Dental adhesive protection against development of noncarious cervical lesions

Abstract

OBJECTIVE: This study aimed to verify whether dental adhesives prevent noncarious cervical lesion (NCCL) development in an in vitro simulation model based on abrasive/erosive challenges. METHODS AND MATERIALS: Extracted human premolars were randomly assigned to one of three treatments (n=16): 1. reference adhesive (Clearfil SE, Kuraray Co., Ltd., Chiyoda City, Tokyo, Japan); 2. experimental adhesive (10 wt% [percentage by weight] beta-tricalcium phosphate nanoparticles); 3. negative control (no treatment). After treatment, specimens were submitted to 11 episodes of 18 hours of acid exposure (1% citric acid solution-0.052 molar (M), pH ~2.5) interspersed by toothbrushing abrasion. Three-dimensional images of teeth were captured at baseline and after 5000, 10,000, 15,000, 35,000, and 55,000 toothbrushing strokes using an intraoral scanner. Tooth wear (mm3) was calculated after each toothbrushing period by scan superimposition. Lesion angle was measured, and shape classified. Data were analyzed using analysis of variance (ANOVA) and Fisher Protected Least Significant Difference (PLSD) tests (α=0.05). RESULTS: Tooth wear increased with toothbrushing strokes overall (p<0.001) and within each treatment (p<0.05) except between 10,000 and 15,000 strokes (p=0.24). Reference had less tooth wear than control overall (mean difference [95% CI]: 0.68 [0.20,1.15], p=0.008) and for all toothbrushing periods (p<0.05) except at 55,000 strokes (0.54 [-0.38,1.46], p=0.25). Reference had less tooth wear than experimental overall (0.54 [0.01,1.07], p=0.046) and for 35,000 strokes (0.80 [0.13,1.46], p=0.019). Experimental had less tooth wear than negative control at 5000 and 10,000 strokes (p<0.05). Treatments had no effect on lesion angle (p=0.52). At 55,000 strokes, reference had more flat-shaped lesions than experimental (p<0.001) and negative control (p<0.001), but experimental and negative control were not different from each other (p=1.00) having more striated lesions. CONCLUSION: Adhesives showed some degree of protection against NCCL development at early stages; however, reference had longer-lasting protection than experimental.