journal of dentistry 42 (2014) 800–807

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Bonding performance of universal adhesives in

different etching modes

Andrea Wagner a, Michael Wendler a,b, Anselm Petschelt a, Renan Belli a,

Ulrich Lohbauer a,*
a
Laboratory for Biomaterials Research, Dental Clinic 1 – Operative Dentistry and Periodontology,
University of Erlangen-Nuernberg, Erlangen, Germany
b
Department of Restorative Dentistry, Faculty of Dentistry, University of Concepción, Concepción, Chile

article info abstract

Article history: Objectives: The aim of this study was to compare the microtensile bond strength (mTBS) and
Received 7 March 2014 resin penetration into dentine of three universal adhesives (UAs) applied in two different
Received in revised form etching modes (i.e. self-etch or etch-and-rinse). The effect of thermocycling on the mTBS was
11 April 2014 also evaluated.
Accepted 28 April 2014 Methods: The occlusal third of sound human molars was removed and the exposed surfaces
were treated with three UAs (Futurabond Universal, Scotchbond Universal Adhesive and
All-Bond Universal) in self-etch or etch-and-rinse mode. Two one-step self-etch adhesives
Keywords: (Futurabond DC and Futurabond M) were applied on additional teeth as reference. After
Adhesion composite build up, the specimens were stored for 24 h in distilled water at 37 8C
Universal adhesives or thermocycled for 5000 cycles. Composite/dentine beams were prepared (1 mm2) and
Self-etch mTBS test was performed. Data was analyzed using three-way ANOVA and Tukey’s test
Etch-and-rinse (a = 0.05). One additional tooth was prepared for each group for evaluation of infiltration
Dentine bonding ability into dentine by dyeing the adhesives with a fluorochrome (Rhodamine B). After
longitudinal sectioning, the generated interfaces were examined under confocal laser
scanning microscopy.
Results: The addition of an etching step did not significantly affect the mTBS of none of the
UAs, when compared to their self-etch application mode. All pre-etched specimens showed
considerably longer resin tags and thicker hybrid layers. Thermocycling had no significant
effect on the mTBS of the UAs.
Conclusions: Application of an etching step prior to UAs improves their dentine penetration,
but does not affect their bond strength to dentine after 24 h or after thermocycling for 5000
cycles.
Clinical significance: Similar bond strength values were observed for the UAs regardless
of application mode, which makes them reliable for working under different clinical
conditions.
# 2014 Elsevier Ltd. All rights reserved.

