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The Journal of Adhesive Dentistry

Edited by Prof. Dr. Roland Frankenberger, Prof. Bart Van Meerbeek

ISSN (print) 1461-5185 • ISSN (online) 1757-9988


January/February 2019
Volume 21 , Issue 1

Pages: 7–26
DOI: 10.3290/j.jad.a41975
Share Abstract:

Bonding Performance of Universal Adhesives: An Updated Systematic Review and Meta-Analysis

Carlos Enrique Cuevas-Suárez / Wellington Luiz de Oliveira da Rosa / Rafael Guerra Lund / Adriana Fernandes da Silva / Evandro Piva

Purpose: To evaluate through a systematic review and meta-analysis whether the immediate and long-term bonding performance of universal adhesives would be improved by prior acid etching.

Materials and Methods: Two reviewers performed a literature search up to April 2018 in eight databases: PubMed, Web of Science, Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BBO. Only studies that evaluated the dentin or enamel bond strength of universal adhesives using a self-etch or etch-and-rinse strategy were included. Analyses were carried out using RevMan 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). A global analysis comparing self-etch or etch-and-rinse strategies and the influence of aging on bonding performance was performed with random-effects models at a significance level of p < 0.05.

Results: A total of 59 in vitro studies were included in the meta-analysis. The enamel bond strength of universal adhesives was improved by the etch-and-rinse approach (p < 0.05). In dentin, this effect was observed for ultra-mild and intermediately strong universal adhesives (p < 0.05). Irrespective of the strategy employed, intermediately strong adhesives showed a decrease in bond strength after all types of aging. This effect was also observed for ultra--mild universal adhesives used in the etch-and-rinse approach (p < 0.05). Mild universal adhesives showed bond strength stability in both strategies (p > 0.05).

Conclusions: The in vitro evidence suggests that bonding performance of mild universal adhesives can be improved by using the selective enamel-etch strategy. Mild universal adhesives seem to be the more stable materials, in both etch-and-rinse or self-etch strategies.

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