The Influence of Erbium Laser Pretreatment on Dentin Shear Bond Strength and Bond Failure Modes: A Systematic Review and Network Meta-Analysis.

Jun Wang, Shuomin Chen, Yutian Wu, Qinhui Zhang, Menghan Wu, Yuge Chen, Liang Chen, Xinhua Hong, Yilin Wang, Shengbin Huang
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Abstract

Purpose: To systematically review in-vitro studies that evaluated the influence of erbium laser pretreatment on dentin shear bond strength (SBS) and bond failure modes.

Materials and methods: Electronic databases (PubMed, Cochrane Central, Embase, and Web of Science) were searched. Only in-vitro studies involving erbium laser irradiation of the dentin surface and SBS testing of the bonded resin block were included. The three common modes of bond failure (1. adhesive, 2. cohesive, and 3. mixed) were observed and analyzed. The network meta-analysis (NMA) was performed by Stata 15.0 software, the risk of bias was evaluated, and the certainty of the evidence was assessed by the Confidence in Network Meta-analysis (CINeMA).

Results: Forty studies with nine pretreatments (1. blank group: BL; 2. phosphoric acid etch-and-rinse: ER; 3. self-etch adhesive: SE; 4. Er:YAG laser: EL; 5. Er,Cr:YSGG laser: ECL; 6. ER+EL; 7. ER+ECL; 8. SE+EL; 9. SE+ECL) were included in this analysis. The NMA of SBS showed that ER+EL [SMD = 0.32, 95% CI (0.11, 0.98)] had the highest SBS next to ER, especially when using one of the 3M ESPE adhesives, followed by EL, ECL, SE and SE+EL. The Ivoclar Vivadent adhesives significantly increased the SBS of the ECL [SMD = 0.37, 95% CI (0.16,0.90)] and was higher than ER+EL [SMD = 0.25,95% CI (0.07,0.85)]. Finally, the surface under the cumulative ranking curve (SUCRA) value indicated that ER+EL (SUCRA = 71.0%) and EL (SUCRA = 62.9%) were the best treatments for enhancing dentin SBS besides ER. ER+EL (SUCRA = 85.3%), ER (SUCRA = 83.7%) and ER (SUCRA = 84.3%) had the highest probability of occurring in adhesive, cohesive and mixed failure modes, respectively.

Conclusion: Er:YAG and Er,Cr:YSGG lasers improved dentin SBS compared to the blank group, especially when the acid etch-and-rinse pretreatment was combined with Er:YAG laser. Shear bond strength and failure mode do not appear to be directly related.

铒激光预处理对牙本质剪切粘接强度和粘接失败模式的影响:系统综述与网络元分析》。
目的:系统回顾评估铒激光预处理对牙本质剪切粘接强度(SBS)和粘接失败模式影响的体外研究:检索电子数据库(PubMed、Cochrane Central、Embase 和 Web of Science)。只纳入了涉及铒激光照射牙本质表面和粘结树脂块 SBS 测试的体外研究。观察并分析了粘接失败的三种常见模式(1.粘接;2.内聚;3.混合)。使用 Stata 15.0 软件进行了网络荟萃分析(NMA),评估了偏倚风险,并使用网络荟萃分析置信度(CINeMA)评估了证据的确定性:结果:40 项研究采用了 9 种预处理方法(1:BL;2.磷酸蚀刻-冲洗:ER;3.自酸蚀粘合剂:SE;4.Er:YAG:Er:YAG:EL;5:EL;5.Er,Cr:YSGG 激光:ECL;6.ER+EL;7.ER+ECL;8.SE+EL;9.SE+ECL)。SBS 的 NMA 显示,ER+EL [SMD = 0.32,95% CI (0.11, 0.98)]的 SBS 值最高,仅次于 ER,尤其是在使用 3M ESPE 粘合剂时,其次是 EL、ECL、SE 和 SE+EL。Ivoclar Vivadent 粘合剂明显增加了 ECL 的 SBS [SMD = 0.37,95% CI (0.16,0.90)],并高于 ER+EL [SMD = 0.25,95% CI (0.07,0.85)]。最后,累积排名曲线下表面值(SUCRA)表明,ER+EL(SUCRA = 71.0%)和EL(SUCRA = 62.9%)是除ER之外增强牙本质SBS的最佳治疗方法。ER+EL(SUCRA = 85.3%)、ER(SUCRA = 83.7%)和ER(SUCRA = 84.3%)分别在粘附、内聚和混合失效模式中出现的概率最高:与空白组相比,Er:YAG 和 Er,Cr:YSGG 激光可改善牙本质 SBS,尤其是在酸蚀冲洗预处理与 Er:YAG 激光相结合的情况下。剪切粘接强度和破坏模式似乎没有直接关系。
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