Effect of smear layer deproteinization on bonding of self-etch adhesives to dentin: a systematic review and meta-analysis

Alshaikh, Khaldoan H.,Hamama, Hamdi H.H.,Mahmoud, Salah H. The Korean Academy of Conservative Dentistry 2018 Restorative Dentistry & Endodontics Vol.43 No.2

Objectives: The aim of this systematic review was to critically analyze previously published studies of the effects of dentin surface pretreatment with deproteinizing agents on the bonding of self-etch (SE) adhesives to dentin. Additionally, a meta-analysis was conducted to quantify the effects of the above-mentioned surface pretreatment methods on the bonding of SE adhesives to dentin. Materials and Methods: An electronic search was performed using the following databases: Scopus, PubMed and ScienceDirect. The online search was performed using the following keywords: 'dentin' or 'hypochlorous acid' or 'sodium hypochlorite' and 'self-etch adhesive.' The following categories were excluded during the assessment process: non-English articles, randomized clinical trials, case reports, animal studies, and review articles. The reviewed studies were subjected to meta-analysis to quantify the effect of the application time and concentration of sodium hypochlorite (NaOCl) and hypochlorous acid (HOCl) deproteinizing agents on bonding to dentin. Results: Only 9 laboratory studies fit the inclusion criteria of this systematic review. The results of the meta-analysis revealed that the pooled average microtensile bond strength values to dentin pre-treated with deproteinizing agents (15.71 MPa) was significantly lower than those of the non-treated control group (20.94 MPa). Conclusions: In light of the currently available scientific evidence, dentin surface pretreatment with deproteinizing agents does not enhance the bonding of SE adhesives to dentin. The HOCl deproteinizing agent exhibited minimal adverse effects on bonding to dentin in comparison with NaOCl solutions.

Do universal adhesives promote bonding to dentin? A systematic review and meta-analysis

Ali. A. Elkaffas,Hamdi H. H. Hamama,Hamdi H. H. Hamama,Salah H. Mahmoud 대한치과보존학회 2018 Restorative Dentistry & Endodontics Vol.43 No.3

Objectives: The aims of this study were to conduct a systematic review of the microtensile bond strength (µTBS) of multi-mode adhesives to dentin and to perform a meta-analysis to assess the significance of differences in the µTBS of one of the most commonly used universal adhesives (Scotchbond Universal, 3M ESPE) depending on whether the etch-and-rinse or self�etch mode was used. Materials and Methods: An electronic search was performed of MEDLINE/PubMed, ScienceDirect, and EBSCOhost. Laboratory studies that evaluated the µTBS of multi-mode adhesives to dentin using either the etch-and-rinse or self-etch mode were selected. A meta�analysis was conducted of the reviewed studies to quantify the differences in the µTBS of Scotchbond Universal adhesive. Results: Only 10 studies fulfilled the inclusion criteria for the systematic review. Extensive variation was found in the restorative materials, testing methodologies, and failure mode in the reviewed articles. Furthermore, variation was also observed in the dimensions of the microtensile testing beams. The meta-analysis showed no statistically significant difference between the etch-and-rinse and self-etch modes for Scotchbond Universal adhesive (p > 0.05). Conclusions: Multi-mode ‘universal’ adhesives can achieve substantial bonding to dentin, regardless of the used modes (either etch-and-rinse or self-etch).

Do universal adhesives promote bonding to dentin? A systematic review and meta-analysis

Elkaffas, Ali. A.,Hamama, Hamdi H.H.,Mahmoud, Salah H. The Korean Academy of Conservative Dentistry 2018 Restorative Dentistry & Endodontics Vol.43 No.3

