This paper presents the state of the art of self-etch adhesive systems. Four topics are shown in this review and included: the historic of this category of bonding agents, bonding mechanism, characteristics/properties and the formation of acid-base resistant zone at enamel/dentin-adhesive interfaces. Also, advantages regarding etch-and-rinse systems and classifications of self-etch adhesive systems according to the number of steps and acidity are addressed. Finally, issues like the potential durability and clinical importance are discussed. Self-etch adhesive systems are promising materials because they are easy to use, bond chemically to tooth structure and maintain the dentin hydroxyapatite, which is important for the durability of the bonding.

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In the short term, MTBS values were material and dental-substrate dependent. After aging, a decrease in bonding effectiveness was observed in all materials, with nanoleakage at the adhesive/dentin interface. The bonding of the UAs was equal or inferior to that of the conventional restorative systems when applied to either substrate and after either storage period.

Both MMAs tested can be considered effective alternatives for bonding to sandblasted indirect resin composite after aging, as they showed similar bond performance to that of the control group. However, separate bottles of silane bonding resin showed higher MSBS values and more durable bonding for etched glass-based ceramic.

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Shear bond strength (SBS) and the interfacial adaptation (IA) of self-adhesive resin (SAR) composites to dentin were evaluated. Two SARs [Vertise Flow (VTF) and Fusio Liquid Dentin (FLD)] were evaluated and compared with a conventional restorative system [adhesive: OptiBond FL and composite: Herculite Précis (OBF/HP)]. Human third molars were used for SBS testing and IA imaging (n=7) using optical coherence tomography (OCT). Flattened dentin disks were prepared and the composites were applied into molds (2.4 mm diameter) that were positioned on dentin. Samples were subjected to SBS testing and OCT analysis, which considered an increase in signal intensity at the bonded interface as evidence of internal gaps. SBS data were analyzed by one-way analysis of variance and Tukey's test and IA data (% distribution of high brightness values) by Kruskal-Wallis and Dunn's test (p≤0.05). No statistically significant difference in SBS was observed between VTF (13.9±3.6 MPa) and FLD (11.3±3.2 MPa), whereas OBF/HP showed higher average strength (27.3±6.1 MPa). However, there was a statistically significant difference in IA when VTF (33.3%) was compared with FLD (1.2%) and OBF/HP (1.5%). The conventional restorative system exhibited superior SBS performance compared with SARs. However, the IA of FLD to dentin had values that were not significantly different from OBF/HP.

The objective of this study was to investigate microtensile bond strength (MTBS) and interfacial adaptation (IA) of bulk-fill restorative systems bonded to dentin in Class-I-preparations. Box-shaped preparations (4-mm-long, 3-mm-wide, 2-mm-high) made in extracted molars, and Teflon matrix with the same dimensions positioned over the occlusal surface were restored, providing a total of 4-mm composite depth using three bulk-fill restorative systems: Tetric EvoCeram Bulk Fill with Tetric N-Bond (TEC/TNB), SureFil SDR Flow with XP Bond (SDR/XPB) and Filtek Bulk Fill Flowable Restorative with Scotchbond Universal (FBF/SBU); or incrementally restored with a conventional restorative system: Herculite Classic with OptiBond FL (HER/OBF). The specimens were sectioned into beams and the MTBS measured after 24-hours or one-year storage. For evaluation of IA, round-tapered tooth preparations (3-mm-diameter, 1.5-mm-deep) were made, restored with each material and their cross-sectional images were obtained after 24-hours using optical coherence tomography (OCT). The gap percentage for each restoration system was calculated using image analysis software. MTBS for both storage periods: HER/OBF=TEC/TNB=SDR/XPB>FBF/SBU (ANOVA, Tukey's post-hoc, P<0.05) differed significantly among groups, which values were significantly reduced after one-year. SDR/XPB showed comparatively lesser gap formation at the tooth-interface after 24 hours (ANOVA, Dunnett's T3 post-hoc, P<0.05). For deeper restorations, bond strength of TEC/TNB and SDR/XPB can be equal to that of HER/OBF after 24-hours and one-year; however, in a shallower preparation, SDR/XPB showed greater initial interfacial adaptation.