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  • Research Articles
    Do universal adhesives promote bonding to dentin? A systematic review and meta-analysis
    Ali A. Elkaffas, Hamdi H. H. Hamama, Salah H. Mahmoud
    Restor Dent Endod 2018;43(3):e29.   Published online June 18, 2018
    DOI: https://doi.org/10.5395/rde.2018.43.e29
    AbstractAbstract PDFPubReaderePub
    Objectives

    The aims of this study were to conduct a systematic review of the microtensile bond strength (µTBS) of multi-mode adhesives to dentin and to perform a meta-analysis to assess the significance of differences in the µTBS of one of the most commonly used universal adhesives (Scotchbond Universal, 3M ESPE) depending on whether the etch-and-rinse or self-etch mode was used.

    Materials and Methods

    An electronic search was performed of MEDLINE/PubMed, ScienceDirect, and EBSCOhost. Laboratory studies that evaluated the µTBS of multi-mode adhesives to dentin using either the etch-and-rinse or self-etch mode were selected. A meta-analysis was conducted of the reviewed studies to quantify the differences in the µTBS of Scotchbond Universal adhesive.

    Results

    Only 10 studies fulfilled the inclusion criteria for the systematic review. Extensive variation was found in the restorative materials, testing methodologies, and failure mode in the reviewed articles. Furthermore, variation was also observed in the dimensions of the microtensile testing beams. The meta-analysis showed no statistically significant difference between the etch-and-rinse and self-etch modes for Scotchbond Universal adhesive (p > 0.05).

    Conclusions

    Multi-mode ‘universal’ adhesives can achieve substantial bonding to dentin, regardless of the used modes (either etch-and-rinse or self-etch).