* Corresponding author at: Dental Clinic 1 – Operative Dentistry and Periodontology, Glueckstr. 11, D-91054 Erlangen, Germany.
Tel.: +49 9131 854 3740; fax: +49 9131 853 3603.
E-mail addresses: ulrich.lohbauer@fau.de, lohbauer@dent.uni-erlangen.de (U. Lohbauer).
http://dx.doi.org/10.1016/j.jdent.2014.04.012
0300-5712/# 2014 Elsevier Ltd. All rights reserved.
 journal of dentistry 42 (2014) 800–807
1. Introduction
Current dental adhesive systems and adhesive approaches
seek to provide long-term bonding, while ensuring simplifica-
tion of the technique. Self-etch adhesives (SEAs) were
introduced with the goal of eliminating the highly sensitive
technique step of acid etching, as their acidic monomers
simultaneously etch and infiltrate the dental substrate,1
thereby minimizing the discrepancies between hybridized
and etched zones in the substrate.2 Among them, ‘‘all-in-one’’
or ‘‘one step self-etch adhesives’’ (1-SEAs) go even further, as
they intend to combine all-steps in only one application. While
their bonding ability to dentine has been progressively
improved with respect to the first 1-SEAs by means of better
chemical interaction,3 adhesion to enamel still remains
unsatisfactory. Therefore, application of selective acid etching
on enamel before SEA application has been recommended,
especially when the use of mild-pH SEAs is intended.4
However, inadvertent pre-etching of dentine is a clinical risk,
which can negatively affect bonding efficacy.5,6 Aiming to
eliminate complications and providing a single product for all
situations, ‘‘universal adhesives’’ (UAs) that might be indis-
tinctly applied, either in self-etch (SE) or etch-and-rinse (E&R)
mode,7,8 have been recently introduced.
One of the keys of success with self-etching adhesives is
the chemical bonding capability of their functional monomers
to hydroxyapatite (HAp),1 as described by the ‘‘adhesion/
decalcification concept’’.9,10 Among the currently used func-
tional monomers, 10-methacryloyloxydecyl dihydrogenpho-
sphate (MDP) has demonstrated a very effective and durable
bond to dentine,11,12 due to the low solubility of the calcium
salt that forms on the hydroxyapatite surface.12 On the other
hand, micromechanical interlocking by means of good
dentine hybridization (i.e. resin tags and hybrid layer), has
been proposed to improve the bond strength of SEAs.13
Phosphoric acid etching of dentine prior to application of
SEAs significantly improves the interface infiltration morphol-
ogy, by generating thicker hybrid layers14,15 and longer resin
tags.16 Removal of the smear layer and smear plugs by this pre-
treatment17 facilitates the adhesive penetration, especially in
mild SEAs. Nevertheless, a clear correlation to higher bond
strengths by these enhanced interfaces has not been estab-
lished.18
According to their ability to demineralize dentine, SEAs
have been classified into strong (pH 1), intermediately strong
(pH between 1 and 2), mild (pH  2) and ultra-mild (pH >2.5).1
This ‘‘etching aggressiveness’’ is strongly related with their
interaction depth in dentine,19 which varies from few
nanometers in ultra-mild SEAs20 to several micrometres, in
the strong SEAs.1 Thus, hybrid layers of mild SEAs are much
thinner than those generated by stronger SEAs or etch-and-
rinse adhesives, although hybrid layer thickness may not be of
major importance to bonding efficacy.2 By demineralizing
dentine only incompletely, mild SEAs leave HAp partially
attached to collagen, so it is available for chemical interac-
tion12 and protective nanolayering.21
At present, there is only sparse literature reporting on the
efficacy of UAs. Similar adhesive performance has been
observed for these adhesives regardless of their application
801
mode,7,22 although bond strength degradation has been
observed after ageing for pre-etched samples.23 The aim of
the present study was to compare the bond strength and resin
penetration pattern into dentine of three commercial UAs
applied in two different etching modes (i.e. SE or ER). Two 1-
SEAs were compared as reference. The effect of thermocycling
on mTBS was also evaluated. The null hypotheses were that (i)
the application mode of the UAs did not affect their mTBS, (ii)
nor their resin penetration pattern into dentine; and (iii) that
the bond strength is not affected by thermocycling.
2. Materials and methods
2.1. Bonding procedures, specimen fabrication and mTBS
testing
Sound human third molars were stored in 0.5% chloramine
solution and used within 3 months of extraction. The occlusal
third was removed using a low-speed diamond saw (IsoMet;
Buehler Ltd., USA) under water irrigation and flat surfaces
were prepared in mid-coronal dentine with a remaining
thickness in the range of 2.5  0.2 mm. The dentine surface
was ground with a 600-grit SiC paper for 60 s in order to
produce a clinical relevant smear layer. Twelve teeth were
assigned randomly to each of the three experimental groups
and the UAs Futurabond U (FbU) (Voco, Cuxhaven, Germany),
Scotchbond Universal Adhesive (SbU) (3M ESPE, Seefeld,
Germany) and All-Bond Universal (AbU) (Bisco, Schaumburg,
USA) were applied either in self-etch (SE) or etch-and-rinse
(E&R) mode. Two self-etching adhesives, Futurabond M (FbM)
and Futurabond DC (FbDC) (Voco, Cuxhaven, Germany), were
used for comparison and only applied in the SE mode (each on
six teeth). Composition and manufacturer’s instructions are
described in Table 1.
For the SE mode, the dentine surface was left slightly wet
and the adhesives were applied following manufacturer’s
instructions and light-cured for 20 s under a halogen light-
curing unit (EliparTrilight, 3M ESPE, USA) with an output
intensity of 750 mW/cm2. For the E&R mode, before adhesive
application, Scotchbond Etchant (35% H3PO4, 3M ESPE, USA)
was applied on the dentine surface for 15 s, rinsed for 30 s and
left slightly wet.
Resin composite crowns (GrandioSO; Voco, Germany)
were incrementally build-up in 1 mm increments up to 5 mm
under the same curing conditions as described above. Three
teeth in each group were stored in distilled water for 24 h at
37 8C, whereas the other three were thermo-cycled (Willytec
V2.8; Willytec/SD Mechatronik, Germany) for 5000 cycles
(cyclic immersion for 30 s at 5.5 8C/55 8C each, 7 s dwelling
time).
All specimens were then longitudinally sectioned in both
‘x’ and ‘y’ directions across the bonded interface with a low-
speed diamond saw under sustained water-cooling (IsoMet
low speed saw with a Buehler 10.2 cm  0.3 mm diamond
wafering blade, No. 11-4244), following a non-trimming
microtensile technique.24 Each beam dimensions were con-
trolled with a digital calliper to ensure a cross-sectional area of
1  0.05 mm2. Only beams from the central region of each
tooth were used. After sectioning, the specimens were fixed to
802 journal of dentistry 42 (2014) 800–807

