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This review aims to comprehensively explore calcium-enriched mixture (CEM) cement as a crucial biomaterial in dentistry/endodontics. With its growing clinical relevance, there is a need to evaluate its composition, chemical/physical/biological properties, clinical applications, and future perspectives to provide clinicians/researchers with a detailed understanding of its potential in endodontic procedures. Through systematic analysis of available evidence, we assess the advantages/limitations of CEM cement, offering valuable insights for informed decision-making in dental/endodontic practice. Our findings highlight the commendable chemical/physical properties of CEM cement, including handling characteristics, alkalinity, color stability, bioactivity, biocompatibility, sealing ability, and antimicrobial properties. Importantly, CEM cement has shown the potential in promoting regenerative processes, such as dentinogenesis and cementogenesis. It has demonstrated successful outcomes in various clinical applications, including vital pulp therapy techniques, endodontic surgery, open apices management, root resorption/perforation repair, and as an orifice/root canal obturation material. The efficacy and reliability of CEM cement in diverse clinical scenarios underscore its effectiveness in endodontic practice. However, we emphasize the need for well-designed clinical trials with long-term follow-up to further substantiate the full potential of CEM cement. This review serves as a robust reference for researchers/practitioners, offering an in-depth exploration of CEM cement and its multifaceted roles in contemporary dentistry/endodontics., (© 2024. The Author(s).)

NANOTECHNOLOGY: is the art and science of dealing with nanoscale particles. This has transformed contemporary dental practices through myriad contributions to biomaterial science. Titanium dioxide nanoparticles procured from Bacillus subtilis, an eco-friendly and biogenic source, can significantly magnify the physiochemical attributes of dental materials. However, postoperative sensitivity is a major drawback of composite restorations. The incorporation of these nanoparticles into dental adhesives can greatly benefit clinical dentistry by resolving this issue. This trial aimed to evaluate the effectiveness of a novel titanium dioxide nanofortified adhesive on the postoperative sensitivity of composite restorations., Methods: This triple-blind, parallel-group randomized controlled trial was conducted at the Department of Operative Dentistry and Endodontics, School of Dentistry, Islamabad, from May 15, 2023, to November 25, 2023. Participants (n = 60) with Class I and II primary carious lesions with a minimum cavity depth of 3-5 mm were randomly assigned to two groups (n = 30). After obtaining informed consent, the restorative procedure was accomplished using a minimally invasive approach and etch-and-rinse adhesive strategy. In group A, a nanofortified adhesive was used for composite restoration, whereas in group B, an adhesive without nanoparticles was used. Postoperative sensitivity was evaluated using the Visual Analog Scale (VAS) score at follow-up periods: of one day, one week, two weeks and one month. A Chi-square test was used to compare postoperative sensitivity between the two groups. The level of significance was set at p < 0.05., Results: A noteworthy association was observed between sensitivity and the group variable at all four evaluation periods: after one day (p = 0.002), 1 week (p = 0.002), 2 weeks (p = 0.007) and one month. In conclusion, participants who underwent restorative intervention using titanium dioxide nanoreinforced adhesives reported a notable reduction in sensitivity at all time intervals. Hence, the occurrence and severity of postoperative sensitivity are significantly reduced using Bacillus subtilis-procured nanofortified adhesives as compared to conventional adhesives without nanoparticles., Trial Registration: This trial was retrospectively registered at ClinicalTrials.gov (ID: NCT06242184) on 03/02/2024. All procedures involving human participants were performed in conformance with this protocol., (© 2024. The Author(s).)