    Citations

    Citations to this article as recorded by  
    • Influence of Proximal-Cervical Undermined Enamel Areas on Marginal Quality and Enamel Integrity of Laboratory and CAD/CAM Ceramic Inlays and Partial Crowns
      Roland Frankenberger, Katharina Friedrich, Marie-Christine Dudek, Julia Winter, Norbert Krämer, Matthias J. Roggendorf
      Journal of Functional Biomaterials.2025; 16(3): 82.     CrossRef
    • Improving Bonding Protocols: The Effect of Selective Dentin Etching with Two Different Universal Adhesives—An In Vitro Study
      Sandro Ferreira, Tiago Rodrigues, Mariana Nunes, Ana Mano Azul, José João Mendes, Ana Filipa Chasqueira, Joana Costa
      Polymers.2025; 17(9): 1215.     CrossRef
    • Effect of surface treatment on glass ionomers in sandwich restorations: a systematic review and meta-analysis of laboratory studies
      Hoda S. Ismail, Ashraf Ibrahim Ali, Franklin Garcia-Godoy
      Restorative Dentistry & Endodontics.2025; 50(2): e13.     CrossRef
    • Tooth-composite bond failure with a universal and an etch-and-rinse adhesive depending on mode and frequency of application
      Ellen Schulz-Kornas, Mathilde Tittel, Hartmut Schneider, Maximilian Bemmann, Marco Pellino, Tobias Meissner, Florian Fuchs, Christian Hannig, Florian Tetschke, Kyung-Jin Park, Michaela Strumpski, Rainer Haak
      Dental Materials.2024; 40(2): 359.     CrossRef
    • Comparison of postoperative hypersensitivity between Total-etch and Universal adhesive system: a randomized clinical trial
      Kiran Javed, Nouman Noor, Muhammad Zubair Nasir, Manzoor Ahmed Manzoor
      Scientific Reports.2024;[Epub]     CrossRef
    • Adhesion and sealing of different universal adhesive systems associated with bulk‐fill resins after using endodontic irrigation solutions: An in vitro study
      Érika Mayumi Omoto, Anderson Catelan, Paulo Henrique dos Santos, Luciano Tavares Angelo Cintra, Fernanda de Souza e Silva Ramos, Caio César Pavani, André Luiz Fraga Briso, Ticiane Cestari Fagundes
      Australian Endodontic Journal.2024; 50(2): 309.     CrossRef
    • Evaluation of the effects of combined application of dimethylaminohexadecyl methacrylate and MDP on dentin bonding and antimicrobial properties
      Jiadi Shen, Ming Ma, Yun Huang, Haochen Miao, Xin Wei
      Journal of Materials Science.2023; 58(31): 12685.     CrossRef
    • Efficacy of adhesive strategies for restorative dentistry: A systematic review and network meta-analysis of double-blind randomized controlled trials over 12 months of follow-up
      Kevin Sheng-Kai Ma, Li-Tzu Wang, Markus B. Blatz
      Journal of Prosthodontic Research.2023; 67(1): 35.     CrossRef
    • Impact of Preceded Tumor Therapeutic Irradiation on the Microtensile Bond Strength of Universal Adhesives Applied in Self-Etch Mode to Human Dentin In Vitro
      Sina Broscheit, Dirk Vordermark, Reinhard Gerlach, Christian Ralf Gernhardt
      Applied Sciences.2023; 13(13): 7873.     CrossRef
    • Effect of the Adhesive Strategy on Clinical Performance and Marginal Integrity of a Universal Adhesive in Non-Carious Cervical Lesions in a Randomized 36-Month Study
      Rainer Haak, Gesa Stache, Hartmut Schneider, Matthias Häfer, Gerhard Schmalz, Ellen Schulz-Kornas
      Journal of Clinical Medicine.2023; 12(18): 5776.     CrossRef
    • Universal Adhesives in Clinical Dentistry
      Fusun Ozer, Shilpa Patnaikuni
      Science, Art and Religion.2023; 2(1--2): 6.     CrossRef
    • Deep proximal margin rebuilding with direct esthetic restorations: a systematic review of marginal adaptation and bond strength
      Hoda S. Ismail, Ashraf I. Ali, Rabab El. Mehesen, Jelena Juloski, Franklin Garcia-Godoy, Salah H. Mahmoud
      Restorative Dentistry & Endodontics.2022;[Epub]     CrossRef
    • Improving Properties of an Experimental Universal Adhesive by Adding a Multifunctional Dendrimer (G-IEMA): Bond Strength and Nanoleakage Evaluation
      Joana Vasconcelos e Cruz, António H. S. Delgado, Samuel Félix, José Brito, Luísa Gonçalves, Mário Polido
      Polymers.2022; 14(7): 1462.     CrossRef
    • Scoping review of trials evaluating adhesive strategies in pediatric dentistry: where do simplified strategies lie?
      António H. S. Delgado, Hasan Jamal, Anne Young, Paul Ashley
      BMC Oral Health.2021;[Epub]     CrossRef
