| dc.description.abstract | The way the adhesive system is applied can interfere with the immediate and long term bond strength of different dental adhesives. Therefore, the aim of this study was
to systematically review the literature, identifying in vitro studies that evaluated the
bond strength of adhesives, regardless of their classification, applied actively
compared to the passive application, in enamel and dentin. The search was done in
Pubmed/Medline, Embase, Scopus, Web of Science, Lilacs, and Gray platforms in
April 2022. In vitro studies that evaluated the bond strength of adhesive systems
applied actively compared to the passive form were included in this study. Meta analyses were separated by substrate (enamel and dentin) and application mode
(conventional or self-etching), using a 95% confidence interval, a random effect model,
and heterogeneity determined by the I2 index. The risk of bias was assessed by a
modified version of the “Joanna Briggs Institute”. From the 3022 articles found, 22
articles were included after removing the duplicates, selecting by title, and fully reading
the selected articles. Meta-analysis of the application of universal adhesives to enamel
after acid etching (applied in the etch-and-rinse mode) demonstrated that passive
application favors bond strength results. For conventional or universal adhesives
applied in etch-and-rinse mode, when actively applied to dentin, they favor bond
strength results. For self-etching or universal adhesives applied in self-etching mode,
active application, both on enamel and dentin, favors bond strength results. Few
studies have evaluated longevity, but those that have evaluated have also observed
favorable responses to active application of the adhesives. Only one self-curing
universal adhesive showed significantly divergent results. Substantial (I2 = 65%) and
considerable (I2 = 87%) heterogeneity were obtained for the meta-analyses of
adhesives applied in the self-etching mode, respectively, to enamel and dentin. The
active application of light-curing adhesive systems in etch-and-rinse mode favors bond
strength to dentin, and in self-etching mode it favors bond strength to unconditioned
enamel and dentin. | |
