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Objective: To evaluate the 36-month clinical performance of Single Bond Universal Adhesive (SBU; 3M ESPE, Germany) in non-carious cervical lesions (NCCLs) using different modes of adhesion according to the FDI criteria. The primary outcome was the retention loss of the restorations, while the secondary outcomes included marginal staining, marginal adaptation, post-operative sensitivity and tooth vitality, recurrence of caries erosion and abfraction, and tooth integrity, all evaluated according to the FDI criteria. Materials and methods: In this study, the SBU Adhesive was applied to 246 NCCLs of 25 patients using different modes of adhesion: Self-etch (SE), selective-enamel-etching (SLE), and etch-and-rinse (ER). All lesions were restored with the same nanohybrid resin composite. The restorations were evaluated at the 1st, the 6th, 12th, 18th, and 36th month using the FDI criteria. The differences between SE, SLE, and ER groups were tested using the Kruskal–Wallis and Mann–Whitney U tests where a value of p < 0.05 was accepted as a criterion for statistical significance. Results: After 36-month the recall rate was 96%. The retention loss rates were 29.33% for SE, 16.66% for SLE, and 3.89% for ER modes. Interactions between time periods and adhesive modes were found to be statistically significant (p < 0.05) for all FDI criteria. ER mode performed significantly better than SE mode for marginal staining, marginal adaptation and recurrence of caries, erosion and abfraction criteria after the 36th month (p < 0.05). There was no statistically significant difference between SE and SLE mode (p > 0.05), nor between SLE and ER mode (p > 0.05). Conclusions: After the 36-month evaluation of all adhesive modes used in the study, restorations performed with the ER adhesion mode were clinically good (2), while those performed with the SE adhesion mode and SLE adhesion mode were clinically satisfactory (3) according to the FDI criteria. The primary outcome, retention loss, was significantly lower in the ER mode compared to SE and SLE modes. For secondary outcomes, the ER mode showed better performance in marginal staining, marginal adaptation, and the recurrence of caries, erosion, and abfraction highlighting its clinical advantages for mid-term success in non-carious cervical lesions. Clinical relevance: Restorations performed with the SE adhesion mode of universal adhesives exhibit clinically acceptable behavior after 36 months of evaluation, although with less success than those performed with the ER adhesion mode. Clinical trial registration: Clinical trials number- NCT06227715, Clinical trials link: [ABSTRACT FROM AUTHOR]

Dental adhesives play a crucial role in modern dentistry by enabling the bonding of diverse restorative materials to tooth surfaces. These systems have evolved through seven generations, each characterized by unique chemical compositions and application techniques. The advancements in dental adhesives have significantly impacted restorative dentistry by preserving tooth structure, enhancing aesthetics, and ultimately improving patient outcomes and treatment options. The choice of adhesive system depends on various factors, including the clinical scenario, material compatibility, and dentist preference. Ongoing advancements in adhesive technology continue to enhance treatment outcomes and streamline procedures for dental practitioners. The development of universal adhesives capable of functioning in both etch-and-rinse and self-etch modes has further simplified clinical protocols. This study is an observational cross-sectional study conducted among Romanian dentists. A questionnaire was distributed via email to Romanian dentists, encompassing seven questions that explored the predominant use of etch-and-rinse or self-etch adhesive systems, preferred adhesive types, and commonly encountered challenges in direct restorations. Statistical analyses were conducted using DATAtab version (2024). The study highlighted the varying preferences among Romanian dentists in selecting suitable adhesive agents. Etch-and-rinse (ER) techniques predominated in direct restorations, with universal adhesives being the most frequently used. Further investigation is warranted to delve into the preferences of Romanian dentists regarding the utilization of self-etch (SE), etch-and-rinse (ER), and universal adhesives (UAs). [ABSTRACT FROM AUTHOR]

The central aim of adhesive dentistry is to improve the compatibility between current adhesives and a range of substrates by employing diverse application techniques. Therefore, the overarching objective of this review is to offer a comprehensive analysis of dentin bonding systems, starting with an introduction to adhesion and a detailed overview of enamel and dentin structures, their histology, and the impact of dentin structure on resin–dentin bonding. It covers the mechanisms of resin–dentin bonding, including resin adhesive application, bonding mechanisms, and factors influencing efficacy. Further, this review explores the composition of resin adhesive systems, including acidic components, cross-linking monomers, solvents, and other critical elements. It also examines various adhesive strategies—etch-and-rinse, self-etch, and universal adhesives—highlighting their applications and advantages. The review extends to clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), demonstrating the practical implications of adhesive systems in enhancing restoration longevity and performance. In conclusion, despite significant advancements, no gold-standard method for optimal adhesion exists. Each adhesive system has distinct strengths and limitations. The review emphasizes the importance of evaluating methods for achieving durable adhesion and staying current with technological advancements in adhesive systems. Summary: This review provides a thorough analysis of dentin bonding systems, delving into the structures and bonding mechanisms of both enamel and dentin. By exploring various adhesive systems and their components, it highlights the ongoing challenges in achieving optimal resin–dentin adhesion. The review also addresses the clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), illustrating how different adhesive techniques impact clinical outcomes. It underscores the necessity for continuous innovation and assessment of adhesive systems to enhance long-term bonding effectiveness in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Resin composites are commonly used in pediatric dentistry, but there is limited evidence on adhesion to primary teeth, especially primary enamel. In this study, three bonding strategies were assessed - one-step self-etch (1-SE), two-step self-etch (2-SE), and three-step etch-and-rinse (3-ER) - by measuring the immediate and aged microshear bond strength (µSBS) to sound primary enamel. Materials and Methods: 120 extracted human primary molars with sound buccal surfaces were used for µSBS testing. Six adhesive protocols (two per bonding strategy) were selected and µSBS was measured either after 24 h or 10,000 thermal cycles (n = 10). Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were used to determine failure modes. Furthermore, 18 primary molars were etched using the different adhesive protocols (n = 3) for the measurement of surface roughness (Sa) using CLSM and morphological analysis using SEM. Results: After 24 h, there was no significant difference in µSBS between 1-SE and 2-SE strategies (p = 0.96), but the 2-SE strategy yielded significantly higher µSBS after thermocycling (p < 0.001). The highest µSBS was obtained using the 3-ER strategy regardless of aging (p < 0.001). The 3-ER strategy clearly exposed enamel prisms and resulted in the highest Sa (p < 0.001). In contrast, if SE strategies were used, enamel prisms were barely recognizable, and Sa was not significantly different from baseline (p > 0.95). Conclusion: The 3-ER strategy is optimal for bonding to primary enamel. The etching effect of SE strategies is weaker, resulting in lower µSBS. Thermocycling revealed that the bonding durability of the 1-SE strategy is inferior to that of to multi-step strategies. [ABSTRACT FROM AUTHOR]

The present study assessed the effect of active application of self-etch adhesives with diode laser irradiation on the shear dentin bond strength. Sixty bovine incisors, each embedded individually in hard plaster blocks, were divided into two groups based on the adhesive system used: Group 1 Adper Easy One and Group 2 Clearfil SE Protect. Based on the application technique of self-etch adhesives, each main group was further divided into three subgroups: passive application, active application with a micro-brush, and active application with a 976-nm diode laser tip (phototherapy active application). Shear bond strength tests were conducted using a universal testing machine and the data were analyzed by two-way ANOVA. Post hoc multiple comparisons were performed with the Tukey HSD test. Additionally, the statistical analysis of failure mode distribution was carried out using the chi-squared test (p < 0.05). While the adhesive system exhibited significant differences in shear dentin bond strengths, there were no significant differences in application techniques. Regardless of the application technique, Clearfil SE Protect demonstrated significantly higher dentin bond strength than Adper Easy One. In the present study, the utilization of phototherapy through a 976-nm diode laser for the active application of the tested self-etch adhesives demonstrated similar initial dentin bond strengths to conventional application methods. [ABSTRACT FROM AUTHOR]

Universal adhesives (UAs) often exhibit comparable or even superior bond strength to traditional adhesive systems, ensuring reliable and long-lasting adhesion between the resin composite and the tooth structure. Therefore, this study aimed to assess the clinical performance of UAs compared to other adhesive systems in direct resin composite restorations through a systematic review and meta-analysis. Two reviewers executed a literature search in five electronic databases: PubMed, EMBASE, Scopus, Web of Science, and Scielo. Clinical trials comparing the clinical evaluation of resin composite restorations in Class I, Class II, or Class V cavities placed with an universal adhesive (UA) system against resin composite restorations placed with another non-UA system were included in the review. An analysis was carried out using Review Manager software version 5.3.5 (London, England, United Kingdom). Standardized effect sizes with 95% confidence intervals were calculated to allow comparisons between different interventions and different outcomes. The methodological quality of each study was assessed using the Cochrane RoB2 tool for randomized clinical trials. A total of 2331 potentially relevant studies were identified. After title and abstract examination, 14 studies remained in the systematic review. From these, a total of 11 studies were included in the meta-analysis. The retention rates of resin composite restorations after 6 months showed no significant difference between total-etch (TE, p=0.83), or self-etch (SE, p=0.78) adhesives and UAs applied in TE and SE modes (p>0.05). However, UAs applied in selective-enamel etching (SEE) mode demonstrated superior clinical performance compared to other adhesives (p=0.01), particularly TE adhesives (p=0.02). Similarly, after >12 months of follow-up, there were no significant differences in retention rates among different adhesive modes (p>0.05). Additionally, the incidence of secondary caries did not significantly differ across adhesive modes at both 6-month and >12-month evaluations (p>0.05). This systematic review and meta-analysis suggested that UAs demonstrate comparable clinical performance to TE and SE adhesive systems in direct resin composite restorations, particularly in terms of restoration retention rates and the incidence of secondary caries. UAs applied in SEE mode exhibited superior clinical outcomes compared to other adhesive systems. These findings indicate that UAs can be considered a viable alternative to traditional adhesive systems in clinical practice, offering flexibility in application while maintaining comparable long-term outcomes. [ABSTRACT FROM AUTHOR]

