Eusufzai Sumaiya Zabin, Barman Aparna, Jamayet Nafij Bin, Ahmad Wan Muhamad Amir W, Mahdi Syed Sarosh, Sheikh Zeeshan, Daood Umer
School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia.
Restorative Dentistry Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Wilayah Persekutuan Kuala Lumpur, Bukit Jalil, Kuala Lumpur 57000, Malaysia.
Materials (Basel). 2023 Feb 17;16(4):1701. doi: 10.3390/ma16041701.
The aim of this study was to evaluate published data regarding riboflavin (RF) as a cross-linker for improved adhesive bond strength to dentin and to analyze previous studies for optimal concentration of riboflavin range suitable for dentin bond. Saliva and distilled water were used as storage media and aging time was 24 h and 6 months. Results of meta-analysis were synthesized using a statistical method of inverse variance in random effects with a 95% Confidence Interval (CI). Cochrane review manager 5.4.1 was used to determine results of the meta-analysis. In total, 3172 articles were found from search databases "PubMed", "Scopus", and "Google Scholar". Six of the fifteen studies were eligible for meta-analysis. Micro tensile strength shows significant improvement with the addition of riboflavin ( < 0.05) compared to without the addition of riboflavin from with 95% CI. A significant difference has been found in micro tensile bond strength between use of the riboflavin cross-linker and without use of the riboflavin crosslinker in the dentin adhesive system. With a 95% confidence interval (CI), the I for micro tensile strength was 89% with strong heterogeneity, Chi = 44.76, df = 5 ( < 0.00001), and overall effect size is Z = 2.22 ( = 0.03) after immediate aging. Chiang et al. 2013 shows maximum mean differences which is 38.50 [17.93-59.07]. After 6 months of aging in distilled water or artificial saliva micro tensile bond strength has been increased with the addition of riboflavin ( < 0.05). It can be clearly seen that pooled effect and 95% CI did not cross the line of no effect. With a 95% confidence interval (CI), the I for micro tensile strength was 96% with strong heterogeneity, Chi = 117.56, df = 5 ( < 0.00001), and overall effect size is Z = 2.30 ( = 0.02). Subgroup analysis proved a similar effect of distilled water and artificial saliva as storage media on micro tensile bond strength after incorporating riboflavin as a collagen crosslinker. An artificial saliva aged forest plot also showed considerable heterogeneity with I = 96%; Tau = 257.32; Chi = 94.37; df = 2 ( < 0.00001); test for overall effect, Z = 1.06 ( = 0.29). Riboflavin prior to or with bonding is recommended to improve the bonding of different adhesive systems.
本研究的目的是评估已发表的关于核黄素（RF）作为交联剂以提高与牙本质的粘结强度的数据，并分析先前研究中适合牙本质粘结的核黄素最佳浓度范围。使用唾液和蒸馏水作为储存介质，老化时间为24小时和6个月。采用随机效应的逆方差统计方法合成Meta分析结果，并给出95%置信区间（CI）。使用Cochrane综述管理器5.4.1来确定Meta分析的结果。通过检索“PubMed”“Scopus”和“谷歌学术”数据库，共找到3172篇文章。15项研究中有6项符合Meta分析的条件。与未添加核黄素相比，添加核黄素后微拉伸强度有显著提高（P<0.05），95%CI显示了这一结果。在牙本质粘结系统中，使用核黄素交联剂和不使用核黄素交联剂的微拉伸粘结强度存在显著差异。对于微拉伸强度，95%置信区间（CI）下的I²为89%，具有很强的异质性，卡方值=44.76，自由度=5（P<0.00001），即时老化后的总体效应大小Z=2.22（P=0.03）。蒋等人在2013年的研究中显示出最大平均差异为38.50[17.93 - 59.07]。在蒸馏水中或人工唾液中老化6个月后，添加核黄素可提高微拉伸粘结强度（P<0.05）。可以清楚地看到，合并效应和95%CI未越过无效应线。对于微拉伸强度，95%置信区间（CI）下的I²为96%，具有很强的异质性，卡方值=117.56，自由度=5（P<0.00001），总体效应大小Z=2.30（P=0.02）。亚组分析证明，在将核黄素作为胶原交联剂加入后，蒸馏水和人工唾液作为储存介质对微拉伸粘结强度具有相似的影响。人工唾液老化的森林图也显示出相当大的异质性，I²=96%；Tau²=257.32；卡方值=94.37；自由度=2（P<0.00001）；总体效应检验，Z=1.06（P=0.29）。建议在粘结前或粘结时使用核黄素以改善不同粘结系统的粘结效果。
