Surface pretreatments for enhancing bond strength of resin composite to sclerotic dentin in non-carious cervical lesions: A systematic review

Faculty Faculty of Dentistry Year: 2025
Type of Publication: ZU Hosted Pages:
Authors:
Journal: Journal of Dentistry Elsevier Ltd Volume: 163
Keywords : Surface pretreatments , enhancing bond strength , resin    
Abstract:
Objective: To evaluate the impact of different surface pretreatments of cervical non-carious dentin on the bond strength to resin composite. Data sources: In vitro studies that assessed the impact of pretreatment of cervical non-carious dentin on bond strength to resin composite were considered for inclusion. The protocol was conducted following PRISMA guidelines and registered in PROSPERO (CRD420251102471). Studies were identified after comprehensive online search in 5 different electronic databases including PubMed (Medline), Web of science, Scopus, Cochrane library, and Google scholar. Results: Eight studies met the inclusion criteria. However, the results were inconsistent, with some studies reporting no significant differences or even inferior outcomes with pretreatments like ethylenediaminetetraacetic acid (EDTA) or sodium hypochlorite. Prolonged application of phosphoric acid (30–40 %, 15–90 s) and combined chemical-mechanical pretreatments (e.g., sandblasting with phosphoric acid) showed potential to improve bond strength compared to controls. Most studies exhibited a high risk of bias, primarily due to lack of blinding, inadequate sample size calculations, and failure to simulate clinical conditions. Conclusion: Current scientific evidence suggests that pretreating cervical non-carious sclerotic dentin with prolonged application of 37 % phosphoric acid—either alone or in combination with mechanical roughening—may enhance bond strength to resin composite. However, the quality of the evidence is low. Further high-quality research, including studies on laser pretreatments and those simulating clinical conditions, is needed to establish reliable guidelines for clinical practice. Clinical significance: Dentin of non-carious cervical lesion is physiologically different from normal dentin due to frequent and prolonged exposure to various oral conditions, such as thermal, chemical, and mechanical stimuli. Consequently, achieving reliable adhesion to this altered dentin substrate remains a clinical challenge. Therefore, surface pretreatment with prolonged application of 37 % phosphoric acid, either alone or in combination with mechanical roughening is recommended to increase the bond strength of resin composite to these lesions.
   
     
 
       

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