Effect of Chlorhexidine on Immediate and Delayed Bond Strength between Resin and Dentin of Primary Teeth: A Systematic Review and Meta-Analysis
Chlorhexidine & Bond Strength to Primary Dentin
Abstract
Objectives: The purpose of this study was to systematically review the literature and use meta-analysis to investigate whether chlorhexidine (CHX) application after acid etching as an adjunct treatment has any influence on the immediate and delayed bond strength to primary dentin.
Materials and Methods: In this review, PubMed, ISI (all data bases), Scopus and Cochrane were searched according to the selected keywords up to April 30, 2018. The full texts of all published articles that met our primary inclusion criteria were obtained. The studies were analyzed in two parts: in vitro studies that evaluated the effect of CHX application during the bonding procedures (application after acid etching) on immediate and delay dentin bond strength of resin-dentin interface.
Results: The initial search yielded 214 publications, of which 8 were selected after thorough methodological assessment. None of the clinical studies fulfilled the eligibility criteria. Our results indicated that in comparison to the control group, CHX significantly reduced immediate resin-dentin bond strength (P=0.043). These values were increased after aging (P<0.001).
Conclusion: Based on this invitro Meta-analysis CHX application, improve resin-dentin bond strength durability in primary teeth.
1. De Munck J, Van Landuyt K, Peumans M, Poitevin A, Lambrechts P, Braem M, et al. A critical review of the durability of adhesion to tooth tissue: methods and results. J Dent Res. 2005 Feb;84(2):118-32.
2. Frankenberger R, Pashley DH, Reich SM, Lohbauer U, Petschelt A, Tay FR. Characterisation of resin-dentine interfaces by compressive cyclic loading. Biomaterials. 2005 May;26(14):2043-52.
3. Carrilho MR, Geraldeli S, Tay F, de Goes MF, Carvalho RM, Tjäderhane L, et al. In vivo preservation of the hybrid layer by chlorhexidine. J Dent Res. 2007 Jun;86(6):529-33.
4. Hashimoto M, Ohno H, Endo K, Kaga M, Sano H, Oguchi H. The effect of hybrid layer thickness on bond strength: demineralized dentin zone of the hybrid layer. Dent Mater. 2000 Nov;16(6):406-11.
5. Hebling J, Pashley DH, Tjäderhane L, Tay FR. Chlorhexidine arrests subclinical degradation of dentin hybrid layers in vivo. J Dent Res. 2005 Aug;84(8):741-6.
6. Tjäderhane L, Larjava H, Sorsa T, Uitto VJ, Larmas M, Salo T. The activation and function of host matrix metalloproteinases in dentin matrix breakdown in caries lesions. J Dent Res. 1998 Aug;77(8):1622-9.
7. Carrilho MR, Tay FR, Donnelly AM, Agee KA, Tjäderhane L, Mazzoni A, et al. Host-derived loss of dentin matrix stiffness associated with solubilization of collagen. J Biomed Mater Res B Appl Biomater. 2009 Jul;90(1):373-80.
8. Birkedal-Hansen H. Matrix metalloproteinases. Adv Dent Res. 1995 Nov;9(3 Suppl):16.
9. Sternlicht MD, Werb Z. How matrix metalloproteinases regulate cell behavior. Annu Rev Cell Dev Biol. 2001;17:463-516.
10. Sulkala M, Tervahartiala T, Sorsa T, Larmas M, Salo T, Tjäderhane L. Matrix metalloproteinase-8 (MMP-8) is the major collagenase in human dentin. Arch Oral Biol. 2007 Feb;52(2):121-7.
11. Pashley DH, Tay FR, Yiu C, Hashimoto M, Breschi L, Carvalho RM, et al. Collagen degradation by host-derived enzymes during aging. J Dent Res. 2004 Mar;83(3):216-21.
12. Nakabayashi N, Watanabe A, Arao T. A tensile test to facilitate identification of defects in dentine bonded specimens. J Dent. 1998 May;26(4):379-85.
13. Spencer P, Wang Y. Adhesive phase separation at the dentin interface under wet bonding conditions. J Biomed Mater Res. 2002 Dec 5;62(3):447-56.
