Bond strength

Organic chemistry

Universal testing machine

Dental bonding

Dental porcelain

Ultimate tensile strength

Composite number

Cubic zirconia

Ceramic

Composite material

Chemistry

Metallurgy

Materials science

Dentistry

Primer (cosmetics)

Layer (electronics)

Adhesive

Zirconium

Medicine

Journal of Prosthodontics

Purpose To evaluate the in vitro bond strength of universal adhesive systems to indirect substrates. Material and Methods Two reviewers performed a literature search up to March 2018 in seven databases: PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO. The review included studies that compared the bond strength of universal adhesives and well‐established material‐specific primers to indirect substrates: lithium disilicate ceramic, yttrium‐stabilized zirconium dioxide ceramic, leucite‐reinforced ceramic, feldspathic porcelain, polymer infiltrated ceramic material, resin composite or metal alloys. Analyses were carried out using RevMan 5.3.5. A global comparison was performed with the standardized mean difference using a random‐effects models at a significance level of p &lt; 0.05. Results A total of 45 studies were included in the qualitative analysis, and the meta‐analysis was performed with 42 studies. Bond strength to glass‐based ceramics and alloys was improved with the use of a specific‐primer as separate step before the bonding procedures (lithium disilicate, p &lt; 0.001; alloys, p &lt; 0.001). The bond strength to zirconium substrates was improved with the use of universal adhesives ( p &lt; 0.001). For bond strength to composite resin as indirect substrate, universal adhesives performed in a manner similar to that of the material‐specific primer ( p = 0.11). Conclusions The clinical procedure of luting zirconia and resin composite restorations could be simplified by using single‐bottle universal adhesives. However, the ability of universal adhesives to achieve an adequate and durable bond to glass‐based ceramics and alloys appears to be limited.

Bonding Strength of Universal Adhesives to Indirect Substrates: A Meta‐Analysis of in Vitro Studies