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Dental Alloy Adhesive Primers and Bond Strength at Alloy-Resin Interface: A Systematic Review and Meta-analyses.

AIM: The present systematic review aimed to report the studies concerning the primers in improving bond strength and identifying pertinent primers for a particular dental alloy by adhering to PRISMA precepts.

MATERIALS AND METHODS: PubMed and Semantic Scholar databases were scoured for articles using 10 search terms. In vitro studies satisfying the inclusion criteria were probed which were meticulously screened and scrutinized for eligibility adhering to the 11 exclusion criteria. The quality assessment tool for in vitro studies (QUIN Tool) containing 12 criteria was employed to assess the risk of bias (RoB).

RESULTS: A total of 48 studies assessing shear bond strength (SBS) and 15 studies evaluating tensile bond strength (TBS) were included in the qualitative synthesis. Concerning SBS, 33.4% moderate and 66.6% high RoB was observed. Concerning TBS, 26.8% moderate and 73.2% high RoB was discerned. Seventeen and two studies assessing SBS and TBS, respectively, were included in meta-analyses.

CONCLUSIONS: Shear bond strength and TBS increased for the primed alloys. Cyclic disulfide primer is best-suited for noble alloys when compared with thiol/thione primers. Phosphoric acid- and phosphonic acid ester-based primers are opportune for base alloys.

CLINICAL SIGNIFICANCE: The alloy-resin interface (ARI) would fail if an inappropriate primer was selected. Therefore, the selection of an appropriate alloy adhesive primer for an alloy plays a crucial role in prosthetic success. This systematic review would help in the identification and selection of a congruous primer for a selected alloy.

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