Update zu Universaladhäsiven

Universaladhäsive sind durch ihren adaptiven Einsatz verschiedener Applikations-modi zum Aufbau des adhäsiven Verbunds zur Zahnhartsubstanz gekennzeichnet. Durch die Reduktion der Arbeitsschritte sind sie in ihrer Anwendung weniger komplex. Dieser Beitrag gibt einen Überblick über die Gruppe der Universaladhäsive mit besonderem Augenmerk auf ihre Zusammensetzung und Anwendung sowie mögliche Indikationsbereiche und Fehlerquellen.

Kernaussagen

• Universaladhäsive bieten den Vorteil indikationsadaptierter Applikationsmodi, da sie im Self-Etch-, Selective (Enamel) Etch- und Etch&Rinse-Modus angewendet werden können.

• Durch den Zusatz funktioneller Monomere, insbesondere 10-MDP, haften sie sowohl an Zahnhartsubstanz als auch an verschiedenen Dentalwerkstoffen.

• 10-MDP ist außerdem in der Lage, durch Nanolayering die adhäsive Verbundzone zu stabilisieren. Dazu sollten Universaladhäsive immer für mindestens 20 Sekunden aktiv appliziert werden. Außerdem müssen sie ausreichend lange verblasen werden, um den Lösungsmittelanteil aus der applizierten Adhäsivschicht zu entfernen.

• Der Silanzusatz in Universaladhäsiven muss kritisch bewertet werden.

• An strukturell veränderter Zahnhartsubstanz ist der adhäsive Verbund von Universaladhäsiven genauso wie bei herkömmlichen Adhäsivsystemen kompromittiert.

Schlüsselwörter

Universaladhäsive - Adhäsivtechnik - 10-MDP - Nanolayering - Reparaturen - Kontamination

