SUMMARY Objectives: This systematic review of in vitro studies investigated the influence of the post-space treatment used to remove the smear layer on the bond strength of the post to root canal dentin. Methods and Materials: In vitro studies included in this study were identified from PubMed/MEDLINE, Lilacs, and Scopus databases up until March 2019, without limits on publication year or language. Two reviewers independently selected the studies based on the inclusion and exclusion criteria, extracted the data, and evaluated the risk of bias of all studies. A random effects model was used for pairwise meta-analyses (control vs. post-space preparation groups) at a significance level of p<0.05. Results: Of the 2,832 potentially eligible studies, 453 studies were selected for full-text analysis, and 75 were included in this systematic review. Only one study was considered to have a low risk of bias. Overall, post-space treatment significantly improves the bond strength to root canal dentin (p<0.00001). Conclusion: Post-space treatment has a positive influence on the bond strength of the post to root canal dentin. In this review, the post-space treatments that improve the adhesive resistance of the post were ethanol, sodium hypochlorite, and ethylene diamine tetra-acetic acid (NaOCl + EDTA), NaOCl + EDTA + ultrasound, erbium-doped yttrium aluminium garnet laser (Er:YAG laser), neodymium-doped yttrium aluminium garnet laser (Nd:YAG laser), and diode laser.
Clinical Relevance Vital bleaching impairs the bonding of adhesive systems to enamel and dentin. Thus, restoration placement should be delayed for at least two weeks after completion of bleaching procedures. SUMMARY Objective: This systematic review evaluates the influence of vital bleaching on the bond strength of adhesive systems to enamel and dentin. Methods: This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). In vitro studies comparing the bond strength of bleached and unbleached enamel and dentin were searched at the electronic databases—PubMed/MEDLINE, Scopus, and Web of Science—with no limit on year or language. The studies were screened and had data extracted by two reviewers independently. Bond strength data were meta-analyzed using the inverse variance method and the random effect model (p≤0.05). Results: The electronic search provided 4941 eligible studies, and 52 were included in the systematic review and the meta-analysis. The global meta-analysis showed that bleaching impairs the bond strength of adhesive systems to enamel and dentin (p<0.001; mean difference [MD]: –0.96; confidence interval [CI]: −1.18 to −0.73), regardless of the bleaching agent (p<0.001; MD: −9.98; CI: −1.37 to −0.58) or substrate (p<0.001; MD: −0.89; CI: −1.12 to −0.66). The detrimental effect of bleaching on bond strength was not observed after two and three weeks after bleaching (p=0.1; MD: −0.39; CI: −0.84 to 0.65; and p=0.18; MD: −0.99; CI: −2.45 to 0.47, respectively). Conclusion: This systematic review and meta-analysis demonstrated that vital bleaching impairs the bonding of adhesive systems to enamel and dentin, and this adverse effect persists for two weeks.
O objetivo deste estudo foi avaliar a resistência de união ao esmalte (RU) imediata e após 6 meses, do adesivo Single Bond universal (3M-Espe) aplicado nas duas estratégias, ao esmalte hígido (HIG), desmineralizado (DES) e erodido (ERO). Foram utilizados 60 incisivos bovinos hígidos, divididos aleatoriamente em 6 grupos experimentais (n10) de acordo com o substrato: HIG, DES (ciclagem de pH) e ERO (imersão em refrigerante de cola) e estratégia de aplicação: com condicionamento ácido (ER) ou autocondicionante (SE). Após a aplicação do adesivo, tubos de amido foram posicionados sobre a superfície de esmalte, individualmente fotopolimerizados e em seguida preenchidos com resina composta totalizando 6 espécimes por dente. Os corpos de prova foram armazenados em água destilada em estufa a 37°C por 24h. Dois espécimes de cada dente foram submetidos ao ensaio de microcisalhamento imediatamente e dois após 6 meses de armazenamento. Os valores de RU (Mpa) foram submetidos à ANOVA-3 fatores (substrato, estratégia e tempo) e teste Tukey (a0,05). Os fatores isolados “substrato” (p0,000) e “estratégia” (p0,021), bem como sua interação (p0,008), foram significantes. Os valores de RU apresentaram a seguinte ordem decrescente: ERO>HIG>DES tendo a estratégia ER apresentado valores significantemente maiores. O esmalte desmineralizado reduz a adesão do sistema adesivo Single Bond Universal, já o erodido não compromete a adesão. O condicionamento ácido prévio à aplicação do adesivo resulta em maior adesão.Palavras-chave: Colagem Dentária. Esmalte Dentário. Resistência ao Cisalhamento.
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