Longevity of indirect restorations cemented with self‐adhesive resin luting with and without selective enamel etching. A Systematic review and meta‐analysis

Abstract

Objective To investigate the influence of the selective etching in the survival rates of indirect restorations cemented with self‐adhesive resin luting. Materials and Methods The eligibility criteria were formulated based on PICOS strategy. The search without restrictions was performed in PubMed/Medline, the Cochrane Library, Web of Science, Scopus, LILACS databases and gray literature until May 2018. Cochrane Collaboration's tool was performed for assessing the risk of bias. According to the bias risk analysis, the studies were classified as low risk of bias and high quality of evidence. The systematic review was conducted according to PRISMA and registered in PROSPERO (CRD42018091202). The meta‐analysis was performed using RevMan 5.3 software (RevMan, Copenhagen, Denmark) and the risk ration and confidence interval was obtained (p < 0.05). Results After database screening, removal of duplicates and eligibility criteria application, two studies were selected for this systematic review, with 65 participants (34 in one and 31 in the other). The pooled meta‐analysis demonstrated no statistically significant difference in clinical longevity for selective etching in indirect restorations (P > .05; I2 = 0%) and risk ratio of 0.46 [0.19‐1.09]. Conclusions Based on the findings, the results of this systematic review suggest that the selective enamel etching prior to application of self‐adhesive luting cements systems for indirect restoration do not influence the clinical longevity of indirect restorations. Clinical significance: The knowledge of the clinical steps of adhesive procedures is fundamental to the success of adhesive restorations and their longevity. Self‐adhesive resin cements simplify the luting procedure of indirect restorations. However, adding a step that could significantly improve long‐term survival would be of great value. Thus, the results of this systematic review will provide data so that the decision making regarding materials used for adhesive cementation is conducted based on scientific evidence.

Assessment of Degree of Conversion and Knoop Microhardness of Different Resin Cementing Agents

“…Resin cements can be classified according to their activation modes, namely: chemically activated; photoactivated (physical activation); and dual-cured [6,9]. In dual activation, the polymerization reaction is initiated both by the emission of visible light and by a chemical reaction (peroxide/amine) [2,9].…”

“…Another classification has become mandatory since the advent of new resin cements with different bonding mechanisms [2]. This way, cements can also be classified as conventional or self-etching cements [3,6]. Conventional cements require previous acid etching and hybridization with the adhesive system, so that the union between the resinous material and the dental structure occurs [3,5,6].…”

“…This way, cements can also be classified as conventional or self-etching cements [3,6]. Conventional cements require previous acid etching and hybridization with the adhesive system, so that the union between the resinous material and the dental structure occurs [3,5,6]. Self-etchers do not require previous acid conditioning with the adhesive system, reducing the sensitivity inherent to the cementation technique by simplifying the procedure and, consequently, optimizing clinical time [2,6].…”

“…Despite the clinical advantages of self-etching resin cements, some studies have indicated that conventional resin cements exhibited higher DC and better mechanical properties [3,4,6]. In this sense, doubts still arise regarding the use of conventional or self-etching resin cements.…”

Effect of Exclusive Primer and Adhesive on Microtensile Bond Strength of Self-Adhesive Resin Cement to Dentin

“…Furthermore, during polymerization, the phosphoric acid group is neutralized while it simultaneously reacts with the alkaline filler and cement shifts from hydrophilic to hydrophobic. Accordingly, the monomer bonds to the calcium ions of the hydroxyapatite resulting in a chemical retention [2,4,[7][8][9].…”