Publication History

Article published online:
30 September 2025

• Literatur

• 1 Buonocore MG. A Simple Method of Increasing the Adhesion of Acrylic Filling Materials to Enamel Surfaces. J Dent Res 1955; 34: 849-853
• 2 Van Meerbeek B, Yoshihara K, Van Landuyt K. et al. From Buonocore’s Pioneering Acid-Etch Technique to Self-Adhering Restoratives. A Status Perspective of Rapidly Advancing Dental Adhesive Technology. J Adhes Dent 2020; 22: 7-34
• 3 Alnazzawi A, Watts DC. Simultaneous Determination of Polymerization Shrinkage, Exotherm and Thermal Expansion Coefficient for Dental Resin-Composites. Dent Mater 2012; 28: 1240-1249
• 4 Cardoso M, de Almeida Neves A, Mine A. et al. Current Aspects on Bonding Effectiveness and Stability in Adhesive Dentistry. Aust Dent J 2011; 56 (Suppl. 1) 31-44
• 5 De Oliveira da Rosa W, Piva E, Fernandez da Silva A. Bond Strength of Universal Adhesives: A Systematic Review and Meta-Analysis. J Dent 2015; 43: 765-776
• 6 Van Meerbeek B, Yoshihara K, Yoshida Y. et al. State of the Art of Self-Etch Adhesives. Dent Mater 2011; 27: 17-28
• 7 Van Meerbeek B, Perdigão J, Lambrechts P. et al. The clinical performance of adhesives. J Dent 1998; 26: 1-20
• 8 Manhart J, Chen H, Hamm G. et al. Buonocore Memorial Lecture. Review of the Clinical Survival of Direct and Indirect Restorations in Posterior Teeth of the Permanent Dentition. Oper Dent 2004; 29: 481-508
• 9 Blunck U. Universaladhäsive – der Weisheit letzter Schluss?. Quintessence 2025; 2: 107-114
• 10 Gwinnett AJ. Acid Etching for Composite Resins. Dent Clin North Am 1981; 25: 271-289
• 11 Perdigão J. Dentin Bonding-Variables Related to the Clinical Situation and the Substrate Treatment. Dent Mater 2010; 26: e24-e37
• 12 Spencer P, Jonggu Park QY, Misra A. et al. Durable bonds at the adhesive/dentin interface: an impossible mission or simply a moving target?. Braz Dent Sci 2012; 15: 4-18
• 13 Eichler E, Vach K, Schlueter N. et al. Dentin adhesion of bulk-fill composites and universal adhesives in class I-cavities with high C-factor. J Dent 2024; 142: 104852
• 14 Delgado AHS, Belmar Da Costa M, Polido MC. et al. Collagen-Depletion Strategies in Dentin as Alternatives to the Hybrid Layer Concept and Their Effect on Bond Strength: A Systematic Review. Sci Rep 2022; 12: 13028
• 15 Menon K, Vijayaraghavan S, Dhanyakumar NM. Comparative Evaluation of the Effect of 37% Orthophosphoric Acid Pre-Etching on the Microtensile Enamel Bond Strength Using Universal Adhesive and Two-Step Self-Etch Adhesive Systems – An in Vitro Study. J Conserv Dent Endod 2023; 26: 671-676
• 16 Kanzow P, Piecha L, Biermann J. et al. Repair Surface Conditioning Measures Affect Enamel and Dentin Bond Strength. Oper Dent 2020; 45: 643-654
• 17 Assis P, Silva C, Nascimento A. et al. Does Acid Etching Influence the Adhesion of Universal Adhesive Systems in Noncarious Cervical Lesions? A Systematic Review and Meta-Analysis. Oper Dent 2023; 48: 373-390
• 18 Shellis RP, Heywood BR, Wahab FK. Formation of brushite, monetite and whitlockite during equilibration of human enamel with acid solutions at 37 degrees C. Caries Res 1997; 1: 71-77
• 19 Yoshihara K, Nagaoka N, Okihara T. et al. Functional Monomer Impurity Affects Adhesive Performance. Dent Mater 2015; 31: 1493-1501
• 20 Van Meerbeek B. From Buonocore’s Pioneering Acid-Etch Technique to Self-Adhering Restoratives. A Status Perspective of Rapidly Advancing Dental Adhesive Technology. J Adhes Dent 2020; 22: 7-34
• 21 Van Landuyt KL, Yoshida Y, Hirata I. et al. Influence of the chemical structure of functional monomers on their adhesive performance. J Dent Res 2008; 87: 757-761
