Percorrer por autor "Bourgi, Rim"
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- Effect of different application modalities on the bonding performance of adhesive systems to dentin : a systematic review and meta-analysisPublication . Hardan, Louis; Bourgi, Rim; Cuevas-Suárez, Carlos Enrique; Devoto, Walter; Zarow, Maciej; Monteiro, Paulo; Jakubowicz, Natalia; Zoghbi, Amine El; Skaba, Dariusz; Mancino, Davide; Kharouf, Naji; Haïkel, Youssef; Lukomska-Szymanska, MonikaDiverse types of dental adhesives exhibit different cytotoxic outcomes on cells in vitro. Currently, no standard adhesive application technique has so far been decisive for clinicians for better durability of resin–dentin bonds of adhesive systems. The purpose of this study was to systematically review the literature to evaluate the bonding performance of adhesive systems to dentin by using different application modalities. The systematic research strategy was conducted by two reviewers among multiple databases: PubMed, Scopus, Web of Science, Embase, and Scielo. In vitro studies reporting the effects of additional steps for the application of adhesive systems on the bond strength to dentin were selected. Meta-analysis was performed using Review Manager Software version 5.3.5 using the random effects model. The methodological quality of each in vitro study was assessed according to the parameters of a previous systematic review. The electronic research through different databases generated a total of 8318 references. After the examination of titles and abstracts, a total of 106 potentially relevant studies accessed the full-text evaluation phase. After full-text examination, 78 publications were included for the qualitative analysis, and 68 studies were included in the meta-analysis. Regarding the etch-and-rinse adhesive systems, the application modalities that improved the overall bond strength were the application of a hydrophobic resin layer (p = 0.005), an extended application time (p < 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p = 0.05), the agitation technique (p = 0.02), and the active application of the adhesive (p < 0.001). For self-etch adhesive systems, the techniques that improved the overall bond strength were the application of a hydrophobic resin layer (p < 0.001), an extended application time (p = 0.001), an application assisted by an electric current (p < 0.001), a double-layer application (p < 0.001), the agitation technique (p = 0.01), and the active application of the adhesive (p < 0.001). The in vitro evidence suggests that the application of adhesive systems using alternative techniques or additional strategies may be beneficial for improving their bond strength to dentin. The application modalities that favored the overall bond strength to dentin were an extended application time, a double-layer application, an application assisted by an electric current, the active application of the adhesive, and the application of a hydrophobic resin layer. Worth mentioning is that some techniques are intended to increase the degree of the conversion of the materials, and therefore, improvements in the biocompatibility of the materials can be expected.
- Immediate dentin sealing for adhesive cementation of indirect restorations : a systematic review and meta-analysisPublication . Hardan, Louis; Devoto, Walter; Bourgi, Rim; Cuevas-Suárez, Carlos Enrique; Lukomska-Szymanska, Monika; Fernández-Barrera, Miguel Ángel; Cornejo-Ríos, Elizabeth; Monteiro, Paulo; Zarow, Maciej; Jakubowicz, Natalia; Mancino, Davide; Haikel, Youssef; Kharouf, NajiImmediate dentin sealing (IDS) involves applying an adhesive system to dentin directly after tooth preparation, before impression. This was considered an alternate to delayed dentin sealing (DDS), a technique in which hybridization is performed following the provisional phase and just before the indirect restoration luting procedure. This study aimed to compare the bond strength of restorations to dentin of the IDS and the DDS techniques throughout a systematic review and meta-analysis. The following PICOS framework was used: population, indirect restorations; intervention, IDS; control, DDS; outcomes, bond strength; and study design, in vitro studies. PubMed (MedLine), The Cochrane Library, ISI Web of Science, Scielo, Scopus, and Embase were screened up to January 2022 by two reviewers (L.H. and R.B.). In vitro papers studying the bond strength to human dentin of the IDS technique compared to the DDS technique were considered. Meta-analyses were carried out by using a software program (Review Manager v5.4.1; The Cochrane Collaboration). Comparisons were made by considering the adhesive used for bonding (two-step etch-and-rinse, three step etch-and-rinse, one-step self-etch, two-step self-etch, and universal adhesives). A total of 3717 papers were retrieved in all databases. After full-text assessment, 22 potentially eligible studies were examined for qualitative analysis, leaving a total of 21 articles for the meta-analysis. For the immediate bond strength, regardless of the adhesive strategy used, the IDS technique improved the bond strength of restorations to the dentin (p < 0.001). Taking into account the subgroup analysis, it seems that the use of the IDS technique with a two-step etch-and-rinse or a one-step self-etch adhesive system does not represent any advantage over the DDS technique (p = 0.07, p = 0.15). On the other hand, for the aged bond strength, regardless of the adhesive strategy used, the IDS technique improved the bond strength of restorations to the dentin (p = 0.001). The subgroups analysis shows that this improvement is observed only when a three-step etch-and-rinse adhesive system (p < 0.001) or when a combination of an adhesive system plus a layer of flowable resin (p = 0.01) is used. The in vitro evidence suggests that the use of the IDS technique improves the bond strength of dentin to resin-based restorations regardless of the adhesive strategy used. The use of a three-step etch-and-rinse adhesive system or the combination of an adhesive system plus a layer of flowable resin seems to considerably enhance the bond strength in the long term.
