Impact of Dentine Pretreatment with Matrix Metalloproteinase Inhibitors on Bond Strength of Coronal Composite Restorations: A Systematic Review and Meta-analysis of In Vitro Studies

Hasan Jamal; Rayan Yaghmoor; Hassan Abed; Anne Young; Paul Ashley

doi:10.1055/s-0042-1757582

European Journal of Dentistry, Table of Contents

CC BY 4.0 · Eur J Dent 2023; 17(04): 974-999
DOI: 10.1055/s-0042-1757582

Review Article

Impact of Dentine Pretreatment with Matrix Metalloproteinase Inhibitors on Bond Strength of Coronal Composite Restorations: A Systematic Review and Meta-analysis of In Vitro Studies

Authors

Hasan Jamal

¹Paediatric Dentistry Department, Eastman Dental Institute, University College London, London, United Kingdom

²Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Eastman Dental Institute, London, United Kingdom
Rayan Yaghmoor

²Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Eastman Dental Institute, London, United Kingdom

³Department of Microbial Diseases, UCL Eastman Dental Institute, Royal Free Hospital, London, United Kingdom

⁴Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
Hassan Abed

⁵Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
Anne Young

²Department of Biomaterials and Tissue Engineering, Royal Free Hospital, UCL Eastman Dental Institute, London, United Kingdom
Paul Ashley

¹Paediatric Dentistry Department, Eastman Dental Institute, University College London, London, United Kingdom

Abstract

Matrix metalloproteinase (MMP) enzymes participate in collagen matrix degradation, including in dentine, potentially compromising bond strength. Therefore, MMP inhibitors have been hypothesized to improve restoration bond strength and stability. This systematic review aimed to evaluate the influence of different MMP inhibitors applied as dentine surface pretreatments on the immediate (24 hours) and longer term (months) bond strength of direct coronal composite restorations. This systematic literature review followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement. A systematic literature search of three databases (Ovid MEDLINE, Ovid Embase, and Google Scholar) was conducted independently by two reviewers from inception to April 2022. An adapted quality assessment tool was independently applied by two reviewers for risk of bias assessment. RevMan v5.4 software was used for meta-analyses. A randomeffectsmodel was used to generatemean differences with 95% confidence intervals for treatment and control comparisons. The Q-test and I2-test were used to test for heterogeneity. The proportion of total variance across studies attributable to heterogeneity rather than chance was calculated. Overall effects were tested using the Z-test, while subgroup differences were tested using Chi-squared tests. Of 934 studies, 64 studies were included in the systematic review and 42 in the meta-analysis. Thirty-one MMP inhibitors were reported, three of which were included in the meta-analysis: 2% chlorhexidine (CHX), 0.3M carbodiimide (EDC), and 0.1% riboflavin (RIBO). Pretreatment with 2% CHX for 30 and 60 seconds did not significantly improve bond strength compared with controls either immediately or after long-termageing. However, pretreatment with 0.3MEDC and 0.1% RIBO (but not CHX) significantly improved bond strength compared with control groups both immediately and over time. Most studies showed a medium risk of bias. These in vitro findings pave the way for rationale clinical trialing of dentine surface pretreatment with MMP inhibitors to improve clinical outcomes.

Keywords

restorations - bond strength - matrix metalloproteinase inhibitors - enzymes - caries - dentine.

Full Text

References

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