Experimental and clinical evaluation of a self-etching and an etch-and-rinse adhesive system. Bonding Performance of a Multimode Adhesive to Artificially-induced Caries-affected Primary Dentin. Effect of a plant-based hemostatic agent on microleakage of self-etching adhesives Effect of ferric sulfate contamination on the bonding effectiveness of etch-and-rinse and self-etch adhesives to superficial dentin Primary dentin etching time, bond strength and ultra-structure characterization of dentin surfaces. Influence of endodontic irrigants on bond strength of a self-etching adhesive. The effect of load cycling on the nanoleakage of dentin bonding systems. Microleakage under orthodontic brackets bonded with different adhesive systems Adhesive performance of dentin bonding agents applied in vivo and in vitro. Effect of intrapulpal pressure and dentin depth. A randomized, controlled clinical trial of one-step self-etching adhesive systems in non-carious cervical lesions. Eight-year randomized clinical evaluation of Class II nanohybrid resin composite restorations bonded with a one-step self-etch or a two-step etch-and-rinse adhesive Effect of adhesive systems and bevel on enamel margin integrity in primary and permanent teeth. Effect of acid etching time and technique on interfacial characteristics of the adhesive-dentin bond using differential staining. Bonding characteristics of self-etching adhesives to intact versus prepared enamel. Four-year clinical evaluation of Class II nano-hybrid resin composite restorations bonded with a one-step self-etch and a two-step etch-and-rinse adhesive. Paucity of Nanolayering in Resin-Dentin Interfaces of MDP-based Adhesives The effect of etching on bacterial microleakage of an adhesive composite restoration.
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 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 Objective : This in vitro study evaluated the effect of Ankaferd Blood Stopper ( ABS ) contamination on the microleakage of one-step and two-step self-etching adhesives . Study design : Class V cavities were prepared at the cemento-enamel junction on both buccal and lingual surfaces of 60 freshly extracted human molars . Teeth were r and omly assigned into three groups according to contamination material applied ( Group I , no contamination ; Group II , blood contamination ; Group III , ABS contamination ) . In contaminated groups , one drop of blood and ABS solution was applied directly to the dentin surface and air-dried . Each group was further divided into two subgroups according to bonding agent used [ Group A , Clearfil SE Bond ( two-step self-etching adhesive ) ; Group B , Adper Easy One ( one-step self-etching adhesive ) ] . Adhesive material s were applied according to the manufacturers ’ recommendations . The specimens were restored using a universal microhybrid composite ( Arabesk ) . After thermocycling ( 5000x , 5 ° C – 55 ° C ) and immersion in a 0.5 % basic fuchsin , dye penetration was evaluated under a stereomicroscope . Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney U tests at p < 0.05 . Results : Significantly higher microleakage scores were observed when one-step self-etching adhesive was applied to blood- and ABS-contaminated dentin . However , when a two-step self etching adhesive was used , microleakage was observed only following blood contamination , not following ABS contamination . Conclusions : Although , blood contamination before adhesive application result ed in increased microleakage with both one-step and two-step self-etching adhesive systems , ABS contamination did not affect microleakage when a two-step self-ething adhesive system was used . Key words : Ankaferd Blood Stopper , blood , microleakage , self-etching adhesive 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 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 The aim of this in vitro study was to evaluate the bond strength of a self-etching adhesive system to dentine irrigated with sodium hypochlorite ( NaOCl ) , chlorhexidine solution ( CX ) and ethylene diamine tetra acetic acid ( EDTA ) by microtensile testing . Sixty human third molars were sectioned 3 mm below the occlusal level and then r and omly divided into six groups : G1(control ) , without irrigant solution ; G2 , 1 % NaOCl ; G3 , 1 % NaOCl followed by the application