Percorrer por autor "Sauro, Salvatore"
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- Collagen-depletion strategies in dentin as alternatives to the hybrid layer concept and their effect on bond strength : a systematic reviewPublication . Delgado, António H. S.; Costa, Madalena Belmar da; Polido, Mário Cruz; Azul, Ana Mano; Sauro, SalvatoreStrategies aiming to improve the longevity of resin–dentin adhesive interface developed so far have only been able to retard the problem. Different approaches are thus needed. The objective of this review was to determine whether the use of collagen-depletion strategies after acid-etching procedures may improve the bond strength of resin-based materials to dentin. A systematic review was planned following 2021 PRISMA statement guidelines, with a search strategy performed in five electronic databases: PubMed/Medline, Scopus, EMBASE, SciELO and IADR Abstract Archive (last search: 17/01/2022). Inclusion criteria encompassed studies which evaluated a collagen-depletion strategy in acid-etched human dentin and tensile/shear bond strength tests. Risk of bias assessment was carried out by two reviewers, working independently on an adapted five-domain risk of bias (RoB) checklist for laboratory studies. Results were synthesized qualitatively, as a meta-analysis was not possible due to limited number of studies and their RoB. A total of eight studies were eligible for inclusion in the systematic review after inclusion/exclusion criteria application. Out of these, two evaluated the effect of using NaOCl followed by an antioxidant, and the remaining six evaluated different enzymatic treatments (bromelain, chondroitinase ABC, papain, and trypsin). None of the studies reported a decrease of bond strength when a collagen-depletion strategy was used, in comparison to traditional hybrid layers (control). All enzymatic treatment studies which respected the inclusion criteria improved the bond strength to dentin. Some specific collagen-depletion strategies seem to play a favorable role in improving immediate bond strengths to dentin. Further research with sound methodology is required to consolidate these findings, since limitations in RoB and a low number of studies were found. The assessment of further proteolytic agents and long-term outcomes is also required.
- Effects and properties of deproteinizing methods in dentin : a comprehensive narrative reviewPublication . Costa, Madalena Belmar da; Azul, Ana Mano; Sauro, Salvatore; Delgado, António H. S.Dentin deproteinization strategies are being revisited as adjunctive approaches to reduce technique sensitivity, improve monomer infiltration to mineralized dentin, and enhance the longevity of resin–dentin interfaces. This organized narrative review critically summarizes the chemistry, kinetics, biological considerations, and clinical translatability of agents used for smear-layer deproteinization or post-etching deproteinization. Searches of PubMed/MEDLINE, Scopus, and LILACS up to October 2025 were used to identify evidence on oxidizing irrigants (sodium hypochlorite/hypochlorous acid, calcium hypochlorite, peracetic acid, chlorine dioxide), enzymatic proteolysis treatments (bromelain, papain, trypsin/pepsin, and GAG-targeting enzymes), physical approaches (heat and lasers), and post-oxidizer reducing/antioxidant strategies. Oxidizers provide the fastest and most surface-verified organic removal, but their clinical value is limited by concentration- and time-dependent oxidative carry-over, which interferes with free-radical polymerization. Enzymes offer a more selective route, although their support is driven largely by bond strength and morphological outcomes rather than direct surface-chemical confirmation. Heat remains a proof-of-principle method rather than a clinical option, whereas laser protocols are highly parameter-sensitive. Overall, deproteinization should be interpreted through a combined framework of surface chemistry, adhesive compatibility, aging behavior, biosafety, and chairside feasibility. Current evidence supports cautious, protocol-specific development rather than routine clinical adoption, with priority given to clinically realistic time-dose windows and paired surface/aging outcomes.
- RoBDEMAT : a risk of bias tool and guideline to support reporting of pre-clinical dental materials research and assessment of systematic reviewsPublication . Delgado, António H. S.; Sauro, Salvatore; Lima, Adriano F.; Loguercio, Alessandro D.; Bona, Alvaro Della; Mazzoni, Annalisa; Collares, Fabricio Mezzomo; Staxrud, Frode; Ferracane, Jack; Tsoi, James; Amato, Julia; Neuhaus, Klaus W.; Ceballos, Laura; Breschi, Lorenzo; Hannig, Matthias; Melo, Mary Anne; Özcan, Mutlu; Scotti, Nicola; Opdam, Niek; Yamaguchi, Satoshi; Paris, Sebastian; Turkun, Lezize Sebnem; Doméjean, Sophie; Rosa, Vinicius; Palin, William; Schwendicke, FalkObjectives: To develop a risk of bias tool for pre-clinical dental materials research studies that aims to support reporting of future investigations and improve assessment in systematic reviews. Methods: A four-stage process following EQUATOR network recommendations was followed, which included project launch, literature review, Delphi process and the tool finalization. With the support of the European Federation of Conservative Dentistry (EFCD) and the Dental Materials Group of the International Association for Dental Research (DMG-IADR), a total of 26 expert stakeholders were included in the development and Delphi vote of the initial proposal. The proposal was built using data gathered from the literature review stage. During this stage, recent systematic reviews featuring dental materials research, and risk of bias tools found in the literature were comprehensively scanned for bias sources. The experts thus reached a consensus for the items, domains and judgement related to the tool, allowing a detailed guide for each item and corresponding signalling questions. Results: The tool features nine items in total, spread between 4 domains, pertaining to the following types of bias: bias related to planning and allocation (D1), specimen preparation (D2), outcome assessment (D3) and data treatment and outcome reporting (D4). RoBDEMAT, as presented, features signalling questions and a guide that can be used for RoB judgement. Its use as a checklist is preferred over a final summary score. Conclusion: RoBDEMAT is the first risk of bias tool for pre-clinical dental materials research, supported and developed by a broad group of expert stakeholders in the field, validating its future use.