Influence of Dentin Biomodifiers Types on Composite-Resin Restorations Bonding

Objectives: This scoping review examines the impact of dentin biomodifiers on the bonding of dentin to composite-resin restorations over time.
Methods: The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCr) guidelines. A systematic search was performed in PubMed, Scopus, and Web of Science. Only papers that met the inclusion criteria were included. Two reviewers independently screened the articles, selected eligible studies, and charted the relevant data.
Results: From 486 potential relevant articles identified, nine met the inclusion criteria, of which seven were meta-analyses. Seven reviews reported bond strength test results ranging from immediate to 36 months evaluation. One assessed both immediate and long-term bond strength without specifying the duration, while another evaluated only immediate bond strength. The identified biomodifiers were categorized into three main groups based on their nature and mechanisms of action: natural agents, chemical agents and compounds, and physical agents. Natural crosslinkers demonstrated significant potential for enhancing the durability of resin-dentin bonds. Among those, grape seed extract (proanthocyanidins) was the most efficient, preserving bond strength even after aging. Whereas, physical agents mainly, non-thermal atmospheric plasma (NTAP), and riboflavin combined with UVA light exhibited strong crosslinking capabilities. Caution is warranted with certain chemical agents as prolonged exposure to deproteinization adversely affected bonding.
Conclusions: Several dentin biomodifiers exist. Their influence on the bonding of dentin to composite-resins varies depending on their nature as they have adverse effects.