Lewis Neil Vincent, Aggarwal Shalini, Borse Nikhil N, Sonawane Shailendra, Dhatavkar Prasanna, Digholkar Rhea, Agarwal Divyanshi
Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College, Dr. D.Y Patil Vidyapeeth, Pune, Maharashtra, India.
Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences, Loni, India.
J Int Soc Prev Community Dent. 2023 Jun 29;13(3):173-184. doi: 10.4103/jispcd.JISPCD_5_23. eCollection 2023 May-Jun.
Matrix metalloproteinases (MMPs) cause degradation of the dentinal matrix, as they act actively on collagen fibrils, leading to their deterioration and collapse. MMP inhibitors are known to be used for the pre-treatment of human dentin before bonding. Most studies on the MMP inhibitors examined the effect of MMP inhibitors on bonding to sound dentin (SD), but few examine their effect on bonding to caries affected dentin (CAD). This systematic review aims to identify and summarize studies that have applied MMP inhibitors for pre-treatment of CAD, and examine the microtensile bond strength (µTBS), bond durability, and the mode of failure.
A systematic review was performed using the PubMed database according to the PRISMA guidelines. A total of 785 original articles published between 2010 and 2022 were initially retrieved. Six studies were selected based on predefined inclusion-exclusion criteria, and their outcomes were extracted and analyzed. The methodological quality assessment was performed using a combined checklist that utilizes the reporting criteria mentioned in the checklist for reporting in-vitro studies guidelines and guidelines for reporting pre-clinical studies on dental materials.
All six studies included here showed a definitive increase of the µTBS when MMP inhibitors were applied to the CAD. The mode of failure was found to be predominantly adhesive in nature. The deviation in the values of µTBS was approximately 2-5 MPa on immediate and delayed testing.
MMP-inhibiting agents could be considered for the pretreatment of teeth with CAD as a part of their tooth preparation area, thereby allowing the clinician to retain CAD and bond to the CAD without endangering the vital pulp.
基质金属蛋白酶（MMPs）可导致牙本质基质降解，因为它们能对胶原纤维产生积极作用，导致其变质和塌陷。已知MMP抑制剂可用于粘结前对人牙本质的预处理。大多数关于MMP抑制剂的研究考察了MMP抑制剂对粘结至健康牙本质（SD）的影响，但很少有研究考察其对粘结至龋损牙本质（CAD）的影响。本系统评价旨在识别和总结应用MMP抑制剂对CAD进行预处理的研究，并考察微拉伸粘结强度（µTBS）、粘结耐久性及失效模式。
根据PRISMA指南使用PubMed数据库进行系统评价。最初检索到2010年至2022年间发表的785篇原始文章。根据预定义的纳入排除标准选择了6项研究，并提取和分析了它们的结果。使用综合检查表进行方法学质量评估，该检查表采用了体外研究报告指南和牙科材料临床前研究报告指南中提到的报告标准。
这里纳入的所有6项研究均表明，将MMP抑制剂应用于CAD时，µTBS有明显增加。发现失效模式主要为粘结性。即时和延迟测试时，µTBS值的偏差约为2 - 5MPa。
作为牙齿预备区域的一部分，MMP抑制剂可考虑用于CAD牙齿的预处理，从而使临床医生能够保留CAD并粘结至CAD，而不会危及牙髓活力。
