Non-Cochrane · intervention · PM40331951
Biomimetic Remineralization Strategies for Dentin Bond Stability-Systematic Review and Network Meta-Analysis.
Costa Rosário, Reis-Pardal Joana, Arantes-Oliveira Sofia, et al. · International journal of molecular sciences · 2025 · PubMed · doi:10.3390/ijms26083488
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
62
current version
GRADE rated
61
No studies
0
Included studies
23
linked below
No studies 0 · 0%Ungraded 1 · 1.6%Very low 3 · 4.8%Low 17 · 27.4%Moderate 41 · 66.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Artificial caries-affected dentin (ACAD) in permanent human teeth (in vitro); human dentin artificially demineralized by chemical or biological protocols to mimic caries-affected dentin | ACAD in permanent human teeth across 23 in vitro studies (16 experimental, 7 quasi-experimental); 22 studies entered the NMAs |
| Intervention | Any biomimetic remineralization (BR) procedure applied immediately before bonding (mineral-promoting agents in adhesives/restoratives or pre-treatment solutions); active-substance groups: fluorine, calcium phosphate, peptide, silica, hydroxyapatite, flavonoids, calcium, HEMA/EGDMA | BR agents actually networked (by network): fluorine, calcium phosphate, peptide, hydroxyapatite, calcium, flavonoids, HEMA, silica |
| Comparison | Dentin without BR (control) | Control (no BR) present as a node in every network |
| Outcomes | Resin-dentin bond strength by shear/micro-shear/micro-tensile tests (SBS/microSBS/microTBS); mean difference in bond strength; measured immediately (24 h) and after artificial aging | 24 h bond strength meta-analyzed via NMA (all 22 NMA studies had 24 h measurements); aged bond strength (thermocycling; 3/6/12/18-month storage) summarized in Table 1 only |
| Study designs | Experimental or quasi-experimental in vitro studies (control group required; agents applied immediately prior to bonding) | 23 in vitro studies included; 22 in NMA (Atomura et al. 2018 excluded from NMA for missing SD/N) |
| Timing | Immediate (24 h) and after artificial aging (thermocycling; storage in fluid for months) | 24 h (all NMAs); artificial aging: thermocycling (4 studies) and fluid storage for months (7 studies), Table 1 (not meta-analyzed) |
Search date: June 2023. Databases: PubMed; ISI Web of Science; SCOPUS; plus reference lists of included studies and relevant systematic reviews
Questions and results
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Calcium-based agent
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, Calcium Phosphate vs Calcium showed no significant difference in 24 h bond strength (MD 0.596, 95% CI -7.289 to 8.482; Low certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD 0.596 [-7.289, 8.482] | 7 studies | Low Downgraded: risk of bias, inconsistency |
Calcium vs Control
Population: permanent human teeth with artificial caries-affected dentin
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h · Etch-and-Rinse; chemical ACAD Calcium minus Control was -0.508 MPa (95% CI -8.207 to 7.191) at 24 h. Source: Table 3; Table A10 · same question in other reviews | MD -0.508 [-8.207, 7.191] | 3 studies | Very low |
Calcium phosphate vs Control
Population: permanent human teeth with artificial caries-affected dentin
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h · Etch-and-Rinse; chemical ACAD Calcium phosphate minus Control was -1.105 MPa (95% CI -4.828 to 2.619) at 24 h. Source: Table 3; Table A10 · same question in other reviews | MD -1.105 [-4.828, 2.619] | 1 study | Low |
Calcium vs Fluorine
Population: permanent human teeth with artificial caries-affected dentin
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h · Etch-and-Rinse; chemical ACAD Calcium minus Fluorine was -0.628 MPa (95% CI -8.504 to 7.248) at 24 h. Source: Table 3; Table A10 · same question in other reviews | MD -0.628 [-8.504, 7.248] | 4 studies | Moderate |
Calcium phosphate vs Fluorine
Population: permanent human teeth with artificial caries-affected dentin
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h · Etch-and-Rinse; chemical ACAD Calcium phosphate minus Fluorine was -1.224 MPa (95% CI -5.931 to 3.482) at 24 h. Source: Table 3; Table A10 · same question in other reviews | MD -1.224 [-5.931, 3.482] | 1 study | Low |
Fluoride agent (e.g., NaF/SDF/KF/CaF2) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, Fluorine vs Control showed no significant difference in 24 h bond strength (MD -0.120, 95% CI -3.783 to 3.544; Very Low certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD -0.120 [-3.783, 3.544] | 8 studies | Very low Downgraded: risk of bias, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs Calcium-based agent
