Does the etching strategy influence the bonding of universal adhesive systems to primary teeth? A systematic review and meta-analysis of in vitro studies.

PURPOSE: To assess through a systematic review and meta-analysis of in vitro studies, the influence of the etching strategy (etch-and-rinse versus self-etch) of universal adhesive systems on bonding to primary teeth. METHODS: A systematic search was carried out in PubMed, Web of Science and Scopus. In vitro studies that compared the bond strength of the etching strategies of universal adhesives to primary teeth were included. Pooled-effect estimates were derived from a random-effects model by comparing the standardized mean difference between the etching strategies (α < 0.05). The risk of bias and heterogeneity between studies were also assessed (Cochrane and I2 tests). RESULTS: Seven studies were included in the review and six in the meta-analyses. For dentin, the immediate bond strength was not influenced by the etching strategy regardless of sound (Z = 0.72, p = 0.47) or caries-affected (Z = 1.27, p = 0.21) substrate, nor after aging (Z = 0.24, p = 0.81). It was not possible to perform a meta-analysis for the enamel substrate. Most studies have a medium risk of bias. CONCLUSIONS: This systematic review and meta-analysis of in vitro studies provides evidence that universal adhesives can be used in both etching strategies in primary dentin. The evidence is currently insufficient about whether selective acid etching of primary enamel is necessary when universal adhesive systems are used.

Degradation of resin-dentine bond of different adhesive systems to primary and permanent dentine.

AIM: To evaluate the water storage degradation of resin-dentine bonds of different adhesive systems to primary and permanent human dentine. METHODS: Flat occlusal human dentine surfaces of 15 primary molars and 15 permanent molars were randomly assigned according to adhesive systems: Adper Single Bond 2; Clearfil SE Bond and One Up Bond F Plus. After bonding procedures, the adhesives were applied according to the manufacturers' instructions and composite resin blocks were built. Restored teeth were sectioned rendering rectangular sticks (RS) (0.4 mm2). The RS were submitted to microtensile bond strength (µTBS) test according to the water storage time: 24 h, 1-year, and 2-years. Mean µTBS values were analysed by three-way analysis of variance (mixed design) and Tukey post hoc test (α = 0.05). The failure mode was analysed at 400× magnification. RESULTS: All three factors isolated showed significant influences on µTBS, as did the cross-product interactions between material vs. storage time (p = 0.01) and substrate vs. storage time (p = 0.002). Bond strength means to primary dentine were lower than to permanent dentine (34.7 ± 10.1 and 45.8 ± 12.9 mPa, respectively) after 2-years of water storage. The one-step self-etch adhesive (One Up Bond F Plus) showed less stable bond strength after 2-years of water storage. CONCLUSION: The resin-dentine bond of primary teeth was more prone to degradation over time compared to permanent dentine.