Effect of Non-Thermal Atmospheric Plasma on Micro-Tensile Bond Strength at Adhesive/Dentin Interface: A Systematic Review.

Mohamed M Awad,Hamdi Hosni Hamama,Mutlu Özcan,Ali Alrahlah,Abdullah Alshehri,Feras Alhalabi,Zaid Aljeaidi

doi:10.3390/ma14041026

Abstract

Objective: The objective of this review was to evaluate the effect of non-thermal atmospheric plasma (NTAP) on adhesives resin–dentin micro-tensile bond strength (μTBS) in previously published studies. Methods: Electronic search was conducted using the Medline, Cochrane library, and Scopus databases. The included studies were laboratory studies that investigated the effect of NTAP on adhesives μTBS to coronal dentin. Studies that evaluated the effect of NTAP on bond strength to indirect substrates, enamel or root dentin, were excluded. The methodological quality of included studies was assessed. Results: Thirteen studies were included in this systematic review. All the included studies were considered to have a medium risk of bias. NTAP significantly improved μTBS at 24 h or after short-term aging in five studies (38.5%) and both immediate and after long-term aging in 5 studies (38.5%). In two studies (15.4%), NTAP resulted in a short-term material-dependent effect that was not stable after long-term aging. Interestingly, in one study (7.7%), NTAP had a positive effect only in the etch-and-rinse (ER) mode after long-term aging. Conclusion: Within the limitations of this systematic review, NTAP application could enhance resin–dentin μTBS of ER adhesives or universal adhesives (UAs) applied in the ER mode. In the ER mode, the rewetting step after NTAP seems to be unnecessary. Because of the limited information currently available in the literature, further studies are required to evaluate the effect of the NTAP application on self-etch (SE) adhesives or UAs applied in the SE mode.

Highlights

Was more prominent with ER adhesives or universal adhesives (UAs) applied in the ER mode
In the case of SE adhesives or UAs applied in the SE strategy, short- or medium-term μTBS results showed the positive effect of non-thermal atmospheric plasma (NTAP) [40,41], while long-term results indicated no effect [34]
Within the limitations of this systematic review, NTAP application could enhance resin–dentin μTBS of ER adhesives or UAs applied in the ER mode

Summary

Introduction

In the ER strategy, dentin is demineralized using phosphoric acid followed by the washing and drying steps before adhesive application and infiltration into dentin. In the SE approach, an acidic primer or adhesive is used to simultaneously demineralize and infiltrate dentin, so the washing and drying steps are not required [2]. Irrespective of the adhesive strategy applied, the achievement of a durable resin–dentin bonding is a challenging task [4,5], and it relies mainly on the hybrid layer which is created as a result of infiltration of adhesive monomers into the demineralized dentin [6]. The SE strategy is associated poor resin infiltration can be noticed within the adhesive interface, which adversely affects the resin–dentin bond durability [7]. Adhesives may not completely encapsulate the exposed collagen fibrils of acid-etched dentin [9,10]

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Discussion

Conclusion