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Meta-Analysis
. 2021 Apr-Jun;21(2):125-137.
doi: 10.4103/jips.jips_590_20.

Effect of laser irradiation on bond strength between zirconia and resin cement or veneer ceramic: A systematic review and meta-analysis

Sandro Basso Bitencourt  1 , Letícia Chaves Ferreira  2 , Leticia Cerri Mazza  1 , Daniela Micheline Dos Santos  1 , Aldieris Alves Pesqueira  1 , Leticia Helena Theodoro  2
Affiliations
Meta-Analysis

Effect of laser irradiation on bond strength between zirconia and resin cement or veneer ceramic: A systematic review and meta-analysis

Sandro Basso Bitencourt et al. J Indian Prosthodont Soc. 2021 Apr-Jun.

Abstract

Aim: This systematic review with meta-analysis aimed to evaluate the effect of the laser treatment on bond strength between Y-TZP and the resin cement or with the veneering ceramic, and the effect on the alteration of the Y-TZP surface roughness.

Settings and design: Systematic review and meta analysis following PROSPERO guidelines.

Materials and methods: A comprehensive review was performed up to September 2020 on four databases (PubMed/MEDLINE, Embase, Scopus, and Cochrane Library), using the combination of keywords: "laser AND zirconia AND surface treatment AND bond strength".

Statistical analysis used: The meta-analysis was based on the Mantel-Haenszel and inverse variance methods. The continuous outcome was evaluated by mean difference and the corresponding 95% confidence intervals.

Results: A total of 37 studies were identified for the inclusion of data, with only in vitro studies. The types of laser reported in the studies were: Er:YAG, Nd:YAG, Er,Cr:YSGG, CO2, Femtosecond, and Yb lasers. A random-effect model found statistically significant differences between lasers and control groups of Y-TZP (P < 0.00001; MD: 3.08; 95% CI: 2.58 to 3.58). Only the bond strength with the Er:YAG laser did not present statistical difference (P = 0.51; MD: 0.22; 95% CI: -0.44-0.88). In another analysis, a random-effect model found a statistically significant difference between the laser and control groups on surface roughness (P < 0.00001; MD: 0.96; 95% CI: 0.86 to 1.06).

Conclusions: Laser irradiation is capable to improve the Y-TZP surface roughness and the bond strength of zirconia with resin cement and veneering ceramics. However, there is a lack of laser protocol for the zirconia surface, a fact that makes a simple and direct comparison difficult.

Keywords: Lasers; resin cement; shear strength; veneering ceramic; zirconium oxide.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Flowchart of search strategy according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement
Figure 2
Figure 2
Meta-analysis between untreated and laser groups of Y-TZP (P< 0.00001; mean difference: 3.08; 95% confidence interval: 2.58 to 3.58)
Figure 3
Figure 3
Meta-analysis between untreated and CO2 laser groups of Y-TZP (P< 0.00001; mean difference: 5.56; 95% confidence interval: 4.11–7.02)
Figure 4
Figure 4
Meta-analysis between untreated and erbium:yttrium–aluminum–garnet laser groups of Y-TZP (P = 0.51; mean difference: 0.22; 95% confidence interval: −0.44–0.88)
Figure 5
Figure 5
Meta-analysis between untreated and neodymium:yttrium–aluminum–garnet laser groups of Y-TZP (P < 0.00001; mean difference: 2.00; 95% confidence interval: 1.47–2.52)
Figure 6
Figure 6
Meta-analysis between untreated and erbium, chromium:yttrium–scandium gallium–garnet laser groups of Y-TZP (P = 0.002; mean difference: 3.20; 95% confidence interval: 1.16–5.24)
Figure 7
Figure 7
Meta-analysis between untreated and femtosecond laser groups of Y-TZP (P < 0.00001; mean difference: 7.69; 95% confidence interval: 5.87–9.51)
Figure 8
Figure 8
Meta-analysis of Y-TZP surface roughness between untreated and laser groups (P < 0.00001; mean difference: 0.96; 95% confidence interval: 0.86–1.06)
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