University of Oulu

Kiuru, O.; Sinervo, J.; Vähänikkilä, H.; Anttonen, V.; Tjäderhane, L. (2021) MMP Inhibitors and Dentin Bonding: Systematic Review and Meta-Analysis, International Journal of Dentistry, Volume 2021, Article ID 9949699, 14 pages,

MMP inhibitors and dentin bonding : systematic review and meta-analysis

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Author: Kiuru, O.1; Sinervo, J.1; Vähänikkilä, H.2;
Organizations: 1Research Unit of Oral Health Sciences, Department of Cariology, Endodontology and Paediatric Dentistry, University of Oulu, Oulu, Finland
2Infrastructure of Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
3Medical Research Centre, University of Oulu and Oulu University Hospital, Oulu, Finland
4Department of Oral and Maxillofacial Diseases, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.3 MB)
Persistent link:
Language: English
Published: Hindawi, 2021
Publish Date: 2021-07-13


Objectives: Resin-dentin bond strength decreases over time. This reduction is related to the loss of hybrid layer integrity. Collagenolytic enzymes, especially matrix metalloproteinases (MMPs), are responsible for the degradation of the collagen matrix of the hybrid layer. Various MMP inhibitors with the ability to prevent enzymatic degradation have been identified. This study aimed to systematically review the literature for studies which evaluated the effect of MMP inhibitors on the immediate and aged dentin bond strengths.

Study Selection: Screening and analysis were carried out by two reviewers. Two databases were searched, and from a total of 740 articles, 43 were accepted for full review. 21 articles with 0.2%–2% chlorhexidine (CHX) treatments were included for meta-analysis. A risk of bias assessment was performed on all studies chosen for meta-analysis. A variety of MMP inhibitors have been studied, CHX being the most widely used.

Conclusions: A clear trend for a lower loss of dentin bond strength was observed with different MMP inhibitors. In meta-analysis, no significant difference was seen between the CHX and control in the immediate bond strengths. Bond strengths in the CHX group were significantly higher than the control group after aging (P < 0.001). The percentage of fractures occurring at the adhesive interface increased after aging. Five out of 21 studies included in the meta-analysis had high and the rest medium risk of bias. More long-term studies with lower risks of bias should be carried out to increase the reliability of results.

Clinical Relevance: The use of MMP inhibition with chlorhexidine can be recommended to increase the longevity of resin-dentin bond strength.

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Series: International journal of dentistry
ISSN: 1687-8728
ISSN-E: 1687-8736
ISSN-L: 1687-8728
Volume: 2021
Article number: 9949699
DOI: 10.1155/2021/9949699
Type of Publication: A2 Review article in a scientific journal
Field of Science: 313 Dentistry
Copyright information: © 2021 O. Kiuru et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.