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Objectives: To evaluate the influence of the sonic device on the clinical performance of one‐step self‐etch adhesive systems in non‐carious cervical lesions (NCCLs) after 18 months. Materials and methods: Forty patients participated in this study. Eighty restorations were assigned to two groups (n = 40): Sonic application and Manual application. After the adhesive application (iBond Self‐Etch, Kulzer, Hanau, Germany), NCCLs were restored using composite resin (Charisma, Kulzer, Hanau, Germany). The restorations were evaluated at baseline and after 18 months both according to the Word Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Friedman repeated measures analysis of variance by rank and Wilcoxon test for significance in each pair were applied (α = 0.05). Results: After 18 months, 38 patients were evaluated. Twenty‐three restorations were lost (19 for manual vs. 4 for sonic application). The retention rates (95% confidence interval) were 50% (CI 34.8%–65.1%) for manual application and 84.2% (CI 69.6%–92.6%) for sonic application (p < 0.05). Twelve restorations showed marginal staining (nine for manual vs. three for sonic application; FDI, p < 0.05) and nine some marginal discrepancy (seven for manual vs. two for sonic application; FDI, p < 0.05). No restorations showed postoperative sensitivity and caries recurrence at the time. Conclusion: The sonic application increases the retention rate of iBond Self‐Etch after 18 months of clinical evaluation in NCCLs. Clinical relevance: The application of a simplified self‐etch adhesive (iBond Self‐Etch) associated to a sonic device seems to be an alternative to improve the clinical behavior in NCCLs. [ABSTRACT FROM AUTHOR]

Nearly 100 million of the 170 million composite and amalgam restorations placed annually in the United States are replacements for failed restorations. The primary reason both composite and amalgam restorations fail is recurrent decay, for which composite restorations experience a 2.0–3.5‐fold increase compared to amalgam. Recurrent decay is a pernicious problem—the standard treatment is replacement of defective composites with larger restorations that will also fail, initiating a cycle of ever‐larger restorations that can lead to root canals, and eventually, to tooth loss. Unlike amalgam, composite lacks the inherent capability to seal discrepancies at the restorative material/tooth interface. The low‐viscosity adhesive that bonds the composite to the tooth is intended to seal the interface, but the adhesive degrades, which can breach the composite/tooth margin. Bacteria and bacterial by‐products such as acids and enzymes infiltrate the marginal gaps and the composite's inability to increase the interfacial pH facilitates cariogenic and aciduric bacterial outgrowth. Together, these characteristics encourage recurrent decay, pulpal damage, and composite failure. This review article examines key biological and physicochemical interactions involved in the failure of composite restorations and discusses innovative strategies to mitigate the negative effects of pathogens at the adhesive/dentin interface. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2466–2475, 2019. [ABSTRACT FROM AUTHOR]