Bonding Performance of a Multimode Adhesive to Artificially-induced Caries-affected Primary Dentin. Adhesion of 10-MDP containing resin cements to dentin with and without the etch-and-rinse technique Effect of ferric sulfate contamination on the bonding effectiveness of etch-and-rinse and self-etch adhesives to superficial dentin Experimental and clinical evaluation of a self-etching and an etch-and-rinse adhesive system. Primary dentin etching time, bond strength and ultra-structure characterization of dentin surfaces. Bonding efficacy of etch-and-rinse adhesives after dentin biomodification using ethanol saturation and collagen cross-linker pretreatment Six-month bracket survival with a self-etch adhesive. Effect of phosphoric acid etching prior to self-etching primer application on adhesion of resin composite to enamel and dentin. Bond strength of self-etching primer and total-etch adhesive systems to primary dentin. Effect of acid etching time and technique on interfacial characteristics of the adhesive-dentin bond using differential staining. Bond strength of a mild self-etch adhesive with and without prior acid-etching. SEM qualitative evaluation of four self-etching adhesive systems. A randomized, controlled clinical trial of one-step self-etching adhesive systems in non-carious cervical lesions. In vivo outcomes of indirect pulp treatment using a self-etching primer versus calcium hydroxide over the demineralized dentin in primary molars. Self-etching adhesive on intact enamel, with and without pre-etching. Eighteen-month bracket survival rate: conventional versus self-etch adhesive. Influence of acid etching and enamel beveling on the 6-month clinical performance of a self-etch dentin adhesive.
PURPOSE To investigate the bonding of a new universal adhesive applied using different etching strategies on sound and caries-affected dentin of primary teeth . MATERIAL S AND METHODS Flat dentin surfaces from 50 primary molars were r and omly assigned to 10 groups according to substrate ( sound dentin [ SD ] vs caries-affected dentin [ CAD ] pH cycled for 14 days ) and bonding approach ( Scotchbond Universal Adhesive : self-etching , vs dry or wet-bonding etch- and -rinse strategies ; Adper Single Bond Plus [ two-step etch- and -rinse adhesive ] and Clearfil SE Bond [ two-step self-etching system ] as controls ) . After 24 h of water storage , bonded sticks with cross-sectional areas of 0.8 mm2 were tested for microtensile bond strength ( μTBS ) . Two sticks from each tooth were immersed in silver nitrate solution in order to evaluate nanoleakage ( NL ) with SEM . The μTBS means were analyzed using two-way ANOVA and Tukey 's tests . For NL , the Kruskal-Wallis and Mann-Whitney tests were used ( α = 0.05 ) . RESULTS The influence of the etching strategy on the bonding performance of the universal adhesive was substrate dependent . The self-etching approach result ed in lower μTBS values and higher silver nitrate uptake into hybrid layers for Scotchbond Universal Adhesive on SD , while no difference among experimental groups was observed in CAD . CONCLUSION It is preferable to use the universal adhesive following either a dry- or wet-bonding etch- and -rinse approach on both sound and caries-affected primary dentin PURPOSE This study evaluated the adhesion of 10-MDP containing self-etch and self-adhesive resin cements to dentin with and without the use of etch- and -rinse technique . MATERIAL S AND METHODS Human third molars ( N=180 ) were r and omly divided into 6 groups ( n=30 per group ) . Conventional ( Panavia F2.0 , Kuraray-PAN ) and self-adhesive resin cements ( Clearfil SA , Kuraray-CSA ) were bonded to dentin surfaces either after application of 3-step etch- and -rinse ( 35 % H3PO4 + ED Primer ) or two-step self-etch adhesive resin ( Clearfil SE Bond ) . Specimens were subjected to shear bond strength test using the universal testing machine ( 0.5 mm/min ) . The failure types were analyzed using a stereomicroscope and quality of hybrid layer was observed under a scanning electron microscope . The data ( MPa ) were analyzed using two-way ANOVA and Tukey 's tests ( α=.05 ) . RESULTS Overall , PAN adhesive cement showed significantly higher mean bond strength ( 12.5 ± 2.3 - 14.1 ± 2.4 MPa ) than CSA cement ( 9.3 ± 1.4 - 13.9 ± 1.9 MPa ) ( P<.001 ) . Adhesive failures were more frequent in CSA cement groups when used in conjunction with two-step self-adhesive ( 68 % ) or no adhesive at all ( 66 % ) . Hybrid layer quality was inferior in CSA compared to PAN cement in all conditions . CONCLUSION In clinical situations where bonding to dentin substrate is crucial , both conventional and self-adhesive resin cements based on 10-MDP can benefit from etch- and -rinse technique to achieve better quality of adhesion in the early clinical period Aim : This study investigated the effect of one hemostatic agent on the shear bond strength of  self-etch and etch- and -rinse adhesive systems . Material s and Methods : Sixty extracted third molars were selected . After preparing a flat surface of superficial dentin , they were r and omly divided into six groups . Adhesives were Tetric N-Bond , AdheSE , and AdheSE One F. Before applying adhesives , surfaces were contaminated with ViscoStat for 60 s in three groups and rinsed . Then composite were attached to surfaces and light cured . After thermocycling , the bond strength was calculated and failure modes were determined by stereomicroscope . The data were analyzed by t-test and one-way ANOVA with P < 0.05 as the level of significance . Results : ViscoStat had significantly decreased the shear bond strength of AdheSE ( P < 0.0001 ) to dentin . Modes of failures in all groups were mainly adhesive . Conclusion : Contamination had an adverse effect on the shear bond strength of AdheSE and reduced it PURPOSE To assess the one-step self-etching adhesive iBond Gluma inside ( 1-SE ) and the two-step etch- and rinse adhesive Gluma Comfort Bond ( 2-ER ) , both used in combination with the fine particle hybrid composite Venus , in a laboratory and in a prospect i ve clinical study . MATERIAL S AND METHODS In the in vitro study , tooth-composite interaction , microleakage , and adhesive failure of 8 Class V restorations per system were evaluated by light and scanning electron microscopy . In the in vivo study , 90 paired Class III/IV restorations were scored over 48 months ( modified USPHS criteria ) . Cumulative failure rates ( CFR ) were calculated . RESULTS In vitro , microleakage and adhesive failure at enamel margins were significantly increased with 1-SE in comparison with 2-ER . With 1-SE , micromechanical interlocking at enamel was reduced and pores within the adhesive layer arose . In vivo , after 48 months with 1-SE , decreased marginal integrity and an increased number of dark marginal color lines were observed . CONCLUSION Because the results of the 4-year clinical study showed lower esthetics and marginal integrity for the 1-SE adhesive , its use should be viewed critically , which is in line with the reduced enamel-adhesive-composite interaction found in vitro OBJECTIVES To evaluate the effect of shortening the etching time on roughness , microhardness and bond strength of three adhesive systems to primary tooth dentin . METHODS Flat dentin surfaces from primary molars were r and omly assigned to six experimental groups . Three different adhesive systems were used : an etch- and -rinse adhesive ( Single Bond ) , a two-step self-etching ( Clearfil SE Bond ) , and a one-step self-etching ( One-Up Bond F ) adhesive . In half of the specimens , the recommended etching time was used , in the other half the etching time was 50 % reduced . After applying the adhesive , resin composite build-ups were constructed and stored in a humid environment for 24h at 37 degrees C. Specimens were sectioned into 1mm(2 ) beams and tested for microtensile bond strength ( MTBS ) . Debonded surfaces were analyzed by scanning electron microscopy ( SEM ) . Additional surfaces were conditioned for microhardness measurements ( KHN ) and for atomic force microscopy ( AFM ) analysis . Intertubular and total surface roughness ( Ra ) were recorded . Results were analyzed with ANOVA and Student-Newman-Keuls tests ( P<0.05 ) . RESULTS Single Bond and Clearfil SE Bond showed higher MTBS than One-Up Bond F. Bond strength and intertubular roughness increased when Single Bond and One-Up Bond F were used with a reduced etching time . For Clearfil SE Bond no differences in MTBS were detected when reducing the etching time . The application of phosphoric acid , Clearfil SE Bond primer and One-Up Bond F decreases dentin microhardness . CONCLUSIONS Shortening One-Up Bond F application time and reducing the etching time of phosphoric acid to one-half of the manufacturer 's recommended etching time when using Single Bond are recommended when bonding to primary dentin Aim : To evaluate whether the application of two simplified etch- and -rinse adhesives to biomodified dentin using ethanol-wet bonding ( EWB ) and collagen cross-linker ( CCL ) pretreatment improves their sealing ability . Material s and Methods : In 176 extracted human molars , the pulp-chambers were deroofed , and teeth were sectioned horizontally . Sample s