14. Ricci HA, Sanabe ME, Costa CA, Hebling J. Effect of chlorhexidine on bond strength of two-step etch-and-rinse adhesive systems to dentin of primary and permanent teeth. Am J Dent. 2010 Jun;23(3):128-32.
15. Leitune VC, Portella FF, Bohn PV, Collares FM, Samuel SM. Influence of chlorhexidine application on longitudinal adhesive bond strength in deciduous teeth. Braz Oral Res. 2011 Sep-Oct;25(5):388-92.
16. Carrilho MR, Carvalho RM, de Goes MF, di Hipólito V, Geraldeli S, Tay FR, et al. Chlorhexidine preserves dentin bond in vitro. J Dent Res. 2007 Jan;86(1):90-4.
17. Nör JE, Feigal RJ, Dennison JB, Edwards CA. Dentin bonding: SEM comparison of the resin-dentin interface in primary and permanent teeth. J Dent Res. 1996 Jun;75(6):1396-403.
18. Nör JE, Feigal RJ, Dennison JB, Edwards CA. Dentin bonding: SEM comparison of the dentin surface in primary and permanent teeth. Pediatr Dent. 1997 May-Jun;19(4):246-52.
19. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009 Jul 21;6(7):e1000100.
20. Sarkis-Onofre R, Skupien JA, Cenci MS, Moraes RR, Pereira-Cenci T. The role of resin cement on bond strength of glass-fiber posts luted into root canals: a systematic review and meta-analysis of in vitro studies. Oper Dent. 2014 Jan-Feb;39(1):E31-44.
21. Jones P.M. COMBINE: Stata Module to Combine n, Mean, and SD from Two Groups According to the Cochrane-RECOMMENDED Formula for Meta-Analyses. [(accessed on 2 March 2021)];2011 Available online: https://ideas.repec.org/c/boc/bocode/s457265.html
22. Ersin NK, Candan U, Aykut A, Eronat C, Belli S. No adverse effect to bonding following caries disinfection with chlorhexidine. J Dent Child (Chic). 2009 Jan-Apr;76(1):20-7.
23. Kapdan A, Öztaş N. Effects of chlorhexidine and gaseous ozone on microleakage and on the bond strength of dentin bonding agents with compomer restoration on primary teeth. J Dent Sci. 2015;10(1):46-54.
24. Lenzi TL, Tedesco TK, Soares FZM, Loguercio AD, de Oliveira Rocha R. Chlorhexidine application for bond strength preservation in artificially-created caries-affected primary dentin. Int J Adhes Adhes. 2014;54:51-6.
25. Manfro AR, Reis A, Loguercio AD, Imparato JC, Raggio DP. Effect of different concentrations of chlorhexidine on bond strength of primary dentin. Pediatr Dent. 2012 Mar-Apr;34(2):e11-5.
26. Oznurhan F, Ozturk C, Ekci ES. Effects of different cavity-disinfectants and potassium titanyl phosphate laser on microtensile bond strength to primary dentin. Niger J Clin Pract. 2015 May-Jun;18(3):400-4.
27. Vieira Rde S, da Silva IA Jr. Bond strength to primary tooth dentin following disinfection with a chlorhexidine solution: an in vitro study. Pediatr Dent. 2003 Jan-Feb;25(1):49-52.
28. van Strijp AJ, Jansen DC, DeGroot J, ten Cate JM, Everts V. Host-derived proteinases and degradation of dentine collagen in situ. Caries Res. 2003 Jan-Feb;37(1):58-65.
29. Zhang SC, Kern M. The role of host-derived dentinal matrix metalloproteinases in reducing dentin bonding of resin adhesives. Int J Oral Sci. 2009 Dec;1(4):163-76.
30. Mazzoni A, Mannello F, Tay FR, Tonti GA, Papa S, Mazzotti G, Di Lenarda R, Pashley DH, Breschi L. Zymographic analysis and characterization of MMP-2 and -9 forms in human sound dentin. J Dent Res. 2007 May;86(5):436-40.