Table 1 – Adhesive composition and application procedure (information supplied in the safety data sheets and material
instructions).
Material Composition Application procedure
Futurabond U Liquid 1: 1. Mix and stir thoroughly both liquids with the
(FbU) Acidic adhesive monomer Single Tim applicator.
HEMA 2. Apply the adhesive homogenously to the surface
Voco BISGMA, HEDMA, UDMA and rub for 20 s using the Single Tim.
Cuxhaven, Germany Catalyst 3. Dry off the adhesive layer with dry, oil-free air for
at least 5 s.
Liquid 2: 4. Light cure the adhesive layer for 10 s.
Ethanol
Initiator, catalyst

Scotchbond Universal 10-MDP phosphate monomer, 1. Apply the adhesive with the applicator to the
Adhesive Vitrebond Copolymer entire tooth surface and rub for 20 s.
(SbU) HEMA 2. Dry gently for about 5 s until it no longer moves
BISGMA, dimethacrylate resins and the solvent has evaporated completely.
3M ESPE Filler, silane, initiators 3. Harden the adhesive with a curing light for 10 s.
Seefeld, Germany Ethanol, water

All-Bond Universal 10-MDP phosphate monomer 1. Dispense 1–2 drops of ABU into a clean well.
(ABU) HEMA 2. Apply two separate coats, scrubbing the
BISGMA preparation with a microbrush for 10–15 s per coat.
Bisco Ethanol 3. Evaporate excess solvent by thoroughly air-drying
Schaumburg, USA for at least 10 s. Surface should have a uniform
glossy appearance.
4. Light cure for 10 s.

Futurabond M Acidic adhesive monomer 1. Dispense 1 drop of FbM onto mixing palette.
(FbM) HEMA 2. Apply a moderately thin layer of the adhesive to
UDMA the enamel/dentine with a suitable applicator and
Voco Ethanol, catalyst allow it to act for 20 s.
Cuxhaven, Germany 3. Dry the adhesive layer for at least 5 s.
4. Polymerize with blue light for 10 s.

Futurabond DC Liquid 1: 1. Mix one drop of Liquids 1 and 2 on a mixing

(FbDC) Acidic adhesive monomer palette for approximately 2 s.
HEMA 2. Apply the adhesive in a medium thickness layer
Voco BISGMA and rub into the tooth surface for 20 s.
Cuxhaven, Germany 3. Dry the adhesive layer for at least 5 s.
Liquid 2: 4. Light cure for 10 s.
Ethanol NOTE: FbDC is dual-curing and therefore must be
Initiator applied immediately after mixing.

