Adhesion to eroded enamel and dentin: systematic review and meta-analysis. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Wiegand, Annette; Lechte, Clemens; Kanzow, Philipp
• Is Part Of: Dental materials. Volume 37:Issue 12(2021)
• Page Start: 1845
• Page End: 1853
• Publication Date: 2021-12
• Subjects: Erosion -- Tooth wear -- Bonding -- Adhesive -- Enamel -- Dentin -- Bond strength; Dentistry -- Periodicals; Dental materials -- Periodicals; 617.695
• DOI: 10.1016/j.dental.2021.09.014
• Languages: English
• ISSNs: 0109-5641

Abstract

Highlights: Erosion impairs bond strength to dentin, but not to enamel. Etch&rinse and self-etch adhesives do not perform significantly different. Surface pretreatment measures can improve bond strength to eroded dentin. Abstract: Objective: The aim of this systematic review and meta-analysis was to compare the bond strength between eroded and sound permanent enamel and dentin and to assess whether bonding performance (immediate and after aging) differs between etch&rinse and self-etch adhesives and can be improved by surface pretreatment prior to bonding. Methods: Electronic databases (PubMed, Scopus, Embase, Web of Science, CENTRAL, LILACS, BBO) were searched by two reviewers. Random-effect meta-analyses were performed to compare bond strength to sound and eroded dental hard tissues without and with surface pretreatment prior to bonding, respectively. The effect of adhesive mode (etch&rinse vs. self-etch) and aging (immediate vs. aged) was compared using subgroup analyses. Statistical heterogeneity was assessed using Cochran's Q and I 2 -statistic. Funnel plots and Egger's regression intercept tests were used to evaluate publication bias. Quality and risk of bias of included studies were also assessed. Results: Fourty-seven studies (45 in vitro, 2 in situ) were included in the systematic review and meta-analyses. Erosion impairs bond strength to dentin (p < 0.001; mean difference: −10.2 MPa [95%CI: −11.9 to −8.6 MPa]), but not to enamel (p = 0.260). Surface pretreatment measures removing or stabilizing the collagenous matrix can improve dentin bond strength (maximum mean difference: +12.4 MPa). Etch&rinse and self-etch adhesives did not perform significantly different on eroded enamel (p = 0.208) and dentin (p = 0.353). The majority of studies (32 of 47) presented a medium risk of bias. Significance: Data from in vitro and in situ studies showed that erosion impairs dentin bonding of etch&rinse and self-etch adhesives and makes surface pretreatment prior to bonding of composite restorations necessary.