Objectives: The aims of this study were to conduct a systematic review of the microtensile bond strength (${\mu}TBS$) of multi-mode adhesives to dentin and to perform a meta-analysis to assess the significance of differences in the ${\mu}TBS$ of one of the most commonly used universal adhesives (Scotchbond Universal, 3M ESPE) depending on whether the etch-and-rinse or self-etch mode was used. Materials and Methods: An electronic search was performed of MEDLINE/PubMed, ScienceDirect, and EBSCOhost. Laboratory studies that evaluated the ${\mu}TBS$ of multi-mode adhesives to dentin using either the etch-and-rinse or self-etch mode were selected. A meta-analysis was conducted of the reviewed studies to quantify the differences in the ${\mu}TBS$ of Scotchbond Universal adhesive. Results: Only 10 studies fulfilled the inclusion criteria for the systematic review. Extensive variation was found in the restorative materials, testing methodologies, and failure mode in the reviewed articles. Furthermore, variation was also observed in the dimensions of the microtensile testing beams. The meta-analysis showed no statistically significant difference between the etch-and-rinse and self-etch modes for Scotchbond Universal adhesive (p > 0.05). Conclusions: Multi-mode 'universal' adhesives can achieve substantial bonding to dentin, regardless of the used modes (either etch-and-rinse or self-etch).

The effect of preheating resin composites on surface hardness: a systematic review and meta-analysis

Elkaffas, Ali A.,Eltoukhy, Radwa I.,Elnegoly, Salwa A.,Mahmoud, Salah H. The Korean Academy of Conservative Dentistry 2019 Restorative Dentistry & Endodontics Vol.44 No.4

Objectives: This paper presents a systematic review and meta-analysis of the effect of preheating on the hardness of nanofilled, nanoceramic, nanohybrid, and microhybrid resin composites. Materials and Methods: An electronic search of papers on MEDLINE/PubMed, ScienceDirect, and EBSCOhost was performed. Only in vitro studies were included. Non-English studies, case reports, clinical trials, and review articles were excluded. A meta-analysis of the reviewed studies was conducted to quantify differences in the microhardness of the Z250 microhybrid resin composite using the Comprehensive Meta-Analysis software. Results: Only 13 studies met the inclusion criteria for this systematic review. The meta-analysis showed that there were significant differences between the non-preheated and preheated modes for both the top and bottom surfaces of the specimens (p < 0.05). The microhardness of the Z250 resin composite on the top surface in the preheated mode (78.1 ± 2.9) was higher than in the non-preheated mode (67.4 ± 4.0; p < 0.001). Moreover, the microhardness of the Z250 resin composite on the bottom surface in the preheated mode (71.8 ± 3.8) was higher than in the non-preheated mode (57.5 ± 5.7, p < 0.001). Conclusions: Although the results reported in the reviewed studies showed great variability, sufficient scientific evidence was found to support the hypothesis that preheating can improve the hardness of resin composites.

The effect of preheating resin composites on surface hardness: a systematic review and meta-analysis

Ali A. Elkaffas,Radwa I. Eltoukhy,Salwa A. Elnegoly,Salah H. Mahmoud 대한치과보존학회 2019 Restorative Dentistry & Endodontics Vol.44 No.4

Objectives This paper presents a systematic review and meta-analysis of the effect of preheating on the hardness of nanofilled, nanoceramic, nanohybrid, and microhybrid resin composites. Materials and Methods An electronic search of papers on MEDLINE/PubMed, ScienceDirect, and EBSCOhost was performed. Only in vitro studies were included. Non-English studies, case reports, clinical trials, and review articles were excluded. A meta-analysis of the reviewed studies was conducted to quantify differences in the microhardness of the Z250 microhybrid resin composite using the Comprehensive Meta-Analysis software. Results Only 13 studies met the inclusion criteria for this systematic review. The meta-analysis showed that there were significant differences between the non-preheated and preheated modes for both the top and bottom surfaces of the specimens (p < 0.05). The microhardness of the Z250 resin composite on the top surface in the preheated mode (78.1 ± 2.9) was higher than in the non-preheated mode (67.4 ± 4.0; p < 0.001). Moreover, the microhardness of the Z250 resin composite on the bottom surface in the preheated mode (71.8 ± 3.8) was higher than in the non-preheated mode (57.5 ± 5.7, p < 0.001). Conclusions Although the results reported in the reviewed studies showed great variability, sufficient scientific evidence was found to support the hypothesis that preheating can improve the hardness of resin composites.

