Mechanical properties and modeling of drug release from chlorhexidine-containing etch-and-rinse adhesives

Bonding efficiency and durability: current possibilities

“…103 A reservoir of CHX for controlled release would be derived from its inclusion into primers and/or adhesives: 87 addition of relatively low CHX concentrations to commercial adhesive, chiefly in ethanol-solvated hydrophobic resins, was shown feasible in this sense. 85,86,87 Controversial results look as if they were related to the concentration of CHX added to the adhesive formulation and/or to the chemical compositions of the adhesives, 93,102,107,108 which may influence resin water sorption, and hence its solubility, degree of conversion, and mechanical properties. 85,109 To endorse CHX incorporation into adhesives, Stanislawczuk et al 87 advised the conduction of further studies in more clinically relevant conditions.…”

“…85,86,87 Controversial results look as if they were related to the concentration of CHX added to the adhesive formulation and/or to the chemical compositions of the adhesives, 93,102,107,108 which may influence resin water sorption, and hence its solubility, degree of conversion, and mechanical properties. 85,109 To endorse CHX incorporation into adhesives, Stanislawczuk et al 87 advised the conduction of further studies in more clinically relevant conditions. In vitro studies have already attested that CHXcontaining primers of two-step self-etch and simplified etch-and-rinse adhesives are capable of, respectively, inhibiting MMPs 108 and reducing nanoleakage, 104 precluding time-related bond strength loss.…”

“…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. 88 Compared to control, aged CHX-treated dentin relates to higher bond strength values 73,74,77,78,79,80,89,90,91,92 which are interestingly equivalent to each other in most of the immediate evaluations.…”

“…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. It should be considered that CHX is leached from demineralized and mineralized powdered human dentin with water rinsing.…”

Dentin Bonding: Can We Make it Last?

“…90 Two-step SE adhesive with chlorhexidine added into the primer is effective in inhibiting dentinal MMPs 69 and preventing bond strength loss in vitro, 66 and adding chlorhexidine into simplified ER adhesive reduces nanoleakage and time-related loss of bond strength 83 without affecting mechanical properties. 83,91 The first commercially available adhesive system containing 0.2% chlorhexidine (Peak Universal Bond, Ultradent Products Inc, South Jordan, UT, USA) was introduced recently. Whether it is effective in preventing the hybrid layer degradation and time-related loss of bond strength remains to be demonstrated.…”