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Evaluation of bond strength between relining materials and 3D printed interim crown materials: A systematic review
Jade Rodrigues Monteiro1, Laura Buarque Caminha Lins2, Pedro Thiago de Oliveira Neves2
1MSc student, Faculty of Dentistry, Department of Oral Rehabilitation, University of Pernambuco (UPE), Recife, PE, Brazil.
Statement Of Problem:
The increasing use of 3-dimensionally (3D) printed interim crowns has raised concerns regarding the effectiveness of bonding materials, particularly after postpolymerization procedures, and the influence of surface treatments on bond strength remains unclear.
Purpose:
The purpose of this systematic review and meta-analysis was to compare the bond strength of polymethyl methacrylate (PMMA) relining materials with other relining materials used for 3D printed interim crowns and to evaluate the influence of surface treatments on bond strength.
Material And Methods:
This systematic review followed the PRISMA 2020 guidelines and was registered in the Open Science Framework (OSF). Electronic searches were conducted in the PubMed/MEDLINE, Scopus, Embase, Web of Science, and LILACS databases up to November 2025, without language or publication date restrictions. In vitro studies evaluating the bond strength between 3D printed interim crowns and relining materials were included. Risk of bias was assessed with the RoBDEMAT tool. A meta-analysis was performed with a random-effects model, calculating mean differences (MD) and 95% confidence intervals (CI). Because of methodological heterogeneity, only groups without surface treatment were included in the quantitative synthesis, with subgroup analyses comparing PMMA with bis-acrylic resin and flowable composite resin.
Results:
Nine in vitro studies were included in the qualitative synthesis, and 5 were included in the meta-analysis. No statistically significant difference in bond strength was observed between PMMA and other relining materials (bis-acrylic resin and flowable composite resin) (MD=-0.81; 95% CI: -2.91 to 1.29; P=.45). Subgroup analyses also showed no significant differences between PMMA and bis-acrylic resin (P=.63) or between PMMA and flowable composite resin (P=.53). High heterogeneity was observed across studies. Surface treatments, particularly mechanical abrasion combined with adhesive application, were associated with improved bond strength and a higher incidence of cohesive and mixed failures.
Conclusions:
Based on the available in vitro evidence, PMMA, bis-acrylic resin, and flowable composite resin demonstrate comparable bond strength when used to reline 3D printed interim crowns without surface treatment. Surface treatments may enhance bond strength; however, the effectiveness of these protocols depends on the materials involved. Because of high heterogeneity and limited standardized methodologies, the results should be interpreted with caution, and further laboratory and clinical studies are warranted.