Deep proximal margin rebuilding with direct esthetic restorations: a systematic review of marginal adaptation and bond strength

Ismail Hoda S.,Ali Ashraf I.,Mehesen Rabab El.,Juloski Jelena,Garcia-Godoy Franklin,Mahmoud Salah H. 대한치과보존학회 2022 Restorative Dentistry & Endodontics Vol.47 No.2

This review aimed to characterize the effect of direct restorative material types and adhesive protocols on marginal adaptation and the bond strength of the interface between the material and the proximal dentin/cementum. An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Studies were included if they evaluated marginal adaptation or bond strength tests for proximal restorations under the cementoenamel junction. Only 16 studies met the inclusion criteria and were included in this review. These studies presented a high degree of heterogeneity in terms of the materials used and the methodologies and evaluation criteria of each test; therefore, only a descriptive analysis could be conducted. The included studies were individually evaluated for the risk of bias following predetermined criteria. To summarize the results of the included studies, the type of restorative material affected the test results, whereas the use of different adhesive protocols had an insignificant effect on the results. It could be concluded that various categories of resin-based composites could be a suitable choice for clinicians to elevate proximal dentin/cementum margins, rather than the open sandwich technique with resin-modified glass ionomers. Despite challenges in bonding to proximal dentin/cementum margins, different adhesive protocols provided comparable outcomes.

Correlation between different methodologies used to evaluate the marginal adaptation of proximal dentin gingival margins elevated using a glass hybrid

Ismail Hoda S.,Morrow Brian R.,Ali Ashraf I.,Mehesen Rabab El.,Garcia-Godoy Franklin,Mahmoud Salah H. 대한치과보존학회 2022 Restorative Dentistry & Endodontics Vol.47 No.4

Objectives This study aimed to evaluate the effect of aging on the marginal quality of glass hybrid (GH) material used to elevate dentin gingival margins, and to analyze the consistency of the results obtained by 3 in vitro methods. Materials and Methods Ten teeth received compound class II cavities with subgingival margins. The dentin gingival margins were elevated with GH, followed by resin composite. The GH/gingival dentin interfaces were examined through digital microscopy, scanning electron microscopy (SEM) using resin replicas, and according to the World Dental Federation (FDI) criteria. After initial evaluations, all teeth were subjected to 10,000 thermal cycles, followed by repeating the same marginal evaluations and energy dispersive spectroscopy (EDS) analysis for the interfacial zone of 2 specimens. Marginal quality was expressed as the percentage of continuous margin at ×200 for microscopic techniques and as the frequency of each score for FDI ranking. Data were analyzed using the paired sample t-test, Wilcoxon signed-rank test, and Pearson and Spearmen correlation coefficients. Results None of the testing techniques proved the significance of the aging factor. Moderate and strong significant correlations were found between the testing techniques. The EDS results suggested the presence of an ion-exchange layer along the GH/gingival dentin interface of aged specimens. Conclusions The marginal quality of the GH/dentin gingival interface defied aging by thermocycling. The replica SEM and FDI ranking results had stronger correlations with each other than either showed with the digital microscopy results. Objectives This study aimed to evaluate the effect of aging on the marginal quality of glass hybrid (GH) material used to elevate dentin gingival margins, and to analyze the consistency of the results obtained by 3 in vitro methods. Materials and Methods Ten teeth received compound class II cavities with subgingival margins. The dentin gingival margins were elevated with GH, followed by resin composite. The GH/gingival dentin interfaces were examined through digital microscopy, scanning electron microscopy (SEM) using resin replicas, and according to the World Dental Federation (FDI) criteria. After initial evaluations, all teeth were subjected to 10,000 thermal cycles, followed by repeating the same marginal evaluations and energy dispersive spectroscopy (EDS) analysis for the interfacial zone of 2 specimens. Marginal quality was expressed as the percentage of continuous margin at ×200 for microscopic techniques and as the frequency of each score for FDI ranking. Data were analyzed using the paired sample t-test, Wilcoxon signed-rank test, and Pearson and Spearmen correlation coefficients. Results None of the testing techniques proved the significance of the aging factor. Moderate and strong significant correlations were found between the testing techniques. The EDS results suggested the presence of an ion-exchange layer along the GH/gingival dentin interface of aged specimens. Conclusions The marginal quality of the GH/dentin gingival interface defied aging by thermocycling. The replica SEM and FDI ranking results had stronger correlations with each other than either showed with the digital microscopy results.