Cytogenotoxicity Induced by Dental Adhesives: A Systematic Review

Dental adhesives are an essential tool for dental direct and indirect restoration and, therefore, have grown in popularity among clinicians and researchers. With the purpose of enhancing the contact between the walls of the dental prepared cavity and the restorative material, dental adhesives systems differ from one another according to the employed etching technique and to the area of the tooth to be etched. When dentin is etched, the adhesive may reach the dental pulp through the microtubules and induce changes in this vital tissue, including DNA damage and/or cellular death (cytogenotoxicity). The aim of this study was to evaluate cytogenotoxicity induced by dental adhesives by means of systematic review. Thus, a total of 17 selected studies were carefully analyzed by three reviewers (TGP, MAPM, and DAR), who attributed scores to each study according to the used analysis parameters. Our results revealed that dental adhesives may indeed induce cytogenotoxicity in vitro, because all included studies reported positive response at, at least, one administered dose. As for the quality assessment, 16 studies (out of 17) were categorized as either Strong or Moderate, which suggests our findings can be considered reliable. Positively, such findings suggest that dental adhesives and their cytogenotoxic effects are crucial data for elucidating the risk of genetic damage and/or cellular death associated with dental adhesives, as well as for guiding the development of new products with different compositions.