J Adhes Dent. 2018;20(1):7-18. doi: 10.3290/j.jad.a39775.
This study systematically reviewed the literature to compare the bonding ability of dental adhesives applied to sound dentin (SoD) vs caries-affected dentin (CAD).
Three international databases (Medline/PubMed, Scopus, and Web of Science) were searched. Eligible studies which evaluated the bond strength to both SoD and CAD were included. Random effects meta-analyses were conducted to calculate pooled mean difference between substrates, separately for etch-and-rinse and self-etch adhesives. Subgroup analyses were carried out to explore heterogeneity considering the methods used for removal of infected carious dentin. A comparison between etch-and-rinse and self-etch adhesives restricted to CAD was also performed. Statistical heterogeneity was considered using the I2 test. The risk of bias of all included studies was assessed.
In total, 2260 articles were found, 65 were selected for full-text reading, and 40 studies were included. The meta-analyses favored SoD over CAD for both etch-and-rinse (effect size: -10.04; 95% confidence interval [CI]: -11.94, -8.14; I2 = 95%) and self-etch adhesives (effect size: -6.76; 95% CI: -8.23, -5.30; I2 = 89%). In the subgroup analyses, SoD was favored irrespective of the method used for caries removal (effect size ≤ -4.86; I2 ≥ 28%): excavation (manual or with burs), grinding with abrasive papers, combination of more than one method, and when the method was not mentioned. The meta-analysis restricted to CAD favored etch-and-rinse over self-etch adhesives (effect size: 3.13; 95% CI: 1.82, 4.44; I2 = 72%). Most included studies were judged as having an unclear risk of bias.
Bonding to SoD yields better results compared to CAD. Etch-and-rinse adhesives performed better than self-etch adhesives when applied to CAD.
本研究系统地回顾了文献，比较了应用于正常牙本质（SoD）和龋病牙本质（CAD）的牙科胶粘剂的粘结性能。
检索了三个国际数据库（Medline/PubMed、Scopus 和 Web of Science）。纳入评估了 SoD 和 CAD 粘结强度的合格研究。分别对酸蚀冲洗型和自酸蚀型胶粘剂进行了随机效应荟萃分析，以计算基质间的 pooled mean difference。进行了亚组分析，以考虑用于去除感染性龋坏牙本质的方法来探索异质性。还对 CAD 中酸蚀冲洗型和自酸蚀型胶粘剂进行了比较。使用 I2 检验评估了统计异质性。评估了所有纳入研究的偏倚风险。
共发现 2260 篇文章，其中 65 篇进行了全文阅读，最终纳入了 40 项研究。荟萃分析结果表明，酸蚀冲洗型和自酸蚀型胶粘剂对 SoD 的粘结效果均优于 CAD（效应量：-10.04；95%置信区间 [CI]：-11.94，-8.14；I2 = 95%）。在亚组分析中，无论龋坏去除方法如何（效应量≤-4.86；I2≥28%：挖除[手动或用涡轮机]、用砂纸打磨、联合使用多种方法，或方法未提及），SoD 均优于 CAD。限制在 CAD 时的荟萃分析结果表明，酸蚀冲洗型优于自酸蚀型胶粘剂（效应量：3.13；95%CI：1.82，4.44；I2 = 72%）。纳入的大多数研究被判定为存在不清楚的偏倚风险。
与 CAD 相比，SoD 的粘结效果更好。CAD 时，酸蚀冲洗型胶粘剂的性能优于自酸蚀型胶粘剂。
