European Archives of Paediatric Dentistry

, Volume 20, Issue 1, pp 1–8 | Cite as

Evaluation of the efficiency of fluoride-releasing adhesives for preventing secondary caries in-vitro: a systematic review and meta-analysis

  • F. V. MartinsEmail author
  • W. F. Vasques
  • E. M. Fonseca
Systematic Review



To evaluate the efficiency of fluoride-releasing adhesives for the prevention of secondary caries on in-vitro tests.

Materials and methods

This study was performed according to the PRISMA checklist. The bibliographic research was performed to identify in-vitro studies between January 2000 and September 2017. The selected studies were submitted to bias risk assessment and data extraction. In the meta-analysis the data were evaluated using Review Manager Software.


The 11 studies that met all inclusion criteria showed that the most common risks of bias were: absence of the sample size calculation description, absence of the single operator protocol and blind operation of the test machine. The meta-analysis was performed with six studies that used polarised light microscopy in order to quantify the mineral content of dentine and presented the values as means and standard deviations.


Most of the authors presented that the fluoride-containing adhesive systems had a significant effect to reduce in-vitro secondary caries. The meta-analysis did not present statistical difference between fluoride-free and fluoride-containing adhesive systems. The artificial caries challenge methodology may have affected the results.


Secondary caries Resin restorations Adhesive Fluoride 



None. No Funding was asked for this study.

