Surface pretreatments for enhancing bond strength of resin composite to sclerotic dentin in non-carious cervical lesions: A systematic review

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-09-21 DOI:10.1016/j.jdent.2025.106123

Kareem Hamdi , Ahmed Zaeneldin , Ahmed Hesham Samaha , Hamdi H Hamama

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引用次数: 0

Abstract

Objective

To evaluate the impact of different surface pretreatments of cervical non-carious dentin on the bond strength to resin composite.

Data sources

In vitro studies that assessed the impact of pretreatment of cervical non-carious dentin on bond strength to resin composite were considered for inclusion. The protocol was conducted following PRISMA guidelines and registered in PROSPERO (CRD420251102471). Studies were identified after comprehensive online search in 5 different electronic databases including PubMed (Medline), Web of science, Scopus, Cochrane library, and Google scholar.

Results

Eight studies met the inclusion criteria. However, the results were inconsistent, with some studies reporting no significant differences or even inferior outcomes with pretreatments like ethylenediaminetetraacetic acid (EDTA) or sodium hypochlorite. Prolonged application of phosphoric acid (30–40 %, 15–90 s) and combined chemical-mechanical pretreatments (e.g., sandblasting with phosphoric acid) showed potential to improve bond strength compared to controls. Most studies exhibited a high risk of bias, primarily due to lack of blinding, inadequate sample size calculations, and failure to simulate clinical conditions.

Conclusion

Current scientific evidence suggests that pretreating cervical non-carious sclerotic dentin with prolonged application of 37 % phosphoric acid—either alone or in combination with mechanical roughening—may enhance bond strength to resin composite. However, the quality of the evidence is low. Further high-quality research, including studies on laser pretreatments and those simulating clinical conditions, is needed to establish reliable guidelines for clinical practice.

Clinical significance

Dentin of non-carious cervical lesion is physiologically different from normal dentin due to frequent and prolonged exposure to various oral conditions, such as thermal, chemical, and mechanical stimuli. Consequently, achieving reliable adhesion to this altered dentin substrate remains a clinical challenge. Therefore, surface pretreatment with prolonged application of 37 % phosphoric acid, either alone or in combination with mechanical roughening is recommended to increase the bond strength of resin composite to these lesions.

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表面预处理提高树脂复合材料与非龋齿性宫颈病变硬化牙本质的结合强度：系统综述。

目的：评价不同表面预处理对牙本质与树脂复合材料结合强度的影响。数据来源：体外研究评估了预处理宫颈非龋齿牙本质对树脂复合材料结合强度的影响。该方案按照PRISMA指南进行，并在PROSPERO （CRD*********）上注册。在PubMed （Medline）、Web of science、Scopus、Cochrane library和谷歌scholar等5个不同的电子数据库中进行综合在线检索后确定了研究。结果：8项研究符合纳入标准。然而，结果并不一致，一些研究报告使用乙二胺四乙酸（EDTA）或次氯酸钠等预处理没有显著差异，甚至效果较差。与对照组相比，长时间使用磷酸（30-40%，15-90秒）和化学-机械联合预处理（如磷酸喷砂）有可能提高粘结强度。大多数研究显示出高偏倚风险，主要是由于缺乏盲法，样本量计算不足，以及未能模拟临床条件。结论：目前的科学证据表明，长时间使用37%磷酸单独或联合机械粗化预处理颈部非龋齿硬化牙本质可提高其与树脂复合材料的结合强度。然而，证据的质量很低。需要进一步开展高质量的研究，包括激光预处理和模拟临床条件的研究，为临床实践建立可靠的指导方针。临床意义：宫颈非龋齿病变的牙本质由于经常和长时间暴露于各种口腔条件下，如热、化学和机械刺激，在生理上与正常牙本质不同。因此，实现这种改变后的牙本质基质的可靠粘附仍然是一个临床挑战。因此，建议长期使用37%磷酸进行表面预处理，单独或结合机械粗化，以提高树脂复合材料与这些病变的结合强度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.