Background and objective: The aim of this randomized split-mouth study-controlled clinical trial was to compare the 2-year clinical performance of resin composite restorations placed at non-caries cervical lesions (NCCL) with one-step self-etch, total-etch, and selective enamel etch and self-etch adhesive techniques. Materials and methods: Thirty-two patients received three resin composite restorations each at NCCLs (Tetric EvoCeram/Ivoclar/Vivadent), bonded with a total-etch adhesive agent (ExciTE F/Ivoclar/Vivadent) and a self-etch (AdheSE One F/Ivoclar/Vivadent) without and with selective enamel etching. All restorations were evaluated by two examiners at baseline, 6-, 12-, 18-, and 24-months with FDI clinical criteria (post-operation regarding retention, caries occurrence, marginal adaptation, and marginal staining). A logistic regression analysis, a Cohen's kappa statistic, a multifactorial analysis, and X2 were performed with generalized estimating equations. Results: After 2 years, the retention rate was 86.8% for total etch, 92.26% for self-etch, and 93.63% for selective enamel etching and self-etch. No caries was detected on the restorations. Concerning marginal adaptation, the clinically perfect restorations were 26.9% for the total-etch technique, 16% for self-etch, and 25.9% for selective enamel etch and self-etch. The logistic regression model revealed that only time reduced the probability of perfect marginal adaptation. Conclusions: All three adhesive strategies provided restorations with no significant differences in the retention rate or marginal adaptation, whereas the total etch yielded better performance for marginal staining. All restorations were assessed as clinically acceptable after 2 years. [ABSTRACT FROM AUTHOR]

The present study assessed the effect of the active application of self-etch adhesives with phototherapy on enamel bond strength. Sixty bovine incisors, individually embedded in acrylic blocks, were divided into two groups according to the adhesive system used: Group 1 (AEO) Adper Easy One and Group 2 (CSEP) Clearfil SE Protect. According to the application technique of self-etch adhesives, each main group was further divided into three subgroups (n =10): (PA) passive application, (AP) active application, and (PAA) phototherapy active application. Shear bond strength (SBS) tests were conducted using a universal testing machine. The data were analyzed via two-way ANOVA and posthoc multiple comparisons using the Tukey HSD test. Furthermore, statistical analysis of the distribution of failure modes was carried out using the χ2 test (p < 0.05). Two-way ANOVA indicated no significant differences in either adhesive systems (p = 0.797) or application technique (p = 0.869). Similarly, a χ2 test showed no significant difference in the distribution of failure modes concerning surface treatments (p = 0.905). The use of phototherapy as a diode laser for the active application of the tested self-etch adhesives in the present study exhibited similar initial enamel bonding performance to conventional application methods. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. Material and method: MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. Results: Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). Conclusions: The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing. [ABSTRACT FROM AUTHOR]

ABSTRACT: Objective: The aim of this research was to investigate the effect of simplified adhesive strategies (self-etch vs selective enamel etch and 10- vs 20-second adhesive application time) on the marginal integrity in primary molars. Methods: Forty deep class-II cavities were prepared in 40 extracted primary molars. The molars were divided into 4 groups based on the applied universal adhesive strategy as follows: groups 1 and 2: selective enamel etch with 20- or 10-second application time and groups 3 and 4: self-etch with 20- or 10-second application time. All cavities were restored with a sculptable bulk-fill composite restoration. The restorations underwent a thermomechanical loading (TML, 5–50 °C, 2-minute dwelling time, ×1000; 400,000 loading cycles, 1.7 Hz, 49 N). Marginal analysis before and after TML was conducted with scanning electron microscopy and the marginal integrity of each restoration was calculated as a percentage of continuous margins. A beta regression model was adopted to statistically analyse the data with a consequent pairwise comparison. Results: The mean marginal integrity (% ± SD) of the restorations for each tested adhesive strategy after TML was as follows: selective enamel etch/20 seconds = 85.4 ± 3.9, self-etch/20 seconds = 85.3 ± 5.2, self-etch/10 seconds = 80.1 ± 8.2, and selective enamel etch/10 seconds = 80.0 ± 8.5. The difference between both adhesive strategies was not statistically significant at the same application time. The difference between both application times within the same adhesive strategy was statistically significant (P ≤ .01). Conclusions: Universal adhesives applied either in selective enamel etch or in self-etch mode result in comparable marginal integrities when restoring class-II cavities in primary molars. Shortened adhesive application time (10 seconds) could lead to a reduction in the marginal integrity in comparison to the recommended application time of 20 seconds.

Purpose: To investigate the effects of dentin decontamination procedures with ethylenediaminetetraacetic acid (EDTA) after contamination with two hemostatic agents, ViscoStat (VS) and ViscoStat Clear (VSC), on the microtensile bond strength (µTBS) of two different universal adhesives, before and after thermocycling (TC). Materials and Methods: Dentin surfaces of 100 human caries-free molars were either contaminated with one of the hemostatic agents or contaminated and then decontaminated with EDTA before the universal adhesives Scotchbond Universal Adhesive (SBU) or Prime & Bond Active (PBA) were applied in self-etch mode. Composite buildups were made and the teeth were sectioned into sticks (n = 90). Half of them immediately underwent the µTBS test, the other half after aging via TC. The data were statistically analyzed using Welch's ANOVA and the Games-Howell post-hoc test (p < 0.05). Results: Significant differences were observed between the groups (p < 0.001). When the dentin surface was contaminated with VSC, TC significantly reduced the mean bond strength, regardless of the universal adhesive. Decontamination with EDTA showed a significant decrease in bond strength after VS contamination and SBU application. The fracture analysis showed mainly adhesive fractures (78.8%) in all test groups. Conclusion: As EDTA application did not significantly increase the µTBS of either universal adhesive in self-etch mode in-vitro, it cannot be recommended as a decontaminant. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 24-month clinical performance of a "no wait" universal adhesive with different application modes in comparison with an etch-and-rinse and two-step self-etch adhesive in noncarious cervical lesions (NCCLs). Materials and Methods: A total of 234 noncarious cervical lesions in 34 patients were restored following 5 different adhesive approaches: 1. Clearfil Universal Bond Quick (Kuraray Noritake), self-etch mode (CUQ-SE); 2. Clearfil Universal Bond Quick, selective enamel-etch mode (CUQ-SLE); 3. Clearfil Universal Bond Quick, etch-and-rinse mode (CUQ-ER); 4. Clearfil SE Bond (Kuraray Noritake; self-etch adhesive) (CSEB); 5. Tetric N-Bond Universal (Ivoclar Vivadent), etch-and-rinse mode (TBU-ER). All NCCLs were restored with a nanohybrid composite (Tetric N-Ceram; Ivoclar Vivadent). The restorations were evaluated at baseline, 6, 12, and 24 months of clinical service regarding retention, marginal adaptation, marginal discoloration, secondary caries, post-operative sensitivity, color match, surface texture using modified United States Public Health Service (USPHS) criteria. Results: The patient recall rate at 24 months was 73.5%. Eleven restorations, 6 of the CUQ-SE group, 4 of the CSEB group and 1 of the TBU-ER group, were clinically unacceptable due to retention loss. Regarding marginal adaptation and discoloration, CUQ-SE and CSEB groups exhibited higher bravo scores than other groups after 24 months (p < 0.05). At the end of 24-month examinations, no significant differences were detected among the groups regarding secondary caries, post-operative sensitivity, color match and surface texture. Conclusion: The clinical survival rates of the "no wait" universal adhesive at self-etch mode after 24 months were not acceptable. The "no wait" universal adhesive showed clinically acceptable performance in selective enameletch and etch-and-rinse mode, according to the evaluated USPHS criteria. [ABSTRACT FROM AUTHOR]

Dental adhesives play a crucial role in modern dentistry by enabling the bonding of diverse restorative materials to tooth surfaces. These systems have evolved through seven generations, each characterized by unique chemical compositions and application techniques. The advancements in dental adhesives have significantly impacted restorative dentistry by preserving tooth structure, enhancing aesthetics, and ultimately improving patient outcomes and treatment options. The choice of adhesive system depends on various factors, including the clinical scenario, material compatibility, and dentist preference. Ongoing advancements in adhesive technology continue to enhance treatment outcomes and streamline procedures for dental practitioners. The development of universal adhesives capable of functioning in both etch-and-rinse and self-etch modes has further simplified clinical protocols. This study is an observational cross-sectional study conducted among Romanian dentists. A questionnaire was distributed via email to Romanian dentists, encompassing seven questions that explored the predominant use of etch-and-rinse or self-etch adhesive systems, preferred adhesive types, and commonly encountered challenges in direct restorations. Statistical analyses were conducted using DATAtab version (2024). The study highlighted the varying preferences among Romanian dentists in selecting suitable adhesive agents. Etch-and-rinse (ER) techniques predominated in direct restorations, with universal adhesives being the most frequently used. Further investigation is warranted to delve into the preferences of Romanian dentists regarding the utilization of self-etch (SE), etch-and-rinse (ER), and universal adhesives (UAs).

