Clinical reliability of self-adhesive luting resins compared to other adhesive procedures: A systematic review and meta-analysis

Objectives: This systematic review aimed to collect and interpret the randomized clinical trials (RCTs) that investigated the outcome of the self-adhesive luting resins (SA) compared to total-etch (TE), selective etch with dentin adhesives (Sle), selective etch without dentin adhesives (SleSA) or self-etch adhesives (SE).Data sources: A thorough search of Internet databases was conducted without language restrictions, and the search ran up to and including April 2022. The illegible records citations were checked for more relevant clinical studies.Study selection/Results: The inclusion criteria were randomized controlled trials (RCTs) that compared self-adhesive luting resins with total-etch, selective-etch, or self-etch adhesives regarding postoperative sensitivity, incidences of debonding, and survival rates of indirect restorations. From 1732 records, 9 RCTs met the eligibility criteria. Three RCTs compared total-etch adhesive to self-adhesive luting resin for intracoronal restorations, one RCT compared selective etch to self-adhesive luting resin for inlays, and 5 RCTs compared self-adhesive to other protocols for partial ceramic crowns.Postoperative sensitivity showed a non-statistically significant difference between SA and other adhesive pro-tocols, SA revealed a non-statistically significant difference in debonding and survival to TE, but a lower sta-tistically significant difference to Sle, SleSA, and SE.Conclusions: Postoperative sensitivity might not be affected by the adhesive protocol. In relatively short obser-vation, TE revealed comparable survival to SA for intracoronal restorations. SE and Sle exhibited the best clinical outcomes, followed by SleSA. Selective etch, and self-etch adhesives are preferable to self-adhesive resins. Clinical significance: The significance of enamel etching and the superiority of self-etching adhesives over self-adhesive luting resins for reliable and durable bonding and improved clinical outcomes. However, long-term RCTs, particularly for total-etch comparison to self-adhesive luting resins, might be recommended to derive further evidence.

Automated summary

This systematic review aimed to collect and interpret the randomized clinical trials comparing self-adhesive luting resins with other adhesive protocols. The results showed that postoperative sensitivity might not be affected by the adhesive protocol. Overall, selective etch and self-etch adhesives demonstrated better clinical outcomes compared to self-adhesive resins. Rating: 8 out of 10.