Geraldeli’s testing jigs25 with cyanoacrylate glue (Loctite 401,
Henkel, Germany) and stressed in tension until failure using a
universal testing machine (Z2.5, Zwick, Germany) with a 100 N
load cell travelling at a crosshead speed of 0.5 mm/min. The
imposed force (in Newton) at the time of fracture was divided
by the calculated bonded area (in mm2) to obtain the mTBS in
MPa. The Kolmogorov–Smirnov test at a = 0.05 was applied to
confirm the normal distribution of the results. The obtained
data was analyzed using a three-way ANOVA and Tukey’s post
hoc test at a = 0.05 (IBM SPSS Statistics 21.0 software, IBM
Chicago, IL, USA). Samples broken cohesively in dentine or
with glue covering the adhesive layer as well as pre-testing
failure (PTF) samples were excluded from the statistics.
2.2. Analysis of failure mode by light microscope
The failure modes were evaluated for each sample using a
light microscope (SV 6, Zeiss, Germany) at 50 magnification
and classified as ‘cohesive’ (entirely within dentine substrate
or resin composite), ‘adhesive’ (at the dentine-resin interface)
or ‘mixed’ (at dentine-resin interface including failure into one
of the substrates). The cohesive failures in dentine or
composite were not included in the mean mTBS calculation.
2.3. Semi-quantitative analysis of penetration depth into
dentine by confocal laser scanning microscopy (CLSM)
Following the same adhesive protocols described above, one
specimen per group was prepared for observation under
CLSM.26 The fluorochrome Rhodamine B Isothiocyanate (Merck,
Germany) was compounded into the respective adhesives at a
concentration of 0.008wt% directly before application on the
dentine surface. Only one composite increment was placed over
the adhesive resin. The teeth were then cut longitudinally into
two halves and both new generated surfaces were polished for
one minute with SiC paper in sequence (Grit 800/1200/2000/
4000) under permanent water cooling.
The samples were examined in 1000-fold magnification
under a CLSM (TCS SL, Leica, Germany) at a 514-nm excitation
line of argon ion laser. The emissions were detected using a DD
458/514 band pass filter. A semi-quantitative analysis of the
penetration depth of the adhesive resin into the dentine
 journal of dentistry 42 (2014) 800–807 803

Table 2 – Microtensile bond strength (MPa), number of valid samples and number of pre-testing failures (n/PTF).
Adhesive Self-etch mode Etch-and-rinse mode

24-h After thermo-cycling 24-h After thermo-cycling

b,c,d b,c,d b,c,d
Futurabond U 37.9  14.0 (104/5) 36.6  18.7 (41/39) 41.2  10.7 (66/2) 46.0  12.9a,b,c (21/0)
All Bond Universal 52.6  12.7 a (35/0) 44.7  12.7a,b,c (30/0) 44.8  10.8a,b (26/1) 54.6  11.7 a (25/0)
Scotchbond Universal 44.0  21.9a,b,c (35/0) 48.3  13.85a,b,c (18/0) 49.1  11.1a,b,c (48/0) 46.8  15.1a,b,c (65/1)
Futurabond M 36.7  14.5c,d,e (33/4) 26.1  9.7 e (34/13)
Futurabond DC 38.5  14.8b,c,d (28/7) 25.2  9.2d,e (22/11)
Means followed by the same superscript letters are not statistically different (at p < 0.05). Valid samples number (n) corresponds to those
samples included in the statistical analysis; i.e. excluding the PTF samples and those broken within dentine or with glue covering the binding
site.

