活力漂白对牙釉质和牙本质黏结系统黏结强度的影响：体外研究的系统评价和荟萃分析。

Vital Bleaching Influences the Bond Strength of Adhesive Systems to Enamel and Dentin: A Systematic Review and Meta-Analysis of In Vitro Studies.

出版信息

Oper Dent. 2021 Mar 1;46(2):E80-E97. doi: 10.2341/20-035-LIT.

Abstract

OBJECTIVE

This systematic review evaluates the influence of vital bleaching on the bond strength of adhesive systems to enamel and dentin.

METHODS

This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). In vitro studies comparing the bond strength of bleached and unbleached enamel and dentin were searched at the electronic databases-PubMed/MEDLINE, Scopus, and Web of Science-with no limit on year or language. The studies were screened and had data extracted by two reviewers independently. Bond strength data were meta-analyzed using the inverse variance method and the random effect model (p≤0.05).

RESULTS

The electronic search provided 4941 eligible studies, and 52 were included in the systematic review and the meta-analysis. The global meta-analysis showed that bleaching impairs the bond strength of adhesive systems to enamel and dentin (p<0.001; mean difference [MD]: -0.96; confidence interval [CI]: -1.18 to -0.73), regardless of the bleaching agent (p<0.001; MD: -9.98; CI: -1.37 to -0.58) or substrate (p<0.001; MD: -0.89; CI: -1.12 to -0.66). The detrimental effect of bleaching on bond strength was not observed after two and three weeks after bleaching (p=0.1; MD: -0.39; CI: -0.84 to 0.65; and p=0.18; MD: -0.99; CI: -2.45 to 0.47, respectively).

CONCLUSION

This systematic review and meta-analysis demonstrated that vital bleaching impairs the bonding of adhesive systems to enamel and dentin, and this adverse effect persists for two weeks.

摘要

目的

本系统评价评估活髓牙漂白对牙釉质和牙本质黏接系统黏结强度的影响。

方法

本综述按照系统评价和荟萃分析的首选报告项目（PRISMA）进行。在电子数据库-PubMed/MEDLINE、Scopus 和 Web of Science 中搜索比较漂白和未漂白牙釉质和牙本质黏结强度的体外研究，不限制年份或语言。由两名评审员独立筛选和提取数据。使用逆方差法和随机效应模型（p≤0.05）对黏结强度数据进行荟萃分析。

结果

电子检索提供了 4941 项合格研究，其中 52 项研究纳入系统评价和荟萃分析。总体荟萃分析表明，漂白会损害黏接系统对牙釉质和牙本质的黏结强度（p<0.001；平均差异[MD]：-0.96；置信区间[CI]：-1.18 至-0.73），无论漂白剂（p<0.001；MD：-9.98；CI：-1.37 至-0.58）或基底（p<0.001；MD：-0.89；CI：-1.12 至-0.66）如何。漂白后两到三周，漂白对黏结强度的不利影响并不明显（p=0.1；MD：-0.39；CI：-0.84 至 0.65；p=0.18；MD：-0.99；CI：-2.45 至 0.47）。