Are One-step Adhesives Easier to Use and Better Performing? Multifactorial Assessment of Contemporary One-step Self-etching Adhesives

Purpose: The objective of this study was to examine whether one-step self-etching adhesives (1-SEAs) really have an advantage over multistep systems. Materials and Methods: Nine one-step self-etching adhesives (Absolute, Adper Prompt L-Pop, Clearfil S3 Bond, GBond, Hybrid Bond, iBond, One-up Bond F Plus, Optibond All-in-one and Xeno III) were included in this study. One twostep self-etching adhesive (Clearfil SE Bond) and one three-step etch-and-rinse adhesive (Optibond FL) served as controls. Their microtensile bond strength to bur-cut enamel and dentin was determined using a standardized protocol and the respective adhesive/dentin interface of these adhesives was characterized by transmission electron microscopy. Statistical analysis was performed with the Kruskal-Wallis nonparametric test. Results: Regarding bond strength, the control adhesives tended to perform superior to the one-step adhesives. However, a significant difference between the control adhesives and some one-step adhesives could not always be demonstrated, partly due to the statistical setup of this study. Interface analysis by electron microscopy showed wide variation among the one-step adhesives, depending on their composition and their acidity. 1-SEAs also exhibited two different kinds of droplets, depending on their hydrophilicity. Hydrophobic HEMA-free 1-SEAs such as G-Bond were prone to phase separation, while especially HEMA-containing hydrophilic 1-SEAs, such as Clearfil S3 Bond and Xeno III were predisposed to forming osmosis-induced droplets. Hybrid bond, Absolute, and iBond featured both phase separation as well as osmosis. Optibond All-in-one exhibited a clustering reaction of the filler particles upon solvent evaporation. All adhesives including the control adhesives showed signs of nanoleakage, indicating that all adhesives are to some extent permeable to water. A definitive conclusion with regard to quantitative assessment of nanoleakage was much hindered by inconsistencies in the silver deposition. The application procedure of some 1-SEAs sometimes proved as elaborate and time consuming as those of the two-step adhesive Clearfil SE Bond. Conclusion: Considering bond strength and application procedure, 1-SEAs are not always a better alternative to multistep adhesives. Keywords: adhesion, adhesive, one-step self-etching, phase separation, droplets, bonding effectiveness