were r and omly divided into eight groups according to four bonding techniques using two simplified etch- and -rinse adhesives ; Adper Single Bond 2 ( ASB ) and XP Bond ( XPB ) . The bonding protocol s included : ( a ) Water-wet bonding ( WWB ) ; ( b ) EWB ; ( c ) WWB and CCL application ; ( d ) EWB and CCL application . After composite resin restorations , dye leakage evaluation and scanning electron microscope analysis were done . Leakage scores were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests at a significance level of P < 0.05 . Result : For both ASB and XPB adhesives , least dye leakage was observed in EWB groups ( b and d ) ( P = 0.918 and P = 0.399 respectively ) which showed no significant difference , while maximum leakage scores were seen in WWB groups ( a and c ) . Regardless of CCL application and adhesives used , EWB technique depicted ( P = 0.003 and P = 0.004 ) significantly greater sealing ability than WWB . Conclusion : Bonding of ASB and XPB using EWB significantly improved their sealing ability . Biomodification using CCL pretreatment had no significant effect on the sealing ability of adhesives bonded with either WWB or EWB OBJECTIVE To evaluate , over a 6-month period , the clinical performance of a self-etch adhesive ( Transbond Plus Self-Etching ) compared with a conventional adhesive that uses the etch and rinse approach ( Transbond XT ) . MATERIAL S AND METHODS One operator , using the straight-wire technique , placed 567 metallic brackets in 30 patients ( age range 12 - 18 years ) such that homologous teeth from the same arch received different material s. The brackets were bonded following the manufacturer 's instruction except for the fact that the self-etch system was brushed for a longer time than recommended ( 10 - 15 seconds ) . The failure modes were visually classified into three modes : adhesive-enamel , adhesive-bracket , and cohesive failure . The survival rate of the brackets was estimated by Kaplan-Meier and log-rank test ( P < .05 ) . RESULTS The failure rates of the conventional and self-etch  [ corrected ] adhesives  were 10.6 % and 7.4 % , respectively . The failure rate of the conventional system was 0.43 [ corrected ] times greater than that of the self-etch system . The self-etch adhesive showed a higher survival rate compared with the conventional system ( P < .05 ) . Most of the failures were cohesive and at the adhesive-enamel surface . No difference in the fracture debonding mode was observed for the material s. CONCLUSIONS These findings indicate that the self-etch Transbond Plus Self-Etching can be safely used for orthodontic brackets because it provides higher survival rates than does the conventional Transbond XT PURPOSE To investigate the effect of phosphoric acid etching prior to the application of self-etching primer on the adhesion of resin composite to tooth substrates . MATERIAL S AND METHODS Bovine teeth were r and omly divided in four groups of 20 sample s each . Tooth surface conditions were as follows : Group 1 : enamel ground with 600-grit SiC paper ; Group 2 : ground enamel was etched with 35 % phosphoric acid gel for 15 seconds , water-rinsed and completely dried ; Group 3 : ground dentin ; Group 4 : dentin etched using the same method as Group 2 . The sample s in each group were divided in two subgroups of 10 each . UniFil Bond ( UB ) and Clearfil SE Bond ( SE ) were applied as adhesive systems with self-etching primers , and a layer of resin composite ( AP-X ) was placed and light-cured for 40 seconds . The tensile bond strengths ( TBS ) were measured and the resin-tooth interfaces were observed with scanning electron microscopy . RESULTS The mean TBS values were 11.2 MPa ( Group 1-UB ) , 14.3 MPa ( Group 1-SE ) , 16.3 MPa ( Group 2-UB ) , 20.5 MPa ( Group 2-SE ) , 13.4 MPa ( Group 3-UB ) , 16.7 MPa ( Group 3-SE ) , 9.3 MPa ( Group 4-UB ) and 12.6 MPa ( Group 4-SE ) . Two-way ANOVA and Scheffe 's F test showed that the enamel etching significantly increased the TBS values but dentin etching significantly decreased the TBS values PURPOSE The objective of this study was to assess in vitro the tensile bond strength of a self-etching and 2 total-etch , single-bottle adhesive systems to primary dentin . METHODS Thirty-six sound primary canine buccal surfaces were r and omly assigned to 3 groups ( N = 12 ) , corresponding to the tested adhesive systems : ( 1 ) group I = Excite ( EX ) ; ( 2 ) group II = Single Bond ( SB ) ; and ( 3 ) group III = Prompt L-Pop ( PLP ) . After 24-hour storage in distilled water , tensile bond strength was tested for failure at a crosshead speed of 0.5 mm/min . RESULTS Means ( MPa ) and st and ard deviation ( + /- ) were : ( 1 ) EX = 12.72 ( + /- .89 ) ; ( 2 ) SB = 10.86 ( + /- 2.09 ) ; ( 3 ) PLP = 8.66 ( + /- 2.23 ) . Single Bond and Excite showed statistically similar results ( P > .05 ) and provided the highest means . Prompt L-Pop was statistically different from the other groups ( P < .05 ) and reached the lower bond strength to primary dentin . CONCLUSIONS Total-etch agents provided the best overall bonding performance , whereas the all-in-one , self-etching , self-priming adhesive system yielded remarkably lower bond strength to primary teeth dentin Dentin bonding using the total-etch method has been cl aim ed to be technique-sensitive . The aim of this study is to examine the effect of acid-etch variations on the dentin demineralization and interfacial structure of the adhesive-dentin bond using a differential staining technique . Single Bond adhesive with 35 % phosphoric acid gel was used . The occlusal one-third of the crown was removed from 60 extracted , unerupted human third molars . Smear layers were created by abrading the dentin with 600 grit SiC under water for 30 s. The prepared teeth were r and omly assigned to four groups according to etching time ( Group 1 , 10 s ; Group 2 , 15 s ; Group 3 , 30 s ; Group 4 , 60 s ) . In each group , the etching gel was : ( i ) applied and spread to the dentin surface and left to st and undisturbed ; ( ii ) applied and gently agitated during etching ; ( iii ) applied without using dispensing tips for the syringe and left for the same period as above . After rinsing , the etched dentin was then treated with the adhesive per manufacturers ' instructions . 3 - 5 micro m thin sections of the adhesive/dentin ( a/d ) interface were cut with a microtome and stained with Goldner 's trichrome . Stained , thin sections from each prepared tooth were imaged with light microscopy . The depth and extent of dentin demineralization , and the a/d interdiffusion zone were clearly visible by this differential staining microtechnique . The thickness of the interdiffusion zone increased as a function of etching time . However , the etchant gel application methods have a significant influence on dentin demineralization . Although agitating acid gel facilitates the penetration and etching into dentin , it should not be recommended , especially for longer etching time . These results indicated that the etching technique has a large effect on the profile of both dentin demineralization and interfacial structure UNLABELLED The self-etch approach provides dentists with a generation of user-friendly and less technique-sensitive adhesives . Nevertheless , some concern has been raised regarding their bonding effectiveness to enamel , in particular when so-called ' mild ' self-etch adhesives are employed . OBJECTIVES The purpose of this study was to test the hypothesis that the two-step self-etch adhesive Clearfil SE Bond ( C-SE ; Kuraray , Osaka , Japan ) bonds equally effective to enamel/dentin either with or without prior etching with phosphoric acid . METHODS Bur-cut enamel/dentin surfaces prepared from human molars were partially split in two halves by cutting a shallow groove . One half was first etched with 40 % phosphoric acid ( K-etchant ) , while protecting the other half by holding a razor blade in the groove . Next , C-SE was applied strictly following the manufacturer 's instructions , after which the surface was built up using Z100 ( 3 M Espe ) . After 24-h water storage , micro-specimens were prepared with the interface circularly constricted using a Micro-Specimen Former , prior to micro-tensile bond strength ( MPa ) measurement . In addition , interfaces of C-SE with enamel/dentin prepared with and without beforeh and acid etching were examined by Feg-SEM and TEM . RESULTS Beforeh and etching significantly increased the bonding effectiveness of C-SE to enamel . A clearly more micro-retentive surface was revealed by TEM and Feg-SEM when enamel was etched . Phosphoric-acid etching prior to C-SE application on dentin significantly decreased the muTBS to dentin . TEM provided indications of a low- quality hybrid layer after beforeh and phosphoric-acid etching . CONCLUSION Using C-SE , additional etching with phosphoric acid to improve bonding effectiveness should be limited to enamel AIM Recently , there has been a tendency to simplify bonding procedures . Current self-etching adhesives combine conditioning , priming and bonding functions thus reducing technique-sensitivity as well as the risk of making errors . Another important advantage of this approach is that it allows the resin