Immediate and 6-month Bond Strengths of Different

Adhesives in the Oral Environment

Jamille Favarãoa / Maurício Matté Zaninib / Mário Alexandre Coelho Sinhoretic / Gabriel Flores Abunad /
Cláudio Girelli Júniore / Veridiana Camilottif / Marcelo Gianninig / Marcio José Mendonçah

Purpose: To evaluate the microtensile bond strength (μTBS) of three adhesives to dentin after 1 week and
6 months in an oral environment.
Materials and Methods: Class I cavities were prepared in the third molars of 30 patients and randomized into
3 groups according to the following adhesives: Scotchbond Multi-Purpose (SM), Clearfil Protect Bond (CF), and
Scotchbond Universal (UN). These molars were then subdivided into two groups according to the exposure time in
the oral environment: one week (1W) and 6 months (6M). After the exposure time, the teeth were extracted, cut
into beams, and submitted to the μTBS test. The data were analyzed using the Shapiro-Wilk test and two-way
ANOVA followed by Tukey’s post-hoc test with a significance level of 5%, and fracture modes were analyzed.
Results: The bond strengths in MPa (mean ± SD) were SM-1W: 39.5 ± 7.9; SM-6M: 29.7 ± 1.8; CF-1W:
30.5 ± 1.4; CF-6M: 28.6 ± 4.1; UN-1W: 30.6 ± 3.2; and UN-6M: 26.7 ± 2.0. The SM-1W group exhibited signifi-
cantly increased μTBS compared with the other groups. After 6 months in the oral environment, a significant re-
duction of μTBS was only observed for the SM group, whereas similar bond strengths were observed for the other
groups. SM-1W exhibited a predominance of mixed fractures, whereas the other groups showed a predominance
of adhesive fractures.
Conclusions: The adhesives which were applied in the self-etching mode maintained bond strength after six
months in the oral environment. A reduction of μTBS was only observed for the three-step etch-and-rinse adhesive.
Key words: dentin bonding agents, tensile strength, dentin, clinical study.

J Adhes Dent 2017; 19: 475–481. Submitted for publication: 04.08.17; accepted for publication: 02.12.17
doi: 10.3290/j.jad.a39594

T he adhesive strategies currently employed for dentin

bonding include etch-and-rinse or self-etch ap-
proaches.23 An initial etching step followed by a rinsing
phase, a priming step and the application of hydrophobic
resin is necessary for three-step etch-and-rinse adhesives.
Two-step etch-and-rinse adhesives combine the primer and
hydrophobic resin into one application, and the mechanism
is principally based on the combined effect of hybridization
and resin tag formation.22
Self-etching adhesives incorporate a dissolved smear
layer and demineralized dentin components. These adhe-
sives do not require a separate etching step because they
contain acidic resin monomers that simultaneously “etch“
and “prime“ the dental substrates.3 The process has been
further simplified by reducing the number of steps from the
initial two-step adhesive (an acidic primer followed by the
application of a relatively hydrophobic bonding resin on top
of the primed surface) to a one-step adhesive, in which all

a PhD Student, Department of Restorative Dentistry, Dental Materials Division,
Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Bra-
zil. Performed restorations, wrote the manuscript.
b PhD Student, Department of Restorative Dentistry, Dental Materials Division,
Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
Performed microtensile test, and statistical evaluation.
c Professor, Department of Restorative Dentistry, Dental Materials Division,
Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo,
Brazil. Contributed substantially to the discussion and proofread manuscript.
d PhD Student, Department of Restorative Dentistry, Dental Materials Division,
Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo,
Brazil. Performed MEV images.
e Dentist, Department of Prosthodontics, University Estadual do Oeste do
Paraná, UNIOESTE, Cascavel, Paraná, Brazil. Performed exodontic surgery.
f Adjunctive Professor, Department of Prosthodontics, University Estadual do
Oeste do Paraná, UNIOESTE, Cascavel, Paraná, Brazil. Experimental design.
g Professor, Department of Restorative Dentistry, Operative Dentistry Division,
Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo,
Brazil. Contributed substantially to the discussion.
h Adjunctive Professor, Department of Prosthodontics, University Estadual do
Oeste do Paraná, UNIOESTE, Cascavel, Paraná, Brazil. Idea and hypothesis.
Correspondence: Jamille Favarão, Rua Rui Barbosa, 319 / Centro, Vera Cruz
do Oeste, Paraná, Brazil 85845-000. Tel: +55-45-99-983-0623;
e-mail: jamillefavarao@hotmail.com

