesive: a randomized double-blind trial. Dental Mater. 2020;36(11):1474-85. doi: 10.1016/j.dental.2020.08.007

» https://doi.org/10.1016/j.dental.2020.08.007

- Van Dijken JW, Pallesen U. Durability of a low shrinkage TEGDMA/HEMA-free resin composite system in Class II restorations. A 6-year follow up. Dental Mater. 2017;33(8):944-53. doi: 10.1016/j.dental.2017.04.021

» https://doi.org/10.1016/j.dental.2017.04.021

- Öztürk-Bozkurt F, Toz T, Kara-Tuncer A, Gözükara-Bag H, Özcan M. Clinical evaluation of Silorane and nano-hybrid resin composite restorations in class II cavities up to 3 Years. Oper Dent. 2016;41(6):599-606. doi: 10.2341/15-259-C

» https://doi.org/10.2341/15-259-C

- Stape TH, Wik P, Mutluay MM. Class I and II composite restorations with universal adhesives: a systematic review and meta-analysis. J Esthet Restor Dent. 2022;34(2):318-27. doi:10.1111/jerd.12813

» https://doi.org/10.1111/jerd.12813

- Özden G, Karadas M. Clinical performance of different composite materials in class II cavities bonded with universal adhesives. J Esthet Restor Dent. 2025;37(2):314-325. doi: 10.1111/jerd.13285

» https://doi.org/10.1111/jerd.13285

- Hickel R, Mesinger S, Opdam N, Loomans B, Frankenberger R, Cadenaro M, et al. Revised FDI criteria for evaluating direct and indirect dental restorations-recommendations for its clinical use, interpretation, and reporting. Clin Oral Investig. 2023;27(6):2573-92. doi: 10.1007/s00784-022-04814-1

» https://doi.org/10.1007/s00784-022-04814-1

- Cvar JF, Ryge G. Reprint of criteria for the clinical evaluation of dental restorative materials. 1971. Clin Oral Investig. 2005;9(4):215-32. doi: 10.1007/s00784-005-0018-z

» https://doi.org/10.1007/s00784-005-0018-z

- Hopewell S, Chan AW, Collins GS, Hróbjartsson A, Moher D, Schulz KF, et al. CONSORT 2025 statement: updated guideline for reporting randomized trials. Nat Med. 2025;31(6):1776-83. doi: 10.1038/s41591-025-03635-5

» https://doi.org/10.1038/s41591-025-03635-5

- Polesso Patias M, Fernandes-E-Silva P, Carreño NL, Lund RG, Piva E, Silva AF, et al. Comparative clinical performance of universal adhesives versus etch-and-rinse and self-etch adhesives: a meta-analysis. Clin Oral Investig. 2025;29(7):352. doi: 10.1007/s00784-025-06427-w

» https://doi.org/10.1007/s00784-025-06427-w

- Josic U, Maravic T, Mazzitelli C, Radovic I, Jacimovic J, Del Bianco F, et al. 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. Dent Mater. 2021;37(11):e503-e521. doi: 10.1016/j.dental.2021.08.017

» https://doi.org/10.1016/j.dental.2021.08.017

- Cuevas-Suárez CE, Rosa, Lund RG, Silva AF, Piva E. Bonding performance of universal adhesives: an update systematic review. J Adhes Dent. 2019;21(7):7-26. doi: 10.3290/j.jad.a41975

» https://doi.org/10.3290/j.jad.a41975

- Perdigão J, Chew HP, Lee IK, Woodis K, Hatch B. Prospective, randomized clinical trial evaluating the clinical performance of a new universal adhesive in Class I and Class II restorations at 1 year. Clin Oral Investig. 2024;29(1):38. doi: 10.1007/s00784-024-06121-3

» https://doi.org/10.1007/s00784-024-06121-3

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

» https://doi.org/10.1016/j.jdent.2016.05.009

- Lawson NC, Robles A, Fu CC, Lin CP, Sawlani K, Burgess JO. Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions. J Dent. 2015;43(10):1229-34. doi: 10.1016/j.jdent.2015.07.009

