Repair of aged restorations made in direct resin composite – A systematic review

Abstract Objective: to evaluate the different bonding strategies for repairing aged resin composite restorations. Materials and Methods: The review was reported according to PRISMA Statement and registered in the Open Science Framework (DOI:10.17605/OSF.IO/WZTGS). Two reviewers performed a literature search across Embase (758), Pubmed (1244), Scopus (4300), The Cochrane library (128), and Web of Science (2538) databases. The risk of bias was assessed according to random sequence generation, blinding of outcome assessment, incomplete outcome data, selective reporting, coefficient of variation, and other bias. Results: Forty-four in vitro studies with different repair strategies on aged resin composite substrates were included from 1990 up to July 2022 which evaluated superficial treatment using shear, flexural, tensile, and bond strength tests. The most frequent treatments were diamond bur and air abrasion. Meta-analysis showed an overall effect significant to diamond bur (shear test; p = 0.02), air abrasion (shear; p = 0.009; flexural, p = 0.003; tensile; p = 0.004 tests), and to phosphoric acid (tensile test, p < 0.00001). Conclusions: Within the limitations of this study, strategies for improving bond to aged composites may consider better bond using air abrasion or diamond burs, and surface etching with phosphoric followed by the application of an adhesive system. Clinical Significance: This review presents the best treatments for performing the repair on aged resin composite, as guidance for clinical studies to improve emphasis on these findings, with the aim of creating a protocol that will enable dentists to promote minimally invasive treatments. Clinical Significance: This review presents the best treatments for performing repair with resin composite, as guidance for clinical studies to improve emphasis on these findings, with the aim of creating a protocol that will enable dentists to promote minimally invasive treatments.