Clinical Features of the Development and Treatment of Carious and Non-carious Lesions in the Cervical Area of Human Teeth

Abstract

Background: The defects in the cervical area of human teeth are challenging for clinicians because of the hardly accessible location, multi- etiology, and three completely different tissues. Despite multiple investigations, the ideal material that would resolve the abovementioned issue and be perfect for filling class 5 defects is still being searched for. Objectives: Our study aimed to identify carious and non-carious diseases of human teeth cervical area and evaluate restoration's clinical efficiency using adhesive systems of different generations. Methods: We examined and treated 5,892 teeth in 299 patients. In the first stage of the study, a special questionnaire was developed to provide comprehensive data for each patient. In the second stage, we restored 90 cervical defects of teeth in 43 patients. During treatment, we divided the teeth among Group A (with the need for replacement and retreatment of existing restorations) and Group B (with de novo cervical defects) and six subgroups (three in each group: A-1,2,3; and B-1,2,3). We used three types of adhesive systems: fourth- and fifth-generation adhesives in subgroups A1, A2, B1, and B2 and seventh-generation adhesives in subgroups A3 and B3. We evaluated the restoration status according to Modified USPHS criteria: A (Alpha): ideal restoration; B (Bravo): clinically acceptable restoration; C (Charlie): clinically unacceptable restoration; and (Delta): defective restoration. Results: According to the study results, carious and non-carious cervical lesions are more common with advanced age. All subgroups tended towards Criteria A, but neither group reported Criteria C or D. There were no significant differences between groups. The effectiveness of all three types of adhesives also was similar in both groups. Conclusions: A comparison of the three types of adhesives demonstrated their equal efficacy in both the group of patients requiring replacement of existing restorations and the group of de novo patients with teeth cervical area defects.