Two-year clinical evaluation of proanthocyanidins added to a two-step etch-and-rinse adhesive

Lidiane Costa de Souza, Nara Sousa Rodrigues, Diana Araújo Cunha, Victor Pinheiro Feitosa, Sérgio Lima Santiago, Alessandra Reis, Alessandro Dourado Loguercio, Thalita de Paris Matos, Vicente de Paulo Aragão Saboia, Jorge Perdigão

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Objective: To compare the clinical behavior of Proanthocyanidins (PA)-free and PA-containing two-step etch-and-rinse adhesive used underneath resin composite restorations in non-carious cervical lesions (NCCLs) over a 6- (6 M) and 24-month (24 M) period. Methods: 135 restorations were randomly placed in 45 subjects. The NCCLs were conditioned (37% phosphoric acid for 15 s) and distributed into 3 groups: Control (EX0) - ExciTE F (Ivoclar Vivadent) adhesive applied following the manufacturer's recommendations; EX2 and EX5 – 2 wt% and 5 wt% of PA were added to ExciTE F, respectively, and applied as in EX0. Resin composite was placed incrementally and light-cured. The restorations were evaluated at baseline, 6 M and 24 M, using FDI and USPHS criteria. Statistical analyses were performed using Friedman and Wilcoxon tests (α = 0.05). Results: The retention rates were 98% (95% confidence interval 88–99%) for EX0, 92% (80–97%) for EX2; and 85% (72–93%) for EX5 at 6 M. A significant difference was found only for EX5 at 6 M when compared with the respective baseline findings (p = 0.03) and when compared with EX0 and EX2 (p = 0.001) at 6 M. After 24 M, the retention rates were 98% (88–99%) for EX0, 73% (59–84%) for EX2, and 71% (56–82%) for EX5. Only EX0 did not result in significant difference in retention rate at 24 M when compared with baseline but showed a significant higher retention rate when compared with those of EX2 and EX5 (p = 0.001). Conclusion: Adding proanthocyanidins to the adhesive solution jeopardized the retention of composite resins restorations in non-carious cervical lesions after 24 months. Clinical relevance: In spite of being user-friendlier than when used separately, the incorporation of proanthocyanidins into the adhesive solution impairs the longevity of composite restorations.

Original languageEnglish (US)
Pages (from-to)7-16
Number of pages10
JournalJournal of Dentistry
StatePublished - Feb 2019

Bibliographical note

Funding Information:
This investigation was supported by research grants from FUNCAP (Grant# CI3-0093-000670100/14 ) and CAPES (scholarship). The authors would like to thank the generous donations of resin composite Empress Direct by Ivoclar Vivadent.

Publisher Copyright:
© 2018 Elsevier Ltd

Copyright 2019 Elsevier B.V., All rights reserved.


  • Clinical trial
  • Dentin-bonding agents
  • Longevity
  • Non-carious cervical lesions
  • Proanthocyanidins


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