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The purpose of this study was to evaluate the clinical performance of class 5 restorations according to USPHS criteria. Twenty-five patients and 116 abrasion/erosion lesions were restored with either a glass-ionomer cement restoration (Ketac-Fil), a composite resin restoration with a dentin bonding agent (Silux Plus, Scotchbond 2), or a composite resin restoration with a dentin bonding agent and a glass-ionomer liner (Silux Plus, Scotchbond 2, Vitrebond). At 3 years, 24 patients and 110 teeth were evaluated. All restorations were rated clinically acceptable for color match, cavosurface discoloration, surface texture, and caries development. Glass-ionomer cement restorations demonstrated a slightly rougher surface texture than the composite restorations (Friedman Two-way ANOVA, P=0.000). Significant differences were found with retention (Cochran Q test, P=0.012). Percentages retained were: glass ionomer, 97.3% (36/37); composite/dentin bonding agent, 75.7% (28/37); composite/dentin bonding agent/glass-ionomer liner, 100% (36/36). At 3 years class 5 restorations of glass-ionomer cement or composite with a dentin bonding and a glass-ionomer liner demonstrated significantly better retention than restorations of composite with a dentin bonding agent. Increased occlusal function, mobility, and mandibular arch were associated with a decrease in retention rate.
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