Clinical Relevance Non-carious cervical lesion restorations using a dual-cure universal adhesive in self-etch and etch-and-rinse mode showed satisfactory clinical performance after 18 months. SUMMARY Objectives: The objective of this multicenter, double-blind, split-mouth randomized clinical trial was to evaluate the clinical performance of a new dual-cure universal adhesive system (Futurabond U, Voco GmBH) when applied using different strategies over a period of 18 months. Methods and Materials: Fifty patients participated in this study. Two hundred non-carious cervical lesions were restored using the adhesive Futurabond U according to four adhesive strategies (n=50 per group): only self-etch (SEE), selective enamel etching + self-etch (SET), etch-and-rinse with dry dentin (ERDry), and etch-and-rinse with wet dentin (ERWet). After the adhesive application, cavities were restored using Admira Fusion composite resin. These restorations were evaluated according to FDI World Dental Federation criteria for the following characteristics: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity, and caries recurrence. Results: After 18 months, only four patients (12 months: one patient, n=4 restorations; and 18 months: three patients, n=12 restorations) were not evaluated. Fourteen restorations were lost after 18 months of clinical evaluation (four for SEE, three for SET, three for ERDry, and four for ERWet). The retention rates for 18 months (95% confidence interval) were 92% (81%–97%) for SEE, 94% (83%–97%) for SET, 94% (83%–97%) for ERDry, and 92% (81%–97%) for ERWet ( p >0.05). Thirty-eight restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall (13 for SEE, 13 for SET, six for ERDry, and six for ERWet; p >0.05). Fourteen restorations were detected as a minor marginal discoloration at the 18-month recall (six for SEE, six for SET, one for ERDry, and one for ERWet; p >0.05). However, all were considered clinically acceptable. No restorations showed postoperative sensitivity or caries recurrence at the time. Conclusion: The clinical performance of the Futurabond U did not depend on the bonding strategy used, and it was considered reliable after 18 months of clinical evaluation, although more marginal discrepancy was observed in the self-etch group.

Clinical Relevance The photo-initiator system based on an advanced polymerization system may be an alternative that can be used to overcome the disadvantages of radicular dentin, especially for the apical third. SUMMARY Objectives: The purpose of this study was to evaluate the effects of universal adhesives with different photo-initiator systems applied in etch-and-rinse (ER) and self-etch (SE) modes on dentin interaction (push-out bond strength [PBS], nanoleakage [NL], and degree of conversion [DC] within the hybrid layer) in the different root thirds after fiber post cementation. Methods and Materials: Roots of endodontically prepared human premolars were randomly divided into six groups according to one of three adhesive systems (Scotchbond Universal [SBU], Ambar Universal [AMB], and Ambar Universal APS [AMB-APS]) and two adhesive strategies (ER and SE) for each system. Posts were cemented, and PBS was tested at 0.5 mm/min. The NL was evaluated by scanning electron microscopy. DC was measured using micro-Raman spectroscopy. The data were analyzed by three-way analysis of variance and Tukey tests (α=0.05). Results: AMB-APS showed similar performance in all root thirds ( p >0.05) and higher values of DC, especially in the apical third ( p <0.0001). AMB and SBU showed the lowest values in the apical third ( p <0.0001). Conclusions: The APS photo-initiator system contained in universal adhesives is a feasible alternative for improving radicular bonding procedure.