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, HAp vs Calcium showed no significant difference in 24 h bond strength (MD 4.333, 95% CI -5.240 to 13.906; Low certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD 4.333 [-5.240, 13.906] | 0 studies | Low Downgraded: risk of bias, imprecision, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, HAp vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD 3.736, 95% CI -3.063 to 0.536; Low certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD 3.736 [-3.063, 0.536] | 0 studies | Low Downgraded: risk of bias, imprecision, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, HAp vs Control showed no significant difference in 24 h bond strength (MD 4.841, 95% CI -0.848 to 10.530; Low certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD 4.841 [-0.848, 10.530] | 3 studies | Low Downgraded: risk of bias, imprecision, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, HAp vs Fluorine showed no significant difference in 24 h bond strength (MD 4.960, 95% CI -1.806 to 11.727; Low certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD 4.960 [-1.806, 11.727] | 0 studies | Low Downgraded: risk of bias, imprecision, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Calcium-based agent
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, Peptide vs Calcium showed no significant difference in 24 h bond strength (MD 4.044, 95% CI -4.923 to 3.011; Low certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD 4.044 [-4.923, 3.011] | 0 studies | Low Downgraded: risk of bias, imprecision, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, Peptide vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD 3.448, 95% CI -1.833 to 8.729; Low certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD 3.448 [-1.833, 8.729] | 1 study | Low Downgraded: risk of bias, imprecision |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, Peptide vs Control showed no significant difference in 24 h bond strength (MD 4.553, 95% CI -0.635 to 9.740; Moderate certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD 4.553 [-0.635, 9.740] | 4 studies | Moderate Downgraded: risk of bias, imprecision |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, Peptide vs Fluorine showed no significant difference in 24 h bond strength (MD 4.672, 95% CI -1.320 to 10.665; Moderate certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD 4.672 [-1.320, 10.665] | 2 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Hydroxyapatite (e.g., nano-HAp)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + chemical ACAD In the Etch-and-Rinse adhesive + chemical ACAD protocol network, Peptide vs HAp showed no significant difference in 24 h bond strength (MD -0.288, 95% CI -7.988 to 7.411; Very Low certainty). Source: Table 3 (NMA league table, ER + chemical); Table A10 (CINeMA confidence per comparison) · same question in other reviews | MD -0.288 [-7.988, 7.411] | 0 studies | Very low Downgraded: risk of bias, imprecision, inconsistency |
Calcium phosphate vs Control
Population: permanent human teeth with artificial caries-affected dentin
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h · Etch-and-Rinse; biological ACAD Calcium phosphate minus Control was -21.209 MPa (95% CI -25.954 to -16.463) at 24 h. Source: Table 3; Table A11 · same question in other reviews | MD -21.209 [-25.954, -16.463] | 2 studies | Moderate |
Flavonoids (e.g., quercetin, proanthocyanidin) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + biological ACAD In the Etch-and-Rinse adhesive + biological ACAD protocol network, Flavonoids showed 12.771 MPa lower 24 h bond strength than Calcium Phosphate (MD -12.771, 95% CI -20.538 to -5.003; Moderate certainty). Source: Table 3 (NMA league table, ER + biological); Table A11 (CINeMA confidence per comparison) · same question in other reviews | MD -12.771 [-20.538, -5.003] | 0 studies | Moderate Downgraded: risk of bias |
Flavonoids (e.g., quercetin, proanthocyanidin) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + biological ACAD In the Etch-and-Rinse adhesive + biological ACAD protocol network, Flavonoids showed 8.438 MPa higher 24 h bond strength than Control (MD 8.438, 95% CI 2.289 to 14.587; Moderate certainty). Source: Table 3 (NMA league table, ER + biological); Table A11 (CINeMA confidence per comparison) · same question in other reviews | MD 8.438 [2.289, 14.587] | 1 study | Moderate Downgraded: risk of bias, inconsistency, publication bias |
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + biological ACAD In the Etch-and-Rinse adhesive + biological ACAD protocol network, Calcium Phosphate showed 17.012 MPa higher 24 h bond strength than Fluorine (MD 17.012, 95% CI 11.920 to 22.103; Moderate certainty). Source: Table 3 (NMA league table, ER + biological); Table A11 (CINeMA confidence per comparison) · same question in other reviews | MD 17.012 [11.920, 22.103] | 2 studies | Moderate Downgraded: risk of bias, publication bias |
Fluoride agent (e.g., NaF/SDF/KF/CaF2) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + biological ACAD In the Etch-and-Rinse adhesive + biological ACAD protocol network, Fluorine showed 4.197 MPa higher 24 h bond strength than Control (MD 4.197, 95% CI 1.080 to 7.314; Moderate certainty). Source: Table 3 (NMA league table, ER + biological); Table A11 (CINeMA confidence per comparison) · same question in other reviews | MD 4.197 [1.080, 7.314] | 4 studies | Moderate Downgraded: risk of bias, inconsistency |