31. Mazzoni A, Pashley DH, Nishitani Y, Breschi L, Mannello F, Tjäderhane L, Toledano M, Pashley EL, Tay FR. Reactivation of inactivated endogenous proteolytic activities in phosphoric acid-etched dentine by etch-and-rinse adhesives. Biomaterials. 2006 Sep;27(25):4470-6.
32. Chaussain C, Boukpessi T, Khaddam M, Tjaderhane L, George A, Menashi S. Dentin matrix degradation by host matrix metalloproteinases: inhibition and clinical perspectives toward regeneration. Front Physiol. 2013 Nov 1;4:308.
33. Loguercio AD, Stanislawczuk R, Polli LG, Costa JA, Michel MD, Reis A. Influence of chlorhexidine digluconate concentration and application time on resin-dentin bond strength durability. Eur J Oral Sci. 2009 Oct;117(5):587-96.
34. Moon PC, Weaver J, Brooks CN. Review of matrix metalloproteinases' effect on the hybrid dentin bond layer stability and chlorhexidine clinical use to prevent bond failure. Open Dent J. 2010 Jul 20;4:147-52.
35. Osorio R, Yamauti M, Osorio E, Ruiz-Requena ME, Pashley D, Tay F, et al. Effect of dentin etching and chlorhexidine application on metalloproteinase-mediated collagen degradation. Eur J Oral Sci. 2011 Feb;119(1):79-85.
36. Breschi L, Mazzoni A, Nato F, Carrilho M, Visintini E, Tjäderhane L, et al. Chlorhexidine stabilizes the adhesive interface: a 2-year in vitro study. Dent Mater. 2010 Apr;26(4):320-5.
37. Stanislawczuk R, Amaral RC, Zander-Grande C, Gagler D, Reis A, Loguercio AD. Chlorhexidine-containing acid conditioner preserves the longevity of resin-dentin bonds. Oper Dent. 2009 Jul-Aug;34(4):481-90.
38. Zhou J, Tan J, Yang X, Xu X, Li D, Chen L. MMP-inhibitory effect of chlorhexidine applied in a self-etching adhesive. J Adhes Dent. 2011 Apr;13(2):111-5.
39. Gunaydin Z, Yazici AR, Cehreli ZC. In Vivo and In Vitro Effects of Chlorhexidine Pretreatment on Immediate and Aged Dentin Bond Strengths. Oper Dent. 2016 May-Jun;41(3):258-67.
40. Campos EA, Correr GM, Leonardi DP, Pizzatto E, Morais EC. Influence of chlorhexidine concentration on microtensile bond strength of contemporary adhesive systems. Braz Oral Res. 2009 Jul-Sep;23(3):340-5.
41. Hiraishi N, Yiu CK, King NM, Tay FR. Effect of 2% chlorhexidine on dentin microtensile bond strengths and nanoleakage of luting cements. J Dent. 2009 Jun;37(6):440-8.
42. Ricci HA, Sanabe ME, de Souza Costa CA, Pashley DH, Hebling J. Chlorhexidine increases the longevity of in vivo resin-dentin bonds. Eur J Oral Sci. 2010 Aug;118(4):411-6.
43. Hajizadeh H, Ghavamnasiri M, Majidinia S. Randomized clinical evaluation of the effect of chlorhexidine on postoperative sensitivity of posterior composite resin restorations. Quintessence Int. 2013 Nov-Dec;44(10):793-8.
44. Liu Y, Tjäderhane L, Breschi L, Mazzoni A, Li N, Mao J, Pashley DH, et al. Limitations in bonding to dentin and experimental strategies to prevent bond degradation. J Dent Res. 2011 Aug;90(8):953-68.
45. Carrilho MR, Carvalho RM, Sousa EN, Nicolau J, Breschi L, Mazzoni A, et al. Substantivity of chlorhexidine to human dentin. Dent Mater. 2010 Aug;26(8):779-85.
46. Costa AR, Naves LZ, Garcia-Godoy F, Tsuzuki FM, Correr AB, Correr-Sobrinho L, Puppin-Rontani RM. CHX Stabilizes the Resin/demineralized Dentin Interface. Braz Dent J. 2021 Jul-Aug;32(4):106-15.
