Which surface treatment improves the long-term repair bond strength of aged methacrylate-based composite resin restorations? A systematic review and network meta-analysis

Abstract

AbstractThis study aimed to investigate the effect of common surface treatments on the long-term repair bond strength of the aged methacrylate-based composite resin restorations. Also, provide their rankings and two-by-two comparison. In-vitro studies evaluating the methacrylate-based composite resins subjected to rigorous aging procedures before and after being repaired with a new composite were included. A frequentist network meta-analysis was carried out using a random-effects model. P-scores were used to rank the efficacy of the surface treatments. Also, the global and node-split inconsistencies were evaluated. Web of Science, PubMed/Medline, Scopus, and Embase databases were searched until November 11, 2021. Application of diamond bur + silane + total-etch adhesive (shear MD 41.12 MPa, 95% CI 29.02 to 53.21, P-score 0.99; tensile MD 29.36 MPa, 95% CI 12.36 to 46.35; P-score 0.69), and air abrasion with silica-coated alumina + silane + total-etch adhesive (shear MD 16.29 MPa, 95% CI 6.54 to 26.05, P-score 0.66; tensile MD 33.86 MPa, 95% CI 16.17 to 51.54; P-score 0.82) produced the highest (micro)tensile and (micro)shear bond strengths compared to abrasive paper, according to two network meta-analyses containing 22 investigations. There has been no variation comparing self- and total-etch adhesives. Further, mechanical surface treatments should be used alongside the chemical adhesive agents to yield stronger bonds. It is possible to achieve acceptable repair bond strength using common dental clinic equipment. Therefore, clinicians could consider repairing old composite resins rather than replacing them.