The central aim of adhesive dentistry is to improve the compatibility between current adhesives and a range of substrates by employing diverse application techniques. Therefore, the overarching objective of this review is to offer a comprehensive analysis of dentin bonding systems, starting with an introduction to adhesion and a detailed overview of enamel and dentin structures, their histology, and the impact of dentin structure on resin–dentin bonding. It covers the mechanisms of resin–dentin bonding, including resin adhesive application, bonding mechanisms, and factors influencing efficacy. Further, this review explores the composition of resin adhesive systems, including acidic components, cross-linking monomers, solvents, and other critical elements. It also examines various adhesive strategies—etch-and-rinse, self-etch, and universal adhesives—highlighting their applications and advantages. The review extends to clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), demonstrating the practical implications of adhesive systems in enhancing restoration longevity and performance. In conclusion, despite significant advancements, no gold-standard method for optimal adhesion exists. Each adhesive system has distinct strengths and limitations. The review emphasizes the importance of evaluating methods for achieving durable adhesion and staying current with technological advancements in adhesive systems. Summary: This review provides a thorough analysis of dentin bonding systems, delving into the structures and bonding mechanisms of both enamel and dentin. By exploring various adhesive systems and their components, it highlights the ongoing challenges in achieving optimal resin–dentin adhesion. The review also addresses the clinical applications of dental adhesion, including direct restorations, indirect restorations, and immediate dentin sealing (IDS), illustrating how different adhesive techniques impact clinical outcomes. It underscores the necessity for continuous innovation and assessment of adhesive systems to enhance long-term bonding effectiveness in clinical practice.

Background: Self-adhering composites are claimed to bond to teeth without prior acid etching and bonding steps. This study aimed to evaluate the cyclic shear fatigue (CSF) of metal orthodontic brackets bonded to enamel using self-adhering flowable composites (Constic and VertiseTM Flow) in comparison with that of total-etch and self-etch adhesives. Materials and methods: Twenty-five human premolars comprising 100 surfaces were randomly divided into four groups (n = 25): total-etch, self-etch, Constic, and VertiseTM Flow. A total of 10 surfaces were used per group for baseline static shear bond strength (SSBS) evaluation and 15 surfaces for CSF evaluation. Each tooth was treated with the four bonding agents. Both SSBS and CSF were evaluated using a universal testing machine. For CSF, the staircase method was used with an initial pulling load equivalent to 60% of the SSBS of each group for 1000 cycles or until failure. The adhesive remaining index (ARI) was evaluated for surviving samples using a stereomicroscope. Statistical analysis: A one-way ANOVA with Tukey’s post hoc test was used to analyze the CSF data, and a chi-square test was used to analyze the ARI. Results: The total-etch adhesive showed significantly higher CSF values than that of the other groups (p 0.05). Conclusions: Total-etch and self-etch adhesives showed satisfactory bond strengths for orthodontic treatment. However, Constic and VertiseTM Flow self-adhering flowable composites may not be clinically sufficient for bonding metallic orthodontic brackets to enamel.

Naji Ziad Arandi Department of Conservative Dentistry, Faculty of Dentistry, Arab American University, Jenin, PalestineCorrespondence: Naji Ziad Arandi, Department of Conservative Dentistry, Faculty of Dentistry, Arab American University, Jenin, Palestine, Tel +972598126111, Email naji.arandi@aaup.eduAbstract: Adhesive agents are essential to most restorative procedures used in everyday practice. Depending on the clinical situation, the dentist will choose among a rapidly evolving variety of adhesive agents (bonding agents). Due to the availability of many adhesive agents, appropriate selection can take time and effort. Typically, a practitioner relies more on marketing and experience than in-depth material knowledge. The classification of adhesive agents may need to be clarified and easier to remember due to its lack of relevance to clinical procedures. This paper reviews the published literature retrieved from PubMed, Google Scholar, and Scopus by using specific keywords “adhesive agents”, “classification”, “dentin”, “enamel”, “universal”, “self-etch”, “etch-and-rinse”, and “bonding”. The titles and abstracts were screened, and the relevant literature was retrieved. The list of references from each identified article was examined to find other potentially relevant articles. Adhesive agents can be classified as etch-and-rinse, self-etch, or “multi-mode” according to their approach to interacting with the smear layer, and each approach can be further classified according to the number of clinical steps required during application. This article reviews the classification of current adhesive agents and discusses the properties that make a specific adhesive agent the optimal choice for a particular clinical indication. The review will assist the general dentist in understanding the various types of available adhesive agents and how they function. Overall, the review will facilitate decision-making and allow the selection of appropriate materials.Keywords: adhesive agents, bonding agents, classification, dentine, enamel, etch-and-rinse, self-etch, universal adhesives

This study aimed to evaluate internal tooth–filling interfaces of composite fillings made using universal adhesives using micro-computed tomography (µCT). Sixty class V cavities were randomly assigned into six groups: Peak Universal etch and rinse (PER), Peak Universal self-etch (PSE), Adhese Universal etch and rinse (AER), and Adhese Universal self-etch (ASE). Two further adhesives considered gold standards were used as control groups: OptiBond FL (OER) for the etch and rinse technique and Clearfil SE for the self-etch technique (CSE). All teeth were subjected to thermomechanical loading and four-year water storage. Next, they were analyzed using µCT to investigate the internal tooth–filling interfaces. The proportions between the gap volume (GV) at the tooth–filling interface and the volume of applied composite filling (FV), between the gap and cavity volumes (CV), and between the gap volumes at the tooth–filling interface of the external (EGV) and internal (IGV) parts were calculated. Adhese Universal achieved the significantly lowest gap-to-filling- and gap-to-cavity-volume ratios for both types of etching techniques comparing to those of the Peak Universal and control groups. Significant differences between the gaps in external and internal parts of the tooth–filling interface were only noted in the control groups. Internal gap formation and development at the tooth–filling interface depend on the material as well as the type of its application. [ABSTRACT FROM AUTHOR]

Extrafibrillar demineralization is an etching technique that removes only minerals from around the collagen fibrils for resin infiltration. The intrafibrillar minerals are left intact to avoid their replacement by water that is hard for adhesive resin monomers to displace. The present work reported the synthesis of a water-soluble methacryloyloxy glycol chitosan-EDTA conjugate (GCE-MA) and evaluated its potential as an extrafibrillar demineralization agent for self-etch dentin bonding. Glycol chitosan-EDTA was functionalized with a methacryloyloxy functionality. Conjugation was confirmed using Fourier transform-infrared spectroscopy. The GCE-MA was used to prepare experimental self-etch primers. Extrafibrillar demineralization of the primers was evaluated with scaning electron microscopy and transmission electron microscopy. The feasibility of this new self-etch bonding approach was evaluated using microtensile bond strength testing and inhibition of dentin gelatinolytic activity. The antibacterial activity and cytotoxicity of GCE-MA were also analyzed. Conjugation of EDTA and the methacryloyloxy functionality to glycol chitosan was successful. The functionalized conjugate was capable of extrafibrillar demineralization of mineralized collagen fibrils. Tensile bond strength of the experimental self-etch primer to dentin was comparable to that of phosphoric acid-etched dentin and the commercial self-etch primer Clearfil SE Bond 2. The GCE-MA also inhibited soluble rhMMP-9. In-situ zymography detected minimal fluorescence in hybrid layers conditioned with the experimental primer. The GCE-MA was noncytotoxic and possessed antibacterial activities against planktonic bacteria. Synthesis of GCE-MA brought into fruition a self-etch conditioner that selectively demineralizes the extrafibrillar mineral component of dentin. A self-etch primer prepared with GCE-MA achieved bond strengths comparable to commercial reference adhesive systems. • The light curable chitosan derivative selectively demineralizes extrafibrillar dentin. • Experimental primers prepared with the chitosan derivative achieved high dentin bond strengths. • The chitosan derivative exhibits antibacterial and anti-gelatinolytic properties. [ABSTRACT FROM AUTHOR]

The aim of this study was to systematically compare the bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia. The PubMed, ISI (all), and Scopus databases were searched for the selected keywords up to November 1, 2021, without date or language restrictions. In vitro studies comparing the bond strength of self-adhesive and self-etch or total-etch resin cement to zirconia were eligible for inclusion in the study. The selected articles were divided into four groups based on the type of resin cement and the storage time. Statistical analysis was performed using the Biostat Comprehensive Meta-Analysis Software version 2 (α = 0.05). The effect of conventional cement (Glass Ionomer (GI), Resin Modified Glass Ionomer (RMGI) and zinc phosphate) was analyzed using descriptive analysis. The initial search yielded 376 articles, of which 26 were selected after a methodological assessment. Two reviewers independently extracted data and assessed the risk of bias. The results showed that the immediate or delay bond strength of the self-adhesive resin cement to zirconia has no significant difference with the bond strength of self-etch resin cement to zirconia. The immediate and delay bond strength of total-etch cement-zirconia was significantly lower than that of self-adhesive cement-zirconia (P = 0.00). A descriptive analysis of the selected articles showed that the bond strength of self-adhesive resin cement to zirconia was significantly higher than total-etch cement. The results of the meta-analysis showed that both self-adhesive and self-etch resin cement (if applied according to their manufacturer's instruction) are suitable for bonding to zirconia. [ABSTRACT FROM AUTHOR]