of 17 % EDTA ; G4 , 2 % CX ; G5 , 2 % CX followed by the application of 17 % EDTA and G6 , 17 % EDTA . The specimens received the self-etching adhesive system were restored with composite resin , then sectioned and trimmed to obtain four hourglass-shaped slabs from each tooth . The specimens were su bmi tted to the microtensile test in a Universal Testing Machine at a crosshead speed of 0.5 mm min(-1 ) until fracture . The results were su bmi tted to statistical analysis by anova /Newman-Keuls . The means and st and ard deviations ( MPa ) were : G1 , 26.88 ( ±3.81 ) ; G2 , 19.08 ( ±3.89 ) ; G3 , 18.16 ( ±2.21 ) ; G4 , 18.14 ( ±4.32 ) ; G5 , 34.30 ( ±3.32 ) ; G6 , 13.61 ( ±1.21 ) . It was concluded that the application of 2 % CX followed by the application of 17 % EDTA result ed in increasing the bond strength of the self-etching adhesive system to dentine , when compared with the results obtained for the other tested groups OBJECTIVES The purpose of this study was to evaluate the effects of load cycling on nanoleakage of occlusal flat surface or cervical restorations bonded with three self-etching priming systems and a single bottle system . METHODS The dentin bonding systems used in this study were Clearfil SE Bond , Unifil Bond , Prompt L-Pop and Single Bond .  Flat occlusal dentin surfaces and cervical cavities from extracted human molars were bonded with one of the dentin bonding systems . After load cycling of 90N for 5000 cycles , sample s were immersed in a 50 % w/v solution of silver nitrate for 24h , and exposed to photodeveloping solution for 8h . Specimens were sectioned , mounted on stubs , carbon-coated and observed in a Field Emission-SEM using backscattered electron mode . One-way ANOVA was used for statistical analysis of the leakage scores . RESULTS FE-SEM images showed that sample s subjected to load cycling had leakage patterns similar to non-load-cycled sample s for all dentin bonding systems . Load cycling did not affect leakage lengths in any system . Prompt L-Pop had greater silver deposition and leakage score than the other systems . SIGNIFICANCE The dentin bonding systems tested were unable to prevent nanoleakage , and the extent of nanoleakage was not increased by load cycling Objective : This in vitro study aim ed to compare the microleakage of orthodontic brackets between enamel-adhesive and adhesive-bracket interfaces at the occlusal and gingival margins bonded with different adhesive systems . Material s and Methods : A total of 144 human maxillary premolar teeth extracted for orthodontic reasons was r and omly divided into four groups . Each group was then further divided into three sub-groups . Three total-etching bonding systems ( Transbond XT , Greengloo and Kurasper F ) , three one-step self-etching bonding systems ( Transbond Plus SEP , Bond Force and Clearfil S3 ) , three two-step self-etching bonding systems ( Clearfil SE Bond , Clearfil Protectbond and Clearfil Liner Bond ) , and three self-adhesive resin cements ( Maxcem Elite , Relyx U 100 and Clearfil SA Cement ) were used to bond the brackets to the teeth . After bonding , all teeth were sealed with nail varnish and stained with 0.5 % basic fuchsine for 24 h. All sample s were sectioned and examined under a stereomicroscope to score for microleakage at the adhesive-enamel and adhesive-bracket interfaces from both occlusal and gingival margins . Statistical Analysis Used : Statistical analyses were performed with Kruskal-Wallis and Wilcoxon signed-rank tests . Results : The results indicate no statistically significant differences between the microleakage scores of the adhesives ; microleakage was detected in all groups . Comparison of the average values of the microleakage scores in the enamel-adhesive and adhesive-bracket interfaces indicated statistically significant differences ( P < 0.05 ) . The amount of the microleakage was higher at the enamel-adhesive interface than at the bracket-adhesive interface . Conclusions : All of the brackets exhibited some amount of microleakage . This result means that microleakage does not depend on the type of adhesive used The purpose of this study was to evaluate the influence of intrapulpal pressure and dentin depth on bond strengths of an etch- and -rinse and a self-etching bonding agent to dentin in vitro and in vivo . Twenty-four pairs of premolars