    • Does acid etching prior to applying universal adhesives affect the bond strength of glass fiber post to root dentin?
      Helder Callegaro Velho, Eduardo Trindade Dalence, Pablo Soares Machado, Marília Pivetta Rippe, Jovito Adiel Skupien, Vinícius Felipe Wandscher
      International Journal of Adhesion and Adhesives.2021; 105: 102795.     CrossRef
    • Does Adhesive Layer Thickness and Tag Length Influence Short/Long-Term Bond Strength of Universal Adhesive Systems? An In-Vitro Study
      Naji Kharouf, Tarek Ashi, Ammar Eid, Levi Maguina, Jihed Zghal, Nairy Sekayan, Rim Bourgi, Louis Hardan, Salvatore Sauro, Youssef Haikel, Davide Mancino
      Applied Sciences.2021; 11(6): 2635.     CrossRef
    • Chronological history and current advancements of dental adhesive systems development: a narrative review
      Maicon Sebold, Carolina Bosso André, Beatriz Ometto Sahadi, Lorenzo Breschi, Marcelo Giannini
      Journal of Adhesion Science and Technology.2021; 35(18): 1941.     CrossRef
    • Laboratory methods for measuring adhesive bond strength between restoration materials and hard tooth tissues
      I.Ya. Poyurovskaya, A.P. Polikarpova, F.S. Rusanov
      Stomatologiya.2021; 100(5): 88.     CrossRef
    • Effect of Curcumin Suspension and Vitamin C on Dentin Shear Bond Strength and Durability. A Pilot Study
      Dalia A. Abuelenain, Ensanya A. Abou Neel, Tariq S. Abuhaimed, Amal M. Alamri, Hanan S. Ammar, Sahar M. N. Bukhary
      The Open Dentistry Journal.2021; 15(1): 540.     CrossRef
    • Effect of 9.3 μm CO2 and 2.94 μm Er:YAG Laser vs. Bur Preparations on Marginal Adaptation in Enamel and Dentin of Mixed Class V Cavities Restored With Different Restorative Systems
      Clara Isabel Anton y Otero, Enrico Di Bella, Ivo Krejci, Tissiana Bortolotto
      Frontiers in Dental Medicine.2021;[Epub]     CrossRef
    • Adhesion strategy and curing mode of a universal adhesive influence the bonding of dual-cured core build-up resin composite to dentin
      Ahmed Eid Elsayed, Mohamed Amr Kamel, Farid Sabry El-Askary
      Journal of Adhesion Science and Technology.2021; 35(1): 52.     CrossRef
    • Influence of etching mode and composite resin type on bond strength to dentin using universal adhesive system
      Stefan Dačić, Milan Miljković, Aleksandar Mitić, Goran Radenković, Marija Anđelković‐Apostolović, Milica Jovanović
      Microscopy Research and Technique.2021; 84(6): 1212.     CrossRef
    • Universal adhesives - a new direction in the development of adhesive systems
      A. Tichý, K. Hosaka, J. Tagami
      Česká stomatologie a praktické zubní lékařství.2020; 120(1): 4.     CrossRef
    • Effect of Over-Etching and Prolonged Application Time of a Universal Adhesive on Dentin Bond Strength
      Phoebe Burrer, Hoang Dang, Matej Par, Thomas Attin, Tobias T. Tauböck
      Polymers.2020; 12(12): 2902.     CrossRef
    • Profile of a 10-MDP-based universal adhesive system associated with chlorhexidine: Dentin bond strength and in situ zymography performance
      Marina Ciccone Giacomini, Polliana Mendes Candia Scaffa, Rafael Simões Gonçalves, Giovanna Speranza Zabeu, Cristina de Mattos Pimenta Vidal, Marcela Rocha de Oliveira Carrilho, Heitor Marques Honório, Linda Wang
      Journal of the Mechanical Behavior of Biomedical Materials.2020; 110: 103925.     CrossRef
    • Universal dental adhesives: Current status, laboratory testing, and clinical performance
      Sanket Nagarkar, Nicole Theis‐Mahon, Jorge Perdigão
      Journal of Biomedical Materials Research Part B: Applied Biomaterials.2019; 107(6): 2121.     CrossRef
    • Modifying Adhesive Materials to Improve the Longevity of Resinous Restorations
      Wen Zhou, Shiyu Liu, Xuedong Zhou, Matthias Hannig, Stefan Rupf, Jin Feng, Xian Peng, Lei Cheng
      International Journal of Molecular Sciences.2019; 20(3): 723.     CrossRef
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    • 27 Crossref
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    Effect of smear layer deproteinization on bonding of self-etch adhesives to dentin: a systematic review and meta-analysis
    Khaldoan H. Alshaikh, Hamdi H. H. Hamama, Salah H. Mahmoud
    Restor Dent Endod 2018;43(2):e14.   Published online March 6, 2018
    DOI: https://doi.org/10.5395/rde.2018.43.e14
    AbstractAbstract PDFPubReaderePub
    Objectives

