Effect of adhesive strategy of universal adhesives in noncarious cervical lesions – an updated systematic review and meta-analysis

OBJECTIVE: To determine the effect of adhesive strategy (total etch or self-etch) of universal adhesives in non-carious cervical lesions. DATA SOURCE: A search was made in PubMed, Scopus, Cochrane, Web Of Science, Open Gray, Clinical Registries. DATA SELECTION: Randomized Controlled Clinical Trials, studies on non-carious cervical lesions restored using Universal Adhesives, and studies in which universal adhesives have been used in total etch and self -etch strategies were included in this systematic review. DATA EXTRACTION: A total of 17 articles were included in the systematic review and 13 in the meta-analysis. Meta-analysis was conducted to assess the clinical performance of NCCLs in terms of retention, marginal adaptation, marginal discoloration, secondary caries and post-operative sensitivity at 18, 24, 36 month follow-up using USPHS as well as FDI criteria, separately. DATA SYNTHESIS: Overall there was no significant difference between total etch and self etch adhesive strategies for any of the five outcome measures using either the FDI or the USPHS criteria. p > 0.05, 95% CI, I(2) value of 0%. A strongly suspected publication bias in the retention domain was seen at 18 month follow up under FDI criteria. CONCLUSION: Most universal adhesives show acceptable clinical performance. There is no significant effect of the adhesive strategy of universal adhesives on their clinical performance according to the results of our meta-analysis.