were r and omly divided into four groups ( n = 6 ) according to the dentin bonding agent , Single Bond and Clearfil SE Bond , and intrapulpal pressure , null or positive . Each tooth of the pair was further design ated to be treated in vivo or in vitro . The intrapulpal pressure was controlled in vivo by the delivery of local anesthetics containing or not a vasoconstrictor , while in vitro , it was achieved by keeping the teeth under hydrostatic pressure . Class I cavities were prepared and the dentin bonding agents were applied followed by incremental resin restoration . For the teeth treated in vitro , the same restorative procedures were performed after a 6 month-storage period . Beams with 1 mm(2 ) cross-sectional area were prepared and microtensile tested . Clearfil SE Bond was not influenced by any of the variables of the study , while bond strengths produced in vitro were significantly higher for Single Bond . Overall , lower bond strengths were produced in deep dentin , which reached statistical significance when Single Bond was applied under physiological or simulated intrapulpal pressure . In conclusion , in vitro bonding may overestimate the immediate adhesive performance of more technique-sensitive dentin bonding systems . The impact of intrapulpal pressure on bond strength seems to be more adhesive dependent than dentin morphological characteristics related to depth 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 Objectives The aim of this study is to observe the durability of Class II nanohybrid resin composite restorations  , placed with two different adhesive systems , in an 8-year follow-up . Methods Seventy-eight participants received at r and om at least two Class II restorations of the ormocer-based nanohybrid resin composite ( Ceram X ) bonded with either a one-step self-etch adhesive ( Xeno III ) or a control two-step etch- and -rinse adhesive ( Excite ) . The 165 restorations were evaluated using slightly modified United States Public Health Services ( USPHS ) criteria at baseline and then yearly during 8 years . Results One hundred and fifty-eight restorations were evaluated after 8 years . Three participants with five restorations ( three Xeno III , two Excite ) were registered as dropouts . Twenty-one failed restorations ( 13.3 % ) were observed during the follow-up . Twelve in the one-step self-etch adhesive group ( 13.5 % ) and nine in the two-step etch- and -rinse group ( 13.0 % ) . This result ed in nonsignificant different annual failure rates of 1.69 and 1.63 % , respectively . Fracture of restoration was the main reason for failure . Conclusion Good clinical performance was shown during the 8-year evaluation and no significant difference in overall clinical performance between the two adhesives . Fracture was the main reason for failure . Clinical relevance The one-step self-etch adhesive showed a good long-term clinical effectiveness in combination with the nanohybrid resin composite in Class II restorations PURPOSE This study compared the effectiveness of self-etch and total-etch adhesive systems in bonding to the beveled and nonbeveled margins of primary and permanent teeth . METHODS This in vitro , factorial- design ed study allowed evaluation of 3 factors : ( 1 ) tooth type ; ( 2 ) presence of a bevel ; and ( 3 ) adhesive type . Two preparations , each including a beveled and nonbeveled margin , were completed on buccal surfaces of 60 extracted molars ( 30 primary and 30 permanent ) . Preparations were r and omly assigned to self-etch or a total-etch adhesive system and restored with resin composite . After thermocycling , teeth were stained with silver nitrate , sectioned , and measured for microleakage . Statistical analysis used a repeated measures analysis of variance . RESULTS Beveled margins had less microleakage than nonbeveled margins for primary and permanent teeth ( P < .001 ) . Total-etch had less microleakage than self-etch adhesives on primary ( 53 % less , P < .001 ) and on permanent teeth ( 22 % less , P = .01 ) . Self-etch had considerably more microleakage when enamel margins were not beveled . Comparably less microleakage , however , was found for total-etch and self-etch in restorations with beveled margins . CONCLUSIONS Total-etch adhesive and beveled margins result ed in the least microleakage . Margin beveling has a greater