Matrix metalloproteinase (MMP) inhibitors to improve resin-composite bond strength

Abstract

Introduction: The durability of resin composite restoration relies heavily on the stability of the adhesive surface. One of the primary factors affecting the bond is the activation of matrix metalloproteinases (MPP), which degrade exposed collagen fibrils in the dentin hybrid layer. In response, matrix metalloproteinase inhibitors (MMPIs) have been studied to preserve the hybrid layer and maintain bond durability. Objective: This literature review aims to investigate the effect of MMPIs on the bond strength of resin composite to dentin, analyzing their role in preserving long-term adhesion, and assess their impact in one-step adhesive systems. Methods: A bibliographic search has been conducted using databases such as Pubmed and Medline Complete. The PICO model guided the selection of studies published between 2014 and 2024. After applying inclusion and exclusion criteria, 8 studies were selected for analysis. Results: The findings suggest that MMPIs do not significantly enhance immediate bond strength but play a crucial role is maintaining hybrid layer integrity over time. MMPIs such as chlorhexidine showed the most consistent results in preserving long-term bond strength, particularly when used with etch-and-rinse adhesives. Conversely, one-step self-etch systems may activate matrix metalloproteinase due to their acidity, limiting MMPI effectiveness. Conclusion: MMPIs show promise in enhancing the durability of resin-dentin bonds, though their clinical results depend on adhesive protocols. Further research is needed to confirm their efficacy in daily practice.