Ex vivo study of bacterial coronal leakage in indirect pulp treatment

Abstract

Objective: The aim of this study was to evaluate, ex vivo, bacterial coronal leakage with different antimicrobial agents applied to the dentine for indirect pulp treatment (IPT). Study Design: Sixty extracted teeth were prepared and randomly distributed into 5 groups (n=10): Group 1: no antimicrobial dentine treatment; group 2: 1% chlorhexidine (CHX)+1% thymol varnish (Cervitec®); group 3: 2 % CHX solution; group 4: 40% CHX varnish (EC40™) and group 5: Clearfil™ Protect Bond (CPB). Ten teeth served as controls. The teeth were restored using a resin-modified glass ionomer cement (GIC) and then mounted in a two-chamber device. The coronal access was exposed to Streptococcus mutans for 45 days. The appearance of turbidity in the BHI broth of the lower chamber was considered as specimen leakage. Results: Survival analysis, determined by non parametric Kaplan-Meier and log-rank tests, showed that the best results were for groups EC40™+GIC and GIC alone; yet there were not statistically significant differences between them. All specimens of CPB+GIC and 2% CHX+GIC, leaked at 45 days. Conclusions: In IPT the use of GIC without pretreatment of the dentine and pretreatment with 40% CHX varnish resulted in a significant delay of bacterial coronal leakage. Key words:Streptococcus mutans, bacterial leakage, resin-modified glass ionomer cement, indirect pulp treatment.

Chlorhexidine gluconate enhances the remineralization effect of high viscosity glass ionomer cement on dentin carious lesions in vitro

“…In addition to its antimicrobial effect, several studies found that using CHX with polyacrylic acid increased the GIC bond strength [ 31 – 34 ]. CHX neutralized the dentin surface that was applied with an acid conditioner [ 33 ] and also increased the surface energy of the dentin [ 33 ].…”

Effect of chlorhexidine gluconate on dentin carious lesion in vitro

“…CHX is a well-known antimicrobial agent that is frequently used as a cavity disinfectant to prevent pulpitis caused by bacteria after selective caries removal (77,94,95). Several other studies also showed that application of CHX prior to GI restoration helped improve bond strength (29)(30)(31)(32). Shear bond strength of H-GIC was superior in CHX treated groups compared with control group which increased success rate in the long term (32).…”

“…Besides the antimicrobial effect, several studies found that using CHX with polyacrylic acid helps to create desirable bond ability of GIC (29)(30)(31)(32). CHX helps to neutralize the dentin surface that is applied by an acid conditioner (31) and also increases the surface energy of the dentin (31).…”

“…It is not clear about the effect of CHX to GIC restoration (33). But several studies found desirable bond ability when used CHX with GIC (29)(30)(31)(32). RMGIC plus 40% CHX varnish as cavity disinfectant and RMGIC alone was not different in bacterial coronal leakage (29).…”

“…But several studies found desirable bond ability when used CHX with GIC (29)(30)(31)(32). RMGIC plus 40% CHX varnish as cavity disinfectant and RMGIC alone was not different in bacterial coronal leakage (29). Shear bond strength of H-GIC was superior in chlorhexidine treated groups comparing with control group (32).…”