Departamento de Ciências da Saúde e Odontologia Infantil, Área de Odontopediatria, Faculdade de Odontologia de Piracicaba (FOP) - Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil.
Departamento de Ciências da Saúde e Odontologia Infantil, Área de Odontologia Preventiva eSaúde Pública, Faculdade de Odontologia de Piracicaba (FOP) - Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil.
Arch Oral Biol. 2024 Jun;162:105942. doi: 10.1016/j.archoralbio.2024.105942. Epub 2024 Mar 3.
The aim of this scoping review was to evaluate the available scientific evidence regarding the use of flavonoids in the treatment of caries-affected dentin focusing on bonding to dentin.
A comprehensive literature search was performed in five databases from March 2022 and updated in April 2023: PubMed, EMBASE, Scopus, Web of Science, and Scielo. Additionally, the references of included studies were manually searched. Gray literature was excluded from the review.
Inclusion criteria included in vitro, in situ, and in vivo studies (animal or human) published in English. Abstracts, reviews, case reports, book chapters, doctoral dissertations, guidelines, and studies using pure plant extracts were excluded. Data collected from the selected studies were summarized and subjected to narrative and descriptive analysis. Out of the 91 studies identified, only 16 studies met the inclusion criteria.
The review analyzed eight different flavonoids (hesperidin, galardin, proanthocyanidin, genipin, quercetin, naringin, epigallocatechin-3-gallate, and other catechins subtypes) used as pretreatment or loaded into adhesive systems, primers, and phosphoric acid. The use of flavonoids improved the mechanical properties of the materials and modified the biological properties of the dentin, reducing collagen loss by the inhibition of proteolytic activity of matrix metalloproteinases (MMPs).
Based on the findings of this scoping review, it can be concluded that the use of flavonoids as pretreatment or incorporation into dental materials preserves collagen in the hybrid layer, inhibiting the MMPs activities, modifying the collagen fibrils of the dentin matrix and improving the mechanical properties of the dental adhesive systems. Therefore, it represents a promising approach for promoting dentin biomodification. This can result in more stable bonding of adhesive restorations to caries-affected dentin.
本综述旨在评估关于使用类黄酮治疗受龋影响牙本质的现有科学证据，重点关注牙本质的粘结。
从 2022 年 3 月开始，在五个数据库中进行了全面的文献检索，并于 2023 年 4 月进行了更新：PubMed、EMBASE、Scopus、Web of Science 和 Scielo。此外，还手动搜索了纳入研究的参考文献。灰色文献被排除在综述之外。
纳入标准包括以英文发表的体外、体内和体内研究（动物或人类）。排除摘要、综述、病例报告、书籍章节、博士论文、指南以及使用纯植物提取物的研究。从选定研究中收集的数据进行了总结，并进行了叙述性和描述性分析。在确定的 91 项研究中，只有 16 项符合纳入标准。
综述分析了八种不同的类黄酮（橙皮苷、加兰他敏、原花青素、京尼平、槲皮素、柚皮苷、表没食子儿茶素-3-没食子酸酯和其他儿茶素亚型），用作预处理或负载到粘结系统、底漆和磷酸中。类黄酮的使用改善了材料的机械性能，并改变了牙本质的生物学特性，通过抑制基质金属蛋白酶（MMPs）的蛋白水解活性来减少胶原蛋白的损失。
基于本综述的研究结果，可以得出结论，使用类黄酮作为预处理或掺入牙科材料中可以保留混合层中的胶原蛋白，抑制 MMPs 的活性，改变牙本质基质的胶原纤维，改善牙科粘结系统的机械性能。因此，它代表了一种有前途的促进牙本质生物修饰的方法。这可以导致粘结修复体更稳定地粘结到受龋影响的牙本质。
