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.
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.
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基质金属蛋白酶抑制剂对牙本质预处理的影响对冠状复合修复体的键强度：体外研究的系统综述和荟萃分析。
DOI：
10.1055/s-0042-1757582
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发表时间：
2023-10
影响因子：
--
通讯作者：
Ashley, Paul
中科院分区：
文献类型：
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作者：
Jamal, Hasan;Yaghmoor, Rayan;Abed, Hassan;Young, Anne;Ashley, Paul
基质金属蛋白酶（MMP）酶参与胶原基质降解，包括在牙本质中，潜在地损害结合强度。因此，假设MMP抑制剂可以提高修复键的强度和稳定性。本系统综述旨在评估不同的MMP抑制剂作为牙本质表面预处理对直接冠状复合修复体的即时（24小时）和长期（数月）结合强度的影响。本系统文献综述遵循系统评价和荟萃分析的首选报告项目（PRISMA）声明。由两名审稿人独立对三个数据库（Ovid MEDLINE、Ovid Embase和谷歌Scholar）进行了系统的文献检索。两名审稿人独立应用一种适应性质量评估工具进行偏倚风险评估。采用RevMan v5.4软件进行meta分析。随机效应模型用于产生治疗组和对照组比较的95%置信区间的平均差异。采用q检验和i2检验检验异质性。计算各研究中由异质性而非偶然性导致的总方差的比例。总体效应采用z检验，亚组差异采用卡方检验。在934项研究中，64项研究纳入了系统评价，42项纳入了荟萃分析。报道了31种MMP抑制剂，其中3种被纳入荟萃分析：2%氯己定（CHX）， 0.3M碳二亚胺（EDC）和0.1%核黄素（RIBO）。与对照组相比，用2% CHX预处理30和60秒，无论是立即还是长期治疗后，都没有显著提高粘结强度。然而，与对照组相比，使用0.3MEDC和0.1% RIBO（不包括CHX）进行预处理，无论是立即还是随着时间的推移，都显著提高了粘合强度。大多数研究显示中等偏倚风险。这些体外研究结果为使用MMP抑制剂进行牙本质表面预处理以改善临床结果的临床试验铺平了道路。
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.