Influence of MMP inhibitors on bond strength of adhesive restorations: systematic review and meta-analysis

• Ano de defesa: 2019
• Autor(a) principal: Camim, Francielly da Silva
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: eng
• Instituição de defesa: Biblioteca Digitais de Teses e Dissertações da USP
• Palavras-chave em Português: Colagem dentária; Dental bonding; Inibidores de proteases; Matrix metalloproteinases; Metaloproteinases da matriz; Protease Inhibitors
• Link de acesso: http://www.teses.usp.br/teses/disponiveis/25/25148/tde-25112019-205524/

Objectives: This systematic review aimed to evaluate the effect of metalloproteinase (MMPs) inhibitors on bond strength using initial (24 hours) and long-term (6, 12 months or longer) microtensile tests. Sources: A search was carried out in 7 databases and in the gray literature, limited to Portuguese, English and Spanish languages without publication year limit, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) 2009. Study selection: Only in vitro studies assessing the use of MMP inhibitors in adhesive procedures were included. Meta-analyses were conducted with the extracted data and the studies were evaluated for the risk of bias. Data: Of 5,134 potentially eligible studies, 112 were selected for full-text reading, 48 were reviewed, and 43 were included in the meta-analysis. Two independent evaluators selected the studies and assessed the risk of bias. Estimates of the combined effect were reported as means and standard deviation between groups. The most commonly used MMP inhibitor was chlorhexidine (CHX). The initial values of bond strength were higher when CHX was used (p <0.05), but no difference was found in the other time-points between groups using inhibitors and control groups. Etch-andrinse adhesive systems presented better results with the use of CHX, which was not seen in self-etching systems. None of the included studies had low risk of bias, but the analysis including only studies of medium risk of bias showed similar results to the analysis with studies of high risk of bias. Conclusion: The use of 2% CHX affected positively the initial bond strength, but no inhibitor was effective in maintaining the bond strength after the aging process.