• 22 Feitosa VP, Sauro S, Ogliari FA. et al. Impact of hydrophilicity and length of spacer chains on the bonding of functional monomers. Dent Mater 2014; 30: e317-e323
• 23 Yoshihara K, Nagaoka N, Yoshida Y. et al. Atomic level observation and structural analysis of phosphoric-acid ester interaction at dentin. Acta Biomater 2019; 97: 544-556
• 24 Yoshida Y, Yoshihara K, Nagaoka N. et al. Self-Assembled Nano-Layering at the Adhesive Interface. J Dent Res 2012; 91: 376-381
• 25 Jacker-Guhr S, Sander J, Lührs AK. How “Universal” Is Adhesion? Shear Bond Strength of Multi-Mode Adhesives to Enamel and Dentin. J Adhes Dent 2019; 1: 87-95
• 26 Nakabayashi N, Kojima K, Masuhara E. The Promotion of Adhesion by the Infiltration of Monomers into Tooth Substrates. J Biomed Mater Res 1982; 16: 265-273
• 27 Yoshihara K, Yoshida Y, Hayakawa S. et al. Novel Fluoro-Carbon Functional Monomer for Dental Bonding. J Dent Res 2014; 93: 189-194
• 28 Perdigão J, Araujo E, Ramos RQ. et al. Adhesive Dentistry: Current Concepts and Clinical Considerations. J Esthet Restor Dent 2021; 33: 51-68
• 29 Yoshida Y, Yoshihara K, Hayakawa S. et al. HEMA Inhibits Interfacial Nano-Layering of the Functional Monomer MDP. J Dent Res 2012; 91: 1060-1065
• 30 Bourgi R, Hardan L, Cuevas-Suárez CE. et al. Effectiveness of Different Application Modalities on the Bond Performance of Four Polymeric Adhesive Systems to Dentin. Polymers (Basel) 2023; 15: 3924
• 31 Jang JH, Jeon BK, Mo SY. et al. Effect of Various Agitation Methods on Adhesive Layer Formation of HEMA-Free Universal Dentin Adhesive. Dent Mater J 2019; 38: 101-106
• 32 Saito T, Takamizawa T, Ishii R. et al. Influence of Application Time on Dentin Bond Performance in Different Etching Modes of Universal Adhesives. Oper Dent 2020; 45: 183-195
• 33 Loguercio AD, Muñoz MA, Luque-Martinez I. et al. Does Active Application of Universal Adhesives to Enamel in Self-Etch Mode Improve Their Performance?. J Dent 2015; 43: 1060-1070
• 34 Cardenas AFM, Armas-Veja A, Rodriguez Villarreal JP. et al. Influence of the mode of application of universal adhesive systems on adhesive properties to fluorotic enamel. Braz Oral Res 2019; 33: e120
• 35 Imai A, Takamizawa T, Sai K. et al. Influence of Application Method on Surface Free-energy and Bond Strength. Eur J Oral Sci 2017; 125: 385-395
• 36 Falcione D, Pena C, Turssi C. et al. Influence of Application Modes on Increasing Bond Strength Longevity of Self-Etching and Universal Adhesive Systems to Enamel. Oper Dent 2024; 49: 52-64
• 37 Cardenas A, Siqueira F, Rocha J. et al. Influence of Conditioning Time of Universal Adhesives on Adhesive Properties and Enamel-Etching Pattern. Oper Dent 2016; 41: 481-490
• 38 Cavalheiro ACJ, Sousa B, Silva A. et al. Effect of Application Deviations on Dentin Sealing of a Universal Adhesive: Permeability and Nanoleakage. Eur J Dent 2022; 17: 242-249
• 39 Burrer P, Dang H, Par M. et al. Effect of Over-Etching and Prolonged Application Time of a Universal Adhesive on Dentin Bond Strength. Polymers (Basel) 2020; 12: 2902
• 40 Stutzbach FS, Lührs AK, Jacker-Guhr S. Beeinflusst die Double-Layer-Technik die µTBS von Universaladhäsiven nach hämostatischer Kontamination?. ZFA Online 2022;
• 41 Chowdhury A, Saikaew P, Alam A. et al. Effects of Double Application of Contemporary Self-Etch Adhesives on Their Bonding Performance to Dentin with Clinically Relevant Smear Layers. J Adhes Dent 2019; 1: 59-66
• 42 Al-Zain AO, Albuqayli A, Albogami A. et al. Effect of Double Adhesive Layer Application on Micro-Tensile Dentin Bond Strength of a Universal Adhesive. Front Dent Med 2024; 5: 1484498
