Impact of active vs. passive application of dental adhesives on bond strength to dentin and enamel: A systematic review and meta-analysis of in vitro studies

Abstract

The application method of adhesive systems affects both immediate and long-term bond strength. This systematic review analyzed in vitro studies comparing active versus passive application of adhesives on enamel and dentin, regardless of classification. A comprehensive search was conducted in PubMed/Medline, Embase, Scopus, Web of Science, Lilacs, and Grey Literature. Included studies assessed bond strength with active or passive application. Meta-analyses were stratified by substrate (enamel and dentin) and application mode (etch-and-rinse or self-etching), using a random-effects model and I² index for heterogeneity. The RobDEMAT tool assessed the risk of bias. Out of 3022 articles, 23 met the inclusion criteria. Meta-analysis showed that passive application of universal adhesives in etch-and-rinse mode resulted in higher bond strength to enamel. However, active application of etch-and-rinse or universal adhesives in etch-and-rinse mode improved bond strength on dentin. For self-etching or universal adhesives in self-etching mode, active application enhanced bond strength on both enamel and dentin. Few studies assessed longevity, but those that did reported positive outcomes for active application. One self-curing universal adhesive showed significantly different results. In conclusion, active application improves bond strength to dentin in two-step etch-and-rinse mode and to unconditioned enamel and dentin in self-etching mode.

Keywords: Adhesion; Application mode; Dental substrates; Dentin-bonding agents; Enamel; Rubbing.

Fig. 1

Diagram of searches and selection of studies.

Fig. 2

Risk of bias for each selected study.

Fig. 3

Forest plot showing the bond strength results of universal adhesives used in the etch-and-rinse mode in enamel. (I) Scotchbond Universal; (II) All-Bond Universal; (III) Adhese Universal e (IV) G-Premio Bond.

Fig. 4

Forest plot showing the bond strength results of etch-and-rinse and universal adhesives used in the etch-and-rinse mode on dentin. (I) OptBond FL; (II) One-Step; (III) One-Step Plus; (IV) Clearfil Universal Bond Quick; (V) All Bond Universal; (VI) Adhese Universal e (VII) Scotchbond Universal.

Fig. 5

Forest plot showing the bond strength results of self-etching and universal adhesives used in the self-etching mode on enamel. (I) Clearfil S3 Bond; (II) G-Bond; (III) Optibond All-in-One; (IV) Futurabond; (V) Scotchbond Universal; (VI) All-Bond Universal; (VII) Adhese Universal; (VIII) G-Premio Bond; (IX) Clearfil Universal; (X) Futurabond U; (XI) G-Bond Plus e (XII) Prime&Bond Elect.

Fig. 6

Forest plot showing the bond strength results of self-etching and universal adhesives used in self-etching mode on dentin. (I) Adper Prompt L-Pop; (II) Xeno III; (III) Clearfil S3 Bond; (IV) One Up Bond F Plus; (V) Futurabond NR; (VI) Bond Force; (VII) Clearfil SE One; (VIII) Optibond All-in-One; (IX) Futurabond; (X) Adper Easy-One; (XI) Adper SE Plus; (XII) Clearfil SE Bond; (XIII) Clearfil Protect Bond; (XIV) Clearfil Universal Bond Quick; (XV) OptiBond Universal; (VXI) Prime&Bond Universal; (XVII) Scotchbond Universal; (XVIII) Clearfil Universal Bond; (XIX) G-Premio Bond; (XX) All Bond Universal; (XXI) Adhese Universal; and (XXII) Tokuyama Universal Bond.