Flavonoids (e.g., quercetin, proanthocyanidin) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + biological ACAD In the Etch-and-Rinse adhesive + biological ACAD protocol network, Flavonoids vs Fluorine showed no significant difference in 24 h bond strength (MD 4.241, 95% CI -2.652 to 11.135; Moderate certainty). Source: Table 3 (NMA league table, ER + biological); Table A11 (CINeMA confidence per comparison) · same question in other reviews | MD 4.241 [-2.652, 11.135] | 0 studies | Moderate Downgraded: risk of bias, imprecision |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + biological ACAD In the Etch-and-Rinse adhesive + biological ACAD protocol network, Peptide vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD -2.914, 95% CI -8.210 to 2.382; Moderate certainty). Source: Table 3 (NMA league table, ER + biological); Table A11 (CINeMA confidence per comparison) · same question in other reviews | MD -2.914 [-8.210, 2.382] | 2 studies | Moderate Downgraded: risk of bias, imprecision |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + biological ACAD In the Etch-and-Rinse adhesive + biological ACAD protocol network, Peptide showed 18.295 MPa higher 24 h bond strength than Control (MD 18.295, 95% CI 14.418 to 22.172; Moderate certainty). Source: Table 3 (NMA league table, ER + biological); Table A11 (CINeMA confidence per comparison) · same question in other reviews | MD 18.295 [14.418, 22.172] | 3 studies | Moderate Downgraded: risk of bias |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Flavonoids (e.g., quercetin, proanthocyanidin)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + biological ACAD In the Etch-and-Rinse adhesive + biological ACAD protocol network, Peptide showed 9.857 MPa higher 24 h bond strength than Flavonoids (MD 9.857, 95% CI 2.588 to 17.126; Moderate certainty). Source: Table 3 (NMA league table, ER + biological); Table A11 (CINeMA confidence per comparison) · same question in other reviews | MD 9.857 [2.588, 17.126] | 0 studies | Moderate Downgraded: risk of bias, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Etch-and-Rinse + biological ACAD In the Etch-and-Rinse adhesive + biological ACAD protocol network, Peptide showed 14.098 MPa higher 24 h bond strength than Fluorine (MD 14.098, 95% CI 9.684 to 18.512; Moderate certainty). Source: Table 3 (NMA league table, ER + biological); Table A11 (CINeMA confidence per comparison) · same question in other reviews | MD 14.098 [9.684, 18.512] | 2 studies | Moderate Downgraded: risk of bias, publication bias |
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Calcium-based agent
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Calcium Phosphate vs Calcium showed no significant difference in 24 h bond strength (MD 2.663, 95% CI -2.395 to 7.722; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 2.663 [-2.395, 7.722] | 4 studies | Moderate Downgraded: risk of bias, inconsistency |
Calcium-based agent vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Calcium vs Control showed no significant difference in 24 h bond strength (MD -1.124, 95% CI -5.917 to 3.670; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -1.124 [-5.917, 3.670] | 2 studies | Moderate Downgraded: risk of bias, inconsistency |
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Calcium Phosphate vs Control showed no significant difference in 24 h bond strength (MD 1.539, 95% CI -1.738 to 4.817; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 1.539 [-1.738, 4.817] | 1 study | Moderate Downgraded: risk of bias, imprecision |
Flavonoids (e.g., quercetin, proanthocyanidin) vs Calcium-based agent
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Flavonoids vs Calcium showed no significant difference in 24 h bond strength (MD 5.728, 95% CI -2.442 to 13.897; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 5.728 [-2.442, 13.897] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Flavonoids (e.g., quercetin, proanthocyanidin) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Flavonoids vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD 3.065, 95% CI -4.318 to 10.447; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 3.065 [-4.318, 10.447] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Flavonoids (e.g., quercetin, proanthocyanidin) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Flavonoids vs Control showed no significant difference in 24 h bond strength (MD 4.604, 95% CI -2.011 to 11.219; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 4.604 [-2.011, 11.219] | 1 study | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Calcium-based agent vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Calcium vs Fluorine showed no significant difference in 24 h bond strength (MD -0.523, 95% CI -5.404 to 4.358; Low certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -0.523 [-5.404, 4.358] | 3 studies | Low Downgraded: risk of bias, inconsistency |
Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Calcium Phosphate vs Fluorine showed no significant difference in 24 h bond strength (MD 2.140, 95% CI -1.506 to 5.787; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 2.140 [-1.506, 5.787] | 1 study | Moderate Downgraded: risk of bias, inconsistency |