Red-fluorescing dentine indicates bacterial contamination [Caries Res 2002; 36: 315–319]. We investigated effect of removal of red fluorescent dentine caries on shear bond strength and fracture mode of 4 adhesive approaches. Sixty-five carious teeth and 50 noncarious controls were distributed into 4 groups: Clearfil™ self-etch (CSE), OptiBond™ FL total etch (OTE), Scotchbond™ Universal total etch (STE) and self-etch (SSE). Samples were excited at 405 nm and viewed through 530 nm filter. Carious samples were ground flat exposing strongly red-fluorescing (StrongRF) dentine, on which a composite cylinder was placed, using one of 4 adhesives. After 22 h in water, shear bond strength and fracture mode were analysed. StrongRF was removed; composite cylinders were placed on weakly red-fluorescing (WeakRF) dentine and tested as described above. Finally, red-fluorescing dentine was removed, and composite cylinders were placed on non-fluorescing (NonRF) dentine and tested. Composites were placed at 3 corresponding heights in controls. After 22 h in water, shear bond strength testing and fracture mode analysis were performed. Differences were tested using Mann-Whitney or Wilcoxon tests (p ≤0.05). Median (Q1, Q3) shear bond strength on StrongRF was SSE 14.4 (9.2, 18.2) MPa >CSE 10.2 (6.4, 17.3) MPa >STE 9.1 (6.9, 11.2) MPa >OTE 6.8 (4.0, 10.8) MPa. Shear bond strength increased statistically significantly for all adhesives on WeakRF: SSE 19.8 (13.6, 24.3) MPa >STE 19.5 (12.7, 23.1) MPa >CSE 17.5 (12.0, 22.5) MPa >OTE 15.8 (11.9, 20.9) MPa. Only STE 25.6 (22.4, 29.1) MPa and CSE 22.1 (17.6, 24.6) MPa were significantly different on NonRF compared to WeakRF. For controls tested at corresponding depths, superficial shear bond strength was OTE 18.7 (16.0, 22.1) MPa >STE 18.4 (12.0, 25.9) MPa >CSE 18.1 (12.7, 20.7) MPa >SSE 13.0 (9.6, 17.8) MPa. This was significantly higher compared to StrongRF except for SSE. Central shear bond strength was not significantly different to WeakRF, deep shear bond strength was significantly lower for SSE and CSE but higher for OTE compared to carious. Conclusion: StrongRF dentine should be removed for higher shear bond strength, but WeakRF dentine can often be preserved without compromising adhesive bond strength. [ABSTRACT FROM AUTHOR]

To examine whether dentin-etching extension and/or the hydrophobic-rich content of hybrid layers would affect fatigue strengths of a mild universal adhesive after long-term aging. Twin-bonded resin-dentin interfaces were produced by etching sound midcoronal dentin beams with 32 % ortho-phosphoric acid for 15 s (OPA15s), 3 s (OPA3s) or 10 % meta-phosphoric acid for 15 s (MPA15s). Samples were bonded with a mild universal adhesive with or without additional coating using a solvent-free bisGMA-based bonding resin. Self-etch application served as control. Composite buildups were made with a nanofilled composite. Bar-shaped twin-bonded interfaces (0.9 × 0.9 × 12 mm) were aged for two years in artificial saliva at 37 ℃ and tested under 4-point flexure at quasi-static (n = 16) and cyclic loads (n = 35) until failure. The stress-life fatigue behavior was evaluated using the staircase method at 4 Hz. Crack initiation and fracture patterns were evaluated by SEM. Cyclic-loaded data was analyzed by Kruskal-Wallis on Ranks (α = 0.05). Significantly higher fatigue life distributions and higher endurance limits were observed for less aggressive etch-and-rinse protocols (OPA3s and MPA15s) after long-term ageing. Hydrophobic-rich coating produced 20–32 % higher endurance limits, prevented micrometer-sized porosities at bonded interfaces, reduced etching-associated variability and lowered crack formation. Significance Long-term hydrolysis produces detrimental effects on the fatigue strength of resin-dentin interfaces. The bond-promotion effect of less aggressive etch-and-rinse protocols and the creation of hybrid layers with higher hydrophobic-rich content are critical to extend the durability of mild universal adhesives. Therefore, current oversimplification trends in adhesive dentistry may limit resin-dentin bonding performance. • Hydrolytic ageing renders improved assessment of resin-dentin fatigue strengths. • Long-term hydrolysis has detrimental effects on fatigue strengths. • Higher hydrophobicity of hybrid layers lower fatigue strength impairments over time. • It also lowers etching-associated variabilities after ageing. • Oversimplification of resin-dentin bonding protocols compromise interfacial quality. [ABSTRACT FROM AUTHOR]

The aim of this double-blind, and randomized controlled clinical trial was to evaluate the 5-year clinical performance of posterior resin composite restorations placed with the incremental filling technique [IF] or the bulk-fill technique [BF]. Two different adhesive systems were used: etch-&-rinse (ER) or self-etch (SE). Posterior dental teeth of 72 participants (n = 236), with a cavity depth of at least 3 mm, were randomly divided into four groups. Restorations were applied with either Tetric N-Bond or Tetric N-Bond SE. The composite resin Tetric N-Ceram Bulk-Fill was placed either with IF or BF. Restorations were evaluated using FDI criteria at baseline and after 1, 2, 3, 4, and 5 years. Statistical analysis was performed using the Wilcoxon Signed rank test (a=0.05). Two hundred and four restorations were evaluated after 5 years. Eleven restorations were considered 'failed', ten due to fracture (4 IF and 6 BF) and one due to secondary caries (IF). The annual failure rate was 1.2% for BF and 1% for IF (p = 0.35). When comparing BF and IF, no significant differences were found for any of the parameters evaluated (p > 0.05). Regarding the adhesive systems, 44 and 51 restorations showed minor problems in terms of marginal adaptation and staining, with significantly more marginal discoloration when the self-etch adhesive was used (p = 0.002). The bulk-fill restorative technique showed good clinical behavior compared to the incremental filling technique, especially when using an etch-&-rinse adhesive, after 5 years of clinical evaluation. [Display omitted] • Bulk-fill technique had similar clinical behavior to incremental filling technique. • Use of etch & rinse adhesive reduced the risk of marginal staining after 5 years. • Minor not significant discrepancies in color match were shown between techniques. [ABSTRACT FROM AUTHOR]

Background and objective: The aim of this randomized split-mouth study-controlled clinical trial was to compare the 2-year clinical performance of resin composite restorations placed at non-caries cervical lesions (NCCL) with one-step self-etch, total-etch, and selective enamel etch and self-etch adhesive techniques. Materials and methods: Thirty-two patients received three resin composite restorations each at NCCLs (Tetric EvoCeram/Ivoclar/Vivadent), bonded with a total-etch adhesive agent (ExciTE F/Ivoclar/Vivadent) and a self-etch (AdheSE One F/Ivoclar/Vivadent) without and with selective enamel etching. All restorations were evaluated by two examiners at baseline, 6-, 12-, 18-, and 24-months with FDI clinical criteria (post-operation regarding retention, caries occurrence, marginal adaptation, and marginal staining). A logistic regression analysis, a Cohen’s kappa statistic, a multifactorial analysis, and X2 were performed with generalized estimating equations. Results: After 2 years, the retention rate was 86.8% for total etch, 92.26% for self-etch, and 93.63% for selective enamel etching and self-etch. No caries was detected on the restorations. Concerning marginal adaptation, the clinically perfect restorations were 26.9% for the total-etch technique, 16% for self-etch, and 25.9% for selective enamel etch and self-etch. The logistic regression model revealed that only time reduced the probability of perfect marginal adaptation. Conclusions: All three adhesive strategies provided restorations with no significant differences in the retention rate or marginal adaptation, whereas the total etch yielded better performance for marginal staining. All restorations were assessed as clinically acceptable after 2 years.

