The purpose of this study was to evaluate the clinical performance of
class 5 restorations according to USPHS criteria. Twenty-five patients
and 116 abrasion/erosion lesions were restored with either a glass-io
nomer cement restoration (Ketac-Fil), a composite resin restoration wi
th a dentin bonding agent (Silux Plus, Scotchbond 2), or a composite r
esin restoration with a dentin bonding agent and a glass-ionomer liner
(Silux Plus, Scotchbond 2, Vitrebond). At 3 years, 24 patients and 11
0 teeth were evaluated. All restorations were rated clinically accepta
ble for color match, cavosurface discoloration, surface texture, and c
aries development. Glass-ionomer cement restorations demonstrated a sl
ightly rougher surface texture than the composite restorations (Friedm
an Two-way ANOVA, P = 0.000). Significant differences were found with
retention (Cochran Q test, P = 0.012). Percentages retained were: glas
s ionomer, 97.3% (36/37); composite/dentin bonding agent, 75.7% (28/37
); composite/dentin bonding agent/glass-ionomer liner, 100% (36/36). A
t 3 years class 5 restorations of glass-ionomer cement or composite wi
th a dentin bonding agent and a glass-ionomer liner demonstrated signi
ficantly better retention than restorations of composite with a dentin
bonding agent. Increased occlusal function, mobility, and mandibular
arch were associated with a decrease in retention rate.