Nogueira Iara de O, Pereira Carolina N de B, Abreu Lucas G, Diniz Ivana M A, Magalhães Cláudia S de, Silveira Rodrigo R da
Department of Restorative Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
Department of Child and Adolescent Oral Health, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil..
J Prosthet Dent. 2025 May;133(5):1157-1171. doi: 10.1016/j.prosdent.2023.06.020. Epub 2023 Aug 25.
Intraoral repair techniques prevent unnecessary replacement of ceramic restorations, thereby increasing the survival rate. However, adhesion between ceramics and the composite resin is challenging and how different protocols influence adhesion is unclear.
The purpose of this systematic review and meta-analysis was to analyze the influence of different protocols on repairing glass-ceramic surfaces with composite resins.
PubMed, Scopus, ISI Web of Science, and Embase electronic databases were searched to select studies comparing bond strength values or survival rates of glass-ceramic repaired with composite resins using different surface treatment protocols. No publication year or language restriction was applied. Data sets were extracted from all included studies, and the mean differences calculated. A 95% confidence interval was calculated by using the random effect model (Rev Man 5.4).
The search identified 5037 studies, and 165 were assessed for eligibility. Finally, 123 in vitro studies were included in the systematic review and 48 in the meta-analysis. Considering different glass-ceramics, bond strength tests, and aged or not aged specimens, 37 meta-analyses found the effect of repair protocols: only adhesive, silane plus adhesive alone or preceded by hydrofluoric (HF) acid, airborne-particle abrasion (APA) with AlO particles, silica-coated APA (SCAPA), diamond rotary instrument (DRI), and laser irradiation (LI).
For feldspathic porcelain, HF acid, APA, SCAPA, or DRI improved the repair micromechanical retention; applying silane is essential to HF-conditioned surfaces but the use of adhesive is optional when silane is applied. Results for leucite and lithium disilicate were inconclusive in terms of suggesting a treatment other than HF acid plus silane and adhesive applications.
口内修复技术可避免不必要的陶瓷修复体更换，从而提高其存留率。然而，陶瓷与复合树脂之间的粘结具有挑战性，且不同方案如何影响粘结尚不清楚。
本系统评价和荟萃分析的目的是分析不同方案对用复合树脂修复玻璃陶瓷表面的影响。
检索PubMed、Scopus、ISI科学网和Embase电子数据库，以选择比较使用不同表面处理方案用复合树脂修复的玻璃陶瓷的粘结强度值或存留率的研究。不设出版年份或语言限制。从所有纳入研究中提取数据集，并计算平均差异。使用随机效应模型（Rev Man 5.4）计算95%置信区间。
检索到5037项研究，其中165项评估其 eligibility。最终，123项体外研究纳入系统评价，48项纳入荟萃分析。考虑不同的玻璃陶瓷、粘结强度测试以及老化或未老化的标本，37项荟萃分析发现了修复方案的效果：仅使用粘结剂、单独使用硅烷加粘结剂或先使用氢氟酸（HF）、用AlO颗粒进行空气颗粒研磨（APA）、二氧化硅涂层APA（SCAPA）、金刚石旋转器械（DRI）和激光照射（LI）。
对于长石质瓷，HF酸、APA、SCAPA或DRI可改善修复的微机械固位；对于经HF处理的表面，应用硅烷至关重要，但应用硅烷时粘结剂的使用是可选的。对于白榴石和二硅酸锂，除了HF酸加硅烷和粘结剂应用之外，尚无其他明确的处理建议。
