COMPARATIVE EVALUATION OF CLINICAL AND LABORATORY EFFECTIVENESS OF ADHESIVE SYSTEMS USED IN RESTORATIVE DENTISTRY
Abstract
The durability of direct composite restorations is fundamentally dependent on the quality of the hybrid layer formed between the resin and the tooth structure. This article presents a comprehensive study conducted at the Department of Therapeutic Stomatology of Andijan State Medical Institute, designed to bridge the gap between in vitro mechanical testing and in vivo clinical performance. Using the IMRAD framework, the research evaluates three generations of adhesive systems: a three-step etch-and-rinse system, a two-step self-etch system, and a universal adhesive used in self-etch mode. The laboratory phase assessed shear bond strength on dentin substrates, while the clinical phase involved a twelve-month follow-up of non-carious cervical lesions restored with the respective adhesives. The results demonstrate that while etch-and-rinse systems achieve marginally higher bond strengths in the laboratory, universal adhesives exhibit comparable clinical survival rates with significantly reduced postoperative sensitivity. The study concludes that universal adhesives offer an optimal balance of workflow efficiency and clinical reliability for restorative procedures.