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Natural antioxidants to restore immediate bond strength to bleached enamel: Systematic review and meta‐analysis of in vitro studies
Author(s) -
RodríguezBarragué Juana,
VolaGelmini Joanna,
SkurasSiedemburg Marcel,
RiveraGonzaga José Alejandro,
CuevasSuarez Carlos Enrique
Publication year - 2021
Publication title -
journal of esthetic and restorative dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.919
H-Index - 60
eISSN - 1708-8240
pISSN - 1496-4155
DOI - 10.1111/jerd.12743
Subject(s) - bond strength , enamel paint , dentistry , meta analysis , antioxidant , adhesive , dental bonding , medicine , chemistry , materials science , composite material , organic chemistry , layer (electronics)
Objective To evaluate whether natural antioxidant treatment would enhance the immediate bond strength of dental adhesives to bleached enamel through a systematic review and meta‐analysis. Materials and methods Two reviewers performed a literature search up to November 2019 in seven databases. Only in vitro studies that evaluated the effect of the application of natural antioxidants in the bond strength of dental adhesives to bleached enamel were included. Analyses were carried out using RevMan 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). A global analysis was performed with random‐effects models at a significance level of p < 0.05. Results Twenty‐four studies were included in the meta‐analysis. Both in‐office (p ˂ 0.001) and at‐home (p ˂ 0.001) bleaching reduced the immediate bond strength. When compared to bleached enamel, all antioxidants improved the bond strength, but only grape seed extract/proanthocyanidin and lycopene restored it to the control values (p ˃ 0.05). Conclusion In vitro available evidence suggests that the use of natural antioxidants can be beneficial when performing immediate resin‐based restorations after bleaching, however, these results should be taken with caution since they are based on medium and high risk of bias studies; low bias studies are needed to draw relevant conclusions. Clinical significance Despite the lack of clinical evidence, the present study confirms the benefits of applying natural antioxidant agents to enhance the in vitro bond strength when performing immediate esthetic restorations after bleaching. Since certain antioxidant agents proved more effective than others, clinical investigations may be focused on the ones that withhold the most promising results. The application of natural antioxidants after bleaching may enable immediate esthetic restorations to be performed.