Purpose: To evaluate in vitro the effect of saliva contamination on bond strength of a universal adhesive applied with actively (with rubbing motion) and passively (without rubbing motion). Materials and Methods: A total of 144 bovine dentin samples were used, and the universal adhesive, Clearfil Universal Bond Quick, was either applied in accordance with the manufacturer's instructions (passive application) or applied with rubbing motion for 10 s (active application). These 2 groups were divided into 6 subgroups according to saliva contamination (n = 12): 1. control: etch-and-rinse (no saliva); 2. control: self-etch (no saliva); 3. etching/saliva/bonding; 4. etching/bonding/saliva; 5. saliva/bonding; 6. bonding/saliva. A resin composite, Filtek Ultimate, was filled into a polyethylene mold (0.9 mm diameter, 1.2 mm height) on the surfaces. Samples were subjected to microshear bond strength testing, and five specimens from each group were examined using SEM. Resin-dentin interfaces were also observed using transmission electron microscopy (TEM). All failure modes were determined using light microscopy. Statistical analyses were performed with two-way ANOVA, the Kruskall-Wallis test, and the Mann-Whitney U-test (p < 0.05). Results: Active-application groups showed statistically significantly higher bond strengths than did passive groups, regardless of adhesive strategy and saliva contamination (p < 0.05). Application of Clearfil Universal Bond Quick in self-etch mode with rubbing motion improved the µSBS among control groups (p < 0.05). The active application did not make a significant difference among the active groups (p > 0.05), except in group 2. Groups 2 and 5 showed significantly higher µSBS than group 3 among the passive groups (p < 0.05). Conclusion: Rubbing the universal adhesives without any prior etching may increase the dentin bond strength. Following etching, passive application of the universal adhesive (without any additional rubbing motion) could affect the bonding to dentin in the presence of saliva. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the influence of application protocol on the shear bond strength (SBS) and nanoleakage of simplified adhesives over 18 months. Materials and Methods: 810 dentin slices were obtained from 405 caries-free human molars. They were randomly assigned to 54 experimental groups resulting from the combination of "adhesive" (Adper Scotchbond 1XT [S1XT], Solobond M [SM], Scotchbond Universal Adhesive in etch-and-rinse mode [SUER] and self-etch mode [SUSE], Adper Easy Bond [EB], Clearfil S3 Bond Plus [CS3]), "application protocol" (manufacturer's instructions [MI], two extra layers of adhesive [EL], hydrophobic resin layer [HL]), and "aging time" (24 h [24H], 6 months [6M], and 18 months [18M] in water). SBS tests were carried out using a Watanabe device followed by failure mode analysis. For the nanoleakage study, specimens from 54 additional molars were prepared as previously described, immersed in ammoniacal silver nitrate, and evaluated with SEM. SBS data were analyzed with ANOVA followed by Tukey's post-hoc tests; failure mode data were analyzed using chi-squared tests (α = 0.05). Nanoleakage data were analyzed with the Kruskal-Wallis test followed by LSD tests (α = 0.05). Results: After 18M, S1XT and SUSE achieved the highest mean SBS (p < 0.05). Regarding the application protocols, EL and HL provided higher mean SBS than those obtained with MI (p < 0.05). HL resulted in the highest mean SBS and the lowest mean nanoleakage after 18M. Conclusion: Simplified adhesives may need an extra hydrophobic resin layer to achieve a stable and durable adhesive interface. The self-etch approach should be recommended for the universal adhesive. [ABSTRACT FROM AUTHOR]

Self-adhering composites are claimed to bond to teeth without prior acid etching and bonding steps. This study aimed to evaluate the cyclic shear fatigue (CSF) of metal orthodontic brackets bonded to enamel using self-adhering flowable composites (Constic and VertiseTM Flow) in comparison with that of total-etch and self-etch adhesives. Twenty-five human premolars comprising 100 surfaces were randomly divided into four groups (n = 25): total-etch, self-etch, Constic, and VertiseTM Flow. A total of 10 surfaces were used per group for baseline static shear bond strength (SSBS) evaluation and 15 surfaces for CSF evaluation. Each tooth was treated with the four bonding agents. Both SSBS and CSF were evaluated using a universal testing machine. For CSF, the staircase method was used with an initial pulling load equivalent to 60% of the SSBS of each group for 1000 cycles or until failure. The adhesive remaining index (ARI) was evaluated for surviving samples using a stereomicroscope. A one-way ANOVA with Tukey's post hoc test was used to analyze the CSF data, and a chi-square test was used to analyze the ARI. The total-etch adhesive showed significantly higher CSF values than that of the other groups (p < 0.001). Both total-etch (10.78 ± 0.31 MPa) and self-etch (6.75 ± 0.91 MPa) adhesives showed significantly higher CSF than did Constic (1.94 ± 0.31 MPa) and VertiseTM Flow (2.01 ± 0.25 MPa), (p < 0.001). The ARI indicated that more resin remnants were observed with the total-etch and self-etch adhesives than those with the self-adhering flowable composites. However, no significant differences were observed among groups (p > 0.05). Total-etch and self-etch adhesives showed satisfactory bond strengths for orthodontic treatment. However, Constic and VertiseTM Flow self-adhering flowable composites may not be clinically sufficient for bonding metallic orthodontic brackets to enamel. [ABSTRACT FROM AUTHOR]

Context: The significance of enamel etching has been well-researched and established. Limited literature is available comparing the enamel bond strengths of the two-step self-etch adhesive system and the newly introduced universal adhesive (UA) system with prior acid etching. Aims: The aim of the study was to evaluate and compare the microtensile bond strength (μTBS) of composite to enamel with and without 37% orthophosphoric acid pre-etching using a recently introduced UA and a two-step self-etch adhesive. Subjects and Methods: This in vitro , experimental study was conducted on 48 extracted human third molar teeth. Two enamel surface fragments were obtained per tooth, polished using 600-grit silicon carbide abrasive paper, and randomly divided into four groups-CLEARFIL SE BOND with and without acid pre-etching and G-Premio Bond with and without acid pre-etching. The samples were etched using 37% phosphoric acid gel for 30 s, followed by the bonding protocol. Composite resin blocks were built incrementally to a thickness of approximately 6 mm, and the restored samples were stored in distilled water for 24 h at 37°C. They were then sectioned, mounted, and subjected to a μTBS test using a universal testing machine. Statistical Analysis Used: Statistical analysis of the data was performed using one-way ANOVA and Tukey's post hoc test using SPSS software version 22.0. Results: Samples bonded with the UA subjected to prior acid etching protocol demonstrated the highest enamel μTBS. In contrast, those treated with the two-step self-etch adhesive without prior acid etching demonstrated the lowest enamel μTBS. Pre-etching with phosphoric acid significantly increased the enamel bond strength of both bonding agents, with the universal agent showing better results than the two-step adhesive system. Conclusions: Enamel etching with phosphoric acid significantly increases the bond strength of self-etch adhesives. UA with prior acid etching showed the maximum enamel μTBS. Two-step self-etch adhesive without prior acid etching yielded enamel μTBSs unacceptable for long-term, durable bonding. [ABSTRACT FROM AUTHOR]

With the continuous development of adhesive technology leading to a wide variety of bonding systems in the market, clinicians are often faced with a vast number of systems to choose from. Although research and manufacture of bonding systems is constantly progressing, the focus has generally been on simplifying the bonding process by reducing the number of clinical steps, with little emphasis on evidence-based performance. This article draws attention to the current strategies of common commercially available products to guide clinicians during bonding system selection and application. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to evaluate the effect of dentin pretreatment by Dimethyl Sulfoxide (DMSO) on the bond strength and microleakage of a universal bonding agent to dentin. Methods Fifty-six dentinal discs (thickness = 2 mm) were obtained from the crowns of the human third molars. The disks were assigned into 4 groups and treated as follows; self-etch-control group: G-Premio universal adhesive was used in self-etch mode, total-etch-control: G-Premio universal adhesive was used in total-etch mode, self-etch-DMSO: Water-based DMSO (50% volume) was applied on the samples for 60 s followed by application of G-Premio universal adhesive in self-etch mode, and Total-etch-DMSO: The samples were etched, and then, water-based DMSO was applied on them for 60 s followed by the application of G-Premio universal adhesive in total-etch mode. Afterward, resin composite was placed on all samples and light-cured. The samples were kept in distilled water and subjected to 5000 thermal cycles. Microshear bond strength was measured using the universal testing machine and failure modes were analyzed using a stereomicroscope. Forty-eight human third molars were used for microleakage evaluation and a standardized class five cavity was prepared on the buccal surface of each tooth. The teeth were assigned into 4 groups and received aforementioned surface treatment and the cavities were filled with resin composite. After storing in water for 24 h, the samples were subjected to 5000 cycles of thermocycling and the microleakage level of the samples was evaluated using silver nitrate uptake at the bonded interface. Two-way ANOVA test was used to analyze the effect of bonding technique (self-etch/ total-etch) and DMSO pretreatment on the microshear bond strength and microleakage of G-Premio adhesive to dentin. Results Bonding technique had no effect on the bond strength values (p = 0.17) while DMSO pretreatment significantly decreased the microshear bond strength of the samples (p = 0.001). DMSO application increased microleakage significantly in total-etch (P-value = 0.02) while it had no effect in self-etch mode (P-value = 0.44). Conclusions Pretreatment of dentin using 50% DMSO significantly reduced the bond strength of G-Premio Bond in both self-etch and total-etch modes. DMSO effect on microleakage depended on the etching technique; DMSO increased the microleakage level when the adhesive was used in total-etch mode while did not affect the microleakage in self-etch mode.