to etch and infiltrate the substratum simultaneously thus reducing the risk of any discrepancy between these 2 processes . The aim of this study was to evaluate the bonding quality of 4 self-etching adhesives both on dentin and enamel using SEM analysis . METHODS Twenty caries-free molars were used . The a prisma tic enamel layer was removed from the internal and external slopes of the vestibular cusps using a diamond bur . Each molar was then transversally cut just above the pulp chamber using a diamond saw ( composhave 4255 Intensiv ) thus obtaining twenty coronal fragments and 20 radicular fragments . Radicular and coronal fragments were then r and omly divided into 5 groups . Each group consisted of 8 specimens : 4 coronal and 4 radicular ones . A different adhesive system was used for each group following the manufacturer 's directions . Each group underwent the same treatment : a thin layer of flowable composite was applied and then polymerized . Subsequently , a single 2 mm layer of microhybrid composite was added . The coronal and radicular portions were longitudinally cut to show the ground enamel/adhesive , unground enamel/adhesive and dentine/adhesive interfaces . Eighty specimens were obtained and prepared for SEM observation . Forty specimens with an adhesive/enamel interface and 40 with an adhesive/dentine interface . RESULTS The interfacial exam frequently showed gaps between the substratum and the restoration . The final etching was generally satisfactory on ground enamel , while it was poor on unground enamel . Sometimes gaps were evident at the adhesive interface in dentin specimens . The tested adhesive systems produced a suitable hybrid layer and a lot of resin-tags were present . CONCLUSIONS Self-etching adhesives showed an adequate adhesion to dentin . However , while they provided encouraging results on ground enamel they did not show to be dependable on unground enamel PURPOSE To evaluate the clinical effectiveness of two different one-step self-etching adhesives . METHODS Two single-step self-etching adhesive systems , Clearfil Tri-S Bond and G-Bond , were evaluated . As a control , a two-step self-etching adhesive system , Clearfil SE Bond , was used . The teeth to be restored were r and omly assigned . The resin composite used to restore the teeth was Clearfil AP-X. The three adhesive systems were evaluated by Modified USPHS at baseline , 3 months , 6 months , and 12 months . The evaluation consisted of retention rate , color match , marginal discoloration ( interfacial staining ) , marginal adaptation ( integrity ) , wear , post-operative sensitivity , caries recurrence , and other failures . Changes over time and across groups were evaluated statistically using generalized estimating equations . RESULTS During the 12-month study period , no statistical differences were observed among the three groups ( P > 0.05 ) in retention rate , color match , marginal discoloration ( interfacial staining ) , marginal adaptation ( integrity ) . No wear , post-operative sensitivity , caries recurrence , or other failures were detected in any groups . The two one-step self-etching adhesives tested showed good clinical performance at the end of 12 months OBJECTIVE To evaluate the clinical and radiographic outcomes ( 24 months ) of indirect pulp treatment ( IPT ) in primary teeth when a self-etching primer or a calcium hydroxide layer was used over the remaining carious dentin . STUDY DESIGN Primary molar teeth with deep carious lesions without signs and symptoms of irreversible pulpitis were divided into two groups , according to the capping material : Experimental group ( 1 ) : self-etching adhesive system ( Clearfill SE Bond ) ; and Control group ( 2 ) : calcium hydroxide liner ( Dycal ) . Both groups were followed up after application of a resin restoration ( 3 M - Z250 ) . RESULTS After 2 years of clinical and radiographic follow-up , no statistical difference was found between groups ( p = 1 ) . The overall success rate reached 87 % . CONCLUSION These results demonstrate that IPT has a high clinical and radiographic performance in primary teeth and is not dependent on the capping material used over the demineralized dentin OBJECTIVE Bond strengths of composite resin to enamel using self-etch adhesive ( SEA ) Clearfil SE bond system on intact enamel and enamel pre-etched with phosphoric acid were compared . The objective was to determine if the pre-etching would increase the bond strengths of the SEA systems to intact enamel and to evaluate the effect of pre-etching on bond formation of self-etch adhesives on intact enamel . MATERIAL S AND METHOD