Vol 19, No 6, 2017 475

Favarão et al

Assessed eligibility (Np = 162)

Excluded (Np = 126)

Did not meet the inclusion criteria (Np = 121)
Under 18 years (Np = 7)
Included third molars (Np = 36)
Third molar badly positioned (Np = 53)
Third molar caries (Np = 13)
Restored third molars (Np = 4)
Systematic diseases (Np = 7)
Pregnant woman (Np = 1)
Refused to participate (Np = 5)

Randomized (Np = 36; Nt = 36)

Allocated to extraction after Allocated to extraction after

1 week (Np = 17; Nt = 17) 6 months (Np = 19; Nt = 19)

Restored using Restored using Restored using Restored using Restored using Restored using
Scotchbond Clearfil Protect Scotchbond Scotchbond Clearfil Protect Scotchbond
Multi-Purpose Bond Universal Multi-Purpose Bond Universal
(Np = 5; Nt = 5) (Np = 6; Nt = 6) (Np = 6; Nt = 6) (Np = 6; Nt = 6) (Np = 7; Nt = 7) (Np = 6; Nt = 6)

Discontinued intervention
Discontinued intervention (Np = 4; Nt = 4)
(Np = 2; Nt = 2) Pregnant woman
Dropouts (Np = 2; Nt = 2) (Np = 1; Nt = 1)
Dropouts (Np = 3; Nt = 3)

Extraction Extraction Extraction Extraction Extraction Extraction

Scotchbond Clearfil Protect Scotchbond Scotchbond Clearfil Protect Scotchbond
Multi-Purpose Bond Universal Multi-Purpose Bond Universal
(Np = 5; Nt = 5) (Np = 5; Nt = 5) (Np = 5; Nt = 5) (Np = 5; Nt = 5) (Np = 5; Nt = 5) (Np = 5; Nt = 5)

Fig 1 Flow diagram. Np = number of patients; Nt = number of teeth.

components (acidic primer and bonding resin) are incorpo-
rated into a single solution.22
The elimination of separate etching and rinsing steps
has simplified the bonding technique and increased the
popularity of these adhesives in daily practice; however,
manufacturers understand that professionals apply their
own criteria to selecting an adhesive strategy based on the
numbers of steps. Thus, more versatile adhesives that in-
clude etch-and-rinse (two-step) and self-etch (one- or two-
step) options have been released. These new materials are
called “universal” or “multimode” adhesives and can be
applied either with the etch-and-rinse or the self-etch tech-
nique, thus enabling the practitioner to select a specific
adhesive protocol.24
The ability of an adhesive to bond to dentin is commonly
tested using in vitro bond strength tests. These laboratory
tests are designed to closely simulate optimal clinical con-
ditions and are much less expensive than clinical trials be-
cause that they do not require several years to elicit mean-
ingful outcomes. In addition, laboratory testing can evaluate
the effect of a single variable if all of the other variables are
kept constant.13
Although laboratory research can predict the clinical per-
formance of a new adhesive to a certain extent, a clinical
study is always desirable to confirm these results and deter-
mine the clinical bonding efficacy of an adhesive in general
dental practice. Several clinical co-variables that are unique
to the oral environment and affect the clinical performance
of adhesives have been described, such as moisture, physi-
cal stresses, chewing habits, dietary components, and
changes in temperature and pH. These variables may act
simultaneously to accelerate degradation of the adhesive
bonds or result in catastrophic or even fatigue failures.19
A significant reduction in bond strength occurs after long
periods in aqueous environments because absorbed water
affects the mechanical properties of the resin matrix mater-
ial and metalloproteinase activities.3 Therefore, the pur-
pose of this study was to compare the bond strength of
three adhesives (a 3-step etch-and-rinse, a 2-step self-etch,
and a universal adhesive applied in the self-etch mode) to

