Student Theses, Dissertations and Capstones

Document Type


Degree Name

Master of Science (M.S.) in Dentistry

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.


College of Dental Medicine

First Advisor

Sibel Antonson

Publication Date / Copyright Date



Nova Southeastern University


Brief Background: Both three-step etch-and-rinse adhesives and universal adhesives have proven their effectiveness to produce successful bond to dentin. However, there are no studies comparing adhesives’ bond strength when applied by multiple operators, and to variable dentin conditions. Objectives: To evaluate and compare the bond strength of a universal adhesive when applied by multiple operators, and to variable dentin conditions, in comparison to three- step etch-and-rinse adhesive. Methods: Three hundred extracted human teeth were embedded in resin. Five dentists with at least ten years of experience in general dentistry and five pre-dental students applied a universal adhesive (Adhese Universal, Ivoclar Vivadent, Amherst, NY) and an etch-and-rinse adhesive (OptiBond FL, Kerr, Orange, CA) on wet, moist and dry dentin surfaces (n=5/group). Subsequently, composite restorations (Tetric EvoCeram Bulk Fill, Ivoclar Vivadent) were applied using Ultradent shear bond testing jig. After a technique demonstration, the same operators repeated the same bonding procedures. Shear bond strength test was conducted using a universal testing machine (Instron, Canton, MA, USA). Failure mode was evaluated by using scanning electron microscopy (SEM). Results: After calculating the descriptive statistics and pairwise comparisons using a Tukey HSD, a significant difference in dentin bond strength by adhesive was found, p<0.001. Overall universal adhesives possessed 7.38MPa +/-0.73 greater dentin bond strength than etch-and-rinse adhesives. Additionally, a significant difference in dentin bond strength by the operator and surface condition was observed. However, there was no significant difference in dentin bond strength by demonstration. While there was no difference between the dentin surface conditions for the universal adhesive, a significant difference was found with etch-and-rinse adhesive between moist and wet (moist 2.67MPa+/-0.89 greater than wet) (p=0.002), and dry and wet conditions (dry 3.79MPa+/- 0.89 greater than wet) (p<0.001). Further, there was no difference between moist and dry conditions with etch-and-rinse adhesive. Regarding the operators’ variability, expert dentists obtained higher bond strength values (1.65MPa+/-0.73) (p=0.030) than dental students with etch-and-rinse adhesive. However, such a difference was not found with universal adhesive. Conclusion: Universal adhesive showed unaffected to dentin surface condition and operator differences. On the contrary, etch-and-rinse adhesive was influenced by the variability of surface condition and the operator’s expertise. The tested universal adhesive was found to be more reliable as an adhesive system in comparison to the etch-and-rinse adhesives.




Dentin, Etch-and-rinse adhesives, Operator's variability, Shear bond strength, Surface conditions, Universal adhesives



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