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Title Use of total etch systems in resin composite treatments superior to self-etching Systems for bond strength
Clinical Question When bonding resin composite to enamel, do self-etching systems or total-etch systems provide a stronger bond?
Clinical Bottom Line The SEB (total etch systems) yielded the highest micro tensile strength to all regions of dentin. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17379296Proenca/200796 molar teethIn Vitro Comparative Research Study
Key resultsThis in vitro study clearly shows that a total etch system has a greater tensile strength (p<0.05). ANOVA was used as the statistical tool.
Evidence Search (phosphoric acid ;[Substance Name] AND &;Dentin-Bonding Agents&;[Mesh]) AND;Dentin;[Mesh]
Comments on
The Evidence
The authors investigated the micro tensile strength of the self-etch and total etch bonding systems bonded to different regions of dentin. This study showed that regardless of the tested dentin surfaces, SEB (total etch systems) attained the highest micro tensile bond strength to smear layer-covered surfaces.
Applicability These results would seem relevant to all long flat cavity preparations
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords etch, dentin bonding, total etch system, smear layer, self-etch
ID# 475
Date of submission: 01/08/2010spacer Revised: 09/07/2011
E-mail cooperrb@uthscsa.edu
Author Mohammed Moridnia
Co-author(s) R. Bryn Cooper
Co-author(s) e-mail
Faculty mentor/Co-author Kevin M. Gureckis, DMD
Faculty mentor/Co-author e-mail gureckis@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Stormy Laing (San Antonio, TX) on 04/18/2012
A PubMed search on this topic was conducted in April 2012 and more recent and stronger evidence was found: PubMed ID 20672727. This RCT finds that there is no significant difference in the micro-tensile 24 hour bond strength when using a 2 step self etch system in comparison to a 3 step etch and rinse system, neither in dentin or enamel. Indicating that because similar bond strengths can be duplicated by both systems, the choice of which to use is left to the discretion of the clinician and the situation.

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