Compliance with ethical standards

Conflict of interest

None. No member of our team is hired by a dental materials company, or is a representative or has been sought by a company for research project development.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. Amend S, Frankenberger R, Lücker S, et al. Secondary caries formation with a two-species biofilm artificial mouth. Dent Mater Off Publ Acad Dent Mater. 2018;34:786–96.Google Scholar
  2. Askar H, Tu Y-K, Paris S, et al. Risk of caries adjacent to different restoration materials: Systematic review of in situ studies. J Dent. 2017;56:1–10.CrossRefGoogle Scholar
  3. Beyth N, Domb AJ, Weiss EI. An in vitro quantitative antibacterial analysis of amalgam and composite resins. J Dent. 2007;35:201–6.CrossRefGoogle Scholar
  4. Carvalho RM, Chersoni S, Frankenberger R, et al. A challenge to the conventional wisdom that simultaneous etching and resin infiltration always occurs in self-etch adhesives. Biomaterials. 2005;26:1035–42.CrossRefGoogle Scholar
  5. Carvalho FG, Puppin-Rontani RM, Soares LES, et al. Mineral distribution and CLSM analysis of secondary caries inhibition by fluoride/MDPB-containing adhesive system after cariogenic challenges. J Dent. 2009;37:307–14.CrossRefGoogle Scholar
  6. Chaussain-Miller C, Fioretti F, Goldberg M, et al. The role of matrix metalloproteinases (MMPs) in human caries. J Dent Res. 2006;85:22–32.CrossRefGoogle Scholar
  7. Cheng L, Weir MD, Zhang K, et al. Dental primer and adhesive containing a new antibacterial quaternary ammonium monomer dimethylaminododecyl methacrylate. J Dent. 2013;41:345–55.CrossRefGoogle Scholar
  8. Cocco AR, de Rosa WLDO, da Silva AF, et al. A systematic review about antibacterial monomers used in dental adhesive systems: current status and further prospects. Dent Mater Off Publ Acad Dent Mater. 2015;31:1345–62.Google Scholar
  9. Cury JA, de Oliveira BH, dos Santos APP, et al. Are fluoride releasing dental materials clinically effective on caries control? Dent Mater Off Publ Acad Dent Mater. 2016;32:323–33.Google Scholar
  10. De Munck J, Van Landuyt K, Peumans M, et al. A critical review of the durability of adhesion to tooth tissue: methods and results. J Dent Res. 2005;84:118–32.CrossRefGoogle Scholar
  11. Dietschi D, Monasevic M, Krejci I, et al. Marginal and internal adaptation of class II restorations after immediate or delayed composite placement. J Dent. 2002;30:259–69.CrossRefGoogle Scholar
  12. Dionysopoulos P, Kotsanos N, Koliniotou-Koubia E, et al. Inhibition of demineralization in vitro around fluoride releasing materials. J Oral Rehabil. 2003;30:1216–22.CrossRefGoogle Scholar
  13. Dionysopoulos D, Koliniotou-Koumpia E, Helvatzoglou-Antoniades M, et al. In vitro inhibition of enamel demineralisation by fluoride-releasing restorative materials and dental adhesives. Oral Health Prev Dent. 2016;14:371–80.Google Scholar
  14. Ferracane JL, Mitchem JC, Adey JD. Fluoride penetration into the hybrid layer from a dentin adhesive. Am J Dent. 1998;11:23–8.Google Scholar
  15. Hals E, Nernaes A. Histopathology of in vitro caries developing around silver amalgam fillings. Caries Res. 1971;5:58–77.CrossRefGoogle Scholar
  16. Han L, Edward C, Okamoto A, et al. A comparative study of fluoride-releasing adhesive resin materials. Dent Mater J. 2002;21:9–19.CrossRefGoogle Scholar
  17. Ikemura K, Tay FR, Endo T, et al. A review of chemical-approach and ultramorphological studies on the development of fluoride-releasing dental adhesives comprising new pre-reacted glass ionomer (PRG) fillers. Dent Mater J. 2008;27:315–39.CrossRefGoogle Scholar
  18. Itota T, Nakabo S, Iwai Y, et al. Inhibition of artificial secondary caries by fluoride-releasing adhesives on root dentin. J Oral Rehabil. 2002;29:523–7.CrossRefGoogle Scholar
  19. Itota T, Torii Y, Nakabo S, et al. Effect of fluoride-releasing adhesive system on decalcified dentin. J Oral Rehabil. 2003;30:178–83.CrossRefGoogle Scholar
  20. Jackson RJ, Lim DV, Dao ML. Identification and analysis of a collagenolytic activity in Streptococcus mutans. Curr Microbiol. 1997;34:49–54.CrossRefGoogle Scholar
  21. Jacobson A. Effect of low fluoride levels in de/remineralization solutions of pH-cycling model. Caries Res. 1991;25:230–1.Google Scholar
  22. Kuramoto A, Imazato S, Walls AWG, et al. Inhibition of root caries progression by an antibacterial adhesive. J Dent Res. 2005;84:89–93.CrossRefGoogle Scholar
  23. Li F, Weir MD, Chen J, et al. Effect of charge density of bonding agent containing a new quaternary ammonium methacrylate on antibacterial and bonding properties. Dent Mater Off Publ Acad Dent Mater. 2014;30:433–41.Google Scholar
  24. Lobo MM, Gonçalves RB, Pimenta LAF, et al. In vitro evaluation of caries inhibition promoted by self-etching adhesive systems containing antibacterial agents. J Biomed Mater Res B Appl Biomater. 2005;75:122–7.CrossRefGoogle Scholar
  25. Mjör IA, Moorhead JE, Dahl JE. Reasons for replacement of restorations in permanent teeth in general dental practice. Int Dent J. 2000;50:361–6.CrossRefGoogle Scholar
  26. Nakajima M, Sano H, Burrow MF, et al. Tensile bond strength and SEM evaluation of caries-affected dentin using dentin adhesives. J Dent Res. 1995;74:1679–88.CrossRefGoogle Scholar
  27. Nakajima M, Okuda M, Ogata M, et al. The durability of a fluoride-releasing resin adhesive system to dentin. Oper Dent. 2003;28:186–92.Google Scholar
  28. Nascimento FD, Minciotti CL, Geraldeli S, et al. Cysteine cathepsins in human carious dentin. J Dent Res. 2011;90:506–11.CrossRefGoogle Scholar
  29. Nedeljkovic I, Teughels W, De Munck J, et al. Is secondary caries with composites a material-based problem? Dent Mater Off Publ Acad Dent Mater. 2015;31:e247–77.Google Scholar
  30. Pereira-Cenci T, Cenci MS, Fedorowicz Z, et al. Antibacterial agents in composite restorations for the prevention of dental caries. Cochrane Database Syst Rev. 2013;3:CD007819.Google Scholar
  31. Peris AR, Mitsui FHO, Lobo MM, et al. Adhesive systems and secondary caries formation: Assessment of dentin bond strength, caries lesions depth and fluoride release. Dent Mater Off Publ Acad Dent Mater. 2007;23:308–16.Google Scholar
  32. Pinto CF, Paes-Leme AF, Ambrosano GMB, et al. In vitro secondary caries inhibition by adhesive systems in enamel around composite restorations. Oper Dent. 2010;35:345–52.CrossRefGoogle Scholar
  33. Prabhakar AR, Dhanraj K, Sugandhan S. Comparative evaluation in vitro of caries inhibition potential and microtensile bond strength of two fluoride releasing adhesive systems. Eur Arch Paediatr Dent Off J Eur Acad Paediatr Dent. 2014;15:385–91.CrossRefGoogle Scholar
  34. Savarino L, Breschi L, Tedaldi M, et al. Ability of restorative and fluoride releasing materials to prevent marginal dentine demineralization. Biomaterials. 2004;25:1011–7.CrossRefGoogle Scholar
  35. Shinohara MS, De Goes MF, Schneider LFJ, et al. Fluoride-containing adhesive: durability on dentin bonding. Dent Mater Off Publ Acad Dent Mater. 2009;25:1383–91.Google Scholar
  36. Taha AA, Patel MP, Hill RG, et al. The effect of bioactive glasses on enamel remineralization: A systematic review. J Dent. 2017;67:9–17.CrossRefGoogle Scholar
  37. Thomaidis S, Kakaboura A, Mueller WD, et al. Mechanical properties of contemporary composite resins and their interrelations. Dent Mater Off Publ Acad Dent Mater. 2013;29:e132–41.Google Scholar
  38. Wiegand A, Buchalla W, Attin T. Review on fluoride-releasing restorative materials–fluoride release and uptake characteristics, antibacterial activity and influence on caries formation. Dent Mater Off Publ Acad Dent Mater. 2007;23:343–62.Google Scholar
  39. Zalkind MM, Keisar O, Ever-Hadani P, et al. Accumulation of Streptococcus mutans on light-cured composites and amalgam: an in vitro study. J Esthet Dent. 1998;10:187–90.CrossRefGoogle Scholar
  40. Zamperini CA, Bedran-Russo AK. Remineralization potential of mints containing bioactive agents in artificially induced root caries. Caries Res. 2018;52:331–8.CrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2018

Authors and Affiliations

  1. 1.College of DentistryFederal Fluminense University (UFF)NiteróiBrazil
  2. 2.Department of Dental TechniqueFederal Fluminense University(UFF)NiteroiBrazil

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