Background: Acute pulpitis poses a significant clinical challenge. Traditional root canal treatment has been a standard approach, and the incorporation of adjunctive therapies, such as eugenol cement, presents a potential avenue for enhanced efficacy and reduced complications., Objective: This study aimed to assess the clinical efficacy of root canal treatment combined with eugenol cement for acute pulpitis and its impact on inflammatory factor levels., Design: The study employed a parallel, randomized, controlled, experimental design., Setting: The research was conducted at Suzhou Ninth People's Hospital., Participants: A total of 92 patients diagnosed with acute pulpitis and seeking treatment at our hospital between August 2020 and November 2021 were included in the study., Interventions: Participants were randomly assigned to two groups with 46 patients in each group: the control group receiving traditional root canal treatment and the experimental group receiving root canal treatment combined with eugenol cement., Primary Outcome Measures: The primary outcomes assessed included (1) treatment efficiency, (2) masticatory function, (3) complications, and levels of inflammatory factors., Results: In the study, root canal treatment combined with eugenol cement showed superior efficacy (95.7% vs. 76.1%, P < .05) compared to root canal treatment alone. After one month, both groups exhibited reduced bleeding and gingival indices, with a more significant reduction in the experimental group (P < .05). The combined treatment significantly improved masticatory efficiency and occlusal strength (P < .05). The experimental group had a lower complication rate (6.5% vs. 26.1%, P < .05) and reduced inflammatory markers (IL-6, IL-8, TNF-α, LTB4) compared to the control group (P < .05)., Conclusions: Root canal treatment plus eugenol cement enhances masticatory function, reduces complications and inflammatory response in patients with acute pulpitis, alleviates dental pain and looseness, and mitigates inflammatory responses with fewer adverse effects.

Background: Matrix metalloproteinases (MMPs) are critical enzymes involved in the remodeling and defense mechanisms of dental pulp tissue. While their role in permanent teeth has been extensively studied, research focusing on MMPs in primary teeth remains limited. This gap highlights the need for further investigations to understand the specific contributions of MMPs to pulpal defense in primary teeth. Moreover, the clinical efficacy of Biodentine as a pulpotomy material in primary teeth warrants further exploration through well-designed studies to establish its success and long-term outcomes in pediatric dentistry., Aim: This study aims to compare the expression levels of MMP-2, MMP-8, and MMP-9 in cases of reversible and irreversible pulpitis. Additionally, it seeks to evaluate the clinical success of Mineral Trioxide Aggregate (MTA) and Biodentine when used as pulpotomy agents in primary molars. By analyzing the differential expression of these MMPs, the study will contribute to a better understanding of their role in pulpal inflammation and the potential therapeutic outcomes of MTA and Biodentine in primary molars., Design: In this parallel randomized controlled trial, 63 mandibular primary second molars were assigned to two main groups: Group 1, consisting of 42 teeth diagnosed with reversible pulpitis, and Group 2, consisting of 21 teeth diagnosed with irreversible pulpitis. Group 1 was further divided into two randomized subgroups, each containing 21 teeth. The expression levels of MMP-2, MMP-8, and MMP-9 were evaluated in all samples. Pulpotomy treatments were performed using MTA and Biodentine in Group 1. Clinical and radiographic evaluations were conducted over an 18-month follow-up period. Statistical analyses were carried out using The Kolmogorov-Smirnov test, t-test and Fisher's exact test (p < 0.05)., Results: The study revealed that MMP-2 and MMP-9 expression levels were significantly elevated in specimens with irreversible pulpitis (p = 0.01), indicating a potential correlation between these matrix metalloproteinases and the severity of pulpal inflammation. However, no significant difference was observed in the clinical success rates of pulpotomies performed with MTA and Biodentine, suggesting that both materials are equally effective in the treatment of primary molars with reversible pulpitis., Conclusions: The expression of MMP-2 and MMP-9 in pulpal blood presents a promising biomarker for assessing the degree of pulpal inflammation in primary teeth, offering a potentially valuable diagnostic tool. Additionally, the clinical success of Biodentine in pulpotomy procedures supports its viability as an effective alternative to MTA, providing a reliable option., Clinical Trial Registration Id: The study protocol has been registered with an ID: NCT05145686. Registration Date: 9th November 2021., (© 2024. The Author(s).)

This split-mouth blinded randomized controlled study compared the efficacy of a desensitizing agent with oxalate/resin polymer and a universal adhesive containing mesoporous bioactive glass (MBG) for dentin hypersensitivity (DH) relief, using Schiff sensitivity score (SSS) and visual analog scale (VAS). Split quadrants containing teeth with DH were treated with either MS Coat ONE or Hi-Bond Universal with MBG as the functional additive. Assessments at baseline, immediately post-application, and at 1- and 2-week follow-ups used standardized stimulus protocols (air, cold, and acid). The SSS difference was the primary outcome, while the VAS difference was the secondary outcome. A mixed linear effect model performed statistical analysis. Immediate DH reduction occurred in response to air stimuli, with a significant decrease in Group HB than in Group MS (p = 0.0178). Cold stimulus reduction exhibited a gradual cumulative effect, with consistently greater reductions in Group HB than in Group MS (p ≤ 0.0377). Both groups effectively managed acidic stimuli, with no significant differences (p > 0.05). The VAS scores decreased gradually over the follow-up period (p < 0.0001). This study highlights the differential efficacy of treatments for various DH triggers and recommends specific approaches based on different stimulus types. The universal adhesive containing MBG demonstrated DH relief potential, promising efficacy identical to or superior to that of a dedicated desensitizing agent. Further research exploring the long-term efficacy and underlying mechanisms is warranted. The universal adhesive containing MBG can be adopted as an in-office desensitizing agent for DH relief. The desensitizing efficacy of universal adhesive matches or surpasses dedicated agents for air and cold stimuli., (© 2024. The Author(s).)

