AUTHOR=Chen Huan , Sun Guangdi , Wang Huimin , Yu Shiyang , Tian Zilu , Zhu Song 

TITLE=Effect of collagen cross-linkers on dentin bond strength: A systematic review and network meta-analysis

JOURNAL=Frontiers in Bioengineering and Biotechnology

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.2022.1100894

DOI=10.3389/fbioe.2022.1100894

ISSN=2296-4185

ABSTRACT=<p><bold>Objective:</bold> This study aimed to evaluate the role of collagen cross-linkers in the bonding performance of the resin-dentin interface through a systematic review and a network meta-analysis.</p><p><bold>Sources:</bold> The literature search was conducted in several databases like PubMed, EMBASE, Cochrane, Scopus and Web of Science from their inception till 30 April 2022.</p><p><bold>Study selection:</bold> The inclusion criteria consisted of <italic>in vitro</italic> studies evaluating the micro-tensile and micro-shear bond strengths of different cross-linkers acting on dentin. Bayesian network meta-analysis was conducted using RStudio.</p><p><bold>Data:</bold> Out of the 294 studies evaluated in the full-text analysis, 40 were included in the systematic review and meta-analysis. Most studies have used cross-linkers as primer (65.1%), followed by incorporating them into in adhesives and acid etching agents. The application methods of the adhesive system were classified as “etch-and-rinse (ER) adhesives” (77%) and “self-etching (SE) adhesives”. Moreover, there were six types of cross-linkers in this presented review, of which the most numerous were polyphenols.</p><p><bold>Conclusion:</bold> Different application methods of cross-linkers, the long-term results showed that were only effective when used for longer durations, the immediate results were not statistically different. According to immediate and long-term results, etch-and-rinse (ER) adhesives showed a greater bonding performance than the control groups (<italic>p</italic> ≤ 0.05), whereas self-etching (SE) adhesives showed similar bond strength values (<italic>p</italic> ≥ 0.05). The result of network meta-analysis (NMA) showed that Dope like compound showed higher long-term bonding performance than other cross-linkers.</p><p><bold>Clinical significance</bold>: Long-term clinical studies may be needed to determine the effect of the cross-linkers on the bonding properties.</p>