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Do different protocols affect the success rate or bond strength of glass-ceramics repaired with composite resin? A
Iara de O Nogueira1, Carolina N de B Pereira1, Lucas G Abreu2
1Department of Restorative Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
Statement Of Problem:
Intraoral repair techniques prevent unnecessary replacement of ceramic restorations, thereby increasing the survival rate. However, adhesion between ceramics and the composite resin is challenging and how different protocols influence adhesion is unclear.
Purpose:
The purpose of this systematic review and meta-analysis was to analyze the influence of different protocols on repairing glass-ceramic surfaces with composite resins.
Material And Methods:
PubMed, Scopus, ISI Web of Science, and Embase electronic databases were searched to select studies comparing bond strength values or survival rates of glass-ceramic repaired with composite resins using different surface treatment protocols. No publication year or language restriction was applied. Data sets were extracted from all included studies, and the mean differences calculated. A 95% confidence interval was calculated by using the random effect model (Rev Man 5.4).
Results:
The search identified 5037 studies, and 165 were assessed for eligibility. Finally, 123 in vitro studies were included in the systematic review and 48 in the meta-analysis. Considering different glass-ceramics, bond strength tests, and aged or not aged specimens, 37 meta-analyses found the effect of repair protocols: only adhesive, silane plus adhesive alone or preceded by hydrofluoric (HF) acid, airborne-particle abrasion (APA) with Al2O3 particles, silica-coated APA (SCAPA), diamond rotary instrument (DRI), and laser irradiation (LI).
Conclusions:
For feldspathic porcelain, HF acid, APA, SCAPA, or DRI improved the repair micromechanical retention; applying silane is essential to HF-conditioned surfaces but the use of adhesive is optional when silane is applied. Results for leucite and lithium disilicate were inconclusive in terms of suggesting a treatment other than HF acid plus silane and adhesive applications.