• 43 Schärer BM, Peutzfeldt A. Impact of Adhesive Application Errors on Dentin Bond Strength of Resin Composite. Biomater Investig Dent 2022; 9: 101-109
• 44 Carvalho CN, Lanza MDS, Dourado LG. et al. Impact of Solvent Evaporation and Curing Protocol on Degree of Conversion of Etch-and-Rinse and Multimode Adhesives Systems. Int J Dent 2019; 2019: 1-6
• 45 Tannen D, Wallum A, Mitchell T. et al. Bond Strength of Silane-Containing Universal Bonding Agents to Lithium Disilicate. J Clin Exp Dent 2025; 17: e358-e365
• 46 Lima RBW, Muniz IAF, Campos DES. et al. Effect of Universal Adhesives and Self-Etch Ceramic Primers on Bond Strength to Glass-Ceramics: A Systematic Review and Meta-Analysis of in Vitro Studies. J Prosthet Dent 2024; 131: 392-402
• 47 Südbeck J, Jacker-Guhr S, Lührs AK. Do Different Pretreatment Methods Influence the Microtensile Bond Strength of Composite Cements to Silicate Ceramic?. J Adhes Dent 2021; 4: 335-345
• 48 Yao C, Ahmed MH, De Grave L. et al. Optimizing Glass-Ceramic Bonding Incorporating New Silane Technology in an Experimental Universal Adhesive Formulation. Dent Mater 2021; 37: 894-904
• 49 Yoshihara K, Nagaoka N, Sonoda A. et al. Effectiveness and Stability of Silane Coupling Agent Incorporated in ‘Universal’ Adhesives. Dent Mater 2016; 32: 1218-1225
• 50 Kanzow P, Wiegand A. Cost-Effectiveness of Repairing versus Replacing Composite or Amalgam Restorations. Br Dent J 2016; 221: 716-716
• 51 Hickel R, Brüshaver K, Ilie N. Repair of Restorations – Criteria for Decision Making and Clinical Recommendations. Dent Mater 2013; 29: 28-50
• 52 Vankerckhoven H, Lambrechts P, Van Beylen M. et al. Unreacted Methacrylate Groups on the Surfaces of Composite Resins. J Dent Res 1982; 61: 791-796
• 53 Mendes L, Loomanns B, Opdam N. et al. Silane Coupling Agents Are Beneficial for Resin Composite Repair: A Systematic Review and Meta-Analysis of In Vitro Studies. J Adhes Dent 2020; 22: 443-453
• 54 Neto HNM, Leite JVC, de Medeiros JM. et al. Scoping Review: Effect of Surface Treatments on Bond Strength of Resin Composite Repair. J Dent 2024; 140: 104737
• 55 Rosentritt M, Liebermann A, Kieschnick A. et al. Werkstoffkundliche Grundlagen für eine erfolgreiche Befestigung. zm online 2019; (20) 36-46
• 56 Awad MM, Alhalabi F, Alzahrani KM. et al. 10-Methacryloyloxydecyl Dihydrogen Phosphate (10-MDP)-Containing Cleaner Improves Bond Strength to Contaminated Monolithic Zirconia: An In-Vitro Study. Materials 2022; 15: 1023
• 57 Xie J, Powers J, Mcguckin R. In Vitro Bond Strength of Two Adhesives to Enamel and Dentin under Normal and Contaminated Conditions. Dent Mater 1993; 9: 295-299
• 58 Lund RG, Da Silveira IA, Ribeiro JS. et al. Influence of Blood Contamination and Decontamination Procedures on Bond Strength of a Two-Step Etch and Rinse Adhesive System. Eur J Gen Dent 2019; 8: 71-75
• 59 Kaneshima T, Yatani H, Kasai T. et al. The Influence of blood contamination on bond strengths between dentin and an adhesive resin cement. Oper Dent 2000; 25: 195-201
• 60 de Carvalho Mendonça EC, Vieira SN, Kawaguchi FA. et al. Influence of Blood Contamination on Bond Strength of a Self-Etching System. Eur J Dent 2010; 04: 280-286
• 61 ADA Council of Scientific Affairs, ADA Council on Dental Benefits and Programs. Statement on posterior resin-based composites. J Am Dent Assoc 1998; 130: 1627-1628
• 62 Kuphasuk W, Harnirattisai C, Senawongse P. et al. Bond Strengths of Two Adhesive Systems to Dentin Contaminated with a Hemostatic Agent. Oper Dent 2007; 32: 399-405
