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Does the etching strategy influence the bonding of universal adhesive systems to primary teeth? A systematic review and meta-analysis of in vitro studies

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Abstract

Purpose

To assess through a systematic review and meta-analysis of in vitro studies, the influence of the etching strategy (etch-and-rinse versus self-etch) of universal adhesive systems on bonding to primary teeth.

Methods

A systematic search was carried out in PubMed, Web of Science and Scopus. In vitro studies that compared the bond strength of the etching strategies of universal adhesives to primary teeth were included. Pooled-effect estimates were derived from a random-effects model by comparing the standardized mean difference between the etching strategies (α < 0.05). The risk of bias and heterogeneity between studies were also assessed (Cochrane and I2 tests).

Results

Seven studies were included in the review and six in the meta-analyses. For dentin, the immediate bond strength was not influenced by the etching strategy regardless of sound (Z = 0.72, p = 0.47) or caries-affected (Z = 1.27, p = 0.21) substrate, nor after aging (Z = 0.24, p = 0.81). It was not possible to perform a meta-analysis for the enamel substrate. Most studies have a medium risk of bias.

Conclusions

This systematic review and meta-analysis of in vitro studies provides evidence that universal adhesives can be used in both etching strategies in primary dentin. The evidence is currently insufficient about whether selective acid etching of primary enamel is necessary when universal adhesive systems are used.

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Acknowledgements

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001.

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Authors and Affiliations

  1. Dental Science Graduate Program, Federal University of Santa Maria, Santa Maria, RS, Brazil

    T. T. Fröhlich & L. D. Gindri

  2. Department of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil

    F. Z. M. Soares

  3. Department of Stomatology, Federal University of Santa Maria, Cidade Universitária, Av. Roraima, 1000 Prédio 26 F, Santa Maria, RS, Brazil

    R. de Oliveira Rocha

Authors
  1. T. T. Fröhlich
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  2. L. D. Gindri
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  3. F. Z. M. Soares
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  4. R. de Oliveira Rocha
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Contributions

TTF conceived the idea and study design. TTF and ROR performed the literature search. TTF and LDG performed the extraction of data. TTF performed the meta-analysis and wrote the manuscript. LDG, FZMS and ROR contributed substantially to discussion and proofread the manuscript before its submission.

Corresponding author

Correspondence to R. de Oliveira Rocha.

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The authors have no conflicts of interest to declare that are relevant to the content of this article.

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Fröhlich, T.T., Gindri, L.D., Soares, F.Z.M. et al. Does the etching strategy influence the bonding of universal adhesive systems to primary teeth? A systematic review and meta-analysis of in vitro studies. Eur Arch Paediatr Dent 22, 1015–1022 (2021). https://doi.org/10.1007/s40368-021-00639-w

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  • DOI: https://doi.org/10.1007/s40368-021-00639-w

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