Eggmann Florin, Hwang Jonathan D, Ayub Jose M, Mante Francis K
Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, CH-4058 Basel, Switzerland.
Materials (Basel). 2023 Mar 24;16(7):2580. doi: 10.3390/ma16072580.
Head and neck cancers are a significant global health burden, with radiation therapy being a frequently utilized treatment. The aim of this systematic review was to provide a critical appraisal of laboratory studies that assessed the effect of irradiation on the adhesive performance of resin-based biomaterials. The analysis included 23 laboratory studies obtained from five databases, with most studies using human enamel, dentin, or both, and bonding procedures involving the fabrication of direct restorations, standardized specimens, bonding of orthodontic brackets, and luting of endodontic fiber posts. The protocols used for irradiation varied, with most studies exposing specimens made from extracted teeth to irradiation using cabinet irradiators to simulate treatment of head and neck cancer. The findings indicate that irradiation reduces the bond strength of dental adhesives and resin-based composites on flat, ground enamel and dentin specimens, with different adhesives and timing of irradiation having a significant impact on adhesive performance. Irradiation also increased microleakage in most studies. The effect of irradiation on marginal adaptation of direct resin-based composite restorations was inconclusive. This systematic review indicates that irradiation has detrimental effects on the adhesive performance of resin-based biomaterials and highlights the need for further clinical and laboratory studies evaluating the performance of adhesive materials and approaches to improve it.
头颈癌是一项重大的全球健康负担，放射治疗是一种常用的治疗方法。本系统评价的目的是对评估辐射对树脂基生物材料粘结性能影响的实验室研究进行批判性评估。分析纳入了从五个数据库中获取的23项实验室研究，大多数研究使用人牙釉质、牙本质或两者，粘结程序包括直接修复体的制作、标准化标本、正畸托槽粘结以及根管纤维桩粘结。所使用的辐射方案各不相同，大多数研究使用柜式辐照器对拔除牙齿制成的标本进行辐照，以模拟头颈癌治疗。研究结果表明，辐射会降低牙科粘合剂和树脂基复合材料在平坦、磨平的牙釉质和牙本质标本上的粘结强度，不同的粘合剂和辐照时间对粘结性能有显著影响。在大多数研究中，辐射还会增加微渗漏。辐射对直接树脂基复合修复体边缘适应性的影响尚无定论。本系统评价表明，辐射对树脂基生物材料的粘结性能有不利影响，并强调需要进一步开展临床和实验室研究，以评估粘结材料的性能并探索改善其性能的方法。
