Can Chlorhexidine enhance the Bond Strength of Self-etch and Etch-and-rinse Systems to Primary Teeth Dentin?

Abstract

Modifying the durability of resin bonding systems resulted in introducing materials with cross-link property, such as chlorhexidine (CHX) that can promote the strength of resin-dentin bonding. The aim of this study was evaluation of the effect of CHX on shear bond strength (SBS) of self-etch (SE) and etch-and-rinse (E&R) bonding systems to the primary teeth dentin. In this study, 40 freshly extracted primary molars collected and were cut mesiodistally, and then the buccal and lingual surface enamel was grounded. The specimens were randomly divided into two groups: I: Single Bond adhesive and II: Clearfil SE Bond adhesive. Then, each group was divided into two subgroups: On the buccal surface of each sample CHX was applied for 30 seconds and on the lingual surface of (I, II groups), CHX was not applied. The SBS (MPa) of samples was assessed using the Zwick universal testing machine. Data were analyzed by paired t-test and independent t-test using Statistical Package for the Social Sciences (SPSS), version 16. The mean SBS was significantly higher in the Single Bond group with CHX (66.45 ± 8.3) than without CHX (25.43 ± 12.94) in the nonaging group (p = 0.002). There was no significant difference in the mean SBS in the Clearfil SE Bond group with CHX and without CHX in the aging and nonaging groups. CHX had positive influence on immediate SBS of Single Bond adhesive to primary teeth dentin. In addition, no positive effect has been seen in the Clearfil SE Bond system. Now more researches are needed about the recommendation of CHX in resin restorations of primary teeth. Chlorhexidine, Etch-and-rinse adhesive, Failure pattern, Self-etch adhesive, Shear bond strength.

Effect of Cavity Disinfectants on Adhesion to Primary Teeth—A Systematic Review

“…Sixteen in vitro studies [ 12 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ] were included in this systematic review.…”

“…Most authors used primary molars [ 12 , 16 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 ], but Monghini et al [ 17 ] evaluated canines, and Mohammadi et al [ 29 ] used anterior teeth. Sample size varied from 2 [ 25 ] to 20 [ 28 , 31 ] teeth per group.…”

“…After extraction, teeth were stored in thymol [ 12 , 18 , 28 ], chloramine [ 16 , 22 , 23 , 27 , 30 ], distilled water [ 16 , 20 , 22 , 23 , 24 , 25 , 27 , 30 , 32 ], saline solution [ 17 , 26 ], or sodium azide [ 17 , 21 ]. Ricci et al [ 19 ] and Mohammadi [ 29 ] did not report data on the storage medium used after teeth extraction.…”

“…Most of the authors reported the use of 2% chlorhexidine [ 12 , 18 , 19 , 20 , 22 , 23 , 25 , 28 , 29 ] as a cavity disinfectant. A few studies reported results on the application of sodium hypochlorite [ 16 , 24 , 27 ], Er:YAG laser [ 17 , 21 , 26 ], KTP laser [ 25 ], ozone [ 25 ], doxycycline [ 29 ], ethylenediaminetetraacetic acid (EDTA) [ 29 ], propolis [ 25 ], and Aqua-prep™ (Bisco, Schaumburg, IL, USA) [ 26 ].…”

“…Except for Vieira et al [ 12 ], all of the authors studying the effect of 2% chlorhexidine as a cavity disinfectant [ 18 , 19 , 20 , 22 , 23 , 25 , 28 , 29 ] reported positive results, allowing for maintenance or a statistically significant increase in bond strength values. These values ranged from 7.58 ± 3.18 MPa [ 25 ] to 66.45 ± 8.3 MPa [ 28 ] in resin specimens and from 7.1 ± 5.2 MPa to 14.4 ± 6.6 MPa [ 18 ] in caries-affected dentin in glass ionomer specimens. Vieira et al [ 12 ] were the only authors applying chlorhexidine before etching the specimens with phosphoric acid.…”