Table 1.

Advantages and disadvantages of current adhesive strategies

Adhesive strategies	Advantages	Disadvantages
Etch-and-rinse (three-step or two-step)	Gold standard for bonding to enamel17 No requirement for technique-sensitive selective etching	Technique-sensitive bonding to dentine18 Two-step systems prone to hydrolytic degradation19
Self-etch (two-step or one-step)	Chemical bonding to dentine possible via functional monomers20 Less influenced by dentine moisture21	Lower enamel bond strength, especially to uncut (aprismatic) enamel22 One-step systems prone to hydrolytic degradation8
Universal (multi-mode)	Less technique-sensitive; can be used effectively either in etch-and-rinse, self-etch or selective enamel etching mode Can be used to prime restoration fitting surface if they include functional adhesive monomers (for example, MDP, silane)23	Combination of hydrophilic/hydrophobic monomers makes them susceptible to hydrolytic degradation24
Self-adhesive	Ease of use (do not require pre-treatment of tooth surface with etching solutions or bonding agents)9	Lower bond strength to enamel and dentine compared to conventional resin cements10,11
Immediate dentine sealing	Reduced risk of dentine sensitivity25 Increased bond strength to exposed dentine15,26 Allows for simultaneous blocking out of undercuts in preparations for indirect restorations12	Intraoral APA normally required at cementation visit16 Resin-based provisionals can be hard to retrieve and require separating medium12 Currently only evidence for use with light-cure adhesive resin12,16 which may limit use for thick/opaque restorations