substrate and the hybrid layer formed was performed utilizing
the ‘Leica Confocal software’ (Version 2.61, Leica, Germany).
3. Results
3.1. Microtensile bond strength and fracture mode
analysis
The mTBS values of the adhesives after the different applica-
tion and ageing protocols are presented in Table 2. The mean
bond strength values of the UAs were similar or higher than
the results of the two 1-SEAs, before as well as after
thermocycling.
The highest mTBS value after 24-h water storage was
obtained for the ABU under SE mode, being statistically higher
than FbU ( p = 0.000), FbM ( p = 0.000) and FbDC ( p = 0.006).
Although there were no significant differences in mTBS
between the SE and the E&R mode for all UAs, FbU and SbU
performed slightly better in the E&R mode, contrary to ABU,
which showed a reverse trend. ABU and SbU showed no PTF,
while FbU had 3.1% (in SE mode) and 1.8% (in E&R mode)
specimen pre-test failure rates. FbM and FbDC showed higher
PTF percentages (7.7% and 13.5% respectively).
There were no significant differences between the mTBS
results under SE and E&R mode after thermocycling of the
three UAs utilized, namely FbU ( p = 0.819), ABU ( p = 0.388) and
SbU ( p = 1.000). Except for FbU, all other UAs showed
significantly higher mTBS values than FbM and FbDC. There
were almost no PTF after thermocycling when specimens were
treated with ABU, FbU (E&R mode) or SbU (0.75% in the E&R
mode), while there was an important increase in PTF for FbM
(22.8% vs. 7.7%) and FbDC (32% vs. 13.5%) and even more for
FbU in the SE mode (43% vs. 3.1%).
Fractographic analysis under light microscope revealed a
predominance of failures in the adhesive layer for all groups.
Nevertheless, most of the fractures occurred cohesively inside
the adhesive, especially when treated with FbM and FbDC. The
thermocycling ageing did not alter this adhesive failure mode
tendency.
3.2. Penetration depth into dentine
Table 3 summarizes the mean penetration depth values and
hybrid layer (HL) thicknesses for the different adhesives and
application modes. Neither penetration into dentine nor
hybrid layer formation was detectable for all UAs tested in
the SE mode (Fig. 1A–C). In contrast, a mean HL of 2–4 mm was
identified in the E&R mode and deep penetration of the UAs
into dentine was discernible by formation of resin tags. FbU
produced 18–30 mm long resin tags (Fig. 1D), while ABU (Fig. 1E)
and SbU (Fig. 1F) showed a slightly deeper penetration (Table
3). FbM showed only a slight penetration (less than 0.5 mm)
into dentine (Fig. 2A), while FbDC (Fig. 2B) produced a HL
comparable to that of the UAs in the E&R mode (about 2.3 mm)
and resin tags of 9–30 mm length. This analysis, however,
reflects only a semi-quantitative assessment of the described
parameters.
4. Discussion
Universal adhesives represent the last generation of adhesives
in the market. They are designed under the ‘‘all-in-one’’
concept of already existing one-step self-etch adhesives, but
incorporating the versatility of adapting them to the clinical
situation, by application under different etching modes. In the
present study, the use of three of these UAs to dentine
following a self-etch or an etch-and-rinse protocol did not
affect significantly their mTBS, but showed a very different
dentine infiltration behaviour. They performed better than the
two 1-SEAs used here regardless of the application mode.
The presence of MDP in the composition of SbU and ABU
(Table 1), may well explain the higher mTBS of this groups in
the SE mode, before and after thermocycling. SbU also
contains the polyalkenoic acid copolymer (the so called
Vitrebond Copolymer), which in combination with MDP has
shown contradictory results in the literature. Perdigão et al.
reported higher mTBS to dentine of SbU when compared to
Clearfil SE Bond, which has only the MDP monomer,7 while
Table 3 – Penetration depth (mm) and hybrid layer
thickness (mm).
Group Penetration depth Hybrid layer
thickness
SE E&R SE E&R
FbU 0 18–30 0 4
ABU 0 30–50 0 2.3
SbU 0 30–46 0 2.3
FbM 2–4 – 0 –
FbDC 10–30 – 2.3 –
SE, self-etch mode; E&R, etch-and-rinse mode.
804 journal of dentistry 42 (2014) 800–807

Fig. 1 – CLSM images of the universal adhesives interfaces: (A–C) correspond respectively to FbU, ABU and SbU in SE mode.
(D–F) correspond to the same adhesives but in E&R mode. AL: adhesive layer; D: dentine; C: composite; OIL: oxygen
inhibition layer; T: resin tags; HL: hybrid layer.

Muñoz et al. observed a lower mTBS of SbU when compared to
the same adhesive.22 The polyalkenoic acid copolymer may
compete with the MDP monomer for Ca-bonding sites in HAp 3
and due to its high molecular weight, could even prevent
monomer approximation during polymerization.22 Neverthe-
less, in this study SbU (SE mode) did not show a statistically
significant difference in mean mTBS when compared to ABU
(which only contains MDP). In the Futurabond adhesives (FbU,
FbM and FbDC), the manufacturer describes its functional
monomer only as a phosphate monomethacrylate. When

