Isleine Portal Caldas1, Gutemberg Gomes Alves2, Igor Bastos Barbosa3, Pantaleo Scelza3, Fernando de Noronha3, Miriam Zaccaro Scelza4. 1. Doctoral Program in Dentistry of University Federal Fluminense (UFF), Niteroi, RJ, Brazil. 2. Professor, Molecular and Cell Biology Department, Institute of Biology, University Federal Fluminense (UFF), Niteroi, RJ, Brazil. 3. Geriatric Dentistry Department, Faculty of Dentistry of University Federal Fluminense (UFF), Niteroi, RJ, Brazil. 4. Full Professor, Endodontics and Geriatric Dentistry Department, Laboratory Experimental of Culture Cell (LECCel), Faculty of Dentistry, University Federal Fluminense (UFF), Niteroi, RJ, Brazil. Electronic address: scelza@terra.com.br.
Abstract
OBJECTIVES: The increased demand for esthetics and minimally invasive tooth restorations resulted in a rapid development of adhesive dentistry. However, much controversy remains about the safe use and cytotoxic effects of different groups of dental adhesives. The present study performed a systematic review to identify the answer to the following question: are self-etch adhesives more cytotoxic than those employing the etch-and-rinse system? METHODS: This systematic review was performed in accordance with the PRISMA statement; a quality assessment for in vitro studies was conducted using the ToxRTool. Specific search strategies were developed and performed in the electronic databases MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, and LILACS/BBO. After removal of duplicated studies and application of the exclusion criteria, ten eligible articles were selected and submitted to a qualitative descriptive analysis comparing both groups of dental adhesives. Most in vitro test systems employed pulp cells or gingival fibroblasts. RESULTS: The methodologies presented great variability regarding the exposure to the test materials. Only four studies assessed the role of the degree of conversion of the materials in their toxicity, with conflicting results. SIGNIFICANCE: While the lack of methodological standardization among the studies still hinders the establishment of a relationship between type of dental adhesive and toxicity, studies employing dentin barrier systems indicate greater cytotoxicity for etch-and-rinse adhesives.
OBJECTIVES: The increased demand for esthetics and minimally invasive tooth restorations resulted in a rapid development of adhesive dentistry. However, much controversy remains about the safe use and cytotoxic effects of different groups of dental adhesives. The present study performed a systematic review to identify the answer to the following question: are self-etch adhesives more cytotoxic than those employing the etch-and-rinse system? METHODS: This systematic review was performed in accordance with the PRISMA statement; a quality assessment for in vitro studies was conducted using the ToxRTool. Specific search strategies were developed and performed in the electronic databases MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, and LILACS/BBO. After removal of duplicated studies and application of the exclusion criteria, ten eligible articles were selected and submitted to a qualitative descriptive analysis comparing both groups of dental adhesives. Most in vitro test systems employed pulp cells or gingival fibroblasts. RESULTS: The methodologies presented great variability regarding the exposure to the test materials. Only four studies assessed the role of the degree of conversion of the materials in their toxicity, with conflicting results. SIGNIFICANCE: While the lack of methodological standardization among the studies still hinders the establishment of a relationship between type of dental adhesive and toxicity, studies employing dentin barrier systems indicate greater cytotoxicity for etch-and-rinse adhesives.
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