- Polyethylene fiber reinforcement in resin composite restorations : a systematic review of clinical trialsPublication . Bourgi, Rim; Holiel, Ahmed A.; Delgado, António H. S.; Flores-Ledesma, Abigailt; Khafaja, Souheir; Cuevas-Suárez, Carlos EnriquePurpose: To synthesize evidence from randomized controlled trials (RCTs) on the clinical performance of ultra-high-molecular-weight polyethylene (UHMWPE) fiber-reinforced direct composite restorations compared to conventional composites in posterior teeth and non-carious cervical lesions. Methods: A systematic review was conducted following PRISMA guidelines (PROSPERO: CRD420251178877). Databases were searched up to November 2025 for RCTs evaluating fiber-reinforced versus non-reinforced direct composite restorations in Class I, II, or V cavities. Grey literature and trial registries were not searched, framing this as a restricted-source systematic review of peer-reviewed published evidence. The primary outcome was restoration failure/survival; secondary outcomes included marginal adaptation, discoloration, and postoperative sensitivity. Risk of bias was assessed using RoB 2, and certainty of evidence was evaluated with GRADE. Results: Four RCTs (404 patients, 494 restorations) with 12–24 month follow-up were included. All trials reported 100% restoration survival in both fiber-reinforced and control groups. No statistically significant differences were found in any clinical performance parameter. The evidence was of moderate certainty for primary outcomes in adults but low to very low for secondary outcomes and pediatric/NCCL indications, limited by short follow-up, imprecision, and risk of bias. Conclusions: Within the limited observation period of up to 24 months, UHMWPE fiber reinforcement did not demonstrate a measurable clinical advantage over contemporary non-reinforced composite protocols for posterior teeth. The uniformly high survival rates and comparable performance indicate excellent short-term outcomes for both approaches under controlled conditions. Absence of observed benefit should not be interpreted as equivalence; long-term RCTs are required to determine if fiber reinforcement mitigates late complications such as fracture in structurally compromised teeth.
- The use of probiotics as adjuvant therapy of periodontal treatment : a systematic review and meta-analysis of clinical trialsPublication . Hardan, Louis; Bourgi, Rim; Cuevas-Suárez, Carlos Enrique; Flores-Rodríguez, Maythé; Omaña-Covarrubias, Arianna; Nicastro, Marco; Lazarescu, Florin; Zarow, Maciej; Monteiro, Paulo; Jakubowicz, Natalia; Proc, Patrycja; Lukomska-Szymanska, MonikaFor many years, the use of probiotics in periodontitis treatment was reflected in their abilities to control the immune response of the host to the presence of pathogenic microorganisms and to upset periodontopathogens. Accordingly, the aim of the present study was to assess the use of probiotics as adjuvant therapy on clinical periodontal parameters throughout a systematic review and meta-analysis. The literature was screened, up to 4 June 2021, by two independent reviewers (L.H. and R.B.) in four electronic databases: PubMed (MedLine), ISI Web of Science, Scielo, and Scopus. Only clinical trials that report the effect of the use of probiotics as adjuvants in the treatment of periodontal disease were included. Comparisons were carried out using Review Manager Software version 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). A total of 21 studies were considered for the meta-analysis. For the index plaque, the use of probiotics did not improve this clinical parameter (p = 0.16). On the other hand, for the periodontal pocket depth, the clinical attachment loss, the bleeding on probing, and the use of probiotics as adjuvant therapy resulted in an improvement of these parameters, since the control group achieved statistically higher values of this parameter (p < 0.001; p < 0.001; and p = 0.005, respectively). This study suggests that the use of probiotics led to an improvement in periodontal pocket depth, clinical attachment loss, and bleeding on probing parameters. On the other hand, this protocol seems to not be beneficial for the index plaque parameter.