Belmar da Costa Madalena, Delgado António H S, Pinheiro de Melo Teresa, Amorim Tomás, Mano Azul Ana
Instituto Universitário Egas Moniz (IUEM), Almada, Portugal.
Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, London, UK.
Biomater Investig Dent. 2021 Feb 15;8(1):24-38. doi: 10.1080/26415275.2021.1884558.
To summarize and report laboratory studies of adhesion in eroded substrates, which used bond strength as an outcome measure. To determine the strategies available to overcome bonding difficulties, the quality and consistency of the methodology and to find evidence gaps.
The present review followed PRISMA-ScR guidelines. A search was conducted on PubMed/Medline, Scopus and EMBASE (Ovid) databases to identify published peer-reviewed papers (2010-2020). For final qualitative synthesis, 29 articles were selected which respected the inclusion criteria. Data charting was carried out, independently, by two reviewers and quality assessment of the articles was performed.
The primary studies included fall into four major categories: comparison of restorative materials and application modes, enzymatic inhibitors, surface pretreatments or remineralization strategies. Most studies found evaluated dentin (76%), while 17% evaluated enamel, and 7% evaluated both substrates. The majority of the studies reported an effective intervention (83%). Bond strength to eroded dentin is significantly reduced, while in enamel erosion is beneficial. The bond strength to eroded dentin is material-dependent and favored in systems containing 10-MDP. Great disparities among the erosion models used were found, with citric acid in different concentrations being the preferred method, although standardization is lacking.
Adhesives containing 10-MDP show beneficial results in eroded dentin, and surface preparation methods should be considered. Studies which evaluated adhesion to eroded enamel/dentin show high heterogeneity in what concerns aims and methodology. Strategies that focus on remineralizing dentin and strategies to protect bond longevity in this substrate require further research.
总结并报告关于侵蚀性底物黏附的实验室研究，这些研究将粘结强度作为结果指标。确定可用于克服粘结困难的策略、方法的质量和一致性，并找出证据空白。
本综述遵循PRISMA-ScR指南。在PubMed/Medline、Scopus和EMBASE（Ovid）数据库中进行检索，以识别已发表的经同行评审的论文（2010 - 2020年）。为进行最终的定性综合分析，选择了29篇符合纳入标准的文章。由两名评审员独立进行数据图表绘制，并对文章进行质量评估。
主要研究分为四大类：修复材料和应用模式的比较、酶抑制剂、表面预处理或再矿化策略。大多数研究评估的是牙本质（76%），而17%评估的是釉质，7%同时评估了这两种底物。大多数研究报告了有效的干预措施（83%）。与侵蚀性牙本质的粘结强度显著降低，而在釉质中侵蚀是有益的。与侵蚀性牙本质的粘结强度取决于材料，在含有10 - MDP的系统中更有利。发现所使用的侵蚀模型存在很大差异，不同浓度的柠檬酸是首选方法，但缺乏标准化。
含有10 - MDP的粘结剂在侵蚀性牙本质中显示出有益效果，应考虑表面处理方法。评估与侵蚀性釉质/牙本质粘结的研究在目的和方法方面显示出高度异质性。专注于牙本质再矿化的策略以及保护该底物中粘结持久性的策略需要进一步研究。