Labial surfaces of 40 caries free permanent upper central and lateral incisors were cleaned , sectioned of their roots . All specimens were mounted on acrylic block and divided r and omly into four groups . In two groups the application of self-etch adhesive , Clearfil SE bond was carried as per manufacturer 's instructions , composite cylinders were built , whereas in the other two groups , 37 % phosphoric acid etching was done before the application of self-etching adhesives . Then the resin tags were analyzed using scanning electron microscope and shear bond strength was measured using Instron universal testing machine . RESULTS When phosphoric acid was used , there was significant increase in the depth of penetration of resin tags and in the Shear Bond Strength of composite to enamel . CONCLUSION The results indicate that out of both treatment groups , pre-etching the intact enamel with 37 % phosphoric acid result ed in formation of longer resin tags and higher depth of penetration of resin tags of the Clearfil SE bond , and attaining higher bond strength of the Clearfil SE bond to intact enamel The aim of this study was to evaluate , over an 18-month period , the clinical performance of a self-etch adhesive [ Transbond Plus Self Etching Primer ( SEP ) , 3 M Unitek ] compared with a conventional adhesive that employs the etch- and -rinse approach ( Transbond XT , 3 M Unitek ) . One operator , using the straight-wire technique , bonded 567 metallic brackets to the teeth of 30 patients ( age range 12 - 18 years ) in a way that patients acted as self-control . The brackets were bonded following the manufacturers ' instructions except for the fact that the self-etch system was brushed for a longer time than recommended ( 10 - 15 seconds ) since previous investigations have reported that prolonged application times can improve the bonding efficacy of self-etch systems to enamel . The failure modes were visually classified into : adhesive-enamel , adhesive-bracket , and cohesive failure . The survival rates of the brackets were estimated by Kaplan-Meier and log-rank test ( P < 0.05 ) . The failure rates of the self-etch and conventional adhesives were 15.6 and 17.6 per cent , respectively . No significant differences in the survival rate were observed between the material s ( P > 0.05 ) . Most of the failures were cohesive and at the adhesive-enamel interface . There was no difference in the fracture debonding mode . These findings indicate that Transbond Plus SEP can be safely used for orthodontic brackets since the survival rates are similar to the conventional Transbond XT This study tested the hypothesis that beveling and /or etching enamel does not affect the 6-month clinical performance of the self-etch adhesive Clearfil SE Bond in class V noncarious lesions . With Institutional Review Board approval , 34 patients were enrolled in this study . A total of 120 noncarious cervical lesions were selected and assigned to 4 groups : ( 1 ) Clearfil SE Bond was applied without any cavity preparation ; ( 2 ) After the enamel was beveled , Clearfil SE Bond was applied ; ( 3 ) After the enamel was etched for 15 seconds with 35 % phosphoric acid , Clearfil SE Bond was applied ; ( 4 ) After the enamel was beveled and etched with 35 % phosphoric acid for 15 seconds , Clearfil SE Bond was applied . A microfilled composite resin was used for all restorations . Six months after initial placement , 120 restorations ( a 100 % recall rate ) were re-evaluated . Retention rates at 6 months were 100 % for all groups . Sensitivity to air improved from baseline to 6 months , but the overall difference was not statistically significant . The 6-month retention rate of the self etch dentin adhesive system Clearfil SE Bond was not improved by enamel beveling or by enamel etching . For the self-etch material Clearfil SE Bond , instrumentation or etching of enamel may not be critical for its clinical performance at 6 months
However , for the ultra-mild All-Bond Universal adhesive , the etch- and -rinse strategy was significantly different than the self-etch mode in terms of dentin micro-tensile bond strength , as well as in the global analysis of enamel micro-tensile and micro-shear bond strength ( p≤0.05 ) .
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 .
CLINICAL SIGNIFICANCE Selective enamel etching prior to the application of a mild universal adhesive is an advisable strategy for optimizing bonding
OBJECTIVES A systematic review was conducted to determine whether the etch- and -rinse or self-etching mode is the best protocol for dentin and enamel adhesion by universal adhesives .