Abstract
Statement of problem
A consensus on whether to use an adhesive layer on glass-ceramics after etching with
hydrofluoric acid and applying a silane-coupling agent is lacking.
Purpose
The purpose of this systematic review and meta-analysis was to determine whether adhesive
layer application after etching and silanization influences the bond strength values
of glass-ceramics to resin-based materials.
Material and methods
PubMed, ISI Web of Science, and Scopus electronic databases were searched to select
in vitro studies comparing bond strength values of etched and silanized glass-ceramics
bonded with or without an adhesive layer. No publication year or language restriction
was applied. Data sets were extracted, and the mean differences were applied by using
the Rev Man 5.3 program. The association between bond strength (shear/microshear or
tensile/microtensile) and an adhesive layer application on nonaged and aged specimens
was analyzed.
Results
Of 4727 potentially eligible studies, 54 were selected for full-text analysis, and
15 were included for qualitative synthesis; of these, 14 were used in the meta-analysis.
A total of 2 meta-analyses were performed with heterogeneity varying from high to
moderate among study specimens. For shear/microshear studies, both nonaged (MD, 1.36
[95% CI: -0.18, 2.90], P=.080, I2=79%) and aged (MD, 0.89 [95% CI: -1.04, 2.82], P=.370, I2=80%) specimens presented no statistically significant difference between groups bonded
with or without an adhesive layer application. For microtensile studies, both nonaged
(MD, -1.49 [95% CI: -2.48, -0.50], P=.003, I2=88%) and aged (MD, -3.87 [95% CI: -5.63, -2.11], P<.001, I2=97%) specimens exhibited higher values without an adhesive application.
Conclusions
Regardless of the bond strength test used, an adhesive layer application did not improve
the bond strength of etched and silanized glass-ceramics to resin-based materials.
The influence of this adhesive layer application should be evaluated under clinical
conditions.
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Article info
Publication history
Published online: February 19, 2020
Identification
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© 2020 by the Editorial Council for The Journal of Prosthetic Dentistry.
