Restauração de lesões cervicais não cariosas : fatores relacionados a sua sobrevivência e impactos periodontais

Abstract

The present study had as objective to evaluate the survival aspects of restorations before the interventions proposed by two randomized clinical trials with different times of follow-up, one with 36 months and another with 60 months. Additionally, the aim of this study was to evaluate the periodontal condition of patients who received non-carious cervical lesion restorations (NCCL) in these studies. The study with 36 months of follow-up (Number of patients - Np = 42; Number of restorations -Nr = 182) was performed with 3 different groups, in which different solutions were applied (control - placebo solution, experimental 1 - solution of Chlorhexidine 2%, and experimental 2 - 10% sodium hypochlorite solution) for 60 seconds after acid etching and before application of the adhesive and restoration of NCCL. Thus, this first study gave rise to two studies (study 1 and 2), respectively, on the effects of pretreatment with CHX 2% and NaOCl 10% on the retention of NCCL restorations. The study with 60 months of follow - up (Np = 36; Nr = 172) gave rise to study 3, which was designed to evaluate the effect of different forms of isolation of the operative field (absolute isolation - with rubber dam and clamp, Or relative insulation - with retractor wire, lip retractor, and both with saliva succion) for performing NCCL restorations. An experienced, trained and calibrated evaluator in each of the two large studies evaluated the restorations after 6, 12, 24, 36 or 60 months using the FDI criteria. For the periodontal evaluation, the same gold standard evaluator for both studies evaluated the cases according to pre-established criteria. Another researcher compared the information obtained with the already existing ones in the clinical records of the patients with those obtained in the clinical examination and in the application of the questionnaire carried out in the last recalls of each study, of 3 or 5 years. The union of the periodontal data from the two samples gave rise to a fourth study, which represents the association between aspects related to restorations (margin level and type of isolation) and adjacent periodontal tissues. The results demonstrated that the use of different solutions, such as 2% chlorhexidine or 10% sodium hypochlorite, during the restorative process, as well as the type of isolation performed during the restorative treatment, did not influence the survival rate of NCCL over time. Also, from the periodontal point of view, the type of insulation and the presence of the restorations did not show damage to the periodontal criteria evaluated after 36 or 60 months follow up. There was a relevant association between certain characteristics of the lesions and the patients with the failure rates of the restorations.