» https://doi.org/10.1016/j.jdent.2015.07.009

- Yoshihara K, Hayakawa S, Nagaoka N, Okihara T, Yoshida Y, Van Meerbeek B. Etching efficacy of self-etching functional monomers. J Dental Res. 2018;97(9):1010-6. doi: 10.1177/0022034518763606

» https://doi.org/10.1177/0022034518763606

- Carvalho RM, Mendonça JS, Santiago SL, Silveira RR, Garcia FC, Tay FR, et al. Effects of HEMA/solvent combinations on bond strength to dentin. J Dental Res. 2003;82(8):97-601. doi: 10.1177/154405910308200805

» https://doi.org/10.1177/154405910308200805

- Oliveira RP, Paula BL, Ribeiro ME, Alves E, Costi HT, Silva C. Evaluation of the bond strength of self-etching adhesive systems containing HEMA and 10-MDP monomers: bond strength of adhesives containing HEMA and 10-MDP. Int J Dent. 2022;2022:5756649. doi: 10.1155/2022/5756649

» https://doi.org/10.1155/2022/5756649

- Pappa E, Gkavela G, Sampri I, Masouras K, Rahiotis C, Kakaboura A. A 2-Year randomized clinical trial of three bonding techniques in non-carious cervical lesions. Medicina (Kaunas). 2024;60(6):1005. doi: 10.3390/medicina60061005

» https://doi.org/10.3390/medicina60061005

- Hong X, Huang Z, Tong Z, Jiang H, Su M. Clinical effects of different etching modes for universal adhesives: a systematic review and meta-analysis. Ann Palliat Med. 2021;10(5):5462-73. doi: 10.21037/apm-21-890

» https://doi.org/10.21037/apm-21-890

- Javed K, Noor N, Nasir MZ, Manzoor MA. Comparison of postoperative hypersensitivity between Total-etch and Universal adhesive system: a randomized clinical trial. Sci Rep. 2024;14(1):678. doi: 10.1038/s41598-024-51175-8

» https://doi.org/10.1038/s41598-024-51175-8

- Rosa Rodolpho PA, Rodolfo B, Collares K, Correa MB, Demarco FF, Opdam NJ, et al. Clinical performance of posterior resin composite restorations after up to 33 years. Dent Mater. 2022;38(4):680-8. doi: 10.1016/j.dental.2022.02.009

» https://doi.org/10.1016/j.dental.2022.02.009

- Fang K, Chen K, Shi M, Wang L. Effect of different adhesive systems on dental defects and sensitivity to teeth in composite resin restoration: a systematic review and meta-analysis. Clin Oral Investig. 2023;27(6):2495-511. doi: 10.1007/s00784-023-05007-0

» https://doi.org/10.1007/s00784-023-05007-0

- Peumans M, Vandormael S, De Coster I, De Munck J, Van Meerbeek B. Three-year clinical performance of a universal adhesive in non-carious cervical lesions. J Adhes Dent. 2023;25:133-46. doi: 10.3290/j.jad.b4186751

» https://doi.org/10.3290/j.jad.b4186751

- Schroeder M, Correa IC, Bauer J, Loguercio AD, Reis A. Influence of adhesive strategy on clinical parameters in cervical restorations: a systematic review and meta-analysis. J Dent. 2017;62:36-53. doi: 10.1016/j.jdent.2017.05.006

» https://doi.org/10.1016/j.jdent.2017.05.006

- Josic U, Maravic T, Mazzitelli C, Radovic I, Jacimovic J, Del Bianco F, et al. 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. Dent Mater. 2021;37:e503-e521. doi: 10.1016/j.dental.2021.08.017

» https://doi.org/10.1016/j.dental.2021.08.017

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Published

2025-11-17

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Section

Original Articles

How to Cite

Mendonça, T. S., Carvalho, A. A., Zago, J. K. M., Barata, T. de J. E., Torres, Érica M., Freitas, G. C. de, & Lopes, L. G. (2025). Clinical performance of posterior resin composite restorations bonded with universal adhesive system using three different application modes: a 26-month randomized clinical trial. Journal of Applied Oral Science, 33, e20250402. https://doi.org/10.1590/