Bond strength of universal adhesives – etch-and-rinse technique compared to self-etching

Dental adhesives are needed for the adhesion of resin-based filling materials to the tooth. New dental adhesives have evolved over time to provide faster application techniques and to improve chemistry and facilitate stronger binding. The most recent adhesives are called universal adhesive systems. The universal adhesives may be used either as self-etching adhesives or with the etch-and-rinse technique.


Is there any difference in dentin bond strength for universal adhesives using etch-and-rinse or self-etching mode?

We searched three electronic databases. We only included systematic reviews published in English. We identified 105 articles out of which 10 were considered potentially relevant. One person read these in full text. One systematic review was included in the answer. Primary studies published after the systematic review were listed in the answer.

Identified literature

Systematic review:

Included studiesExperimental settingOutcome (no of studies)
Rosa et al 2015 [1]
10 in vitro studies. Extracted teeth.

Universal adhesive used in self-etch and etch-and-rinse mode.

Storage in water for 24 hours before outcome measurement.

Aging by storage 1 year (1 study) or thermocycling (1 study)
Dentin bond strength: Micro-tensile bond strength (7).

Enamel bond strength: Micro-tensile bond strength (2), micro-shear bond strength (2)
Authors' conclusion:
“The enamel bond strength of universal adhesives is improved with prior phosphoric acid etching. However, this effect was not evident for dentin with the use of mild universal adhesives with the etch-and-rinse strategy.”

In vitro-studies published after the literature search date of the systematic review by Rosa et al were listed in the answer [2–26]:

