牙本质即刻封闭陶瓷修复体的粘接强度评估:系统回顾与元分析

Pooran Samimi, Pedram Iranmanesh, Maryam Khoroushi, Mohammad Hossein Kafi, Niloufar Jafari
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引用次数: 0

摘要

问题陈述:引入即刻牙本质封闭(IDS)是为了克服延迟牙本质封闭的缺点,如牙本质小管污染、微渗漏和随着时间推移粘结强度的破坏。目的:本研究旨在确定 IDS 对陶瓷修复体与牙本质粘接强度的影响:在本系统综述和荟萃分析中,研究方案已在 PROSPERO 数据库中注册,注册号为 CRD420202014 27。MEDLINE(PubMed)、Web of Science、Scopus 和 ProQuest 数据库的检索截止到 2021 年 1 月,并于 2022 年 1 月更新。此外,还检索了 Worldcat.org 和 Opengrey.eu、ProQuest 学位论文和毕业论文以及 Google Scholar,以探索灰色文献。纳入了评估有无 IDS 的陶瓷修复体与牙本质粘接强度的体外研究。评估研究偏倚风险的标准有七项。统计分析使用 RevMan 5.3 进行。采用反方差法确定微拉伸粘接强度(µTBS)和剪切粘接强度(SBS)的平均差:共有 10 项研究(20 个数据集)被纳入荟萃分析。关于 µTBS 分析,IDS 的粘接强度明显高于延迟牙本质封闭(DDS)(MD:1.16, 95%CI:0.28_2.03, I2=0%)。但在 SBS 分析中,两者之间没有发现明显差异(MD:0.25, 95%CI: -0.56-1.06,I2=96%)。所有研究均被归类为中度或高度偏倚风险:大多数体外证据显示,IDS 对间接修复体的粘接强度和耐久性有良好的影响。粘接系统和陶瓷的类型以及粘接前的处理是决定性因素。由于结果的异质性和具有中度/高度偏倚风险的研究,证据的质量较低。
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Bond Strength Evaluation of Ceramic Restorations with Immediate Dentin Sealing: A Systematic Review and Meta-Analysis.

Statement of the problem: Immediate dentin sealing (IDS) was introduced to overcome the disadvantages of delayed dentin sealing like pollution of dentin tubules, microleakage, and bond strength destruction over time. The effect of IDS on the bond strength of indirect restorations is still debatable.

Purpose: This study was conducted to determine the effect of IDS on the bond strength of ceramic restorations to dentin.

Materials and method: In this systematic review and meta-analysis, the study protocol was registered on the PROSPERO database under the registration number CRD420202014 27. MEDLINE (PubMed), Web of Science, Scopus, and ProQuest databases were searched until January 2021 and updated in January 2022. Worldcat.org and Opengrey.eu, ProQuest dissertation and thesis, and Google Scholar were searched to explore the grey literature. The in vitro studies evaluating the bond strength of ceramic restoration to dentin with and without IDS were included. Seven criteria were assessed to evaluate the risk of bias in the study. Statistical analyses were conducted using RevMan 5.3. The inverse variance method was used to determine the mean difference of micro-tensile bond strength (µTBS) and shear bond strength (SBS).

Results: A total of 10 studies (20 datasets) were included in the meta-analysis. Regarding the µTBS analysis, IDS had a significantly higher bond strength than Delayed Dentin Sealing (DDS) (MD:1.16, 95%CI:0.28_2.03, I2=0%). However, no significant difference was found between them in the SBS analysis (MD:0.25, 95%CI: -0.56-1.06, I2=96%). All studies were categorized to have a moderate or high risk of bias.

Conclusion: Most in vitro evidence showed favorable results for the effect of IDS on the bond strength and durability of indirect restorations. The adhesive system and the type of ceramic and its treatment before cementation are determining factors. Due to the heterogeneity of the outcomes and studies with a moderate/high risk of bias, the quality of the evidence was low.

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