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©Operative Dentistry, 2007, 32-1, 3-10 N Akimoto• M Takamizu • Y Momoi Clinical RelevanceThis 10-year clinical evaluation of a self-etching adhesive system showed only slight marginal change of some restorations; however, these changes were not severe. Consequently, these clinical conditions did not require replacement, since no recurrent caries were present. Clinically, these data demonstrate that this self-etching adhesive system is acceptable for placement of a long-term adhesive restoration in human teeth. SUMMARYThis study evaluated the long-term clinical performance of a self-etching adhesive system, Clearfil Liner Bond 2. Two operators placed a total of 87 restorations among 42 patients. Carious dentin was identified with the help of Caries Detector and was removed using only a low speed round bur. Clearfil Liner Bond 2 was applied following the manufacturer's directions, and the resin composite was then placed. The number of restorations placed by cavity classification were: 8-Class I, 11-Class II, 21-Class III, 2-Class IV and 45-Class V. The restorations were evaluated in 5 categories according to modified USPHS criteria: pulpal response, marginal integrity, marginal discoloration, retention and secondary caries. Assessments were done at baseline, immediately after placement and at 6-months and 1, 5, 7 and 10 years. Recall rates at each assessment period were 83.9% (6-months), 82.8% (1 year), 59.8% (5 years), 77.0% (7 years) and 50.6% (10 years). In terms of assessment categories, there were no recorded sensitivity, retention loss or secondary caries at any of the five recall periods. At the 10-year assessment, 40 out of 44 restorations (90.9%) were rated Bravo for marginal integrity and 39 restorations (88.6%) were rated Bravo for marginal discoloration (Wilcoxon signed-ranks test p<0.05). This data demonstrates the retention rate and pulpal response of the self-etching adhesive system Clearfil Liner Bond 2 was excellent at 10 years. Most cases showed slight marginal changes during clinical function; however, these changes were not clinically severe by USPHS criteria. These data demonstrate that placement of the Clearfil Liner Bond 2 self-etching adhesive system was demonstrated to be acceptable for the clinical restoration of human teeth following 10 years of clinical function.

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Objectives: In 2002, FDI (World Dental Federation) published a policy advocating that caries be treated by minimal intervention (MI). This MI policy has been accepted worldwide and is taught in universities. But acceptance in general dental practice has been slower, especially in Japan where healthcare payment and practice favor drilling and filling. To help disseminate this MI policy into general practice, the Japanese Society of Conservative Dentistry developed an evidence-based clinical Guideline for restoring carious permanent teeth in adult patients. Methods:The Guideline was developed by a committee of nine university clinicians and a librarian. The committee selected the most frequent clinical questions in treating caries and used electronic databases to search and assess the best scientific evidence for each. Members then added their clinical experience and used the Delphi Method to discuss and reach consensus on each question on treating caries with MI policy. Graded recommendations and guidance were made for each clinical question. The provisional Guideline was strengthened after review and discussion with university researchers and general practitioners. Results:The Guideline addresses the 16 most frequent clinical questions in treating adult caries, including restorative methods and how to tackle root caries. Recommendations for treatment using MI policy were developed using the best scientific evidence and consensus of experienced clinicians.Clinical Significance: The Guideline offers a practical expert view of treating caries with the MI policy that incorporates the best scientific evidence, the latest techniques, the most preferable materials and the general consensus of expert clinicians. / 262