title: Adhesive systems for restoring primary teeth: a systematic review and meta-analysis of in vitro studies.
abstract: OBJECTIVE
  To systematically review the literature for in vitro studies that evaluated the immediate or after ageing bond strength of etch-and-rinse and self-etch adhesive systems to enamel and dentin of primary teeth.
  
  
  METHODS
  The search was conducted in PubMed/MEDLINE, Cochrane, SciELO, Lilacs, and Scopus databases with no publication year or language limits, following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. From 459 potentially eligible studies, 39 were selected for full-text analysis, and 5 were identified in reference lists, with 36 considered in the meta-analysis. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Pooling bond strength data was calculated using random effects analysis method, comparing two categories of adhesives (etch-and-rinse versus self-etch systems) when applied in different types and conditions of substrate (α  =  0.05).
  
  
  RESULTS
  No statistical significant difference in bond strength between both categories was observed in caries-affected dentin at immediate evaluation and in sound dentin after ageing. Etch-and-rinse adhesives, however, performed better in sound enamel and dentin substrates considering immediate bond strength. None study assessed the long-term adhesive effectiveness to sound or demineralized enamel.
  
  
  CONCLUSIONS
  Although the articles included in this meta-analysis showed high heterogeneity and high risk of bias, the in vitro literature suggests superior performance of etch-and-rinse adhesives in primary teeth in comparison with self-etch systems.
authors.affiliation: Graduate Program in Dental Science, Federal University of Santa Maria, Santa Maria, Brazil.
authors.forename: Tathiane Larissa
authors.initials: TL
authors.lastname: Lenzi
authors.affiliation: Department of Pediatric, Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Thais
authors.initials: T
authors.lastname: Gimenez
authors.affiliation: Department of Pediatric, Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Tamara Kerber
authors.initials: TK
authors.lastname: Tedesco
authors.affiliation: Department of Pediatric, Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Fausto Medeiros
authors.initials: FM
authors.lastname: Mendes
authors.affiliation: Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil.
authors.forename: Rachel de Oliveira
authors.initials: Rde O
authors.lastname: Rocha
authors.affiliation: Department of Pediatric, Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Daniela Prócida
authors.initials: DP
authors.lastname: Raggio
mesh_terms: D006801:Humans; D000134:Acid Etching, Dental / Q000379:methods; D003188:Composite Resins / Q000737:chemistry; D001840:Dental Bonding; D003731:Dental Caries / Q000188:drug therapy; D003743:Dental Enamel / Q000187:drug effects; D003804:Dentin; D017220:Dentin-Bonding Agents / Q000737:chemistry; D008422:Materials Testing; D019279:Resin Cements / Q000737:chemistry; D033081:Shear Strength; D014094:Tooth, Deciduous
chemical_list: D003188:Composite Resins; D017220:Dentin-Bonding Agents; D019279:Resin Cements