Statement of Problem: Dental implants are particularly susceptible to occlusal overloading because, unlike natural teeth, they lack a periodontal ligament to help absorb occlusal forces. However, studies evaluating the impact of different crown and luting materials on the damping behavior and strain distribution of implant-supported crowns are lacking., Purpose: The purpose of this in vitro study was to investigate the damping behavior and strain distribution of peri-implant bone associated with 5 different CAD-CAM implant-supported crowns and 3 luting materials., Material and Methods: A titanium implant was embedded in a plastic tube with epoxy resin and 5 different crown materials (polymethyl methacrylate, resin-infiltrated ceramic, lithium disilicate, titanium, and zirconia) luted to prosthetic abutments with 3 different luting materials (zinc oxide non-eugenol cement, zinc phosphate cement, and adhesive resin cement) and an uncemented condition were tested (n=5). Strain gauges were attached at the crestal and apical levels of the implant model. All specimens were load tested from 0 to 200 N. Slopes of load/time, microstrain/time, and time required to reach the maximum load were examined to represent the damping behavior. Absolute maximum strain (AMS) and its occurrence level were examined to represent the strain distribution. Two-way ANOVA, followed by the Tukey HSD test, were used for statistical analysis (α=.05)., Results: All slopes and times to reach the maximum load in each crown material were statistically similar (P>.05), except for the polymethyl methacrylate group, which showed less steepness in all slopes and more time required to reach the maximum load significantly (P<.05). Both the polymethyl methacrylate group (224.5 ±30.2) and the titanium group (224.0 ±24.3) exhibited significantly higher AMS at the crestal level compared with the resin-infiltrated ceramic group (210.6 ±5.0) (P<.05). The lithium disilicate (218.1 ±15.0) and zirconia groups (217.3 ±14.8) demonstrated comparable AMS values with the others (P>.05). The uncemented group demonstrated steeper slopes and less time required to reach the maximum load compared with the adhesive resin group (P<.05), while slopes and times of the zinc phosphate and zinc oxide non-eugenol groups were comparable (P>.05). The uncemented group (242.7 ±25.3) exhibited significantly higher AMS at the crestal level than the other groups (P<.05)., Conclusions: The crown material significantly affected the damping behavior of peri-implant bone, unlike the luting material. Polymethyl methacrylate with a high damping behavior exhibited high strain at the crestal level. In contrast, resin-modified ceramic with a moderate damping behavior exhibited low strain at the crestal level. Strain at the crestal level could be effectively reduced by approximately 13% through cementation., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to compare the micro-shear bond strength (μSBS) of caries-affected dentin (CAD) and sound dentin (SoD) in primary and permanent teeth using an alternative self-etch application of "no wait" universal adhesive., Methods and Materials: Flat midcoronal dentin surfaces from 72 permanent third molars and 72 second primary molars were distributed randomly into 12 groups according to the substrate SoD and artificially-created CAD (pH cycling for 14 days) and the adhesive system (GLUMA Bond5, a two-step etch & rinse adhesive, GLUMA Bond, a one-step self-etch adhesive, and Tokuyama Universal Bond, a one-step self-etch adhesive) (n=12). Bonded dentin resin discs were put through micro-shear bond strength testing after 10,000 thermocycles. The results were evaluated using two-way ANOVA and the Bonferroni test with a significance level of α = 0.05., Results: When compared to SoD, the etch & rinse system's test results on artificially created CAD showed a statistically significant poorer bonding performance in both permanent and primary teeth in all groups (p<0.05). While the bond strengths of permanent teeth using total-etch adhesive on sound dentin were statistically significantly higher than those using Tokuyama Universal Bond adhesive (p<0.05), there was no significant difference in sound dentin in primary teeth (p>0.05)., Conclusions: The etch & rinse system performed the poorest of all adhesive systems on CAD. The Tokuyama Universal Bond's adhesive strength was similar in SoD and CAD on primary teeth. The use of Tokuyama Universal Adhesives can speed up restorative treatment in pediatric dentistry., (©Operative Dentistry, 2024.)

