Introduction: Dental erosion is considered a challenge in oral rehabilitation. Adhesion to eroded substrates, especially dentin, is complex and defiant. Therefore, it is important to find out which adhesive protocols are evidence-based and what has been researched up to this date.
Objectives: To report and summarize in vitro research that tested bond strength in eroded enamel/dentin. This will identify current knowledge gaps and guide future research.
Methods: The review was conducted following PRISMA-ScR guidelines. PubMed/Medline, Scopus and EMBASE databases were searched to identify peer-reviewed articles published in the last 10 years. Laboratory studies which tested bond strength in human/bovine samples were included. Three reviewers independently performed data charting and quality assessment of papers.
Results: The search retrieved 29 studies. The studies included comparison of restorative materials and application modes, enzymatic inhibitors, surface pre-treatments and remineralization techniques. Dentin (76%) was the preferred substrate, whereas 17% tested enamel and 7% evaluated both. 83% of studies document an effective intervention. The majority of studies tested an etch-and-rinse adhesive strategy.
Conclusion: It is well established that eroded enamel seems to be beneficial as a substrate for adhesion, while the contrary happens in dentin. Adhesive type and composition seem significant in bonding to the latter. 10-MDP-containing adhesives demonstrated better bond strength results. Remineralising agents also represent a promising method to increase bond in dentin and should be further studied.
Clinical implications: Establishing clear protocols based on current in vitro evidence is key to impact clinical outcomes regarding adhesion to an eroded substrate. Adhesive choice in dentin and remineralising formulations should be considered.
Keywords: dentin, erosion, adhesion, enamel, eroded, in vitro
