This randomized controlled clinical trial aims to compare the 12-month clinical performance of two HEMA-free universal adhesive systems for restoring anterior cervical carious lesions. Participants will be randomly allocated (1:1) to receive restorations using either a two-bottle HEMA-free universal adhesive (G2-Bond Universal) or a one-bottle HEMA-free universal adhesive (BeautiBond Xtreme), both applied in self-etch mode. The primary outcome is restoration retention, while secondary outcomes include marginal adaptation, marginal discoloration, and postoperative sensitivity, evaluated at baseline (24 hours), 6 months, and 12 months using the modified USPHS criteria.
This single-center, parallel-arm, randomized controlled clinical trial will be conducted at the Department of Conservative Dentistry, Faculty of Dentistry, Cairo University. Fifty participants with ICDAS 3 or 4 anterior cervical carious lesions will be randomly assigned in a 1:1 ratio to receive restorations using either G2-Bond Universal (two-bottle HEMA-free universal adhesive) or BeautiBond Xtreme (one-bottle HEMA-free universal adhesive), both applied in self-etch mode and restored with Beautifil II LS composite resin. Clinical performance will be evaluated at baseline (24 hours), 6 months, and 12 months using the modified USPHS criteria. The primary outcome is restoration retention. Secondary outcomes include marginal adaptation, marginal discoloration, and postoperative sensitivity. Participants and outcome assessors will be blinded, while the operator cannot be blinded because of differences in the adhesive application protocols.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
50
Two-bottle HEMA-free universal adhesive system used in self-etch mode for restoring anterior cervical carious lesions according to the manufacturer's instructions.
One-bottle HEMA-free universal adhesive system (Shofu Inc.) used in self-etch mode for restoring anterior cervical carious lesions according to the manufacturer's instructions.
Restoration retention
Clinical assessment of restoration retention using the Modified United States Public Health Service (USPHS) criteria at baseline, 6 months, and 12 months. Retention will be recorded as ordinal categorical data using two categories: Alpha (complete restoration retention; best clinical outcome) and Charlie (partial or complete loss of the restoration requiring repair or replacement; worst clinical outcome and considered failure).
Time frame: 12 Months
Marginal adaptation
Clinical assessment of marginal adaptation using the Modified United States Public Health Service (USPHS) criteria at baseline, 6 months, and 12 months. Marginal adaptation will be recorded as ordinal categorical data using Alpha (closely adapted margins with no visible or detectable crevice; best clinical outcome), Bravo (visible crevice with explorer penetration but no exposed dentin; clinically acceptable), and Charlie (crevice with exposed dentin requiring repair or replacement; worst clinical outcome and considered failure).
Time frame: 12 months
Marginal discoloration
Clinical assessment of marginal discoloration using the Modified United States Public Health Service (USPHS) criteria at baseline, 6 months, and 12 months. Marginal discoloration will be recorded as ordinal categorical data using Alpha (no marginal discoloration; best clinical outcome), Bravo (marginal discoloration without axial/pulpal-direction penetration; clinically acceptable), and Charlie (marginal discoloration with axial/pulpal-direction penetration requiring clinical intervention; worst clinical outcome and considered failure).
Time frame: 12 months
Postoperative sensitivity
Clinical assessment of postoperative sensitivity using the Modified United States Public Health Service (USPHS) criteria at baseline, 6 months, and 12 months. Postoperative sensitivity will be recorded as ordinal categorical data using Alpha (absence of postoperative sensitivity; best clinical outcome), Bravo (slight postoperative sensitivity that is clinically acceptable and does not require intervention), and Charlie (persistent postoperative sensitivity requiring clinical intervention; worst clinical outcome and considered failure).
Time frame: 12 months
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