Fluoride agent (e.g., NaF/SDF/KF/CaF2) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Fluorine vs Control showed no significant difference in 24 h bond strength (MD -0.601, 95% CI -2.932 to 1.730; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -0.601 [-2.932, 1.730] | 8 studies | Moderate Downgraded: risk of bias, inconsistency |
Flavonoids (e.g., quercetin, proanthocyanidin) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Flavonoids vs Fluorine showed no significant difference in 24 h bond strength (MD 5.205, 95% CI -1.809 to 12.219; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 5.205 [-1.809, 12.219] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
HEMA/EGDMA-based desensitizer vs Calcium-based agent
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HEMA vs Calcium showed no significant difference in 24 h bond strength (MD 3.023, 95% CI -3.815 to 9.861; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 3.023 [-3.815, 9.861] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
HEMA/EGDMA-based desensitizer vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HEMA vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD 0.360, 95% CI -5.589 to 6.309; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 0.360 [-5.589, 6.309] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
HEMA/EGDMA-based desensitizer vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HEMA vs Control showed no significant difference in 24 h bond strength (MD 1.899, 95% CI -3.210 to 7.009; Low certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 1.899 [-3.210, 7.009] | 1 study | Low Downgraded: risk of bias, imprecision |
Flavonoids (e.g., quercetin, proanthocyanidin) vs HEMA/EGDMA-based desensitizer
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Flavonoids vs HEMA showed no significant difference in 24 h bond strength (MD 2.705, 95% CI -5.654 to 11.063; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 2.705 [-5.654, 11.063] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
HEMA/EGDMA-based desensitizer vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HEMA vs Fluorine showed no significant difference in 24 h bond strength (MD 2.500, 95% CI -2.603 to 7.603; Low certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 2.500 [-2.603, 7.603] | 1 study | Low Downgraded: risk of bias, imprecision |
Hydroxyapatite (e.g., nano-HAp) vs Calcium-based agent
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HAp vs Calcium showed no significant difference in 24 h bond strength (MD -1.792, 95% CI -7.415 to 3.831; Low certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -1.792 [-7.415, 3.831] | 0 studies | Low Downgraded: risk of bias, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HAp showed 4.455 MPa lower 24 h bond strength than Calcium Phosphate (MD -4.455, 95% CI -8.857 to -0.053; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -4.455 [-8.857, -0.053] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HAp vs Control showed no significant difference in 24 h bond strength (MD -2.916, 95% CI -5.854 to 0.023; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -2.916 [-5.854, 0.023] | 5 studies | Moderate Downgraded: risk of bias, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs Flavonoids (e.g., quercetin, proanthocyanidin)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HAp showed 7.520 MPa lower 24 h bond strength than Flavonoids (MD -7.520, 95% CI -14.758 to -0.281; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -7.520 [-14.758, -0.281] | 0 studies | Moderate Downgraded: risk of bias, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HAp vs Fluorine showed no significant difference in 24 h bond strength (MD -2.315, 95% CI -6.066 to 1.436; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -2.315 [-6.066, 1.436] | 0 studies | Moderate Downgraded: risk of bias, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs HEMA/EGDMA-based desensitizer
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HAp vs HEMA showed no significant difference in 24 h bond strength (MD -4.815, 95% CI -10.709 to 1.079; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -4.815 [-10.709, 1.079] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Calcium-based agent
