Bond strength of flowable dental composites in the cementation of indirect restorations: a systematic review and...

This systematic review evaluated experimental evidence on how incorporating flowable dental composites affects the bond strength of dental cementation.

This systematic review, following PRISMA guidelines, assessed in vitro studies (2003-2025) on the effect of flowable composites on cementation bond strength using a comprehensive database search, QUIN Tool for bias assessment, Begg's and Egger's tests for publication bias, and random-effects meta-analysis with SMD and I² statistics.

This systematic review included eight in vitro studies published between 2003 and 2025. The meta-analysis found no statistically significant differences among the various bond strength test methods. Although the shear bond strength (SBS) test demonstrated a significant effect, the high heterogeneity among studies limits the reliability of this result. Etchable ceramics showed favourable effect sizes, but again, the high heterogeneity reduces the certainty of this finding. No significant difference was observed between self-etch and self-adhesive resin cements; however, self-etch resin cements tended to perform better in terms of bond strength. Nevertheless, the substantial heterogeneity in both adhesive groups indicates notable variability across studies. For the dual-cured group, a statistically significant standardized mean difference was observed, suggesting a positive effect of the dual-cured luting cement compared to the light-cured luting cement.

Flowable dental composites generally perform comparably to conventional resin cements, with dual-cured and self-etch resin cements showing a tendency toward improved bond strength. However, variability across studies limits the certainty of these results. Further standardized in vitro studies are needed to confirm these findings and guide clinical application.