本研究旨在通过系统综述和荟萃分析,确定交联剂在牙本质表面粘合剂或预处理中用作改性剂时在树脂-牙本质粘结强度(BS)中的作用。本文是根据PRISMA2020声明的方向进行的。这篇综述的研究问题是:“交联剂的使用会改善树脂基材料对牙本质的BS吗?”在以下数据库中进行了文献检索:Embase,PubMed,Scielo,Scopus,和WebofScience。包括报告使用交联剂后对BS的影响的手稿。使用ReviewManagerv5.4.1进行荟萃分析。通过比较使用交联剂或对照组获得的BS值之间的标准化平均差异来进行比较。基于所使用的粘合剂策略(总蚀刻或自蚀刻)进行亚组比较。直接和长期数据分别进行分析。共有50篇文章被纳入定性分析,同时考虑了45篇文章进行定量分析。荟萃分析表明,表没食子儿茶素-3-没食子酸酯(EGCG)预处理,碳化二亚胺,乙二胺四乙酸(EDTA),戊二醛,和核黄素交联剂改善了树脂复合材料对牙本质的长期BS(p≤0.02)。另一方面,使用原花青素作为预处理改善了即时和长期BS值(p≤0.02)。当掺入粘合剂配方中时,只有戊二醛,核黄素,EGCG改善长期BS对牙本质的影响。可以得出结论,不同的交联剂如碳二亚胺的应用,EDTA,戊二醛,核黄素,和EGCG改善了牙本质粘合剂系统的长期BS。当这些交联剂作为单独的步骤使用时和当掺入粘合剂体系的配方中时,观察到这种效果。
This study aimed to identify the role of crosslinking agents in the resin-dentin bond strength (BS) when used as modifiers in adhesives or pretreatments to the dentin surface through a systematic
review and meta-analysis. This paper was conducted according to the directions of the PRISMA 2020 statement. The research question of this
review was: \"Would the use of crosslinkers agents improve the BS of resin-based materials to dentin?\" The literature search was conducted in the following databases: Embase, PubMed, Scielo, Scopus, and Web of Science. Manuscripts that reported the effect on the BS after the use of crosslinking agents were included. The meta-analyses were performed using
Review Manager v5.4.1. The comparisons were performed by comparing the standardized mean difference between the BS values obtained using the crosslinker agent or the control group. The subgroup comparisons were performed based on the adhesive strategy used (total-etch or self-etch). The immediate and long-term data were analyzed separately. A total of 50 articles were included in the qualitative analysis, while 45 articles were considered for the quantitative analysis. The meta-analysis suggested that pretreatment with epigallocatechin-3-gallate (EGCG), carbodiimide, ethylenediaminetetraacetic acid (EDTA), glutaraldehyde, and riboflavin crosslinking agents improved the long-term BS of resin composites to dentin (p ≤ 0.02). On the other hand, the use of proanthocyanidins as a pretreatment improved both the immediate and long-term BS values (p ≤ 0.02). When incorporated within the adhesive formulation, only glutaraldehyde, riboflavin, and EGCG improved the long-term BS to dentin. It could be concluded that the application of different crosslinking agents such as carbodiimide, EDTA, glutaraldehyde, riboflavin, and EGCG improved the long-term BS of adhesive systems to dentin. This effect was observed when these crosslinkers were used as a separate step and when incorporated within the formulation of the adhesive system.