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs Calcium showed no significant difference in 24 h bond strength (MD 2.654, 95% CI -3.216 to 8.524; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 2.654 [-3.216, 8.524] | 0 studies | Moderate Downgraded: risk of bias, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD -0.009, 95% CI -4.076 to 4.058; Low certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -0.009 [-4.076, 4.058] | 1 study | Low Downgraded: risk of bias, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs Control showed no significant difference in 24 h bond strength (MD 1.530, 95% CI -2.373 to 5.434; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 1.530 [-2.373, 5.434] | 3 studies | Moderate Downgraded: risk of bias, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Flavonoids (e.g., quercetin, proanthocyanidin)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs Flavonoids showed no significant difference in 24 h bond strength (MD -3.074, 95% CI -10.755 to 4.607; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -3.074 [-10.755, 4.607] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs Fluorine showed no significant difference in 24 h bond strength (MD 2.131, 95% CI -2.213 to 6.475; Low certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 2.131 [-2.213, 6.475] | 1 study | Low Downgraded: risk of bias, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs HEMA/EGDMA-based desensitizer
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs HEMA showed no significant difference in 24 h bond strength (MD -0.369, 95% CI -6.728 to 5.990; Low certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -0.369 [-6.728, 5.990] | 0 studies | Low Downgraded: risk of bias, inconsistency |
Self-assembling/remineralizing peptide (e.g., P11-4, PAA-PASP) vs Hydroxyapatite (e.g., nano-HAp)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Peptide vs HAp showed no significant difference in 24 h bond strength (MD 4.446, 95% CI -0.440 to 9.332; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 4.446 [-0.440, 9.332] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Mesoporous silica (SiO2) vs Calcium-based agent
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Silica vs Calcium showed no significant difference in 24 h bond strength (MD 1.964, 95% CI -5.802 to 9.730; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 1.964 [-5.802, 9.730] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Mesoporous silica (SiO2) vs Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Silica vs Calcium Phosphate showed no significant difference in 24 h bond strength (MD -0.699, 95% CI -7.633 to 6.234; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -0.699 [-7.633, 6.234] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Mesoporous silica (SiO2) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Silica vs Control showed no significant difference in 24 h bond strength (MD 0.840, 95% CI -5.270 to 6.950; Low certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 0.840 [-5.270, 6.950] | 1 study | Low Downgraded: risk of bias, inconsistency |
Flavonoids (e.g., quercetin, proanthocyanidin) vs Mesoporous silica (SiO2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Flavonoids vs Silica showed no significant difference in 24 h bond strength (MD 3.764, 95% CI -5.241 to 12.769; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 3.764 [-5.241, 12.769] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Mesoporous silica (SiO2) vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Silica vs Fluorine showed no significant difference in 24 h bond strength (MD 1.441, 95% CI -5.099 to 7.980; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD 1.441 [-5.099, 7.980] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Mesoporous silica (SiO2) vs HEMA/EGDMA-based desensitizer
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, Silica vs HEMA showed no significant difference in 24 h bond strength (MD -1.059, 95% CI -9.024 to 6.906; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -1.059 [-9.024, 6.906] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Hydroxyapatite (e.g., nano-HAp) vs Mesoporous silica (SiO2)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + chemical ACAD In the Self-Etch adhesive + chemical ACAD protocol network, HAp vs Silica showed no significant difference in 24 h bond strength (MD -3.756, 95% CI -10.536 to 3.024; Moderate certainty). Source: Table 3 (NMA league table, SE + chemical); Table A12 (CINeMA confidence per comparison) · same question in other reviews | MD -3.756 [-10.536, 3.024] | 0 studies | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Peptide vs Silica
Population: permanent human teeth with artificial caries-affected dentin
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h · Self-Etch; chemical ACAD Peptide minus Silica was -0.690 MPa (95% CI -7.941 to 6.560) at 24 h. Source: Table 3; Table A12 · same question in other reviews | MD -0.690 [-7.941, 6.560] | 0 studies | Moderate |
Fluoride agent (silver diamine fluoride, SDF) vs No biomimetic remineralization (control)
Population: Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Immediate (24 h) resin-dentin bond strength (MPa) 24 h (immediate) · Self-Etch + biological ACAD Only one in vitro study assessed a Self-Etch adhesive with the biological ACAD protocol; it was insufficient for network meta-analysis, so no pooled effect estimate is available (ungraded). Source: Results 3.2 and 3.4 (Self-Etch with biological ACAD: 1 study, insufficient for NMA) · same question in other reviews | Only 1 in vitro study (de Siqueira et al., 2020) assessed Self-Etch adhesive with biological ACAD; insufficient to perform a network meta-analysis, so no pooled estimate is reported. | 1 study | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: N/A | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: N/A | no |
