Two-year randomized clinical trial of different restorative techniques in non-carious cervical lesions and MMP activity in gingival crevicular fluid

Abstract

Objectives: To evaluate different restorative techniques for non-carious cervical lesions (NCCLs) and the activity of matrix metalloproteinases (MMPs) in gingival crevicular fluid.

Materials and methods: Two hundred restorations were performed in 50 patients using resin composite restorative system without (I) and with selective enamel conditioning (II) and resin-modified glass-ionomer cement without (III) and with EDTA pretreatment (IV). Gingival crevicular fluid samples were collected in 15 patients. Restorations were evaluated using USPHS criteria at baseline and after 2 years. Percentages of MMP activity were assessed by zymography as a surrogate outcome. Equality tests of two proportions, logistic regression analysis, survival analysis, ANOVA repeated measures, and Fisher tests were used.

Results: No differences in clinical performance were found among groups. Group I had lower retention at 2 years than at baseline. Decreased alpha scores for marginal integrity and marginal discoloration were observed for all groups after 2 years. MMP-2 decreased after 1 year, and its activity increased back to the initial level after 2 years, mainly for groups I, II, and III. MMP-9 increased after 1 year, and it was reduced to the initial level after 2 years, mainly for group I.

Conclusions: All restorative techniques performed similarly in NCCLs after 2 years with initial marginal defect alterations. MMP-2 reestablished its initial levels after 2 years, and MMP-9 had few alterations over time in crevicular fluid. Clinical relevance The different restorative techniques are equally successful in NCCLs after 2 years of clinical functioning and have similar effects on MMPs present in crevicular fluid.

Keywords: Clinical trial; Gingival crevicular fluid; Glass-ionomer cement; Matrix metalloproteinases; Non-carious cervical lesions; Resin composite.