Influência do protocolo resin coating na interface adesiva e resistência à fratura de restaurações indiretas: uma revisão sistemática e meta análise

Abstract

Indirect restorations have emerged as an effective alternative for restorative treatment of large cavities, but they also pose challenges related to cementation protocols that influence the longevity of these restorations. In this context, the resin coating technique has developed as an ally to the restorative process, bringing the possibility of greater resistance and positive impacts on the longevity of indirect restorations. Thus, this study aims to perform an evaluation through a systematic review with meta-analysis of in vitro studies that compared fracture resistance and adhesion between adhesive protocols that involved the resin coating technique prior to cementation of indirect restorations and those that did not use the technique. A total of 12 studies were included for analysis of the results, after searching the PubMed/MEDLINE, Web of Science, Scopus, Embase and ProQuest databases with the aid of an electronic website ‘Rayyan QCRI’, so that all of them effectively evaluated the bond strength. However, none of them presented quantitative data on fracture resistance, which limited this review to some extent. To analyze adhesion strength, the adhesive systems used in the resin coating protocol were considered, so that 4 of the 12 studies used universal adhesives in addition to self-etching adhesive systems. The meta-analysis was performed by a reviewer and assessed using the RevMan v5.4 software program. The risk of bias was assessed using the RoBDEMAT tool. Thus, when using selfetching adhesive systems, resin coating demonstrated greater adhesion strength, despite variability between results (P < 0.00001; Standardized Mean Difference [SMD]: 1.44). However, the difference was not very significant when universal adhesive systems were used (P = 0.02; SMD: 0.83). Within the limitations of this systematic review, it can be concluded that the resin coating technique is improved when the selfetching adhesive system is associated, but even so, the technique presents interesting efficacy when the universal adhesive is used. Therefore, regardless of the adhesive, when applied, the resin coating technique has the potential to increase adhesion resistance in indirect restorations.