    The aim of this systematic review was to critically analyze previously published studies of the effects of dentin surface pretreatment with deproteinizing agents on the bonding of self-etch (SE) adhesives to dentin. Additionally, a meta-analysis was conducted to quantify the effects of the above-mentioned surface pretreatment methods on the bonding of SE adhesives to dentin.

    Materials and Methods

    An electronic search was performed using the following databases: Scopus, PubMed and ScienceDirect. The online search was performed using the following keywords: ‘dentin’ or ‘hypochlorous acid’ or ‘sodium hypochlorite’ and ‘self-etch adhesive.’ The following categories were excluded during the assessment process: non-English articles, randomized clinical trials, case reports, animal studies, and review articles. The reviewed studies were subjected to meta-analysis to quantify the effect of the application time and concentration of sodium hypochlorite (NaOCl) and hypochlorous acid (HOCl) deproteinizing agents on bonding to dentin.

    Results

    Only 9 laboratory studies fit the inclusion criteria of this systematic review. The results of the meta-analysis revealed that the pooled average microtensile bond strength values to dentin pre-treated with deproteinizing agents (15.71 MPa) was significantly lower than those of the non-treated control group (20.94 MPa).

    Conclusions

    In light of the currently available scientific evidence, dentin surface pretreatment with deproteinizing agents does not enhance the bonding of SE adhesives to dentin. The HOCl deproteinizing agent exhibited minimal adverse effects on bonding to dentin in comparison with NaOCl solutions.

