Clinical Evaluation of Restorations Following AIr-Abrasive and Rotary Preparation of Carious Cavities After 18 Months of Follow-Up

Introduction. The longevity of composite restorations depends not only on the properties of restorative materials but also on the characteristics of hard dental tissue preparation. Air-abrasive preparation is considered a minimally invasive alternative to conventional rotary preparation; however, its impact on long-term clinical outcomes requires further investigation. Objective. To evaluate the influence of air-abrasive and rotary preparation of carious cavities on the clinical effectiveness of restorations after 18 months of follow-up. Materials and methods. A total of 120 patients aged 31–50 years who received 182 Class I restorations according to Black’s classification were examined. Depending on the preparation protocol and adhesive pretreatment, three groups were formed: conventional rotary preparation with acid etching, air-abrasive preparation without etching, and air-abrasive preparation with etching. After 18 months, 140 restorations were evaluated according to the USPHS criteria. Statistical analysis included Fisher’s exact test and multiple pairwise comparisons with Bonferroni correction. Results. After 18 months, all investigated protocols demonstrated high clinical effectiveness. The proportion of restorations receiving an Alpha rating according to the USPHS criteria ranged from 93.8% to 100%, whereas no Charlie ratings were recorded in any group. The best outcomes were observed in the air-abrasive preparation with etching group. No statistically significant intergroup differences were found according to the USPHS criteria (p > 0.05). Rank analysis demonstrated a high level of agreement between laboratory indicators of the adhesive interface and long-term clinical outcomes of restorations. Conclusions. Air-abrasive preparation combined with acid etching provides a high level of clinical effectiveness of restorations and demonstrates a tendency toward superior outcomes compared with the other investigated protocols. A strong agreement was established between the experimental characteristics of hard dental tissue surfaces and the clinical performance of restorations after 18 months of follow-up.