Aims: The aim of the present study was to evaluate and compare the push-out bond strength of single and multiple fiber-reinforced posts cemented with dual-cure resin cement using total-etch and self-etch adhesive systems. Methods: Sixty single-rooted maxillary permanent incisors were decoronated and endodontically treated. Following post space preparations, the roots were divided into four groups (n = 15); Group 1: single fiber-reinforced composite post with the total-etching agent, Group 2: single fiber-reinforced composite post with the self-etching agent, Group 3: multiple pin posts with the total-etching agent, and Group 4: multiple pin posts with the self-etching agent and then cemented using dual-cure resin cement. The samples were then sectioned to obtain approximately 2-mm disks, and a push-out test was performed. Data obtained were statistically analyzed using analysis of variance, post hoc Tukey, and unpaired t-test. Results: The mean push-out bond strength values showed that Group 3 had significantly higher bond strength as compared to the other groups (P < 0.05). Conclusions: Dentapreg multiple pin posts with total-etching agents resulted in higher push-out bond strength as compared to single fiber-reinforced posts and self-etching agents.

This study aimed at comparing shear-bond strength (SBS) of different self-etching adhesive systems (Clearfil S3 Bond Plus, G-Premio BOND and IBond) to dentin without or with diode-laser irradiation before photo-polymerization and to determine the effect of storage and thermo-cycling on SBS of adhesive systems. Methods: The buccal surface of 84 extracted maxillary premolars was grounded to create flat surface. The specimens were allocated into 3 groups (n = 28) depending upon the adhesive systems, then each group was divided into two sub-group (I, II) (n = 14). After the placement of respective adhesive systems on the flat surface, adhesive system in group I was photo-polymerized immediately, while in group II, the adhesive systems were exposed to diode-laser before photo-polymerization. Composite cylinder (4 mm in diameter and 2 mm height) was built on the flat surface of each specimen. Then group I and II were divided into two sub-groups (n = 7) according to the storage time and thermo-cycling (1 day without thermo-cycling or 72 days with thermo-cycling) then all the specimens were stored in distilled water. The SBS was measured at the end of storage period. ANOVA, Duncan’s Multiple Range Test and independent t-test “P ≤ 0.05” were used for data analysis. Results: G-premio BOND showed the highest mean value of SBS followed by Clearfil S3 Bond plus without significant difference between them, while IBond revealed the least mean value. Laser irradiation had positive effect on the bond-strength of all tested adhesive systems. The results also showed that the storage with thermo-cycling had negative effect on the bond-strength in groups without laser irradiation for all tested adhesive systems, while for groups with laser irradiation, the reduction in the bond-strength of all tested adhesive systems was not significant. Conclusion: Diode-laser application prior to photo-polymerization of self-etch adhesive systems significantly increased the bond-strength to dentin and can increase the durability of composite adhesion.

Introduction: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. Material and method: MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. Results: Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). Conclusions: The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing.

Background: This study aimed to evaluate the effect of dentin pretreatment by Dimethyl Sulfoxide (DMSO) on the bond strength and microleakage of a universal bonding agent to dentin. Methods: Fifty-six dentinal discs (thickness = 2 mm) were obtained from the crowns of the human third molars. The disks were assigned into 4 groups and treated as follows; self-etch-control group: G-Premio universal adhesive was used in self-etch mode, total-etch-control: G-Premio universal adhesive was used in total-etch mode, self-etch-DMSO: Water-based DMSO (50% volume) was applied on the samples for 60 s followed by application of G-Premio universal adhesive in self-etch mode, and Total-etch-DMSO: The samples were etched, and then, water-based DMSO was applied on them for 60 s followed by the application of G-Premio universal adhesive in total-etch mode. Afterward, resin composite was placed on all samples and light-cured. The samples were kept in distilled water and subjected to 5000 thermal cycles. Microshear bond strength was measured using the universal testing machine and failure modes were analyzed using a stereomicroscope. Forty-eight human third molars were used for microleakage evaluation and a standardized class five cavity was prepared on the buccal surface of each tooth. The teeth were assigned into 4 groups and received aforementioned surface treatment and the cavities were filled with resin composite. After storing in water for 24 h, the samples were subjected to 5000 cycles of thermocycling and the microleakage level of the samples was evaluated using silver nitrate uptake at the bonded interface. Two-way ANOVA test was used to analyze the effect of bonding technique (self-etch/ total-etch) and DMSO pretreatment on the microshear bond strength and microleakage of G-Premio adhesive to dentin. Results: Bonding technique had no effect on the bond strength values (p = 0.17) while DMSO pretreatment significantly decreased the microshear bond strength of the samples (p = 0.001). DMSO application increased microleakage significantly in total-etch (P-value = 0.02) while it had no effect in self-etch mode (P-value = 0.44). Conclusions: Pretreatment of dentin using 50% DMSO significantly reduced the bond strength of G-Premio Bond in both self-etch and total-etch modes. DMSO effect on microleakage depended on the etching technique; DMSO increased the microleakage level when the adhesive was used in total-etch mode while did not affect the microleakage in self-etch mode. [ABSTRACT FROM AUTHOR]

Introduction: Resin composite materials are considered as adequate restorative material for posterior teeth. Unlike amalgam, resin composite can bond to enamel which is one of the main advantages of using resin composite as a restorative material. Currently, this micro-mechanical retention is considered to be the strongest adhesion in the oral cavity, however, there is scarcity of data regarding comparison of post-operative sensitivity in teeth restored with composite using two different adhesive systems. This study was designed to compare the mean post-operative sensitivity after class II restorations, in teeth restored by using self-etch and total-etch adhesive protocols. Material & Methods: After meeting the inclusion criteria 370 patients were enrolled. Informed consent and demographic information was taken. Then patients were divided equally into two groups using the single blinded randomized controlled trial. Randomization was done using computer generated random allocation of numbers in each group. One group is treated with Self-Etch (SE) adhesive technique and other with Total-Etch (TE) adhesive technique. Rubber dam was applied in all cases. Post-operative sensitivity was recorded in both groups after seven days using Visual Analogue Scale. Collected data was entered and analysed using SPSS version 21. Results: In our study, mean age of the patients was 30.83±5.91 years, male to female ratio of the patients was 1.04:1. The mean value of post-operative sensitivity of the patients was 0.89±0.721. The mean value of post-operative sensitivity of group A patients was 0.65±0.62 while the mean value of post-operative sensitivity of group B patients was 1.13±0.74 (p-value

Background and Objective: Microleakage is one of the most important causes of failure in restoration and secondary caries. This study was conducted in order to compare dentinal microleakage of class II composite restorations using Universal Dental Adhesive, with and without liner. Methods: In this laboratory study, two Class II cavities were prepared in the mesial and distal surfaces of 48 healthy premolar teeth. Then, the samples were divided into 6 groups of 8 according to the application method of Single Bond Universal adhesive and liner: selective etching of enamel (SEE), self-etch (SE) technique, SEE technique and resin-modified glass-ionomer (RMGI) liner, SE technique and RMGI Liner, SEE technique and Flow Liner, and SE technique and Flow Liner. Restoration was done with Filtek Z250 composite. Microleakage was evaluated and compared using 2% fuchsine based on intensity 0 to 3. Findings: In the SEE group, 56.2% of restorations did not have microleakage. 31.2% had grade 3 microleakage and 12.5% had grade 1 microleakage. However, in the SEE+RMGI group, 81.25% and the SEE+Flow group, 81.2% of the restorations had no microleakage. In the SE group, 18.7% of restorations showed zero microleakage, 50% showed grade 3 microleakage, and 31.2% showed grade 2 microleakage. However, in the SE+RMGI group, 81.25% and in the SE+Flow group, 93.7% of the restorations did not have microleakage. The distribution of dentinal microleakage intensity between SEE and SE methods (p=0.067) and between SEE+RMGI and SEE+Flow groups (p=0.194) was not significant. However, in the SE+Flow and SE+RMGI groups, this difference was significant (p

Purpose: The purpose of this in vitro study was to compare the shear bond strength of different universal adhesives to enamel and dentin with and without additional phosphoric acid etching before and after thermocycling (TC). Materials and Methods: The mesial, distal, lingual, and buccal surfaces of the teeth were ground flat to expose two enamel areas and two dentin areas. Specimens were randomly divided into 36 groups (n = 10). Four adhesives were tested: Scotchbond Universal (SBU), Prime & Bond Elect (PBE), All-Bond Universal (ABU), and iBond Universal (IBU). The application was performed in the self-etch mode (SE) or in the etch-and-rinse mode (ER). Optibond FL (OFL) was used as an etch-and-rinse control. After composite buildups were made, half of the groups were tested before and the other half after TC. The failure mode was evaluated using a light microscope. Results: In enamel, mean bond strengths ranged from 13.4 to 21.9 MPa in the SE mode before TC. When used as an ER adhesive, mean bond strengths exceeded 30 MPa. TC did not influence the mean bond strengths in either application mode. Regarding dentin, significant differences in the SE mode were adhesive dependent. Differences were only detected between SBU and IBU before TC and were not present after TC. When SBU, PBE, and ABU were used as ER adhesives, no differences were detected before TC. TC only affected IBU when compared to the other adhesives. Conclusion: Universal adhesives benefit from phosphoric acid etching, as bond strengths increased especially at enamel surfaces. [ABSTRACT FROM AUTHOR]

