Effects of mussel-inspired compounds on dentin bonding: a systematic review and meta-analysis.

BACKGROUND

Resin-based materials used in the treatment of dental caries face insufficient bonding durability at the dentin interface. Mussel-inspired compounds, as a novel class of bio-inspired materials, offer promising potential for enhancing dentin bonding performance. This meta-analysis assessed the efficacy of monomeric and polymeric mussel-inspired compounds on resin-dentin bond strength and/or anti-enzymatic effects.

METHODS

This systematic review and meta-analysis was registered in PROSPERO (CRD42025649875). Following PRISMA guidelines, a systematic search covered PubMed, Web of Science, Cochrane Library, EMBASE, and Scopus up to March 1, 2025. Included studies compared experimental groups using mussel-inspired compounds to controls, assessing resin-dentin bond strength and/or anti-enzymatic effects. Risk of bias was assessed using the QUIN Tool. Statistical analysis involved standard pairwise meta-analysis and heterogeneity assessment. The publication bias was examined using funnel plots. A sensitivity analysis was conducted by excluding studies with positive controls.

RESULTS

A total of 13 studies were included in systematic review and 12 studies in meta-analysis. The pooled results suggested that mussel-inspired compounds significantly enhanced the immediate bond strength (SMD = 0.91, p = 0.0008) and markedly reduced the bond strength degradation after aging (SMD = -3.97, p = 0.0001). Subgroup analysis showed the monomeric form significantly improved the immediate bond strength (SMD = 1.26, p < 0.00001) and reduced aging-related degradation (SMD = -4.00, p < 0.0001), while the polymeric form showed no significant effects. The mussel-inspired compounds also significantly suppressed collagen degradation, indicated by reduced hydroxyproline release (SMD = -9.04, p < 0.00001). Sensitivity analysis confirmed the robustness of these findings, as excluding studies with active positive controls yielded consistent and significant results.

CONCLUSIONS

Monomeric mussel-inspired compounds enhance immediate dentin bond strength and improve its durability by mitigating aging-induced degradation and inhibiting collagen degradation, while polymeric compounds demonstrate no statistically significant benefits.