Does 2% chlorhexidine digluconate cavity disinfectant or sodium fluoride/hydroxyethyl methacrylate affect adhesion of universal adhesive to dentin?

Abstract

Abstract:The objectives of this study were to investigate the adhesion of a universal adhesive used either in total-etch or self-etch mode with and without 2% chlorhexidine digluconate cavity disinfectant (CHX) or sodium fluoride/hydroxyethyl methacrylate (NaF/HEMA) to dentin. Dentin surfaces of extracted human non-carious third molar teeth (N=18) were exposed and randomly assigned to two groups. Half of the teeth were conditioned with total-etch and the other with self-etch adhesive mode. The teeth were then randomly divided into two groups where half were cleaned with 2% CHX (Cavity Cleanser, Bisco, CC) and the other half with NaF/HEMA (Aqua Prep F, Bisco, APF). Control groups in total-etch (C1) and self-etch (C2) adhesive system did not receive any cavity disinfectant.Dentin surfaces were conditioned with universal adhesive (Single Bond Universal, SBU) and resin composite blocks (3M Z550) were bonded incrementally on the conditioned dentin using a mould. The teeth were stored in water for 48 h and from each tooth beam-shaped specimens (1 mm 2 ) were prepared (n=14, per group). Microtensile bond strength (MBS) was were predominantly adhesive between the dentin and the adhesive resin. Mixed failures were more common for both C1 and C2 and total etch-CC combination.

Effect of Cavity Disinfectants on Dentin Bond Strength and Clinical Success of Composite Restorations—A Systematic Review of In Vitro, In Situ and Clinical Studies

“…Most of the studies reported results on the application of cavity disinfectant agents such as chlorhexidine [ 12 , 13 , 14 , 15 , 16 , 17 , 23 , 24 , 26 , 27 , 36 , 39 , 42 , 53 , 56 , 57 , 61 , 62 , 65 , 66 , 67 , 68 , 69 , 70 , 72 , 73 , 75 , 77 , 79 , 81 , 86 , 87 , 88 , 90 , 91 , 98 , 100 , 102 , 103 , 104 , 105 , 111 , 113 , 122 , 123 , 124 , 126 , 128 , 132 , 133 , 134 , 135 , 137 , 142 , 143 ,…”

“…Regarding its performance as a cavity disinfectant, chlorhexidine presented with positive results in the majority of the studies [ 16 , 17 , 24 , 36 , 39 , 42 , 53 , 56 , 57 , 61 , 62 , 65 , 66 , 67 , 68 , 69 , 72 , 73 , 75 , 77 , 79 , 81 , 86 , 87 , 90 , 91 , 98 , 100 , 102 , 103 , 104 , 105 , 111 , 113 , 122 , 123 , 124 , 128 , 132 , 134 , 135 , 137 , 142 , 143 , 148 , 153 , 157 ], allowing for maintenance or even an increase in bond strength values. On the other hand, a few authors [ 14 , 15 , 26 , 27 ,…”

“…Bravo et al [ 123 , 124 ] also conducted studies testing the three different adhesive systems—etch-and-rinse, self-etch and universal—but find no differences between them. One other author tested the same universal system either as a self-etch or as an etch-and-rinse and concluded that bond strength values increased when using the universal system in etch-and-rinse mode and decreased when using it as a self-etch [ 102 ].…”

Bond Strength of Universal Adhesives to Dentin: A Systematic Review and Meta-Analysis

“…The qualitative synthesis of the studies included in this systematic review are summarized in Table 2 . Several strategies were identified: Air abrasion [ 58 , 59 ], application of crosslinking agents [ 57 , 60 , 61 , 62 , 63 , 64 , 65 ], application of dentin desensitizers [ 66 , 67 ], use of matrix metalloproteinases (MMP) inhibitors [ 10 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ], the use of the ethanol-wet bonding technique [ 78 ], application of an extra hydrophobic resin layer [ 56 , 79 , 80 , 81 , 82 , 83 , 84 , 85 ], dentin pretreatment with laser [ 55 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ], multiple layer application [ 93 , 94 , 95 , 96 , 97 , 98 , 99 ], non-atmospheric plasma [ 100 , 101 ], prolonged curing time [ 102 ,…”

Effect of 2% Chlorhexidine Following Acid Etching on Microtensile Bond Strength of Resin Restorations: A Meta-Analysis

“…The reason is that weak acids possess the potential to activate the MMPs, particularly when their pH lies between 2.3 and 5, which is the case of many self-etch adhesives, making them very effective at activating gelatinase action [32]. Adhesion depends on the adhesive system used, with the non-simplified adhesive systems (etch and rinse) being more stable and effective than the simplified adhesive systems (self-etch) [44][45][46].…”