Oper Dent. 2020 Nov 1;45(6):598-607. doi: 10.2341/19-185-L.
One-step self-etch adhesive systems provide a clinical time gain, decreasing the number of clinical steps. When a clinician is able to follow a simpler process of adhesion there is less chance of adhesive failure.
Objective: A systematic review and meta-analyses were performed to evaluate whether one-step self-etching (1SSE) adhesive systems are as effective as two-step self-etching (2SSE) adhesives in noncarious cervical lesion (NCCL) restorations.Methods: This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and recorded in the PROSPERO (CRD42018096747). Electronic systematic searches were conducted in the following databases: PubMed/MEDLINE, Scopus, and Cochrane Library for published articles. Only randomized clinical trials that compared 1SSE with 2SSE adhesives systems were selected. The outcomes were retention, postoperative sensitivity, secondary caries, color match, marginal discoloration, marginal adaptation, and anatomical form.Results: The searches resulted in 476 studies. After applying the eligibility criteria, five randomized controlled trials were selected in which 822 restorations in NCCLs were distributed in 237 patients. The results showed no statistical difference between 1SSE and 2SSE in relation to retention (p=0.23; relative risk [RR]=1.55; 95% confidence interval [CI]=0.76, 3.19), postoperative sensitivity ( p=0.50; RR=3.00; 95% CI=0.13, 70.64), Secondary caries (p=0.63; RR=0.68; 95% CI=0.14, 3.31), color match (p=0.41; RR=0.64; 95% CI=0.23, 1.83), marginal discoloration (p=0.93; RR=1.02; 95% CI=0.65, 1.61), and anatomical form (p=0.56; RR=1.38; 95% CI=0.46, 4.13). However there was statistical difference in relation to marginal adaptation ( p=0.01; RR=1.95; 95% CI=1.14, 3.34).Conclusion: This systematic review with meta-analysis revealed that both 1SSE and 2SSE adhesive systems have comparable clinical effectiveness in a follow-up period of 12 to 24 months, except in relation to marginal adaptation.
一步自酸蚀粘结系统提供了临床时间上的优势，减少了临床操作步骤的数量。当临床医生能够遵循更简单的粘结流程时，粘结失败的可能性就会降低。
目的：本系统评价和荟萃分析旨在评估一步自酸蚀（1SSE）粘结系统在非龋性颈领病变（NCCL）修复中是否与两步自酸蚀（2SSE）粘结系统同样有效。
本系统评价按照系统评价和荟萃分析首选报告项目（PRISMA）的指南进行，并在 PROSPERO（CRD42018096747）中进行了记录。电子系统检索了 PubMed/MEDLINE、Scopus 和 Cochrane 图书馆中已发表的文章。仅选择了比较 1SSE 和 2SSE 粘结系统的随机临床试验。结果包括保留率、术后敏感、继发龋、颜色匹配、边缘变色、边缘适应性和解剖形态。
检索结果产生了 476 项研究。在应用纳入标准后，选择了五项随机对照试验，其中 237 名患者的 NCCL 中有 822 个修复体。结果显示，1SSE 和 2SSE 在保留率（p=0.23；相对风险[RR]=1.55；95%置信区间[CI]=0.76, 3.19）、术后敏感（p=0.50；RR=3.00；95% CI=0.13, 70.64）、继发龋（p=0.63；RR=0.68；95% CI=0.14, 3.31）、颜色匹配（p=0.41；RR=0.64；95% CI=0.23, 1.83）、边缘变色（p=0.93；RR=1.02；95% CI=0.65, 1.61）和解剖形态（p=0.56；RR=1.38；95% CI=0.46, 4.13）方面无统计学差异。然而，在边缘适应性方面有统计学差异（p=0.01；RR=1.95；95% CI=1.14, 3.34）。
本系统评价和荟萃分析显示，在 12 至 24 个月的随访期内，1SSE 和 2SSE 粘结系统在临床效果上具有可比性，除了边缘适应性方面。
