Purpose: The systematic review aims to evaluate the difference in shear bond strength (SBS) of “etch and rinse” to self-etch adhesive systems, when used between restorations in the sandwich technique.
Methods: Electronic search was performed on PubMed, Scopus, and Cochrane library databases. The studies published till March 31, 2021 were taken up for the review. A customized tool was used to assess the risk of bias. Covidence software was used to record the decisions, and RevMan 5.1 was used to perform meta-analysis. Data were collected regarding SBS and modes of failure of different etching systems.
Results: Ten in vitro studies were included for qualitative synthesis and meta-analysis after screening. Self-etch adhesive system showed a higher SBS value compared to the “etch and rinse” adhesive system in the quantitative synthesis. However, there was not a significant difference between both the adhesive groups when a two-step self-etch adhesive system was used with glass ionomer cement. Cohesive failure was seen predominantly in both the adhesive system\'s followed by mixed and adhesive failure. The articles showed a low-to-moderate risk of bias.
Conclusion: Self-etch adhesive systems are recommended over “etch and rinse” adhesive systems in sandwich technique.
Clinical significance: The better SBS provided by self-etch adhesive system compared to “etch and rinse” adhesive system can widen the life span of sandwich restorations.