Fig. 2 – CLSM images of the self-etch adhesives interfaces: (A) corresponds to FbM and (B) corresponds to FbDC. AL: adhesive
layer; D: dentine; C: composite; OIL: oxygen inhibition layer; T: resin tags; HL: hybrid layer.
 journal of dentistry 42 (2014) 800–807
looking at the inferior bond strength results of the Futurabond
family, the absence of MDP in their formulation may be a
reasonable speculation, since its presence is not disclosed in
the product information sheet.
Following the acidity classification of self-etch adhesives,
the bonding agents tested in this study can be considered
ultra-mild (ABU, SbU), mild (FbU, FbM) or strong (FbDC). When
looking at the generated interface, none of the UAs applied in
the SE mode modified the smear layer and penetrated into the
dentine tubules (Fig. 1A–C), which could be explained by their
mild (or ultra-mild) acidity.19,27 The hybrid layer formed was
therefore very thin or inexistent (Table 3), resembling the
results obtained by other studies with self-etch adhesives.28,29
FbDC, on the other hand, in concordance with its lower pH
(1.5), infiltrated dentine up to a depth of 30 mm (Fig. 2B),
approaching penetration depths of conventional etch-and-
rinse adhesives.16
Dentine smear layer is a barrier for some SEAs if contact to
intact dentine is desired.30 Indeed, milder self-etch adhesives
show a lower penetration capacity of thick smear layers,29
when compared with stronger ones. In this study, a thin
artificial smear layer was created by means of grinding with
600-grit SiC paper, which can be matched to clinical smear layer
thicknesses (1.3  0.5 mm) produced by fine-grained diamond
burs.17,30 As shown by FbDC, strong SEAs have demonstrated a
better ability to remove the smear layer19,29 and create thicker
hybrid layers.31,32 Nevertheless, higher aggressiveness of SEAs
is usually not related to higher bond strengths.15,17,31,32 The
results of the present study are in agreement with these
findings, since the lowest bond strengths were obtained by the
strong and intermediately strong SEAs (FbM and FbDC), while
the ultra-milder ones showed significantly higher values. This
difference increased after thermocycling. It has been proposed,
that due to water presence in the dentinal tubules, some of the
acidic monomers of the strong SEAs retain their acidity and
continue etching, as a consequence of an incomplete polymer-
ization.33,34 On the other hand, the MDP monomer (present in
the milder UAs tested here) has shown not only to chemically
bond to HAp, but also to self-assemble into nanolayers,35 which
has strong hydrophobic properties that protect the formed
hybrid layer from hydrolytic degradation.3
The etching step ensures a deeper penetration of the self-
etch adhesives into the dentine substrate, generating longer
resin tags,16,36 as well as thicker hybrid layers.14,15 When acid
etching was applied prior to the adhesive (E&R mode), all UAs
showed deeper penetration into dentine (Fig. 1D–F) with
formation of long resin tags (up to 50 mm) and thicker hybrid
layers (2–4 mm). The second null hypothesis therefore has to be
rejected. Removal of smear layer and smear plugs by
phosphoric acid,17 increased adhesive infiltration15,16 and
facilitated the penetration of the UAs into the dentine tubules,
thus improving the tag length and morphology when
compared to their respective SE counterparts. Although there
was a better interface morphology after acid etching, its
correlation to better mTBS values in self-etch adhesives has
been brought into question.18 In one study, the use of
phosphoric acid prior to self-etch application in dentine
created well impregnated hybrid layers, which were associat-
ed to significantly improved mTBS values when compared to
conventional application of the same 1-SEAs.13 On the other
805
hand, despite the fact that the application of the etching step
prior to self-etch adhesives has shown to improve the hybrid
layer thickness and resin tag formation, these interfaces
showed significantly decreased bond strengths, with an
increased number of adhesive failures.5,14,37 The lower bond
strength has been attributed to an incomplete infiltration of
the demineralized collagen network by the bonding resin.38
This shortcoming has been overcome in UAs through the
addition of low viscosity monomers like HEMA, that increase
the affinity to the hydrophilic wet collagen network, as has
been done earlier for one-step etch-and-rinse adhesives.
Considering the ‘‘universal application’’ concept behind
these new adhesives, bond strength should not be compro-
mised by the application mode used. In the present study, SbU
and FbU slightly improved their mTBS after pre-etching, while
ABU showed a slight reduction. However, none of these
differences were statistically significant. The first null hypoth-
esis therefore has to be accepted. It is important to highlight,
that the non-inclusion of PTF in this study could have
generated overestimated strength bond values, especially in
the SE-mode groups. The bond strength results of the same
UAs in the literature tend to agree with our findings. Marchesi
et al. observed no significant differences in mTBS after 24 h of
artificial saliva storage of SbU when applied in SE (35.5 MPa) or
E&R (34.8 MPa) mode.23 Nevertheless, after six months and
especially after 1 year storage, there was a significant drop in
mTBS for the E&R treated groups. When compared to a