Aim: The purpose of this study was to evaluate the effectiveness and strength of three various dentin-bonding agents used with adhesives on primary teeth., Materials and Methods: The study used 80 recently extracted, healthy human maxillary anterior primary teeth that had undergone physiologic resorption, or over-retention. Teeth were cut to expose a flat dentin surface at a depth of 1.5 mm. All samples were divided into four groups (20 samples in each group) as follows: Group I-Control group, Group II-Primary teeth bonding with 6th-generation bonding agent, Group III-Primary teeth bonding with 7th-generation bonding agent, Group IV-Primary teeth bonding with 8th-generation bonding agent. All of the samples' dentinal surfaces were covered with composite resin using a Teflon mold after adhesive had been applied. A universal testing machine (INSTRON) was used to assess the shear bond strength. Data were collected and statistically analyzed., Results: The maximum mean shear bond strength was found in 8th-generation bonding agent (30.76 ± 0.16), followed by 7th-generation bonding agent (26.08 ± 0.21), 6th-generation bonding agent (25.32 ± 0.06), and control group (6.18 ± 0.09). Statistically significant difference was found between the three different bonding agents ( p < 0.001)., Conclusion: On conclusion, the 8th-generation bonding agent demonstrated a greater shear bond strength to dentin than the 7th and 6th-generation bonding agent., Clinical Significance: The emergence of different bonding techniques to the market improves the durability and quality of restorations. An effective bonding to the tooth would also reduce bacterial penetration, marginal microleakage, possibility of pulpal inflammation preserve tooth structure, and postoperative sensitivity by allowing less cavity preparation. How to cite this article: Alqarni AS, Al Ghwainem A. Assessment of the Efficacy and Bond Strength of Different Dentin-bonding Agents with Adhesives on Primary Teeth: An In Vitro Study. J Contemp Dent Pract 2024;25(4):342-345.

Purpose: The objective of this multicentre randomised controlled trial was to compare the clinical/radiographic outcomes of cervical pulpotomy using calcium-enriched mixture cement (PCEM) and pulpectomy using Metapex (PM) in primary molars with irreversible pulpitis (IP)., Methods: A total of 134 primary molars from 94 children were randomly assigned to two intervention groups: the PCEM group (n = 74) and the PM group (n = 60). Baseline characteristics including age/gender/molar type/tooth type/jaw were recorded. The primary outcome measures were clinical/radiographic success rates assessed at the first and second follow-up appointments. Secondary outcomes included reasons for clinical/radiographic failures. Multiple logistic regression analysis was performed to determine the impact of various factors on the success rates., Results: The mean age of the participants in both groups was similar (PCEM group: 5.4 years, PM group: 5.5 years). Gender distribution, molar type, tooth type, jaw, and number of practitioners were comparable between the groups. The clinical success rate at the first follow-up was 98.6% in the PCEM group and 96.4% in the PM group. At the second follow-up, the clinical success rate was 97.1% in the PCEM group and 91.1% in the PM group. The radiographic success rates at the first and second follow-up were 98.6% and 96.4% in the PCEM group and 96.4% and 91.1% in the PM group, respectively. Multiple logistic regression analysis did not reveal any significant association between the success rates and age/gender/molar type/jaw, or treatment groups (P > 0.05)., Conclusion: In primary molars with IP, both simple/conservative cervical pulpotomy using calcium-enriched mixture cement and pulpectomy using Metapex demonstrated high clinical/radiographic success rates. No significant differences were observed between the two treatment modalities. These findings suggest that both techniques can be considered effective treatment options for managing primary molars with IP., Trial Registration Number: Trial registration number: IRCT20201226049838N1, retrospectively registered on 12 January 2021., (© 2024. The Author(s), under exclusive licence to European Academy of Paediatric Dentistry.)

