Purpose: To evaluate in a randomized clinical evaluation the 3-year clinical durability of a one-step universal adhesive
and compare it intraindividually with a 2-step self-etch adhesive in Class II restorations.
Materials and Methods: Each of 57 participants (mean age 58.3 years) received at least two extended Class II
restorations that were as similar as possible. The cavities in each of the 60 individual pairs of cavities were randomly
distributed to the 1-step universal adhesive (All-Bond Universal: AU) and the control 2-step self-etch adhesive
(Optibond XTR: OX). A low shrinkage composite (Aelite LS) was used for all restorations, which were evaluated
using slightly modified USPHS criteria at baseline and 1, 2, and 3 years.
Results: 114 Class II restorations were evaluated at three years. Eight restorations, 3 AU and 5 OX, failed during
the follow-up, resulting in 94.7% (AU) and 91.2% (OX) success rates (p > 0.05). Annual failure rates were 1.8% and
2.9%, respectively. The main reason for failure was composite fracture.
Conclusion: Class II composite restorations placed with a 1-step universal adhesive showed good short-term efficacy.