Objectives

The aim of this study was to systematically review the literature and statistically analyze bond strength data to identify the influence that composite cements, type of test methodology, chemical and mechanical pre-treatments have on the bond strength of composite cements to zirconia in three different artificial aging conditions.

Methods

The literature was electronically searched in MEDLINE, PUBMED, EMBASE, and SCOPUS to select relevant articles that evaluated the bond strength between zirconia and composite cements. A manual search was performed by scanning the reference lists of included studies. All articles were published online before December 2016 and in English. From electronic database and manual searches, 444 studies were identified; 161 articles with 1632 test results met the inclusion criteria. Test results were assigned into 3 aging conditions: non-aged, intermediate-aged and aged groups. Generalized estimating equations (GEE) were used to explore actual mean bond strengths. As the bond strength is a non-negative value, lognormal distribution was used.

Results

In non-aged condition, data showed statistically significant interactions between cement type and type of test. There was no statistically significant interaction between mechanical and chemical pre-treatments.

In intermediate-aged and aged conditions, data showed no statistically significant interactions between mechanical and chemical pre-treatments and between cement type and type of test.

Conclusions

This meta-analysis appeared to indicate that mechanical pre-treatments, and in particular ceramic coating, combined with methacryloyloxydecyl dihydrogen phosphate (MDP) containing primers yielded the highest long-term bond strength (aged-condition). However, data are limited and caution should be exercised before applying these results to clinical situations.

中文翻译：

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复合水泥与氧化锆的粘结：体外研究的系统综述和荟萃分析

目标

这项研究的目的是系统地回顾文献并对粘结强度数据进行统计分析，以确定在三种不同的人工环境中复合水泥，测试方法类型，化学和机械预处理对复合水泥与氧化锆的粘结强度的影响。老化条件。

方法

在MEDLINE，PUBMED，EMBASE和SCOPUS中对文献进行了电子搜索，以选择相关的文章来评估氧化锆与复合水泥之间的粘结强度。通过扫描纳入研究的参考清单进行手动搜索。所有文章均于2016年12月之前以英文发布。从电子数据库和人工搜索中，确定了444项研究；161篇文章的1632测试结果符合纳入标准。将测试结果分为3个老化条件：未老化，中年和老化组。使用广义估计方程（GEE）来探索实际的平均粘结强度。由于粘结强度为非负值，因此使用对数正态分布。

结果

在未老化的条件下，数据显示出水泥类型和测试类型之间的统计学显着相互作用。机械和化学预处理之间没有统计学上显着的相互作用。

在中老年条件下，数据显示机械和化学预处理之间以及水泥类型和测试类型之间没有统计学上的显着相互作用。

结论

这项荟萃分析似乎表明，机械预处理，尤其是陶瓷涂层，与包含底漆的甲基丙烯酰氧基癸基磷酸二氢酯（MDP）结合使用，可获得最高的长期粘合强度（老化条件）。但是，数据有限，在将这些结果应用于临床之前应谨慎行事。