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Effect of different adhesive systems on dental defects and sensitivity to teeth in composite resin restoration: a systematic review and meta-analysis

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Abstract

Objectives

This meta-analysis aimed to elucidate the effects of various acid etching patterns on the sensitivity of teeth and their clinical effectiveness following composite resin repair.

Materials and methods

PubMed, Cochrane Library, Web of Science, and Embase databases were searched for relevant studies on the postoperative sensitivity (POS) of composite resin restorations after using different bonding systems. The retrieval was from the inception of the databases to August 13, 2022, with no filter of written language. Literature screening was conducted by two independent researchers. The Cochrane risk-of-bias assessment tool was adopted for quality evaluation, and Stata 15.0 for analysis.

Results

Twenty-five randomized controlled trials were included in the present study. Following resin composite restoration, 1309 restorations were bonded by self-etching (SE) adhesives, whereas 1271 restorations were bonded by total-etching (TE) adhesives. The meta-analyses showed that there is no evidence to prove the SE and TE will affect POS at present when measured using the modified United States Public Health Service (USPHS) criteria [RR = 1.00 (95% CI: 0.96, 1.04)], the World Dental Federation (FDI) [RR = 1.06 (95% CI: 0.98, 1.15)], or the visual analog scale (VAS) [SMD = 0.02 (95% CI: −0.15, 0.20)] scales. At a certain follow-up time, TE adhesives provide better outcomes in terms of color match, marginal staining, and marginal adaptation. In other words, TE adhesives have better esthetic results.

Conclusions

The type of bonding technique (ER and SE) does not affect the risk and degree of POS in class I/II and class V restorations. Further research is required to verify whether these findings apply to different forms of composite resin restorations.

Clinical relevance

Besides the fact that TE barely increase postoperative sensitivity, it also yields superior cosmetic results.

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Availability of data and materials

The original contributions presented in the study are included in the article/supplementary material; further inquiries can be directed to the corresponding author.

Funding

This work was supported by the Project of NINGBO Leading Medical & Health Discipline, Project Number: 2022-F20.

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Authors and Affiliations

  1. Department of Stomatology, Ningbo No.2 Hospital, Ningbo City, Zhejiang Province, 315010, China

    Keda Fang & Liang Wang

  2. Department of Stomatology, Zhoushan Hospital of Zhejiang Province, Zhoushan, Zhejiang Province, 316021, China

    Kenan Chen

  3. Department of Stomatology, Navy Specialty Medical Center of Peoples’ Liberation Army, Shanghai, 200052, China

    Mengqi Shi

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Contributions

Conceptualization: Keda Fang; methodology: Kenan Chen; formal analysis and investigation: Mengqi Shi; writing original draft preparation: Mengqi Shi, Liang Wang; writing review and editing: Keda Fang, Kenan Chen; funding acquisition: Keda Fang; resources: Kenan Chen, Liang Wang; supervision: Keda Fang; and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Supplementary Figure 1

Forest plots of the performed meta-analysis, meta-analysis for using the USPHS criteria to measure surface texture of self-etching vs. total-etching systems in (a) Class I/II and (b) Class V composite resin restorations. Study, pooled effect estimates for different outcomes, 95% confidence intervals (95% CI) and relative weight (%) from random- and fixed-effect meta-analysis are presented. Heterogeneity was assessed by I2-statistic and p value. SMD, standardized; RR, relative risk (PNG 70 kb)

High resolution image (TIF 210 kb)

Supplementary Figure 1b

(PNG 94 kb)

High resolution image (TIF 260 kb)

Supplementary Figure 2

Forest plots of the performed meta-analysis, meta-analysis for using the USPHS criteria to measure marginal integrity of self-etching vs. total-etching systems in Class I/II composite resin restorations. Study, pooled effect estimates for different outcomes, 95% confidence intervals (95% CI) and relative weight (%) from random- and fixed-effect meta-analysis are presented. Heterogeneity was assessed by I2-statistic and p value. SMD, standardized; RR, relative risk (PNG 117 kb)

High resolution image (TIF 341 kb)

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Fang, K., Chen, K., Shi, M. et al. Effect of different adhesive systems on dental defects and sensitivity to teeth in composite resin restoration: a systematic review and meta-analysis. Clin Oral Invest 27, 2495–2511 (2023). https://doi.org/10.1007/s00784-023-05007-0

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