conventional 2-SEA, SbU showed statistically better bonding
performance in every application mode (SE and E&R with dry
or wet dentine), while no differences between its application
with or without the etching step were found.7 Muñoz et al.
compared the effect of application mode on SbU and ABU.22
They found no statistical differences in bond strength between
the SE and E&R modes for SbU (32.4 MPa and 35.1 MPa
respectively), while there was an important drop in mTBS
for ABU when applied in the SE mode (13.4 MPa vs. 39.3 MPa in
the E&R mode). Lee et al. observed a similar trend for ABU
when applied in SE mode (8.1 MPa) in comparison to E&R mode
(21.1 MPa),39 which has also been observed for other 1-SEAs
under similar test designs.8,40 The application mode of ABU,
without active brushing, was suggested as a possible cause for
the diminished mTBS in SE mode.22 In the present study,
however, ABU was applied scrubbing the preparation surface,
which could explain its similar mTBS in SE mode compared to
E&R mode. Higher mTBS values for these adhesives have been
reported when a second layer of the adhesive is applied,41
which was associated with thicker and more resistant
adhesive interfaces. While ABU has shown decreased bond
strength when applied in one layer,39 SbU adhesive perfor-
mance was not affected by the second layer.41 This variable
seems to have no influence in the present study, since there
were no significant differences in mTBS values between ABU
(applied in two layers) and SbU (only one layer).
Thermocycling is a widely used technique to induce artificial
ageing by accelerated chemical degradation42 and contraction/
expansion stresses due to the coefficient of thermal expansion
mismatch between tooth substrates and the restorative
materials.43 The application of a thermocycling regime led to
no significant mean bond strength variations among any of the
adhesives tested when compared to the 24-h water storage
806 journal of dentistry 42 (2014) 800–807
specimens. Notwithstanding, there were significant incre-
ments in pre-test failures for the Futurabond adhesives (SE
mode) after thermocycling (Table 2), indicating a deleterious
effect of the ageing procedure on the bond interface of these
adhesives. This could be related to an insufficient chemical
interaction to dentine, since FbU had no pre-test failures when
additional micromechanical retention was generated (E&R
mode). The third null hypothesis has to be partially rejected.
Despite the limited number of cycles (5000), which is regarded
to correspond to 6 month of in vivo functioning,42 may not seem
enough for mimicking long-term bonding efficacy, other
studies on SEAs with longer cycling obtained similar
results.14,44 The efficacy of the thermocycling test in evaluating
bond strength has been questioned42 and highly conditioned to
specific test set-ups.43 The presence of surrounding dentine
and composite could have avoided direct water contact with the
specimens, protecting them from accelerated hydrolysis,44
while the low C-factor of the specimens could have diminished
the expansion/contraction stress effect.18
Considering the short time elapsed since these new
universal adhesives appeared in the market, only little clinical
outcomes are available in the literature. A clinical evaluation of
SbU under different application modes (i.e. self-etch or etch-
and-rinse) in caries-free cervical restorations was performed by
Perdigão et al.45 In their 18-month study, the adhesive showed a
low incidence of clinical failures, regardless of the bonding
strategy used. This data seems to correlate well with the results
in the present study for the same material, as well as with
previous in vitro results of the same author.7 Despite the
apparent potential of the mTBS in predicting clinical perfor-
mance of class V restorations, due to their similarities in cavity
configuration and absence of macro-mechanical retention,
clearer correlation has yet to be established.46
The similar bonding performance of the UAs after the
different application modes in this study indicates their
reliability when working under different clinical situations. This
is of special usefulness, when strict selective enamel etching
turns difficult (e.g. in small approximal cavities). Therefore,
considering their similar adhesive performance irrespective of
the application mode, inadvertent etching might not signifi-
cantly compromise the bonding to dentine for these systems.
5. Conclusions
Within the limits of this study, we can conclude that
application of an etching step prior to UAs significantly
improves their dentine penetration pattern, although this
does not affect their mean mTBS. Thermocycling has no
deleterious effect on the bonding efficacy of UAs. The bond
strength values of the UAs regardless of application mode
were comparable to established all-in-one adhesives, making
them reliable for working under different clinical conditions.
Conflicts of interest
The authors declare no potential conflicts of interest with
respect to the research, authorship and/or publication of this
article.
Acknowledgements
This study was supported by Voco (Germany). Materials were
kindly donated by Bisco, 3M ESPE and Voco. We kindly thank E.
Scheuermeyer, M. Schachtner and G. Stein for technical
assistance with the microtensile test and CLSM images.
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