Abstract

This systematic review and meta-analysis aimed to evaluate the effect of Er:YAG laser etching on shear bond strength (SBS) of brackets bonded to the enamel and compare to the phosphoric acid (control). Electronic databases (PubMed, Scopus, and Web of Science) and a manual search were conducted up to January 2021. In vitro studies comparing Er:YAG laser and phosphoric acid etching for metal bracket bonding to human teeth, that performed aging of samples submitted to SBS tests were included. The risk of bias was assessed considering specific parameters. Statistical analysis was conducted using the RStudio statistical program for meta-analysis. Among 1456 potentially eligible studies, 19 were selected for full-text analysis, and 12 were included for qualitative and quantitative analysis. In the general meta-analysis, phosphoric acid etching showed higher SBS (n = 516; p = 0.02; I² = 95.4%). The 100 mJ (p = 0.05; I² = 76.2%) and <100 mJ subgroup (p < 0.01; I² = 89.5%) showed a significant difference, favoring phosphoric acid etching, however, there was no significant difference in the >100 mJ subgroup (p < 0.32; I² = 93.3%). In the 500-thermocycle subgroup, phosphoric acid etching had a significantly higher SBS (p < 0.01; I² = 96.2%), however, there was no significant difference in etching techniques for the 5000-cycle subgroup (p = 0.10; I² = 69.1%). Although Er:YAG laser provides lower SBS than phosphoric acid etching, it provides an adequate bracket bonding. Further investigations to establish a laser protocol and clinical evidence are important for the consolidation of Er:YAG laser as a viable alternative to phosphoric acid.

摘要

本系统评价和荟萃分析旨在评估 Er:YAG 激光蚀刻对与牙釉质粘合的托槽的剪切粘合强度 (SBS) 的影响，并与磷酸（对照）进行比较。电子数据库（PubMed、Scopus 和 Web of Science）和手动搜索进行到 2021年1 月。比较 Er:YAG 激光和磷酸蚀刻金属托槽与人类牙齿粘合的研究，包括对提交 SBS 测试的样品进行老化的研究。考虑特定参数评估偏倚风险。使用 RStudio 统计程序进行统计分析以进行荟萃分析。在 1456 项可能符合条件的研究中，选择 19 项进行全文分析，12 项纳入定性和定量分析。在一般荟萃分析中，磷酸蚀刻显示出更高的 SBS（n  = 516；p  = 0.02；I ²  = 95.4%）。100 mJ ( p  = 0.05; I ²  = 76.2%) 和 <100 mJ 亚组 ( p  < 0.01; I²  = 89.5%）显示出显着差异，有利于磷酸蚀刻，然而，在 >100 mJ 亚组中没有显着差异（p  < 0.32；I ²  = 93.3%）。在 500 次热循环亚组中，磷酸蚀刻的 SBS 显着较高（p  < 0.01；I ²  = 96.2%），但 5000 次循环亚组的蚀刻技术没有显着差异（p  = 0.10；I ² = 69.1%）。尽管 Er:YAG 激光提供的 SB​​S 低于磷酸蚀刻，但它提供了足够的托槽粘合。建立激光方案和临床证据的进一步研究对于巩固 Er:YAG 激光作为磷酸的可行替代品非常重要。