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Bond strength of flowable dental composites in the cementation of indirect restorations: a systematic review and meta-analysis

Evidence-Based Dentistry volume 26, pages 178–179 (2025)Cite this article

Subjects

Abstract

Aim

This systematic review evaluated experimental evidence on how incorporating flowable dental composites affects the bond strength of dental cementation.

Material And Methods

This systematic review, following PRISMA guidelines, assessed in vitro studies (2003–2025) on the effect of flowable composites on cementation bond strength using a comprehensive database search, QUIN Tool for bias assessment, Begg’s and Egger’s tests for publication bias, and random-effects meta-analysis with SMD and I² statistics.

Results

This systematic review included eight in vitro studies published between 2003 and 2025. The meta-analysis found no statistically significant differences among the various bond strength test methods. Although the shear bond strength (SBS) test demonstrated a significant effect, the high heterogeneity among studies limits the reliability of this result. Etchable ceramics showed favourable effect sizes, but again, the high heterogeneity reduces the certainty of this finding. No significant difference was observed between self-etch and self-adhesive resin cements; however, self-etch resin cements tended to perform better in terms of bond strength. Nevertheless, the substantial heterogeneity in both adhesive groups indicates notable variability across studies. For the dual-cured group, a statistically significant standardized mean difference was observed, suggesting a positive effect of the dual-cured luting cement compared to the light-cured luting cement.

Conclusion

Flowable dental composites generally perform comparably to conventional resin cements, with dual-cured and self-etch resin cements showing a tendency toward improved bond strength. However, variability across studies limits the certainty of these results. Further standardized in vitro studies are needed to confirm these findings and guide clinical application.

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Data availability

The dataset used in the present study is available from the corresponding author upon reasonable request.

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Acknowledgements

We appreciate all the people who helped us in providing this manuscript.

Author information

Authors and Affiliations

  1. Associate Professor of Restorative Dentistry, Department of Restorative Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran

    Baharan Ranjbar Omidi

  2. Department of Operative Dentistry, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran

    Soolmaz Heidari

  3. Postgraduate Student of Operative Dentistry, Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran

    Armin Izadpanah

Authors
  1. Baharan Ranjbar Omidi
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  2. Soolmaz Heidari
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Contributions

All authors contributed substantially to the conception and design of the study. A.I. and B.O. conducted the systematic literature search, study selection, and data extraction. S.H.& A.I. performed the statistical analysis and contributed to data interpretation. A.I. drafted the manuscript, and all authors critically revised it for important intellectual content. All authors read and approved the final version of the manuscript.

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Correspondence to Armin Izadpanah.

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Omidi, B.R., Heidari, S. & Izadpanah, A. Bond strength of flowable dental composites in the cementation of indirect restorations: a systematic review and meta-analysis. Evid Based Dent 26, 178–179 (2025). https://doi.org/10.1038/s41432-025-01187-8

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