Effects of Desensitizers on Adhesive-Dentin Bond Strength: A Systematic Review and Meta-analysis

Purpose: To systematically review in vitro studies that evaluated adhesive-dentin bond strength with or without the addition of desensitizers. Materials and Methods: A search was conducted in four databases (PubMed, Embase, Web of Science, and Cochrane Library) without publication date or language limits in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA). Two reviewers selected the studies, extracted data, and assessed the risk of bias independently. The inclusion criterion was the evaluation of the effect of immediate or aged bond strength after applying desensitizer in the bonding step. The risk of bias was assessed following the method used by Sarkis-Onofre et al.(41) Meta-analysis was conducted using Review Manager 5.3. Results: A total of 1636 articles were found using the search strategy above; 59 articles were selected for full-text analysis, and 32 were systematically reviewed, with 18 considered in the meta-analysis. Results showed a significant difference among various kinds of desensitizers. The subgroup comparison showed high heterogeneity among the different kinds of desensitizers. The use of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and arginine-CaCO3 showed no negative effect on the immediate bond strength, whereas other desensitizers showed some influence. Conclusion: Different desensitizers have various effects on microtensile bond strength. Desensitizers may be selected based on the bond strength and especially used to relieve tooth sensitivity after tooth preparation.