Does Antimicrobial Photodynamic Therapy Influence the Bond Strength of Direct Restorative Materials to Healthy and Decayed Dentin? A Systematic Review

Objective: To evaluate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of adhesive restorative materials to healthy and caries-affected dentin. Material and Methods: 04 electronic databases and 02 additional searches were assessed. In vitro studies considering sound or caries-affected human or bovine dentin (population), use of aPDT before restorative treatment (intervention), use of other dentin disinfection techniques (comparison), and bond strength to dentin (outcome) were included. The risk of bias for in vitro studies was used as a method to check the evidence. The method used to present and synthesize results was data extraction. Results: The total number of included studies was 11, including 550 permanent teeth. Bond strength was evaluated mainly through the shear bond strength (SBS) test, with dentin affected by caries being the substrate most frequently used in studies. Six studies demonstrated that aPDT with methylene blue (MB) negatively affected the SBS values of resin-modified glass ionomer cement (RMGIC) to dentin. Regarding risk of bias assessment, all studies were at high risk of bias. Conclusion: The effects of aPDT on adhesion to dentin vary depending on the type of substrate and the photosensitizer used. Mainly, MB negatively affected the SBS values from RMGIC to dentin. The conclusion should be interpreted considering the high risk of bias in the studies.