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MMP Inhibitors and Dentin Bonding: Systematic Review and Meta-Analysis.

O Kiuru1, J Sinervo1, H Vähänikkilä2

  • 1Research Unit of Oral Health Sciences, Department of Cariology,Endodontology and Paediatric Dentistry, University of Oulu, Oulu, Finland.

International Journal of Dentistry
|June 17, 2021
PubMed
Summary

Matrix metalloproteinase (MMP) inhibitors, particularly chlorhexidine (CHX), can prevent collagen degradation in resin-dentin bonds. Studies show CHX significantly improves aged bond strength, suggesting its use for enhanced dental restoration longevity.

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Area of Science:

  • Dental Materials Science
  • Biomaterials Engineering
  • Adhesive Dentistry

Background:

  • Resin-dentin bond strength diminishes over time due to hybrid layer degradation.
  • Collagenolytic enzymes, specifically matrix metalloproteinases (MMPs), degrade the collagen matrix within the hybrid layer.
  • MMP inhibitors offer a potential solution to prevent this enzymatic degradation.

Purpose of the Study:

  • To systematically review existing literature on the effects of MMP inhibitors on immediate and aged resin-dentin bond strengths.
  • To evaluate the efficacy of various MMP inhibitors, with a focus on chlorhexidine (CHX), in preserving bond integrity over time.

Main Methods:

  • A systematic literature search was conducted across two databases.
  • 43 articles were selected for full review from an initial 740.
  • A meta-analysis included 21 studies utilizing 0.2%-2% chlorhexidine (CHX) treatments, with a risk of bias assessment performed.

Main Results:

  • MMP inhibitors demonstrated a trend towards reduced loss of dentin bond strength.
  • No significant difference in immediate bond strengths was observed between CHX and control groups.
  • Aged bond strengths were significantly higher in the CHX group compared to the control (P < 0.001).
  • Increased adhesive interface fractures were noted after aging.

Conclusions:

  • MMP inhibition, especially with chlorhexidine, shows promise in increasing the longevity of resin-dentin bonds.
  • Clinical application of CHX for MMP inhibition is recommended to enhance restoration durability.
  • Further long-term studies with reduced risk of bias are needed to solidify these findings.