    Citations

    Citations to this article as recorded by  
    • Evaluating the remnants of Al 2 O 3 particles on different dentine substrate after sandblasting and various cleaning protocols
      Faeze Hamze, Khotan Aflatoonian, Mahshid Mohammadibassir, Mohammad-Bagher Rezvani
      Journal of Adhesion Science and Technology.2025; 39(6): 869.     CrossRef
    • Preservation Strategies for Interfacial Integrity in Restorative Dentistry: A Non-Comprehensive Literature Review
      Carmem S. Pfeifer, Fernanda S. Lucena, Fernanda M. Tsuzuki
      Journal of Functional Biomaterials.2025; 16(2): 42.     CrossRef
    • Outcome of Er, Cr:YSGG laser and antioxidant pretreatments on bonding quality to caries-induced dentin
      Lamiaa M. Moharam, Haidy N. Salem, Ahmed Abdou, Rasha H. Afifi
      BMC Oral Health.2025;[Epub]     CrossRef
    • Advancing Adhesive Strategies for Endodontically Treated Teeth—Part II: Dentin Sealing Before Irrigation Increases Long‐Term Microtensile Bond Strength to Coronal Dentin
      Joana A. Marques, Rui I. Falacho, Gabriela Almeida, Francisco Caramelo, João Miguel Santos, João Rocha, Markus B. Blatz, João Carlos Ramos, Paulo J. Palma
      Journal of Esthetic and Restorative Dentistry.2025; 37(7): 1865.     CrossRef
    • A comparison of different cleaning approaches for blood contamination after curing universal adhesives on the dentine surface
      Ting Liu, Haifeng Xie, Chen Chen
      Dental Materials.2024; 40(11): 1786.     CrossRef
    • Effect of fiber-reinforced direct restorative materials on the fracture resistance of endodontically treated mandibular molars restored with a conservative endodontic cavity design
      Merve Nezir, Beyza Arslandaş Dinçtürk, Ceyda Sarı, Cemile Kedici Alp, Hanife Altınışık
      Clinical Oral Investigations.2024;[Epub]     CrossRef
    • Effect of the use of bromelain associated with bioactive glass-ceramic on dentin/adhesive interface
      Rocio Geng Vivanco, Ana Beatriz Silva Sousa, Viviane de de Cássia Oliveira, Mário Alexandre Coelho Sinhoreti, Fernanda de Carvalho Panzeri Pires-de-Souza
      Clinical Oral Investigations.2024;[Epub]     CrossRef
    • Experimental and Chitosan-Infused Adhesive with Dentin Pretreated with Femtosecond Laser, Methylene Blue-Activated Low-Level Laser, and Phosphoric Acid
      Fahad Alkhudhairy
      Photobiomodulation, Photomedicine, and Laser Surgery.2024; 42(10): 634.     CrossRef
    • Evaluation of Effective Bond Strength of Composite Resin to Etched Dentin after Dentin Pretreatment: An In-vitro Study
      Muhammed Bilal, Shiraz Pasha, Arathi S. Nair
      Journal of the Scientific Society.2024; 51(4): 545.     CrossRef
    • Comparison of Different Dentin Deproteinizing Agents on Bond Strength and Microleakage of Universal Adhesive to Dentin
      Fatih Bedir, Gül Yıldız Telatar
      Journal of Advanced Oral Research.2023; 14(1): 44.     CrossRef
    • Addition of metal chlorides to a HOCl conditioner can enhance bond strength to smear layer deproteinized dentin
      Kittisak Sanon, Antonin Tichy, Takashi Hatayama, Ornnicha Thanatvarakorn, Taweesak Prasansuttiporn, Takahiro Wada, Yasushi Shimada, Keiichi Hosaka, Masatoshi Nakajima
      Dental Materials.2022; 38(8): 1235.     CrossRef
    • Internal and Marginal Adaptation of Adhesive Resin Cements Used for Luting Inlay Restorations: An In Vitro Micro-CT Study
      Linah M. Ashy, Hanadi Marghalani
      Materials.2022; 15(17): 6161.     CrossRef
    • Collagen-depletion strategies in dentin as alternatives to the hybrid layer concept and their effect on bond strength: a systematic review
      António H. S. Delgado, Madalena Belmar Da Costa, Mário Cruz Polido, Ana Mano Azul, Salvatore Sauro
      Scientific Reports.2022;[Epub]     CrossRef
    • NaOCl Application after Acid Etching and Retention of Cervical Restorations: A 3-Year Randomized Clinical Trial
      M Favetti, T Schroeder, AF Montagner, RR Moraes, T Pereira-Cenci, MS Cenci
      Operative Dentistry.2022; 47(3): 268.     CrossRef
    • Resin infiltrant protects deproteinized dentin against erosive and abrasive wear
      Ana Theresa Queiroz de Albuquerque, Bruna Oliveira Bezerra, Isabelly de Carvalho Leal, Maria Denise Rodrigues de Moraes, Mary Anne S. Melo, Vanara Florêncio Passos
      Restorative Dentistry & Endodontics.2022;[Epub]     CrossRef
    • Bis[2-(Methacryloyloxy) Ethyl] Phosphate as a Primer for Enamel and Dentine
      R. Alkattan, G. Koller, S. Banerji, S. Deb
      Journal of Dental Research.2021; 100(10): 1081.     CrossRef
    • Influence of Dentine Pre-Treatment by Sandblasting with Aluminum Oxide in Adhesive Restorations. An In Vitro Study
      Bruna Sinjari, Manlio Santilli, Gianmaria D’Addazio, Imena Rexhepi, Alessia Gigante, Sergio Caputi, Tonino Traini
      Materials.2020; 13(13): 3026.     CrossRef
    • A novel prime-&-rinse mode using MDP and MMPs inhibitors improves the dentin bond durability of self-etch adhesive
      Jingqiu Xu, Mingxing Li, Wenting Wang, Zhifang Wu, Chaoyang Wang, Xiaoting Jin, Ling Zhang, Wenxiang Jiang, Baiping Fu
      Journal of the Mechanical Behavior of Biomedical Materials.2020; 104: 103698.     CrossRef
    • The effects of deproteinization and primer treatment on microtensile bond strength of self-adhesive resin cement to dentin
      In-Hye Bae, Sung-Ae Son, Jeong-Kil Park
      Korean Journal of Dental Materials.2019; 46(2): 99.     CrossRef
    • Effect of Papain and Bromelain Enzymes on Shear Bond Strength of Composite to Superficial Dentin in Different Adhesive Systems
      Farahnaz Sharafeddin, Mina Safari
      The Journal of Contemporary Dental Practice.2019; 20(9): 1077.     CrossRef
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    • 20 Crossref
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