effect in minimizing microleakage than the type of adhesive used 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 PURPOSE This study tested the null hypothesis that the preparation of the enamel surface would not affect the enamel microtensile bond strengths of self-etching adhesive material s. MATERIAL S AND METHODS Ten bovine incisors were trimmed with a diamond saw to obtain a squared enamel surface with an area of 8 x 8 mm . The specimens were r and omly assigned to five adhesives : ( 1 ) ABF ( Kuraray ) , an experimental two-bottle self-etching adhesive ; ( 2 ) Clearfil SE Bond ( Kuraray ) , a two-bottle self-etching adhesive ; ( 3 ) One-Up Bond F ( Tokuyama ) , an all-in-one adhesive ; ( 4 ) Prompt L-Pop ( 3 M ESPE ) , an all-in-one adhesive ; and ( 5 ) Single Bond ( 3 M ESPE ) , a two-bottle total-etch adhesive used as positive control . For each specimen , one half was roughened with a diamond bur for 5 seconds under water spray , whereas the other half was left unprepared . The adhesives were applied as per manufacturers ' directions . A universal hybrid composite resin ( Filtek Z250 , 3 M ESPE ) was inserted in three layers of 1.5 mm each and light-cured . Specimens were sectioned in X and Y directions to obtain bonded sticks with a cross-sectional area of 0.8 + /- 0.2 mm2 . Sticks were tested in tension in an Instron at a cross-speed of 1 mm per minute . Statistical analysis was carried out with two-way analysis of variance and Duncan 's test at p < .05 . Ten extra specimens were processed for observation under a field-emission scanning electron microscope . RESULTS Single Bond , the total-etch adhesive , result ed in statistically higher microtensile bond strength than any of the other adhesives regardless of the enamel preparation ( unprepared = 31.5 MPa ; prepared = 34.9 MPa , not statistically different at p < .05 ) . All the self-etching adhesives result ed in higher microtensile bond strength when enamel was roughened than when enamel was left unprepared . However , for ABF and for Clearfil SE Bond this difference was not statistically significant at p > .05 . When applied to ground enamel , mean bond strengths of Prompt L-Pop were not statistically different from those of Clearfil SE Bond and ABF . One-Up Bond F did not bond to unprepared enamel . Commercial self-etching adhesives performed better on prepared enamel than on unprepared enamel . The field-emission scanning electron microscope revealed a deep inter prisma tic etching pattern for the total-etch adhesive , whereas the self-etching systems result ed in an etching pattern ranging from absent to moderate OBJECTIVE The objective of this prospect i ve clinical trial was to evaluate the 4-year clinical performance of an ormocer-based nano-hybrid resin composite ( Ceram X ; Dentsply/DeTrey ) in Class II restorations placed with a one-step self-etch ( Xeno III ; Dentsply/DeTrey ) and two-step etch- and -rinse adhesive ( Ivoclar Vivadent ) . METHODS Seventy-eight participants received at r and om at least two , as similar as possible , Class II restorations of the nano-hybrid resin composite bonded with either a single step self-etch adhesive or a control 2-step etch- and -rinse adhesive . The 165 restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 4 years . RESULTS 162 restorations were evaluated at 4 years . Postoperative sensitivity was observed in 6 patients ( 3 Xeno III , 3 Exite ) between 1 and 3 weeks . Eleven failed restorations ( 6.8 % ) were observed during the follow up . Seven in the one-step self-etch adhesive group ( 7.7 % ) and four in the 2-step etch- and -rinse group ( 5.6 % ) . This result ed in non-significant different annual failure rates of 1.9 % and 1.4 % , respectively . Fracture of restoration was the main reason for failure . CONCLUSION The ormocer-based nano-hybrid resin composite showed a good clinical performance in Class II cavities during the 4 year evaluation . No significant difference was seen in overall clinical effectiveness between the two adhesives Self-assembled nanolayering structures have been reported in resin-dentin interfaces created by adhesives that contain 10-methacryloyloxydecyl dihydrogen phosphate ( 10-MDP ) . These structures have been hypothesized to contribute to bond durability . The objective of the present study was to determine the extent of