A 2-year in vitro evaluation of a chlorhexidine-containing acid on the durability of resin–dentin interfaces

Abstract

The addition of CHX digluconate in the acidic conditioner may be an excellent tool to increase the long-term stability of collagens fibrils within the hybrid layer against host-derived metalloproteinases without the need for additional steps for the bonding protocol.

Effect of 2% Chlorhexidine Gluconate on the Degradation of Resincomposite–dentin Bond Strength When Using Self-Etch Adhesive Systems

“…In addition, Stanislawczuk et al reported that an application time of 15 s was sufficient for inhibiting the degradation of the adhesive resin-dentin bond because the bond between 2% CHX and dentin collagen fibrils had already formed at that time [11,23].…”

“…However, studies have shown that not all acids can be neutralized. This results in incomplete monomer infiltration and the formation of a demineralization zone below the hybrid layer, which exposes the collagen fibrils [10,11].…”

Bonding efficiency and durability: current possibilities

“…76 CHX was accordingly shown to partially conserve the integrity of the hybrid layer, 77 , favoring bond durability. CHX can be used as an antiproteolytic "primer" solution directly applied on the dentin surface, or after phosphoric acid etching and rinsing 74,78,79,80,81,82 or incorporated into the acid etching agent 83,84 or within the adhesive system composition. 74,85,86,87 The use of 2% CHX solution as an effective and nonspecific protease inhibitor primer, after acid-etching, is attractive from a clinical point of view, since it is already used in other oral health situations as an antimicrobial agent.…”

“…100 Besides, the degradation of the adhesive interface in primary teeth may be counteracted or blocked by the application of CHX as a therapeutic primer. 92,101 Avoiding to add another step in the adhesive treatment of dentin, 6,88 some investigators have studied the beneficial effects of incorporation CHX into the etchant 83,84 or the adhesive. 87,97,102,103,104 First strategy was alleged to reduce the effectiveness of CHX in the inhibition of MMPs and CCs, due to the limited contact time and the little concentration of CHX at the moment of adhesive application.…”

“…Inhibitors of endogenous dentin proteases other than CHX, such as the quaternary ammonium surface-acting benzalkonium chloride (BAC) 124,125,126,127 the tetracyclines (TCs) and their antimicrobially inactive analogs (minocycline, for now), 71,84,128,129,130 bisphosphonates (batimastat, galardin, and zoled ron ate), 93,129,131,132 g reen tea poly phenol epigallocatechin-3-gallate (EGCG), 40,133,134 and the chelating agent ethylenediaminetetraacetic acid (EDTA) 135,136,137 are being studied as better alternatives associated with dentin hybrid layer preservation.…”