Desmitificando protocolos adesivos e restauradores: resina composta pré-aquecida apresenta melhor desempenho clínico em lesões cervicais não cariosas?

Abstract

Laboratory investigations play a fundamental role in advancing science. However, to validate their findings, it is crucial to conduct clinical studies, where a multitude of variables, known and unknown, as well as complex mechanisms, are present. Relying solely on conclusions drawn from laboratory studies to make clinical recommendations can result in generalized "truths," often unfounded, or even myths, in any field of knowledge. These misconceptions can lead to financial and time costs, or even to harm, such as unwanted side effects since the current protocol or practice have already undergone a broader and more comprehensive evaluation in a clinical setting. Throughout this thesis, some myths related to dentin bonding, which can influence clinical decisions, will be explored. For this purpose, principles of evidence-based practice will be applied, allowing for a thorough analysis of the findings present in the literature. In adhesive and restorative dentistry, various myths pervade practice, such as the preheating of composite resin for direct restorations. Despite positive laboratory results regarding preheating, few clinical studies are available in the literature. To debunk this practice, two randomized, double-blind, split-mouth clinical trials, with a 24-month follow-up, were conducted to assess retention fracture rates in non-carious cervical lesions. The first compared a preheated thermoviscous composite resin with one that was not preheated, while the second investigated the most effective method of preheating the composite resin, using a Caps dispenser device associated with the Caps Warmer or a VisCalor Caps Dispenser/Warmer. Regardless of the preheating method or the presence of heating, both studies demonstrated high retention rates after the 24-month period. Even though heating demonstrates promising results in vitro, clinical evaluations up to 24 months do not demonstrate any clinically important benefit of the technique.