Statement of Problem: Even though polyetheretherketone (PEEK) has become popular for various prosthetic indications, a standard adhesive protocol to bond the PEEK to titanium bases has not been yet established. How the heat-pressing technique performs in this respect is also not clear., Purpose: The purpose of this in vitro study was to investigate the effect of an adhesive system-cement combination, the heat-pressing technique, and thermomechanical aging on the retention force between titanium bases and PEEK specimens., Material and Methods: Sixty 9×11×20-mm PEEK specimens with a titanium base slot integrated into the design were milled to simulate an implant-supported PEEK framework for a cantilevered fixed prosthesis. The specimens were assigned to 8 groups (n=10) according to the titanium base primer (MKZ or Monobond) and resin cement (DTK or Multilink hybrid) used and with or without thermomechanical aging. Twenty PEEK specimens were directly heat-pressed on titanium bases, and half of the specimens were not subjected to thermomechanical aging (n=10). For nonaged groups, the PEEK specimen complex was tightened to an implant analog and secured on a custom-made pull-off device. Retention forces were measured by using the pull-off tensile test in a universal testing machine, and the maximum tensile bond strength (MPa) was calculated. The aged groups were subjected to 5000 cycles of thermal aging (5 °C to 55 °C), and the specimens were clamped to load the extension (cantilever) for 1 200 000 cycles with 120 N and 200 N at 1.5-Hz frequency. After aging, the pull-off test was performed for those specimens that survived thermomechanical aging. A nonparametric Kruskal-Wallis test was used to determine whether there was a difference among the groups, followed by pairwise Wilcoxon rank tests with Bonferroni correction. The Wilcoxon rank test was used to analyze the effect of thermomechanical aging in each adhesive system-cement or heat-press group (α=.05 for all tests)., Results: None of the specimens failed during cyclic loading. According to the Kruskal-Wallis test, the effect of the PEEK-Ti base bonding technique on the retention force in the nonaged (P=.019) and thermomechanically aged groups was significant (P=.010). In the nonaged groups, the heat-pressing technique resulted in a higher retention force than when the specimens were bonded by using the Monobond-Multilink hybrid combination (P=.031). Thermomechanical aging did not significantly affect the results (P>.241). All failures were adhesive, with cement remaining only on the Ti-bases., Conclusions: All bonding protocols tested resulted in a stable bond between PEEK and Ti-bases, as all specimens survived thermomechanical aging. The heat-pressing technique resulted in mean bond strength values similar to those obtained with the tested adhesive system-cement combinations with 1 exception; the nonaged heat-pressed groups presented higher bond strength than the Monobond-Multilink hybrid combination. Failure types indicated that the weaker bond was between the PEEK and the cements tested rather than between the titanium base and the cements, regardless of the adhesive system-cement combination., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Although studies have explored the physical and mechanical properties of different composite resins with the preheating technique, evidence that the use of preheated restorative composite resin as a luting agent influences the adaptation of fixed dental prostheses is lacking., Purpose: The purpose of this systematic review was to answer the question: Does the use of preheated restorative composite resin as a luting agent influence the adaptation of fixed dental prostheses?, Material and Methods: Seven databases and nonpeer-reviewed literature were searched, without language or year restrictions. Studies directly comparing the adaptation of fixed dental prostheses cemented with preheated restorative composite resin or resin cement were considered eligible for inclusion. Assessment of the risk of bias was based on a 9-item checklist., Results: Of 2109 retrieved articles, 4 in vitro studies met the inclusion criteria. Three of them concluded that preheated restorative composite resin produced a greater mismatch than resin cement, and the remaining study reported that composite resin improved the adaptation of fixed dental prostheses. All included studies had a medium risk of bias. The high level of heterogeneity among the studies precluded meta-analysis., Conclusions: The use of preheated restorative composite resin as a luting agent seems to negatively influence the adaptation of fixed dental prostheses. It was not possible to evaluate whether variables such as the formulation of the resin material or its heating time and temperature influence the adaptation of fixed dental prostheses because of the high heterogeneity of the included studies., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Aim: This systematic review and network meta-analysis (NMA) aimed to establish a clinically relevant hierarchy of the different adhesive and/or restorative approaches to restore cavitated root caries lesions through the synthesis of available evidence., Materials and Methods: A systematic search was conducted in