The long-term effectiveness of chlorhexidine as a matrix metalloproteinase (MMP) inhibitor may be compromised when water is incompletely removed during dentin bonding. This study challenged this anti-bond degradation strategy by testing the null hypothesis that wet-bonding with water or ethanol has no effect on the effectiveness of chlorhexidine in preventing hybrid layer degradation over an 18-month period. Acid-etched dentin was bonded under pulpal pressure simulation with Scotchbond MP and Single Bond 2, with water wet-bonding or with a hydrophobic adhesive with ethanol wetbonding, with or without pre-treatment with chlorhexidine diacetate (CHD). Resin-dentin beams were prepared for bond strength and TEM evaluation after 24 hrs and after aging in artificial saliva for 9 and 18 mos. Bonds made to ethanol-saturated dentin did not change over time with preservation of hybrid layer integrity. Bonds made to CHD pretreated acid-etched dentin with commercial adhesives with water wet-bonding were preserved after 9 mos but not after 18 mos, with severe hybrid layer degradation. The results led to rejection of the null hypothesis and highlight the concept of biomimetic water replacement from the collagen intrafibrillar compartments as the ultimate goal in extending the longevity of resin-dentin bonds.

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The aim of this study was to evaluate the influence of light exposure associated with 35% hydrogen peroxide (Pola Office, SDI, Melbourne, Vic., Australia) or 15% hydrogen peroxide (BriteSmile, Discus, Culver City, CA, USA) on the microhardness and color changes of bovine enamel. Experimental groups were Britesmile + Light (BL) (15% hydrogen peroxide + plasm arc; 4 x 20 minutes), Britesmile + No Light (BN) (BL, no light), Pola office + Light (PL) (35% hydrogen peroxide + LED; 4 x 8 minutes), and Pola office + No light (PN) (PL, no light). Color changes (DeltaE) and the CIELAB (Commission Internationale de l' Eclairage, L* a* b* color system) parameters (L*, a*, and b*) were assessed with a spectrophotometer before (B), immediately (A), 1 day and 7 days after bleaching. The microhardness was measured before (B) and after (A), the obtained data were submitted to a two-way analysis of variance, and DeltaE were submitted to t-test for each period. Only Pola Office, in which the peroxide is associated with the light, improved DeltaE when evaluated immediately after bleaching (p < 0.001). Light exposure did not influence DeltaE after 1 day or 7 days for either bleaching system. The enamel microhardness was not altered after bleaching for BriteSmile. However, enamel microhardness was reduced after bleaching for Pola Office, 283 MPa (+/-21) and 265 MPa (+/-27), respectively. It was concluded that these two bleaching systems were efficient regardless of the light systems used. However, the 35% hydrogen peroxide altered the enamel microhardness. CLINICAL SIGNIFICANCE Enamel microhardness was affected by a 35% hydrogen peroxide in-office bleaching therapy. Moreover, the in-office bleaching outcome was not improved by using the light associated with systems tested in this study. (J Esthet Restor Dent 21:387-396, 2009).