COMPARATIVE EVALUATION OF CLINICAL EFFICACY OF VARIOUS ADHESIVE PROTOCOLS

A comparative study of the effectiveness of the "basic adhesive protocol" and the "optimized adhesive protocol" was conducted in clinical conditions. The quality of 320 composite restorations of teeth with the diagnosis of "K02.1 Dentin caries" was assessed: 157 restorations were made using the "basic adhesive protocol" (in accordance with the manufacturer's instructions), 163 restorations - using the "optimized adhesive protocol". Observation periods: 1-2 days, 7-14 days after treatment, 6 months, 12 months, 18 months, 24 months. Higher clinical efficacy of the “optimized adhesive protocol” was established.. The use of the "optimized adhesive protocol" allows to significantly reduce the probability of postoperative sensitivity on the 1-2 (p=0.0066) and 7-14 days after treatment (p=0.013), to achieve better marginal adhesion during long-term observation - after 18 months (p=0.014) and 24 months after treatment (p=0.0057). The tightness of the border of the composite restoration with tooth tissues according to vital staining data is statistically significantly higher when using the "optimized adhesive protocol": long-term observation after 18 months (p=0.002) and 24 months (p=0.0016) shows reliably significant differences between the "basic adhesive protocol" (according to the instructions) and the "optimized adhesive protocol". The absence of recurrent caries and pigmentation is also statistically significant in the comparison group. The "optimized adhesive protocol" is clinically more effective, which is confirmed by the data after 18 months (p=0.036) and 24 months (p=0.0092). The use of the developed "optimized adhesive protocol" allows to extend the "service life" of composite dental restorations and reduce possible negative consequences that arise after aesthetic restoration of teeth with light-cured composite materials using modern adhesive technologies. It should be emphasized that unjustified independent changes in the method of working with the adhesive and violation of the manufacturer's instructions with a high degree of probability can lead to deterioration in the quality of the adhesive bond of the composite with hard tooth tissues, adverse reactions from the pulp and failure of aesthetic restoration of the tooth as a whole.