476 The Journal of Adhesive Dentistry


Table 1 Experimental groups
Adhesives Exposure time in oral environment
Scotchbond Multi-Purpose (3-step etch-and-rinse) 1W, control
6M
Clearfil Protect Bond (2-step self-etch) 1W
6M
Scotchbond Universal (universal, self-etch mode) 1W
6M
W: week; M: month.
dentin in restorations of class I cavities after 1-week and
6-month service in the oral environment. The null hypothe-
sis was that long-term exposure to the oral environment
and differences in adhesive composition and application
approach do not affect the microtensile bond strength
(μTBS) to dentin.
MATERIALS AND METHODS
The experimental design followed the Consolidated Stan-
dards of Reporting Trials (CONSORT) statement.20 This was
a randomized, blind, prospective clinical trial. All partici-
pants were informed about the nature and objectives of the
study; however, they were not aware of the adhesive that
would be used in the restoration to be evaluated.
The local Ethics Committee on Investigations Involving
Human Subjects reviewed and approved the protocol and
consent form for this study. Written informed consent was
obtained from all participants prior to starting treatment.
Based on pre-established criteria, 30 volunteers were se-
lected (Fig 1).
A total of 162 participants with at least one sound third
molar indicated for extraction were examined by a pre-cali-
brated operator to determine whether they met the following
inclusion and exclusion criteria (Fig 1): good general health,
at least 18 years of age, not allergic to any component of
the materials used. Moreover, the participant’s teeth had to
have occlusal contact and a position that allowed for abso-
lute isolation and extraction without odontosection.
Thirty patients were selected, with one tooth each to be
restored. The patients were randomly assigned to 3 groups
according to the adhesive used: Scotchbond Multi-Purpose
(SM) (3M; St Paul, MN, USA); Clearfil Protect Bond (CF) (Ku-
raray Noritake; Tokyo, Japan); Scotchbond Universal (UN)
(3M). Each group was divided into two subgroups with 5
teeth per group according to the exposure time in the oral
environment, 1 week or 6 months (Table 1).2,8
The same calibrated operator restored all teeth. Radio-
graphs were obtained using the panoramic and interproxi-
mal techniques. Before placing the rubber-dam, the oper-
ator anesthetized the teeth with 3% mepivacaine solution
Vol 19, No 6, 2017
Favarão et al
Manufacturer and lot
3M; St Paul, MN, USA.
Primer: N478117
Adhesive: N465871
Kuraray Noritake; Tokyo, Japan.
Primer: 00115A
Adhesive: 00212A
3M
504834
(Mepisv, Nova DFL; Rio de Janeiro, RJ, Brazil); the teeth
were then cleaned with pumice and water followed by rins-
ing and drying.
Class I cavities were prepared (4 mm in width x 5 mm in
length x 3 mm in depth) with the cavosurface margin in
enamel, flat bottom wall, and parallel surrounding walls.
The cavity was prepared first using a spherical diamond bur
(#1014, KG Sorensen; Cotia, SP, Brazil), followed by a cy-
lindrical diamond bur (#2094, KG Sorensen), and finished
with a superfine diamond bur (#1093FF, KG Sorensen). The
burs were replaced after five preparations to maintain cut-
ting efficacy. Cavity depth was measured with a millimeter
periodontal probe (Golgran; São Caetano do Sul, SP, Bra-
zil). The teeth receiving the conventional etch-and-rinse ad-
hesive (Scotchbond Multi-Purpose) were conditioned with
37% phosphoric acid (Condac 37, FGM; Joinville, Brazil).
Clearfil Protect Bond and Scothcbond Universal were
applied in the self-etch mode. All adhesives were applied
according to the manufacturer’s instructions (Table 2).
All photoactivation procedures were performed using an
LED-curing unit at 1200 mW/cm2 (Bluephase G2, Ivoclar
Vivadent; Schaan, Liechtenstein). Filtek Z350 composite
shade A2 (3M) was applied in 2-mm increments and light
cured for 20 s. Then, the occlusal adjustment of the restor-
ations was performed with a diamond bur (#1111FF, KG
Sorensen) so that the tooth presented occlusal contact.
The restorations were finished with Enhance (Dentsply;
Petrópolis, RJ, Brazil) and polished with diamond felt disks
(FGM) and Prisma Gloss paste (Dentsply).
The restored teeth remained in the oral environment for
periods of one week (± 1 day) or 6 months (± 7 days). After
these periods, the teeth were extracted by a single special-
ist in maxillofacial surgery, individually stored in 0.5% chlo-
ramine solution for 1 week under refrigeration at 4°C, and
stored in distilled water at 37°C for 24 h.8
Two-mm increments of composite were added to the oc-
clusal surface of the composite restorations to obtain sam-
ples with a suitable length so that they could be adapted to
the testing machine.
The teeth were then positioned in a diamond cutting ma-
chine (Isomet 1000, Buehler; Lake Bluff, IL, USA) and sec-
tioned in the mesiodistal and buccolingual directions to
477
Favarão et al

