Which surface treatment promotes higher bond strength for the repair of resin nanoceramics and polymer-infiltrated ceramics? A systematic review and meta-analysis.

Statement Of Problem: Which surface treatment provides the optimal bond strength (BS) for the repair of resin nanoceramics (RNCs) and polymer-infiltrated ceramics (PICs) is unclear.

Purpose: The purpose of this systematic review and meta-analysis of in vitro studies was to determine the best surface treatment protocols for the repair of PICs and RNCs.

Material And Methods: The PubMed, Scopus, and Web of Science electronic databases were searched to select in vitro studies in English up to March 2020. Studies with fewer than 5 specimens, those that did not evaluate the BS of PICs or RNCs, and those with aging for fewer than 30 days and 5000 cycles were excluded. Data sets were extracted, and the mean differences were analyzed by using a systematic review software program.

Results: Among 284 potentially eligible studies, 21 were selected for full-text analysis, and 9 were included in the systematic review, of which 6 were used in the meta-analysis. The meta-analyses were performed for each treatment surface versus their respective control group and their combinations according to material: RNCs and PICs. For RNCs, airborne-particle abrasion with aluminum oxide (AlO) treatment was statistically higher than tribochemical silica airborne-particle abrasion (CoJet) (P=.02, I=90%) and that in the hydrofluoric acid (HF) (P<.001, I=0%) groups and was statistically similar to diamond rotary instrument grinding (P=.40, I=54%). For PICs, the treatment with hydrofluoric acid (HF) was statistically significantly higher than with CoJet (P=.03, I=62%) and airborne-particle abrasion with AlO (P<.001, I=98%).

Conclusions: The best surface treatment protocol for repair varied according to the restorative material. HF followed by silanization is suggested for PICs, and airborne-particle abrasion with AlO or preparation with a diamond rotary instrument for RNCs.