Universal adhesives (UAs) exhibit considerable versatility; however, no single commercial product has attained recognition as a clinical gold standard. This study evaluated the functional performance, retention, and marginal integrity of various UA brands in non-carious cervical lesion (NCCL) restorations and examined the effects of different adhesion strategies. A search of electronic databases was conducted for randomized clinical trials (RCTs) published between 2015 and 2025. Only RCTs that assessed the retention and marginal integrity of UAs with follow-ups of 18–48 months, using the USPHS/FDI criteria, were included. This review was registered with PROSPERO (CRD420251026490) and adhered to PRISMA 2020 and PICOS guidelines. Risk of bias was evaluated using the RoB 2 tool; statistical significance was defined as p 0.05). Although ER and SEE strategies significantly enhance long-term retention, no UA brand showed consistent superiority to be considered a gold standard.
D’Elia et al. (Fri,) studied this question.