Table 2 Composition and application mode

Adhesives Composition Application mode

Scotchbond Multi-Purpose
Primer: HEMA, polyalkenoic acid polymer, water 1. Acid etch for 15 s, rinse for 15 s. Blot excess
water using absorbent paper.
Adhesive: bis-GMA, HEMA, tertiary amines, photo- 2. Apply one coat of primer.
initiator 3. Gently blow air for 5 s at 10 cm to evaporate solvent.
4. Apply one coat of adhesive.
5. Light cure for 10 s.

Clearfil Protect Bond
Primer: MDPB, MDP, HEMA, hydrophilic aliphatic
methacrylate, water, CQ, dyes, initiators,
accelerators
Adhesive: MDP, bis-GMA, HEMA, hydrophobic
aliphatic methacrylate, sodium fluoride, colloidal
silica, CQ, initiators, accelerators
1. Dispense the necessary amount of primer into a
well of the mixing dish immediately before
application. Avoid exposing the material to
operating light or natural light. After 3 min, apply to
the entire cavity wall. Leave it in place for 20 s.
Gently blow air to evaporate the volatile ingredients.
2. Dispense the necessary amount of bond into a
well of the mixing dish immediately before
application. Avoid exposing the material to
operating light or natural light. After 3 min, apply to
the entire cavity wall. Create a uniform bond film
using a gentle blow air.
3. Light cure for 10 s.

Scotchbond Universal
MDP, bis-GMA, HEMA, decamethylene DMA, ethanol, 1. Apply the adhesive for 20 s with vigorous agitation.
water, silane treated silica, 2-propenoic acid, 2. Gently air thin for 5 s.
2-methyl-, reaction products with 1,10-decanediol 3. Light cure for 10 s.
and phosphorous oxide, copolymer of acrylic and
itaconic acid, dimethylaminobenzoate(−4),
camphorquinone, (dimethylamino)ethyl
methacrylate, methyl ethyl ketone

Table 3 Mean values and standard deviation of experimental groups’ bond strength (MPa)

Adhesive Exposure time

1 week 6 months
Scotchbond Multi-Purpose 39.5 ± 7.9Aa (control) 29.7 ± 1.8Ba

Clearfil Protect Bond 30.5 ± 1.4Ab 28.6 ± 4.1Aa

Scotchbond Universal 30.6 ± 3.2Ab 26.7 ± 2.0Aa

Different upper case letters represent statistically significant differences in rows. Different lower case letters indicate statistically significant differences in columns.

obtain sticks with a 0.75 ± 0.1 mm2 cross-sectional area8
and the long axis perpendicular to the pulp wall. Seven to
ten sticks per tooth were obtained, of which the central five
were used for mechanical tests to standardize the location
of the sticks.
The cross-sectional area of the sticks was measured
with a digital caliper to transform kgf to MPa. Then, the
specimens were attached to a microtensile device (0G01,
Geraldeli’s jig) with a cyanoacrylate adhesive (Henkel;
Itapevi, SP, Brazil) and loaded to failure in tension using a
universal testing machine (Instron 4411; Canton, MA, USA)
at a crosshead speed of 1.0 mm/min2 until failure.
Fractured specimens were examined with an optical mi-
croscope (Leica Microsystems; Wetzlar, Germany) at 40X
magnification by a single blinded and calibrated operator to
determine the failure mode. Failure modes were classified
as adhesive, mixed or cohesive.
Representative fractured sticks from each group were
desiccated, mounted in aluminum stubs, and sputter
coated with gold (Balzers SCD 050 Sputter Coater, Balzers
Union; Balzers, Liechtenstein) to analyze the fracture pat-
terns via SEM (JSM 5600 LV, JEOL; Tokyo, Japan).
The data were subjected to the Shapiro-Wilk test, a two-
way ANOVA, and Tukey’s post-hoc test at a pre-set alpha of
0.05 using Bioestat 5.1 software (Maua Institute; São
Paulo, AM, Brazil).
RESULTS
The mean μTBS, including the standard deviation, are pre-
sented in Table 3.
Two-way ANOVA revealed significant differences
(p < 0.05) among the adhesives and exposure time factors;

