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Year : 2021  |  Volume : 21  |  Issue : 2  |  Page : 125-137

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

1 Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Sao Paulo State University (UNESP), Sao Paulo, Brazil
2 Department of Surgery and Integrated Clinic, Division of Periodontics, Group for the Research and Study of Laser in Dentistry, Aracatuba Dental School, Sao Paulo State University (UNESP), Sao Paulo, Brazil

Correspondence Address:
Sandro Basso Bitencourt
Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Sao Paulo State University (UNESP), Sao Paulo, Brazil - 1193; José Bonifácio street, Araçatuba, São Paulo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jips.jips_590_20

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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.

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