This study compared the shear bond strength (SBS) and micromorphology of composite resin to human dentin after pre-treatment with silica-modified aluminum oxide air abrasion. Forty-six molar teeth were treated with either Scotchbond Multi-Purpose (SCMP) or Clearfil SE Bond (CLSE) adhesive. Buccal surfaces were pre-treated with the CoJet air abrasion system (SB), and lingual surfaces were controls. The adhesion of light-cured resin composite to the treated dentin surface was evaluated with SBS. After debonding, substrate surfaces were examined with an optical microscope for failure analysis. In addition, 15 molar teeth were sectioned and randomly assigned to one of five groups, according to the dentin surface pre-treatment and adhesive type, and examined with high-vacuum scanning electron microscopy/energy dispersive X-rays (SEM/EDS). The type of adhesive had a significant effect on SBS (p = 0.000); CLSE had the highest values. SB did not affect SBS (p = 0.090). SEM/EDS revealed residual aluminum and/or silicon on all dentin surfaces after SB, except for the control. Treatment with 32% phosphoric acid in the SCMP adhesive decreased the amounts of aluminum and silicon compared to SB dentin only, whereas CLSE resulted in similar quantities of aluminum and silicon as air-abraded dentin. The results of this study indicate that CLSE might have a higher bond strength to dentin than SCMP. Pre-treatment with SB does not appear to affect bonding strength. [ABSTRACT FROM AUTHOR]

Aims: The aim of the present study was to evaluate and compare the push-out bond strength of single and multiple fiber-reinforced posts cemented with dual-cure resin cement using total-etch and self-etch adhesive systems. Methods: Sixty single-rooted maxillary permanent incisors were decoronated and endodontically treated. Following post space preparations, the roots were divided into four groups (n = 15); Group 1: single fiber-reinforced composite post with the total-etching agent, Group 2: single fiber-reinforced composite post with the self-etching agent, Group 3: multiple pin posts with the total-etching agent, and Group 4: multiple pin posts with the self-etching agent and then cemented using dual-cure resin cement. The samples were then sectioned to obtain approximately 2-mm disks, and a push-out test was performed. Data obtained were statistically analyzed using analysis of variance, post hoc Tukey, and unpaired t-test. Results: The mean push-out bond strength values showed that Group 3 had significantly higher bond strength as compared to the other groups (P < 0.05). Conclusions: Dentapreg multiple pin posts with total-etching agents resulted in higher push-out bond strength as compared to single fiber-reinforced posts and self-etching agents. [ABSTRACT FROM AUTHOR]

This study aimed at comparing shear-bond strength (SBS) of different self-etching adhesive systems (Clearfil S3 Bond Plus, G-Premio BOND and IBond) to dentin without or with diode-laser irradiation before photo-polymerization and to determine the effect of storage and thermo-cycling on SBS of adhesive systems. Methods: The buccal surface of 84 extracted maxillary premolars was grounded to create flat surface. The specimens were allocated into 3 groups (n = 28) depending upon the adhesive systems, then each group was divided into two sub-group (I, II) (n = 14). After the placement of respective adhesive systems on the flat surface, adhesive system in group I was photo-polymerized immediately, while in group II, the adhesive systems were exposed to diode-laser before photo-polymerization. Composite cylinder (4 mm in diameter and 2 mm height) was built on the flat surface of each specimen. Then group I and II were divided into two sub-groups (n = 7) according to the storage time and thermo-cycling (1 day without thermo-cycling or 72 days with thermo-cycling) then all the specimens were stored in distilled water. The SBS was measured at the end of storage period. ANOVA, Duncan's Multiple Range Test and independent t -test " P ≤ 0.05" were used for data analysis. Results: G-premio BOND showed the highest mean value of SBS followed by Clearfil S3 Bond plus without significant difference between them, while IBond revealed the least mean value. Laser irradiation had positive effect on the bond-strength of all tested adhesive systems. The results also showed that the storage with thermo-cycling had negative effect on the bond-strength in groups without laser irradiation for all tested adhesive systems, while for groups with laser irradiation, the reduction in the bond-strength of all tested adhesive systems was not significant. Conclusion: Diode-laser application prior to photo-polymerization of self-etch adhesive systems significantly increased the bond-strength to dentin and can increase the durability of composite adhesion. [ABSTRACT FROM AUTHOR]

Objective: A combination of self-etch and additional etch techniques as pre-cementation procedures for fiber post restoration was reported able to increase the bonding of adhesive material. This research aimed to determine the effects of different etching techniques on resin cement penetration into dentinal tubules. Materials and methods: Thirty-two endodontic treated premolars were prepared for 10 mm fiber posts and were divided into two groups (n = 16). Group one was treated with self-etch only, and the second was treated with a combination of self-etch and additional etching. The fiber posts were cemented using fluorescent rhodamine B 0.1%-colored resin cement. The samples were cut to a 2 mm thickness in the middle third of the root and were evaluated with confocal laser scanning microscopy (CLSM). Statistical analysis measurements were analyzed by an independent t-test and Pearson correlation test. Results: There were statistically different in densities hybrid layer and resin tag penetration lengths. Statistically strong linear positive correlations between the hybrid layer density and resin tag penetration length in both groups were also observed. Hybrid layer density (9.68 μm), resin tag penetration depth (32.51 μm) in the self-etch group with additional etching were higher than in the other group. The Pearson correlation test results between hybrid bond density and resin tag penetration depth in the self-etch treatment group showed a value of r = 0.634 and p-value = 0.008 and in the etching group self-treatment with additional etching a value of r = 0.516 and p-value = 0.041 (p ≤ 0.05). Conclusion: There is a statistically significant positive correlation or linear relationship between hybrid bond density and the penetration depth of resin tags in both treatment groups: the thicker the hybrid layer density, the deeper the penetration of the resin tags. This phenomenon may increase mechanical strength regarding stronger binding of resin cement to a tooth’s substrate.

Universal adhesives have been widely used in dentistry due to their easy application process and wide range of applications. In the literature, the etching modes of universal adhesives, coating methods of universal adhesives, pretreatment of adhesive, and other factors were reported to have an impact on the bonding performance of universal adhesives. This review focused on the factors affecting the bonding performance of universal adhesives and aimed to provide evidence-based recommendations for clinical practice. Current research suggests that the etch-and-rinse mode can achieve a better adhesive strength of enamel and that the etch-and-rinse mode and the self-etch mode exhibit a similar adhesive performance in bonding dentin. The bond strength would be improved by prolonging the application time, applying a double layer of adhesives, and wetting enamel and dentin with water or ethanol before adhesive procedures. Chlorohexidine (0.2%) and metal nanoparticles can inhibit matrix metalloproteinases (MMPs) and improve the long-term bond strength of dentin. Finally, universal adhesives have excellent stability and saliva pollution resistance, although they lack blood pollution resistance. In the clinic, dentists should pay attention to the etching modes of universal adhesives, coating methods of universal adhesives, pretreatment of adhesive, and other factors that may affect the effect strength. universal adhesives will be improved in bonding strength of enamel in self-etch mode and bonding performance in demineralized dentals around caries.

Purpose: To evaluate the clinical efficacy at 6 months (6 M) and 12 months (12 M) of 3 adhesive strategies (two-step etch-and-rinse; two-step self-etch; one step self-etch) used in composite resin restorations in primary molars. Methods: This randomized clinical study involved 101 class II restorations in primary molars of 34 children (4–8 years old), distributed by 3 groups according to the 3 tested adhesive systems: GI- ClearfilTMS3Bond Plus (CSB); GII- ClearfilTMSE Protect Bond (CSEPB); GIII- Prime&Bond®XP (PBXP). Restorations were evaluated according to FDI criteria, immediately after execution, at 6 M and 12 M. All ethical and legal requirements were met. Statistical analysis was performed using IBM®SPSS®v26 and MS Excel® (5% significance level). Results: The aesthetic, biological and most of the functional parameters evaluated remained without significant changes over time. Statistically significant differences were only found regarding the "marginal adaptation" parameter at 12 M, with worsening of scores for the three groups (p < 0.001). Comparing the groups, no significant differences were detected between any of the evaluated parameters (aesthetics properties: p = 0.721; functional properties: p = 0.122). Conclusions: After a one-year period, the self-etch adhesives tested presented a clinical efficacy similar to the etch-and-rinse adhesive in restoring class II cavities in primary molars. Trial registration number: ISRCTN11458186. [ABSTRACT FROM AUTHOR]

Abstract Background It is still not fully understood what pretreatment is best for achieving maximum tightness for pit and fissure sealings (PFS). Aim This study investigated microleakage of PFS placed after etching with phosphoric acid or after the application of self‐etching primers/adhesives (SEPA). Design 131 third molars were assigned to ten groups. In Hel‐P, Helioseal® was applied after phosphoric acid etching. In the other groups, SEPA were used (Dyr‐AP: Adper™ Prompt™ L‐Pop™, Dyract® Seal; Bea: BeautiSealant Primer and Paste; Hel‐Exp: Experimental primer, Helioseal®; Hel‐Cl: Clearfil™ SE Bond1, Helioseal®). Specimens were stored in distilled water at 37°C (28 days), followed by 3500 thermocycles and staining with 5% methylene blue (M) or 5% silver nitrate (S). After methylene blue staining and sectioning, microleakage was assessed light microscopically. During silver nitrate staining, specimens were dissolved by 32% HCl and remaining PFS were evaluated under a SEM. Results Tightness, percentage of penetrated area, and maximum dye penetration were best for Hel‐P and Hel‐Cl (p

