ABSTRACT
STATEMENT OF PROBLEM: A consensus on whether to use an adhesive layer on glass-ceramics after etching with hydrofluoric acid and applying a silane-coupling agent is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to determine whether adhesive layer application after etching and silanization influences the bond strength values of glass-ceramics to resin-based materials. MATERIAL AND METHODS: PubMed, ISI Web of Science, and Scopus electronic databases were searched to select in vitro studies comparing bond strength values of etched and silanized glass-ceramics bonded with or without an adhesive layer. No publication year or language restriction was applied. Data sets were extracted, and the mean differences were applied by using the Rev Man 5.3 program. The association between bond strength (shear/microshear or tensile/microtensile) and an adhesive layer application on nonaged and aged specimens was analyzed. RESULTS: Of 4727 potentially eligible studies, 54 were selected for full-text analysis, and 15 were included for qualitative synthesis; of these, 14 were used in the meta-analysis. A total of 2 meta-analyses were performed with heterogeneity varying from high to moderate among study specimens. For shear/microshear studies, both nonaged (MD, 1.36 [95% CI: -0.18, 2.90], P=.080, I2=79%) and aged (MD, 0.89 [95% CI: -1.04, 2.82], P=.370, I2=80%) specimens presented no statistically significant difference between groups bonded with or without an adhesive layer application. For microtensile studies, both nonaged (MD, -1.49 [95% CI: -2.48, -0.50], P=.003, I2=88%) and aged (MD, -3.87 [95% CI: -5.63, -2.11], P<.001, I2=97%) specimens exhibited higher values without an adhesive application. CONCLUSIONS: Regardless of the bond strength test used, an adhesive layer application did not improve the bond strength of etched and silanized glass-ceramics to resin-based materials. The influence of this adhesive layer application should be evaluated under clinical conditions.
Subject(s)
Dental Bonding , Resin Cements , Ceramics , Dental Cements , Dental Porcelain , Humans , Materials Testing , Silanes , Surface Properties , Tensile StrengthABSTRACT
Uma revisão sistemática realizada para responder à seguinte pergunta de pesquisa: O momento de realização das etapas de acabamento e polimento na adaptação marginal em restaurações diretas de resina composta fotoativada à base de metacrilato? Foram selecionados estudos in vitro que avaliaram a influencia do momento de realização das etapas de acabamento e polimento na adaptação marginal em restaurações de resina composta fotoativada à base de metacrilato. A avaliação do risco de viés foi baseada em uma lista de verificação de 6 itens. MEDLINE via PubMed, EMBASE, Web of Science, Scopus, LILACS e BBO via Virtual Health Library, Cochrane Library e bancos de dados da literatura cinza foram pesquisados, sem restrição de idioma ou ano. Dos 6.680 estudos potencialmente elegíveis, 8 estudos foram incluídos. Todos os estudos incluídos apresentaram alto risco de viés. O elevado nível de heterogeneidade entre os estudos excluiu a metanálise. Embora os estudos incluídos nesta revisão sistemática pareçam sugerir que o acabamento e polimento tardio poderia melhorar a adaptação marginal em restaurações de resina composta fotoativa à base de metacrilato, o alto risco de viés e alta heterogeneidade entre os estudos indicam a necessidade de mais investigações com um melhor desenho metodológico para concluir esta questão. (AU)
A systematic review was performed to answer the following research question: Does the finishing and polishing time influence the marginal adaptation in direct photoactivated methacrylate-based composite resin restorations? In vitro studies evaluating the influence of the finishing and polishing time on the marginal adaptation in photoactivated methacrylatebased composite resin restorations were selected. Assessment of the risk of bias was based on a 6-item checklist. The MEDLINE via PubMed, EMBASE, Web of Science, Scopus, LILACS and BBO via Virtual Health Library, Cochrane Library, and the grey literature databases were searched, without language or year restriction. From 6680 retrieved articles, 8 studies were included. All included studies were considered to be at high risk of bias. The high level of heterogeneity across the studies excluded meta-analysis. Even though the studies included in this systematic review seems to suggest that delayed finishing and polishing could improve the marginal adaptation in photoactivated methacrylate-based composite resin restorations, the high risk of bias and high heterogeneity across the studies indicate the need for further investigations with a better methodological design to conclude this question. (AU)
