Restor Dent Endod.  2022 May;47(2):e23. 10.5395/rde.2022.47.e23.

Is dentin biomodification with collagen cross-linking agents effective for improving dentin adhesion? A systematic review and metaanalysis

• Silva JC
• Filho ELC
• Silva PGdB
• Costa FWG
• Saboia VdPA

• KMID: 2548127
• DOI: http://doi.org/10.5395/rde.2022.47.e23

Abstract

Objectives
The aim of this investigation was to evaluate the effectiveness of collagen cross-linking agents (CCLAs) used in combination with the adhesive technique in restorative procedures.
Materials and Methods
In this systematic review, the authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. An electronic search was performed using PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and DOSS, up to October 2020. The gray literature was also researched. Only randomized clinical trials were selected.
Results
The selection process yielded 3 studies from the 838 retrieved. The addition of CCLAs in the retention of restorations increased the number of events. The postoperative sensitivity scores and marginal adaptation scores showed no significant difference between the CCLA and control groups, and the marginal pigmentation scores showed a significant increase in the CCLA group. There were no caries events in any group throughout the evaluation period.
Conclusions
This systematic review showed that there is no clinical efficacy to justify the use of CCLAs in the protocols performed.

Keyword

Adhesive; Collagen; Cross-linking agents; Dentin; Dentin-bonding agents

Figure

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  Figure 1 Flow diagram of the study identification, screening, and inclusion process. Adapted from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). References for the 9 excluded articles are listed in Supplementary References.

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  Figure 2 Risk of bias (RoB) summary: review of the authors' assessment of each RoB item, presented as percentages across all included studies in the meta-analysis. Symbol colors: green, low RoB; yellow, unclear RoB; red, high RoB.

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  Figure 3 Forest plot of the retention rates.CCLA, collagen cross-linking agent; CI, confidence interval.

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  Figure 4 Forest plot of the postoperative sensitivity rates.CCLA, collagen cross-linking agent; CI, confidence interval.

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  Figure 5 Forest plot of the marginal staining rates.CCLA, collagen cross-linking agent; CI, confidence interval.

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  Figure 6 Forest plot of the marginal adaptation rates.EGCG, epigallocatechin-3-gallate; CCLA, collagen cross-linking agent; CI, confidence interval.

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