478 The Journal of Adhesive Dentistry

 Favarão et al

with the increase of exposure time in the oral environment,

there was a reduction in the dentin bond strength for one of 100%
the adhesives. Tukey’s post-hoc test demonstrated that the
use of SM adhesive with one week of oral environment ex- 80%
posure yielded μTBS that were significantly higher than
those of the other adhesives, which did not differ signifi- 60%
cantly. However, a reduction in bond strength to dentin was
observed only for the SM adhesive after six months. 40%
Fracture analysis revealed a predominance of mixed fail-
ures for SM at 1 week, whereas the SM (6 months), CF and 20%
UN adhesives showed increased percentages of adhesive
failures (Fig 2). Cohesive failures within dentin or resin were 0%
not observed. Figure 3 depicts representative SEM images

1S (Control)

6M

1S

6M

1S

6M
of the failures for each group.

DISCUSSION Scotchbond Clearfil Protect Scotchbond

In the oral environment, a number of factors acting simulta-
neously, including moisture, physical stress, chewing hab-
its, dietary components, as well as changes in temperature
and pH, may accelerate the degradation of adhesive bonds
or result in catastrophic or even fatigue failures. Thus, once
an adhesive performs well in vitro, a clinical trial is neces-
sary to evaluate its efficacy.18
Therefore, the present study was conducted using differ-
ent exposure times in the oral environment. Restorations
with different adhesives were performed to better under-
stand the behavior of these adhesives in clinical conditions.
In this study, the 3-step etch-and-rinse adhesive Scotch-
bond Multi-Purpose exhibited the highest bond strengths
after 1 week in the oral environment (39.5 MPa). This find-
ing was related to the increased retentive area on the den-
tin surface created by phosphoric acid, as well as the pres-
ence of the resin bond which sealed dentin and produced
Multi-Purpose Bond Universal
Mixed
Adhesive
Fig 2 Fracture pattern analysis in %.
the initial μTBS.10 Similar results were found by Hamouda
et al,9 who compared the in vitro bond strength of self-etch
and etch-and-rinse adhesives after 24 h and found that the
latter adhesive exhibited significantly higher bond strength
(38.3 MPa).
Despite obtaining the best results after 1 week in the
oral environment, the etch-and-rinse adhesive showed a re-
duction in bond strength of 25% (29.7 MPa) after 6 months.
Similar results were obtained by Hashimoto et al,11 who
evaluated primary molars restored using Scotchbond
Multi-Purpose in vivo and observed a reduction in bond

D D
A A

C
a b

C
Fig 3 SEM micrographs of debonded speci-
mens. Images a and b show a mixed failure A
for group SM-1S, with remnants of the ad- C
hesive (A) and composite (C) attached to A
dentin (D). Images c and d show an adhe-
sive failure for group UN-6M, without expo-
c d
sure of dentin surface.