| 12Impact of risk of bias on the pooled results | Yes | No | no |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | Partial Yes | no |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Moderate | no |
Included primary studies 23
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| de Siqueira et al., 2020 Effect of Silver Diamine Fluoride on the Bonding Properties to Caries-affected Dentin. PMID:32322837 | 1 other review | not stated | not extracted yet | not extracted yet |
| Van Duker et al., 2019 Effect of silver diamine fluoride and potassium iodide on bonding to demineralized dentin. PMID:31295396 | 1 other review | not stated | not extracted yet | not extracted yet |
| Altinci et al., 2018 Microtensile bond strength to phosphoric acid-etched dentin treated with NaF, KF and CaF 2 DOI:10.1016/j.ijadhadh.2018.06.016 | this review only | not stated | not extracted yet | not extracted yet |
| Atomura et al., 2018 Influence of FCP-COMPLEX on bond strength and the adhesive-artificial caries-affected dentin interface. PMID:29925732 | this review only | not stated | not extracted yet | not extracted yet |
| Barbosa-Martins et al. (A), 2018 Enhancing bond strength on demineralized dentin by pre-treatment with selective remineralising agents. PMID:29550716 | this review only | not stated | not extracted yet | not extracted yet |
| Barbosa-Martins et al. (B), 2018 Biomimetic Mineralizing Agents Recover the Micro Tensile Bond Strength of Demineralized Dentin. PMID:30223511 | this review only | not stated | not extracted yet | not extracted yet |
| Bauer et al., 2018 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Cardenas et al., 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Chen et al., 2020 Biomimetic remineralization of artificial caries dentin lesion using Ca/P-PILP. PMID:32977980 | this review only | not stated | not extracted yet | not extracted yet |
| Cifuentes-Jimenez et al., 2021 Physicochemical and Mechanical Effects of Commercial Silver Diamine Fluoride (SDF) Agents on Demineralized Dentin. PMID:34817971 | this review only | not stated | not extracted yet | not extracted yet |
| Davila-Sanchez et al., 2020 Influence of flavonoids on long-term bonding stability on caries-affected dentin. PMID:32620332 | this review only | not stated | not extracted yet | not extracted yet |
| de Sousa et al., 2019 The Self-Assembling Peptide P11-4 Prevents Collagen Proteolysis in Dentin. PMID:30612505 | this review only | not stated | not extracted yet | not extracted yet |
| Gungormus & Tulumbaci, 2021 Peptide-assisted pre-bonding remineralization of dentin to improve bonding. PMID:33035925 | this review only | not stated | not extracted yet | not extracted yet |
| Krithi et al., 2020 Microshear bond strength of composite resin to demineralized dentin after remineralization with sodium fluoride, CPP-ACP and NovaMin… PMID:32300520 | this review only | not stated | not extracted yet | not extracted yet |
| Meng et al., 2021 Bonding Performance of Universal Adhesives Applied to Nano-Hydroxyapatite Desensitized Dentin Using Etch-and-Rinse or Self-Etch Mode. PMID:34443268 | this review only | not stated | not extracted yet | not extracted yet |
| Moreira et al., 2021 Impact of biomineralization on resin/biomineralized dentin bond longevity in a minimally invasive approach: An "in vitro" 18-month… PMID:33608139 | this review only | not stated | not extracted yet | not extracted yet |
| Paik et al., 2022 Dentin Biomodification with Flavonoids and Calcium Phosphate Ion Clusters to Improve Dentin Bonding Stability. PMID:35208035 | this review only | not stated | not extracted yet | not extracted yet |
| Pei et al., 2019 Influence of nano-hydroxyapatite containing desensitizing toothpastes on the sealing ability of dentinal tubules and bonding performance… PMID:30529985 | this review only | not stated | not extracted yet | not extracted yet |
| Priya et al., 2020 Evaluation of the bond strength of posterior composites to the dentin, treated with four different desensitizing agents – An In vitro study DOI:10.4103/jicdro.jicdro_55_19 | this review only | not stated | not extracted yet | not extracted yet |
| Pulidindi et al., 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Yang et al., 2018 Effects of calcium-containing desensitizers on the bonding stability of an etch-and-rinse adhesive against long-term water storage and pH… PMID:29176299 | this review only | not stated | not extracted yet | not extracted yet |
| Zhang et al., 2018 Application of electrophoretic deposition to occlude dentinal tubules in vitro. PMID:29391182 | this review only | not stated | not extracted yet | not extracted yet |
| Zumstein et al., 2018 The Effect of SnCl2/AmF Pretreatment on Short- and Long-Term Bond Strength to Eroded Dentin. PMID:29850511 | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Bonding of Glass-Ionomer Cement and Adhesives to Silver Diamine Fluoride-treated Dentin: An Updated Systematic Review and Meta-Analysis. (2022) | 2 | 0.04 |