nanolayering in resin-dentin interfaces after application of commercialized  10-MDP-containing self-etch and universal adhesives to human dentin . Seven commercialized adhesives were examined :  Adhese Universal ( Ivoclar-Vivadent ) , All-Bond Universal ( Bisco , Inc. ) , Clearfil SE Bond 2 , Clearfil S3 Bond Plus , Clearfil Universal Bond ( all from Kuraray Noritake Dental Inc. ) , G-Premio Bond ( GC Corp. ) , and Scotchbond Universal ( 3 M ESPE ) . Each adhesive was applied in the self-etch mode on midcoronal dentin according to the respective manufacturer ’s instructions . Bonded specimens ( n = 6 ) were covered with flowable resin composite , processed for transmission electron microscopy , and examined at 30 r and om sites without staining . Thin-film glancing angle X-ray diffraction ( XRD ) was used to detect the characteristic peaks exhibited by nanolayering ( n = 4 ) . The control consisted of 15%wt , 10%wt , and 5%wt 10-MDP ( DM Healthcare Products , Inc. ) dissolved in a mixed solvent ( ethanol and water weight ratio 9:8 , with photoinitiators ) . Experimental primers were applied to dentin for 20 s , covered with hydrophobic resin layer , and examined in the same manner . Profuse nanolayering with highly ordered periodicity ( ~3.7 nm wide ) was observed adjacent to partially dissolved apatite crystallites in dentin treated with the 15 % 10-MDP primer . Three peaks in the 2θ range of 2.40 ° ( 3.68 nm ) , 4.78 ° ( 1.85 nm ) , and 7.18 ° ( 1.23 nm ) were identified from thin-film XRD . Reduction in the extent of nanolayering was observed in the 10 % and 5 % 10-MDP experimental primer-dentin interface along with lower intensity XRD peaks . Nanolayering and characteristic XRD peaks were rarely observed in specimens prepared from the commercialized adhesives . The sparsity of nanolayering in resin-dentin interfaces created by commercialized adhesives challenges its clinical effectiveness as a mechanism for improving bond longevity in dentin bonding OBJECTIVES The incidence of bacterial microleakage , pulp inflammation and necrosis associated with dentine etching treatments prior to restoration are not known . Consequently , to resolve some of the controversy surrounding the effects and importance of vital dentine etching , the authors investigated these factors . METHODS 110 st and ardised class V cavities were cut into buccal dentine , without exposing the pulp of teeth scheduled for extraction for orthodontic reasons . Cavities were either left unetched , or etched with the non-equivalent treatments of phosphoric acid gel for 60s or Ethylenediaminetetraacetic acid ( EDTA ) for 30s , prior to placement of composite resin . Teeth were collected and pulp responses were evaluated according to ISO guidelines , using pathohistomorphometric analysis and ANOVA statistics . RESULTS Etching was found to be correlated to bacterial microleakage ( p=0.0001 ) and tertiary dentine formation ( p=0.0023 ) . Bacterial microleakage was correlated to inflammatory activity ( p=0.0001 ) . The frequency of bacterial microleakage was : no etching ( 65 % ) , EDTA ( 51 % ) and phosphoric acid ( PA ) ( 20 % ) . SIGNIFICANCE Vital dentine etching treatment is of extreme importance for the placement of RC to minimise bacterial microleakage .  PA etching proved to be more effective at preventing bacterial microleakage than non-etching , and etching with EDTA
The meta- analysis demonstrated that the etch- and -rinse technique significantly reduced the nanoleakage of the Peak Universal and G-Bond Plus adhesives , whereas the self-etch mode reduced the nanoleakage of All-Bond Universal .
In comparison , the etching technique did not significantly alter the nanoleakage of either Prime&Bond Elect or Scotchbond Universal which was characterized by the smallest nanoleakage .
CONCLUSIONS Etching modes significantly , in various ways , influence the nanoleakage of universal adhesives .
CLINICAL SIGNIFICANCE Contrary to the drive to simplify bonding technologies , an appreciation of their adhesive components and how these perform according to bonding technique could yield a knowledge-based practical approach that ultimately improves the longevity of direct composite restorations
PURPOSE The aim of this systematic review was to evaluate how etching modes affect the nanoleakage of universal adhesive from in vitro studies .