Mendes Laura Teixeira, Loomans Bas A C, Opdam Niek J M, Silva Carolina Lopes da, Casagrande Luciano, Lenzi Tathiane Larissa
J Adhes Dent. 2020;22(5):443-453. doi: 10.3290/j.jad.a45175.
To systematically review the literature to determine whether silane combined with adhesive application improves the repair bond strength of direct methacrylate-based resin composites in comparison to the use of an adhesive alone.
The literature up to December 2019 was searched through PubMed/MEDLINE, Scopus, and Lilacs databases with no publication year or language limits. From 676 potentially eligible studies, 81 were selected for full-text analysis, and 19 were included in the systematic review. Two reviewers independently selected the studies, extracted data, and assessed the risk of bias. Meta-analyses were conducted using a random effects model to calculate pooled mean differences between adhesive- vs silane-plus-adhesive surface treatments (global meta-analysis) and considering subgroup analyses (immediate and aged repair bond strengths and type of silane - hydrolyzed or nonhydrolyzed). Statistical analyses were performed using RevMan5.3 at a significance level of 5%.
Global meta-analysis showed that the use of silane prior to adhesive application produced significantly higher repair bond strengths (p=0.003). A higher mean difference (effect size: 7.30, 95% CI: 2.91-17.51) between groups was found when nonhydrolyzed silanes were used. The heterogeneity was high. Studies scored between medium and high risk of bias.
An additional silane application step could increase the repair bond strength of methacrylate-based resin composites.
系统回顾文献，以确定与单独使用粘合剂相比，硅烷与粘合剂联合应用是否能提高直接甲基丙烯酸酯基树脂复合材料的修复粘结强度。
通过PubMed/MEDLINE、Scopus和Lilacs数据库检索截至2019年12月的文献，无出版年份或语言限制。从676项可能符合条件的研究中，选择81项进行全文分析，19项纳入系统评价。两名评价者独立选择研究、提取数据并评估偏倚风险。采用随机效应模型进行荟萃分析，计算粘合剂与硅烷加粘合剂表面处理之间的合并平均差异（整体荟萃分析），并考虑亚组分析（即时和老化修复粘结强度以及硅烷类型——水解或非水解）。使用RevMan5.3进行统计分析，显著性水平为5%。
整体荟萃分析表明，在应用粘合剂之前使用硅烷可产生显著更高的修复粘结强度（p = 0.003）。当使用非水解硅烷时，组间平均差异更高（效应大小：7.30，95%置信区间：2.91 - 17.51）。异质性较高。研究的偏倚风险评分为中到高。
额外的硅烷应用步骤可提高甲基丙烯酸酯基树脂复合材料的修复粘结强度。
