Mineralization strategy on dentin bond stability: a systematic review of in vitro studies and meta-analysis

Objectives This study aimed to systematically review the literature on laboratory researches and statistically determine the influence of mineralizing strategy on the dentin bond stability. Methods The search was conducted in PubMed/MEDLINE, Web of Science, EMBASE, and SCOPUS according to the PRISM guidelines. From 2200 possible eligible articles, 50 were selected for full-text analysis, and 15 were included in the systematic review. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. Bond strength analysis was conducted by RevMan5.3 with random effects model (alpha = 0.05), comparing control (without mineralizing strategy) and experimental groups (mineralizing strategy). Results Fifteen included trials concerned 46 comparisons between experimental groups adopting mineralizing strategy and control groups. Mineralization strategy reduced the dentin bond strength loss after aging. Although non-significant, the aging bond strength was higher than traditional bond methods (p = 0.07), the improvement was significant in pretreat (p = 0.01) and etch and rinse subgroup (p = 0.04). A significant reduction was found in immediate bond strength was associated with the use of mineralization strategy (p = 0.003). The majority of included studies were scored high risk of bias, high heterogeneity was presented in the meta-analyses. Conclusion Mineralization strategy reduced the dentin bond strength loss after aging. Bond strength after aging tends to be increased by mineralization strategy when used as a pretreat procedure, and in etch and rinse adhesive system. However, the mineralization strategy reduced the immediate dentin bond strength and didn't influence aging bond strength in total.