Evaluation of the efficiency of fluoride-releasing adhesives for preventing secondary caries in-vitro: a systematic review and meta-analysis

Aim To evaluate the efficiency of fluoride-releasing adhesives for the prevention of secondary caries on in-vitro tests. Materials and methods This study was performed according to the PRISMA checklist. The bibliographic research was performed to identify in-vitro studies between January 2000 and September 2017. The selected studies were submitted to bias risk assessment and data extraction. In the meta-analysis the data were evaluated using Review Manager Software. Results The 11 studies that met all inclusion criteria showed that the most common risks of bias were: absence of the sample size calculation description, absence of the single operator protocol and blind operation of the test machine. The meta-analysis was performed with six studies that used polarised light microscopy in order to quantify the mineral content of dentine and presented the values as means and standard deviations. Conclusions Most of the authors presented that the fluoride-containing adhesive systems had a significant effect to reduce in-vitro secondary caries. The meta-analysis did not present statistical difference between fluoride-free and fluoride-containing adhesive systems. The artificial caries challenge methodology may have affected the results.