  1. Rosa, W. L., E. Piva and A. F. Silva (2015). "Bond strength of universal adhesives: A systematic review and meta-analysis." J Dent 43(7): 765-776.
  2. Ahn J, Jung KH, Son SA, Hur B, Kwon YH, Park JK. Effect of additional etching and ethanol-wet bonding on the dentin bond strength of one-step self-etch adhesives. Restor Dent Endod 2015;40:68-74.
  3. Chen C, Niu LN, Xie H, Zhang ZY, Zhou LQ, Jiao K, et al. Bonding of universal adhesives to dentine--Old wine in new bottles? J Dent 2015;43:525-36.
  4. Flury S, Peutzfeldt A, Schmidlin PR, Lussi A. Exposed Dentin: Influence of Cleaning Procedures and Simulated Pulpal Pressure on Bond Strength of a Universal Adhesive System. PLoS One 2017;12:e0169680.
  5. Gateva N, Gusiyska A, Stanimirov P, Raychev I, Kabaktchieva R, Author A, et al. Biodegradation and dentin bonding effectiveness of one “universal” selfetch adhesive used in multi-mode manner. Journal of IMAB - Annual Proceeding 2017:1510-1515.
  6. Jang JH, Lee MG, Woo SU, Lee CO, Yi JK, Kim DS. Comparative study of the dentin bond strength of a new universal adhesive. Dent Mater J 2016;35:606-12.
  7. Kim Y, Kim S, Jeong T, Son SA, Kim J. Effects of Additional Acid Etching on the Dentin Bond Strengths of One-Step Self-Etch Adhesives Applied to Primary Teeth. J Esthet Restor Dent 2017;29:110-117.
  8. Leite M, Costa CAS, Duarte RM, Andrade AKM, Soares DG. Bond Strength and Cytotoxicity of a Universal Adhesive According to the Hybridization Strategies to Dentin. Braz Dent J 2018;29:68-75.
  9. Lenzi TL, Raggio DP, Soares FZ, Rocha Rde O. Bonding Performance of a Multimode Adhesive to Artificially-induced Caries-affected Primary Dentin. J Adhes Dent 2015;17:125-31.
  10. Lenzi TL, Soares FZ, Raggio DP, Pereira GK, Rocha RO. Dry-bonding Etch-and-Rinse Strategy Improves Bond Longevity of a Universal Adhesive to Sound and Artificially-induced Caries-affected Primary Dentin. J Adhes Dent 2016;18:475-482.
  11. Lenzi TL, Soares FZM, de Oliveira Rocha R. Does Bonding Approach Influence the Bond Strength of Universal Adhesive to Dentin of Primary Teeth? J Clin Pediatr Dent 2017;41:214-218.
  12. Lezaja Zebic M, Dzeletovic B, Miletic V. Microtensile bond strength of universal adhesives to flat versus Class I cavity dentin with pulpal pressure simulation. J Esthet Restor Dent 2018.
  13. Manfroi FB, Marcondes ML, Somacal DC, Borges GA, Junior LH, Spohr AM. Bond Strength of a Novel One Bottle Multi-mode Adhesive to Human Dentin After Six Months of Storage. Open Dent J 2016;10:268-77.
  14. Michaud PL, Brown M. Effect of universal adhesive etching modes on bond strength to dual-polymerizing composite resins. J Prosthet Dent 2018;119:657-662.
  15. Munoz MA, Luque-Martinez I, Malaquias P, Hass V, Reis A, Campanha NH, et al. In vitro longevity of bonding properties of universal adhesives to dentin. Oper Dent 2015;40:282-92.
  16. Nicoloso GF, Antoniazzi BF, Lenzi TL, Soares FZ, Rocha RO. Is There a Best Protocol to Optimize Bond Strength of a Universal Adhesive to Artificially Induced Caries-affected Primary or Permanent Dentin? J Adhes Dent 2016;18:441-446.
  17. Santos MJM, Costa MD, Rego HMC, Rubo JH, Santos GC, Jr. Effect of surface treatments on the bond strength of self-etching adhesive agents to dentin. Gen Dent 2017;65:e1-e6.
  18. Sezinando A, Luque-Martinez I, Munoz MA, Reis A, Loguercio AD, Perdigao J. Influence of a hydrophobic resin coating on the immediate and 6-month dentin bonding of three universal adhesives. Dent Mater 2015;31:e236-46.
  19. Siqueira FSF, Cardenas AM, Ocampo JB, Hass V, Coelho Bandeca M, Gomes JC, et al. Bonding Performance of Universal Adhesives to Eroded Dentin. J Adhes Dent 2018:1-12.
  20. Sutil B, Susin AH. Dentin pretreatment and adhesive temperature as affecting factors on bond strength of a universal adhesive system. J Appl Oral Sci 2017;25:533-540.
  21. Takamizawa T, Barkmeier WW, Tsujimoto A, Berry TP, Watanabe H, Erickson RL, et al. Influence of different etching modes on bond strength and fatigue strength to dentin using universal adhesive systems. Dent Mater 2016;32:e9-21.
  22. Takamizawa T, Barkmeier WW, Tsujimoto A, Scheidel DD, Erickson RL, Latta MA, et al. Effect of Phosphoric Acid Pre-etching on Fatigue Limits of Self-etching Adhesives. Oper Dent 2015;40:379-95.
  23. Takamizawa T, Barkmeier WW, Tsujimoto A, Suzuki T, Scheidel DD, Erickson RL, et al. Influence of different pre-etching times on fatigue strength of self-etch adhesives to dentin. Eur J Oral Sci 2016;124:210-8.
  24. Thanaratikul B, Santiwong B, Harnirattisai C. Self-etch or etch-and-rinse mode did not affect the microshear bond strength of a universal adhesive to primary dentin. Dent Mater J 2016;35:174-9.
  25. Zenobi W, Feitosa VP, Moura MEM, D'Arcangelo C, Rodrigues LKA, Sauro S. The effect of zoledronate-containing primer on dentin bonding of a universal adhesive. J Mech Behav Biomed Mater 2018;77:199-204.
  26. Zhang ZY, Tian FC, Niu LN, Ochala K, Chen C, Fu BP, et al. Defying ageing: An expectation for dentine bonding with universal adhesives? J Dent 2016;45:43-52.

SBU Enquiry Service consists of systematic literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed. The quality of the studies identified is not systematically reviewed.

Published: 9/24/2018
Contact SBU:
Report no: ut201829
Registration no: SBU 2018/261

Literature search

Project group

Irene Edebert at SBU.

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