Vol 19, No 6, 2017 479

Favarão et al
strengths after 1, 2, and 3 years in the oral environment.
The in vitro results of Bravis et al,4 who evaluated the bond
strength of etch-and-rinse and self-etch adhesives after
250,000 cycles with mechanical loading of 80 N also re-
vealed a statistically significant reduction in bond strength
for the etch-and-rinse adhesive, whereas the self-etch adhe-
sive demonstrated no difference in bond strength after me-
chanical loading.
The reduction in bond strength may well have been re-
lated to collagen exposed during etching which was not filled
by the adhesive; thus, it was degraded by the dentin matrix
metalloproteinases (MMPs). In demineralized dentin, organic
matrix exposure is noted and essentially represented by type
I collagen and proteoglycans that should be completely infil-
trated by adhesive to form the hybrid layer.1 However, a de-
crease in the diffusion gradient of the resin monomers re-
sults in a demineralized collagen matrix layer that is not filled
with monomers.3 Even without bacterial exposure, collagen
may be degraded by metalloproteinases present in the den-
tin matrix, because MMPs are activated by the low-pH phos-
phoric acid and are responsible for the collagen fibril triple-
helix breakdown and its subsequent degradation.6
The universal adhesive Scotchbond Universal (applied in
the self-etch mode) presented μTBS similar to that of
Clearfil Protect Bond and did not show reductions in μTBS
after 6 months in the oral environment. Clearfil Protect
Bond is derived from Clearfil SE Bond, which is considered
a reference for all self-etch adhesives.7,18 However, Clearfil
Protect Bond contains MDPB monomer (12 methacryloyloxy-
dodecyl-pyridinium bromide), an antibacterial agent that co-
polymerizes with other monomers after curing, in addition to
10-MDP monomer.17
Clearfil Protect Bond and Scotchbond Universal have a
pH of approximately 2, which leads to partial demineraliza-
tion of dentin and leaves a substantial amount of hydroxy-
apatite around the collagen fibrils. Self-etch adhesives at
this pH are considered mild, and the maintenance of hy-
droxyapatite protects the collagen fibrils against hydrolytic
and enzymatic degradation.3
The similar results for these two materials may have
resulted from the presence of 10-MDP (10-methacryloyl-
oxydecyl dihydrogen phosphate), which chemically bonds to
dentin. This chemical interaction is effective because of
the formation of a nanolayer on the adhesive interface,
which improves the mechanical resistance of this region.
The interaction of 10-MDP with dentin occurs via ionic
bonds with calcium hydroxyapatite.25 MDP-Ca salts are
formed as a product of this reaction, and these salts are
stable because of their low dissolution rate. The advan-
tages of chemical adhesion are increased bond strength in
the short and long term and the reduction of hybrid layer
degradation.23 In addition to 10-MDP monomer, Scotch-
bond Universal contains Vitrebond copolymer. This poly-
alkenoic acid copolymer also helps to retain the moisture
of demineralized dentin, thus improving monomer infiltra-
tion.22 These features are consistent with the results ob-
tained in this study for self-etch adhesives after 6 months
in the oral environment.
480
Wagner et al25 also found similar results to those of this
study. They evaluated the in vitro bond strength of universal
adhesives and verified that these materials maintained the
bond strength after thermocycling. Marchesi et al15 re-
ported that although Scotchbond Universal showed a reduc-
tion in adhesive bond strength after 6 months of storage in
artificial saliva, the values were maintained after one year.
However, Muñoz et al16 evaluated the immediate in vitro
bond strength of different adhesives (etch-and-rinse, two-
step self-etch, and universal) and found that universal adhe-
sives showed lower bond strength when compared with the
two-step self-etch adhesives.
The differences in the results observed in certain labora-
tory studies may be related to the aging methods. For ex-
ample, in many in vitro studies, the sticks are aged in dis-
tilled water or artificial saliva,12,14,15 which directly exposes
the interface to the hydrolytic action of the storage solution.
In the present study, however, the composite-dentin inter-
face was surrounded by enamel and only indirectly exposed
to the oral environment.
A fractured dental substrate is indicative of the formation
of a thick hybrid layer5 and is reflected in the mixed failure
mode observed in this study for Scotchbond Multi-Purpose
after 1 week in the oral environment. In contrast, the self-
etch adhesives form a thin hybrid layer and a chemical
bond with dentin, so the fractures of the specimens tend to
occur at the adhesive-dentin interface.21
Although the bond strength of the etch-and-rinse adhe-
sive decreased, its bond strength still remained satisfac-
tory. Hence, it can still be indicated, since no clinical dam-
age to the restoration would be incurred after 6 months in
the oral environment. However, this study cannot predict a
discontinuous reduction of the bond strength. Therefore, it
would be interesting to use adhesives that are stable over
time, because this factor brings greater certainty to the clin-
ician that a restoration will not present problems in the long
term.
CONCLUSIONS
Clearfil Protect Bond and Scotchbond Universal, which were
applied in the self-etching mode, maintained their bond
strength after six months in the oral environment.
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Clinical relevance: Adhesives employed in self-etch
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pared to an etch-and-rinse adhesive: their bond
strength did not decrease after six months of service in
the oral environment.
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