We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at "low" risk; 62.1% were classified as "unclear"; and 30.3% as "high" risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.
Objective: the objective of this multi-center double-blind, randomized clinical trial was to evaluate the clinical performance of a new universal adhesive system (Futurabond U, Voco GbmH, Germany) when applied using different application strategies over a period of six months. Material and Methods: for this, 200 restorations were performed on non-carious cervical lesions using the adhesive Futurabond U according to four adhesive strategies (n = 50 per group): self-etch without previous conditioner (SEE); self-etch associated with selective enamel etching (SET); etch-and-rinse with dry dentin (ERDry) and; etch-and-rinse with wet dentin (ERWet). After hybridization, cavities were restored using Admira Fusion composite resin (Voco GmbH). After 6 months of clinical performance, these restorations were evaluated according to FDI criteria in the following items: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity and caries recurrence. Results: seven restorations were lost/fractured after six months of clinical evaluation (2 in the SEE group, 1 in the SET group, 1 in the ERDry group, and 3 in the ERWet group). The retention rates for six months (95% confidence interval) were 96% (86%-98%) for the SEE group, 98% (89%-99%) for the SET group, 98% (89%-99%) for the ERDry group and 94% (83%-97%) for the ERWet group, with no statistical difference identified between any pair of groups (p > 0.05). Twenty-four restorations presented small marginal adaptation defects at the six-months evaluation recall, and all of them were considered clinically acceptable. Conclusion: the clinical performance of the universal adhesive Futurabond U associated to Admira Fusion unidoses resin composite was found to be promise after 6-month of clinical evaluation when applied in non-carious cervical lesions and it was not depending on the bonding strategy employed.
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