Medline/Web of Science/Embase/ Cochrane Library/Scopus/grey literature. RCTs investigating ≥2 restorative strategies (restorative /adhesive materials) for root caries lesions in adult patients were included. Risk of bias within studies was assessed (Cochrane&#95;RoB-2) and the primary outcome was survival rate of restorations at different follow-up times (6-/12-/24-months). Network meta-analyses were conducted using a random effects model stratified by follow-up times. I 2 -statistics assessed the ratio of true to total variance in the observed effects. All available combinations of adhesives (1-SE: one-step self-etch; 2-3ER: two-/three-step etch-and-rinse) and restorative materials (conventional composite (CC) as well as conventional and resin-modified glass ionomer cements (GIC, RMGIC)) were included. Risk of bias across studies and confidence in NMA (CINeMA) were assessed., Results: 547 studies were identified and nine were eligible for the NMA. In total, 1263 root caries lesions have been restored in 473 patients in the included clinical trials. Patients involved were either healthy (n = 6 trials), living in nursing homes (n = 1 trial) or received head-and-neck radiotherapy (n = 2 trials). There was statistically weak evidence to favour either of material/material combination regarding the survival rate. A tendency for higher survival rate (24-months) was observed for 2-3ER/CC (OR 24mths 2.65; 95% CI=1.45/4.84) as well as RMGIC (OR 24mths 2.05; 95% CI=1.17/3.61) compared to GIC. These findings were though not statistically significant and confidence of the NMA was low., Conclusion: An evidence-based choice of restorative strategy for managing cavitated root caries lesions is currently impossible. There is a clear need for more standardised, well-designed RCTs evaluating the retention rate of root caries restoration approaches., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Background: The aim of this study is to evaluate the stress distributions of a primary molar tooth restored with a stainless steel crown (SSC) using resin and glass ionomer luting cements by Finite Element Analysis (FEA)., Methods: Original DICOM data of a primary molar was used to create a 3D model. One model was prepared as a tooth model with SSC. A 30 μm cement layer was used in model. Two different luting cements were tested in the study: self-cure adhesive resin cement, and glass ionomer cement. Vertical and oblique loads of 330 N were applied to simulate maximum bite force and lateral forces in the occlusal contact areas of the models. Maximum von Mises stress values in the models were evaluated as MPa., Results: The maximum von Mises stress value was observed in the force application and general occlusal contact areas for all models. The maximum von Mises stress values were higher in the tooth model with SSC using self-cure adhesive resin cement (478.09 MPa and 214.62 MPa) than in the tooth model with SSC using glass ionomer cement (220.06 MPa and 198.72 MPa) in both vertical and oblique loading, respectively., Conclusions: Depending on the magnitude of the bite force on the SSC, fracture of the luting cement materials could occur if the stress exceeds the endurance limit of the luting cement. Cementation with glass ionomer cement may help to reduce stress levels in SSC restorations of primary molars in children., (© 2024. The Author(s).)

Objective: This double-blind, split mouth randomized clinical trial aimed to assess the clinical performance of Clearfil Universal Bond Quick (CBUq) universal adhesive under different application times (no waiting and waiting) compared to Clearfil SE Bond adhesive in non-carious cervical lesions (NCCLs) over 18 months., Methods: One hundred and eighty-three restorations were distributed randomly into three groups based on the adhesive system and waiting time: CUBq without waiting time (CUBq-NW), CUBq with a 20 s waiting time (CUBq-W), and CSE with a 20 s waiting time. After placement, restorations were evaluated after 18 months using the International Dental Federation (FDI) and United States Public Health Service (USPHS) criteria. Statistical analyses involved Friedman repeated measures analysis of variance and Wilcoxon tests, with a significance level set at 5 %., Results: Over the 18-month period, no restorations were lost across the tested groups. Marginal adaptation evaluation indicated minor discrepancies in 21 restorations (8 CUBq-NW, 6 CUBq-W, and 7 CSE). There were no significant differences observed among the three groups following the 18-month clinical assessment (p > 0.05). Only two restorations showed marginal discoloration after 18 months (1 CUBq-NW and 1 CSE)., Conclusions: The application of Clearfil Universal Bond Quick using either the "waiting" or "no-waiting" technique exhibited excellent clinical results in NCCLs during the 18-month follow-up period, demonstrating comparable performance to Clearfil SE Bond in all assessed outcomes., Clinical Significance: The findings suggest that the new universal adhesive applied using the no-waiting technique demonstrates promising clinical performance when compared to conventional application methods., Trial Registration: ClinicalTrials.gov identifer RBR-69p7mpr., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)