• 63 Ajami A, Kahnamoii M, Kimyai S. et al. Effect of Three Different Contamination Removal Methods on Bond Strength of a Self-Etching Adhesive to Dentin Contaminated with an Aluminum Chloride Hemostatic Agent. J Contemp Dent Pract 2013; 14: 26-33
• 64 O’Keefe K, Pinzon L, Rivera B. et al. Bond Strength of Composite to Astringent-Contaminated Dentin Using Self-Etching Adhesives. Am J Dent 2005; 18: 168-172
• 65 Noppawong S. Bond Strengths of Universal Adhesives to Dentin Contaminated with a Hemostatic Agent. J Adhes Dent 2022; 24: 421-426
• 66 Mempel CA, Jacker-Guhr S, Lührs AK. Contamination of Dentin with Hemostatic Agents – Is EDTA a Valuable Decontaminant before Using a Self-Etch Universal Adhesive?. J Adhes Dent 2022; 24: 345-354
• 67 Jacker-Guhr S, Lührs AK. Beware of Contamination! Do Hemostatic Agents Influence the Microtensile Bond Strength of a Universal Adhesive to Dentin?. Dtsch Zahnärztl Z Int 2021; 3: 167-175
• 68 Abu-Nawareg MM, Hajjaj MS, AbuHaimed TS. et al. The Effect of Hemostatic Agents and Dentin Cleansing Protocols on Shear Bond Strength of Resin Composite Using Universal Adhesive: An in Vitro Study. BMC Oral Health 2024; 24: 1413
• 69 Alzahrani SJ, Hajjaj MS, Abu Haimed TS. et al. Effect of Dentin Contamination with Hemostatic Agents and Cleaning Techniques on Bonding with Self-Adhesive Resin Cement. Med Sci Monit 2024; 30: e943353
• 70 Pashley DH, Nelson R, Kepler EE. The Effects of Plasma and Salivary Constituents on Dentin Permeability. J Dent Res 1982; 61: 978-981
• 71 Kucukyilmaz E, Celik E, Akcay M. et al. Influence of Blood Contamination during Multimode Adhesive Application on the Microtensile Bond Strength to Dentin. Niger J Clin Pract 2017; 20: 1644-1650
• 72 Tachibana A, Castanho GM, Vieira SN. et al. Influence of Blood Contamination on Bond Strength of a Self-Etching Adhesive to Dental Tissues. J Adhes Dent 2011; 13: 349-358
• 73 Nair P, Hickel R, Ilie N. Adverse Effects of Salivary Contamination for Adhesives in Restorative Dentistry. Am J Dent 2017; 30: 156-164
• 74 Bahari M, Savadi Oskoee S, Ebrahimi Chaharom ME. et al. The Effects of Different Surface Contaminators on the Shear Bond Strength of a Universal Adhesive System to Dentin: An Experimental Study. J Dent Res Dent Clin Dent Prospects 2021; 15: 82-86
• 75 Latta MA, Takamizawa T, Radniecki SM. et al. Effects of salivary contamination on the shear bond strengths of universal adhesives to Ddentin. Am J Dent 2024; 37: 268-276
• 76 Atalay C, Meral E. Does Rubbing of Universal Adhesive Reduce the Negative Effect of Saliva on Adhesion?. J Adhes Dent 2021; 1: 57-65
• 77 Schwendicke F, Frencken JE, Bjørndal L. et al. Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal. Adv Dent Res 2016; 28: 58-67
• 78 Erhardt MCG, Toledano M, Osorio R. et al. Histomorphologic Characterization and Bond Strength Evaluation of Caries-Affected Dentin/Resin Interfaces: Effects of Long-Term Water Exposure. Dent Mater 2008; 24: 786-798
• 79 Ceballos L, Camejo DG, Victoria Fuentes M. et al. Microtensile Bond Strength of Total-Etch and Self-Etching Adhesives to Caries-Affected Dentine. J Dent 2003; 31: 469-477
• 80 Isolan C, Sarkis-Onofre R, Lima G. et al. Bonding to Sound and Caries-Affected Dentin: A Systematic Review and Meta-Analysis. J Adhes Dent 2018; 1: 7-18
• 81 Karadas M, Bedir F, Demirbuga S. The Role of Etching Protocols on Bond Strength of Universal Adhesives Applied to Caries Affected Dentin: A Systematic Review and Meta-Analysis. Clin Oral Investig 2024; 28: 683
• 82 Tay F, Kwong S, Itthagarun A. et al. Bonding of a Self-Etching Primer to Non-Carious Cervical Sclerotic Dentin: Interfacial Ultrastructure and Microtensile Bond Strength Evaluation. J Adhes Dent 2000; 2: 9-28