Objectives: To evaluate the influence of the sonic device on the clinical performance of one‐step self‐etch adhesive systems in non‐carious cervical lesions (NCCLs) after 18 months. Materials and methods: Forty patients participated in this study. Eighty restorations were assigned to two groups (n = 40): Sonic application and Manual application. After the adhesive application (iBond Self‐Etch, Kulzer, Hanau, Germany), NCCLs were restored using composite resin (Charisma, Kulzer, Hanau, Germany). The restorations were evaluated at baseline and after 18 months both according to the Word Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Friedman repeated measures analysis of variance by rank and Wilcoxon test for significance in each pair were applied (α = 0.05). Results: After 18 months, 38 patients were evaluated. Twenty‐three restorations were lost (19 for manual vs. 4 for sonic application). The retention rates (95% confidence interval) were 50% (CI 34.8%–65.1%) for manual application and 84.2% (CI 69.6%–92.6%) for sonic application (p < 0.05). Twelve restorations showed marginal staining (nine for manual vs. three for sonic application; FDI, p < 0.05) and nine some marginal discrepancy (seven for manual vs. two for sonic application; FDI, p < 0.05). No restorations showed postoperative sensitivity and caries recurrence at the time. Conclusion: The sonic application increases the retention rate of iBond Self‐Etch after 18 months of clinical evaluation in NCCLs. Clinical relevance: The application of a simplified self‐etch adhesive (iBond Self‐Etch) associated to a sonic device seems to be an alternative to improve the clinical behavior in NCCLs. [ABSTRACT FROM AUTHOR]

Background: Self-etching has been shown to be beneficial compared to the other resin sealants especially in pediatric practice. The present in-vivo study was designed to clinically evaluate the sealing ability and retention of the self-etching sealant compared to the conventional resin sealant. The aim was to evaluate and compare the retention and marginal integrity of the self-etch and acid etch sealant materials at three, six and twelve-month follow up. Methods: The study was designed as a double blinded, split mouth randomized controlled trial, . In total, 35 children (70 teeth) between 7 and 10 years of age formed part of the study. Group 1 received acid-etch sealant and Group 2 received self-etch sealants. The study participants and the investigator who performed the statistical analysis were blinded to the treatment allocation. All the samples were evaluated at 3, 6, and 12 months. The inter-group and intragroup comparison were carried out using the Chi-Square test and Friedman test with level of significance set at 5% and the P value less than 0.05. Results: Complete retention of sealants was observed in 34.5% of conventional acid etch (group 1) and 22.9% of self-etch samples (group 2) whereas complete loss of sealants were seen in 11.4% of group 1 and 20% of the group 2 samples and intergroup comparison of retention failure was non-significant (p=0.135). In total, 85.7% of the group 1 and 82.9% of the group 2 samples exhibited good marginal integrity with no clinical changes in the enamel around the margins but this was not statistically significant (p=0.5). Conclusions: Sealants with fewer procedural steps and those which provide adequate retention would be ideal for use in children. Thus, self-etch sealants have been found to be effective and efficient as a sealant in the present in-vivo study. Clinical Trials Registry, India registration: CTRI/2019/03/018343 (29/03/2019).

Background: Self-etching has been shown to be beneficial compared to the other resin sealants especially in pediatric practice. The present in-vivo study was designed to clinically evaluate the sealing ability and retention of the self-etching sealant compared to the conventional resin sealant. The aim was to evaluate and compare the retention and marginal integrity of the self-etch and acid etch sealant materials at three, six and twelve-month follow up. Methods: The study was designed as a double blinded, split mouth randomized controlled trial, . In total, 35 children (70 teeth) between 7 and 10 years of age formed part of the study. Group 1 received acid-etch sealant and Group 2 received self-etch sealants. The study participants and the investigator who performed the statistical analysis were blinded to the treatment allocation. All the samples were evaluated at 3, 6, and 12 months. The inter-group and intragroup comparison were carried out using the Chi-Square test and Friedman test with level of significance set at 5% and the P value less than 0.05. Results: Complete retention of sealants was observed in 34.5% of conventional acid etch (group 1) and 22.9% of self-etch samples (group 2) whereas complete loss of sealants were seen in 11.4% of group 1 and 20% of the group 2 samples and intergroup comparison of retention failure was non-significant (p=0.135). In total, 85.7% of the group 1 and 82.9% of the group 2 samples exhibited good marginal integrity with no clinical changes in the enamel around the margins but this was not statistically significant (p=0.5). Conclusions: Sealants with fewer procedural steps and those which provide adequate retention would be ideal for use in children. Thus, self-etch sealants have been found to be effective and efficient as a sealant in the present in-vivo study. Clinical Trials Registry, India registration: CTRI/2019/03/018343 (29/03/2019).

Background: Self-etching has been shown to be beneficial compared to the other resin sealants especially in pediatric practice. The present in-vivo study was designed to clinically evaluate the sealing ability and retention of the self-etching sealant compared to the conventional resin sealant. The aim was to evaluate and compare the retention and marginal integrity of the self-etch and acid etch sealant materials at three, six and twelve-month follow up. Methods: This was designed a randomized controlled trial, with double blind parallel, split-mouth design. In total, 35 children (70 teeth) between 7 and 10 years of age formed part of the study. Group 1 received acid-etch sealant and Group 2 received self-etch sealants. The study participants and the investigator who performed the statistical analysis were blinded to the treatment allocation. All the samples were evaluated at 3, 6, and 12 months. The inter-group and intragroup comparison were carried out using the Chi-Square test and Friedman test with level of significance set at 5% and the P value less than 0.05. Results: Complete retention of sealants was observed in 34.5% of conventional acid etch (group 1) and 22.9% of self-etch samples (group 2) whereas complete loss of sealants were seen in 11.4% of group 1 and 20% of the group 2 samples and intergroup comparison of retention failure was non-significant (p=0.135). In total, 85.7% of the group 1 and 82.9% of the group 2 samples exhibited good marginal integrity with no clinical changes in the enamel around the margins but this was not statistically significant (p=0.5). Conclusions: Sealants with fewer procedural steps and those which provide adequate retention would be ideal for use in children. Thus, self-etch sealants have been found to be effective and efficient as a sealant in the present in-vivo study. Clinical Trials Registry, India registration: CTRI/2019/03/018343 (29/03/2019).

Background: Self-etching has been shown to be beneficial compared to the other resin sealants especially in pediatric practice. The present in-vivo study was designed to clinically evaluate the sealing ability and retention of the self-etching sealant compared to the conventional resin sealant. The aim was to evaluate and compare the retention and marginal integrity of the self-etch and acid etch sealant materials at three, six and twelve-month follow up. Methods: The study was designed as a double blinded, split mouth randomized controlled trial, . In total, 35 children (70 teeth) between 7 and 10 years of age formed part of the study. Group 1 received acid-etch sealant and Group 2 received self-etch sealants. The study participants and the investigator who performed the statistical analysis were blinded to the treatment allocation. All the samples were evaluated at 3, 6, and 12 months. The inter-group and intragroup comparison were carried out using the Chi-Square test and Friedman test with level of significance set at 5% and the P value less than 0.05. Results: Complete retention of sealants was observed in 34.5% of conventional acid etch (group 1) and 22.9% of self-etch samples (group 2) whereas complete loss of sealants were seen in 11.4% of group 1 and 20% of the group 2 samples and intergroup comparison of retention failure was non-significant (p=0.135). In total, 85.7% of the group 1 and 82.9% of the group 2 samples exhibited good marginal integrity with no clinical changes in the enamel around the margins but this was not statistically significant (p=0.5). Conclusions: Sealants with fewer procedural steps and those which provide adequate retention would be ideal for use in children. Thus, self-etch sealants have been found to be effective and efficient as a sealant in the present in-vivo study. Clinical Trials Registry, India registration: CTRI/2019/03/018343 (29/03/2019).

Purpose: To evaluate the effect of water storage and cyclic loading on the microtensile bond strength (µTBS) and fracture pattern of adhesives to dentin. Materials and Methods: Midcoronal dentin surfaces (n = 36) were prepared and composite restorations were built up using two adhesives (self-etch and etch-and-rinse). The specimens were randomly divided into 3 groups according to the aging conditions (n = 6): 1. control: storage in water for 24 h (CO); 2. water storage: storage in water for 6 months (WS); 3. mechanical loading: 750,000 mechanical cycles (ML) using the Rub&Roll loading device. Specimens were sections into beams and the μTBS was tested. Fracture patterns were analyzed using stereomicroscopy and fractographic analysis was performed using SEM. μTBS data (n = 53-72 specimens) were subjected to two-way ANOVA and Tukey's post-hoc test. The chi-squared test was used to compare the distribution of failure modes (p < 0.05). Results: Aging conditions and adhesives significantly affected μTBS (p < 0.01). The CO group showed no difference between materials and had highest μTBS. After WS, the self-etch adhesive showed higher μTBS than did the etchand- rinse adhesive. ML resulted in lower μTBS for both adhesives. Materials (p < 0.01) and aging (p < 0.01) significantly influenced the distribution of failure modes. SEM analysis showed that specimens submitted to WS or ML showed features of degradation and fatigue at the fractured interface, depending on the adhesive. Conclusion: Mechanical loading had a negative effect on the bonding efficacy of both adhesives and influenced the fracture pattern, with specimens presenting a different fracture surface from that observed in water-stored specimens. [ABSTRACT FROM AUTHOR]