• 83 Tay FR, Pashley DH. Resin Bonding to Cervcal Sclerotic Dentin: A Review. J Dent 2004; 32: 173-196
• 84 Kwong S. Micro-Tensile Bond Strengths to Sclerotic Dentin Using a Self-Etching and a Total-Etching Technique. Dent Mater 2002; 18: 359-369
• 85 Belmar da Costa M, Delgado AHS, Pinheiro de Melo T. et al. Analysis of Laboratory Adhesion Studies in Eroded Enamel and Dentin: A Scoping Review. Biomater Investig Dent 2021; 8: 24-38
• 86 de Siqueira FSF, Wendlinger M, Araújo LCR. et al. Bonding Performance of Universal Adhesives to Eroded Dentine: A 6-Year Evaluation. J Dent 2023; 136: 104633
• 87 Lührs A, Jacker-Guhr S, Günay H. et al. Composite Restorations Placed in Non-carious Cervical Lesions – Which Cavity Preparation Is Clinically Reliable?. Clin Exp Dental Res 2020; 6: 558-567
• 88 Zimmerli B, De Munck J, Lussi A. et al. Long-Term Bonding to Eroded Dentin Requires Superficial Bur Preparation. Clin Oral Invest 2012; 16: 1451-1461
• 89 Krämer N, Stachniss V, Heidmann I. et al. Therapie der Molaren-Inzisiven-Hypomineralisation (MIH) in einem schwierigen Umfeld – Hat adhäsive Zahnheilkunde an MIH-Zähnen eine Perspektive?. Quintessence 2011; 62: 1601-1612
• 90 Fagrell TG, Dietz W, Jälevik B. et al. Chemical, Mechanical and Morphological Properties of Hypomineralized Enamel of Permanent First Molars. Acta Odontol Scand 2010; 68: 215-222
• 91 Bozal CB, Kaplan A, Ortolani A. et al. Ultrastructure of the surface of dental enamel with molar incisor hypomineralization (MIH) with and without acid etching. Acta Odontol Latinoam 2015; 28: 192-198
• 92 Alzahrani AY, Alamoudi NMH, El Meligy OAES. Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review. Dent J 2023; 11: 157
• 93 Lygidakis NA, Garot E, Somani C. et al. Best Clinical Practice Guidance for Clinicians Dealing with Children Presenting with Molar-Incisor-Hypomineralisation (MIH): An Updated European Academy of Paediatric Dentistry Policy Document. Eur Arch Paediatr Dent 2022; 23: 3-21
• 94 Santos PS, Vitali FC, Fonseca-Souza G. et al. Dentin Hypersensitivity and Toothache among Patients Diagnosed with Molar-Incisor Hypomineralization: A Systematic Review and Meta-Analysis. J Dent 2024; 145: 104981
• 95 Bekes K. Molaren-Inzisiven-Hypomineralisation: Gibt es einen Einfluss auf die Lebensqualität von betroffenen Kindern?. Oralprophylaxe Kinderzahnmedizin 2025; 47: 29-31
• 96 Krämer N, Bui Khac NHN, Lücker S. et al. Bonding Strategies for MIH-Affected Enamel and Dentin. Dent Mater 2018; 34: 331-340
• 97 Rolim TZC, da Costa TRF, Wambier LM. et al. Adhesive Restoration of Molars Affected by Molar Incisor Hypomineralization: A Randomized Clinical Trial. Clin Oral Invest 2021; 25: 1513-1524
• 98 Lagarde M, Vennat E, Attal J. et al. Strategies to Optimize Bonding of Adhesive Materials to Molar-incisor Hypomineralization-affected Enamel: A Systematic Review. Int J Paed Dent 2020; 30: 405-420
• 99 Sundfeld D, da Silva L, Kluppel O. et al. Molar Incisor Hypomineralization: Etiology, Clinical Aspects, and a Restorative Treatment Case Report. Oper Dent 2020; 45: 343-351
• 100 Fagrell TG, Lingström P, Olsson S. et al. Bacterial Invasion of Dentinal Tubules beneath Apparently Intact but Hypomineralized Enamel in Molar Teeth with Molar Incisor Hypomineralization. Int J Paed Dent 2008; 18: 333-340
• 101 Lygidakis NA, Dimou G, Stamataki E. Retention of Fissure Sealants Using Two Different Methods of Application in Teeth with Hypomineralised Molars (MIH): A 4 Year Clinical Study. Eur Arch Paediatr Dent 2009; 10: 223-226