2. Frankenberger R, Pashley DH, Reich SM, Lohbauer U, Petschelt A, Tay FR. Characterisation of resin-dentine interfaces by compressive cyclic loading. Biomaterials. 2005 May;26(14):2043-52.
3. Carrilho MR, Geraldeli S, Tay F, de Goes MF, Carvalho RM, Tjäderhane L, et al. In vivo preservation of the hybrid layer by chlorhexidine. J Dent Res. 2007 Jun;86(6):529-33.
4. Hashimoto M, Ohno H, Endo K, Kaga M, Sano H, Oguchi H. The effect of hybrid layer thickness on bond strength: demineralized dentin zone of the hybrid layer. Dent Mater. 2000 Nov;16(6):406-11.
5. Hebling J, Pashley DH, Tjäderhane L, Tay FR. Chlorhexidine arrests subclinical degradation of dentin hybrid layers in vivo. J Dent Res. 2005 Aug;84(8):741-6.
6. Tjäderhane L, Larjava H, Sorsa T, Uitto VJ, Larmas M, Salo T. The activation and function of host matrix metalloproteinases in dentin matrix breakdown in caries lesions. J Dent Res. 1998 Aug;77(8):1622-9.
7. Carrilho MR, Tay FR, Donnelly AM, Agee KA, Tjäderhane L, Mazzoni A, et al. Host-derived loss of dentin matrix stiffness associated with solubilization of collagen. J Biomed Mater Res B Appl Biomater. 2009 Jul;90(1):373-80.
8. Birkedal-Hansen H. Matrix metalloproteinases. Adv Dent Res. 1995 Nov;9(3 Suppl):16.
9. Sternlicht MD, Werb Z. How matrix metalloproteinases regulate cell behavior. Annu Rev Cell Dev Biol. 2001;17:463-516.
10. Sulkala M, Tervahartiala T, Sorsa T, Larmas M, Salo T, Tjäderhane L. Matrix metalloproteinase-8 (MMP-8) is the major collagenase in human dentin. Arch Oral Biol. 2007 Feb;52(2):121-7.
11. Pashley DH, Tay FR, Yiu C, Hashimoto M, Breschi L, Carvalho RM, et al. Collagen degradation by host-derived enzymes during aging. J Dent Res. 2004 Mar;83(3):216-21.
12. Nakabayashi N, Watanabe A, Arao T. A tensile test to facilitate identification of defects in dentine bonded specimens. J Dent. 1998 May;26(4):379-85.
13. Spencer P, Wang Y. Adhesive phase separation at the dentin interface under wet bonding conditions. J Biomed Mater Res. 2002 Dec 5;62(3):447-56.
14. Ricci HA, Sanabe ME, Costa CA, Hebling J. Effect of chlorhexidine on bond strength of two-step etch-and-rinse adhesive systems to dentin of primary and permanent teeth. Am J Dent. 2010 Jun;23(3):128-32.
15. Leitune VC, Portella FF, Bohn PV, Collares FM, Samuel SM. Influence of chlorhexidine application on longitudinal adhesive bond strength in deciduous teeth. Braz Oral Res. 2011 Sep-Oct;25(5):388-92.
16. Carrilho MR, Carvalho RM, de Goes MF, di Hipólito V, Geraldeli S, Tay FR, et al. Chlorhexidine preserves dentin bond in vitro. J Dent Res. 2007 Jan;86(1):90-4.
17. Nör JE, Feigal RJ, Dennison JB, Edwards CA. Dentin bonding: SEM comparison of the resin-dentin interface in primary and permanent teeth. J Dent Res. 1996 Jun;75(6):1396-403.
18. Nör JE, Feigal RJ, Dennison JB, Edwards CA. Dentin bonding: SEM comparison of the dentin surface in primary and permanent teeth. Pediatr Dent. 1997 May-Jun;19(4):246-52.
19. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009 Jul 21;6(7):e1000100.
20. Sarkis-Onofre R, Skupien JA, Cenci MS, Moraes RR, Pereira-Cenci T. The role of resin cement on bond strength of glass-fiber posts luted into root canals: a systematic review and meta-analysis of in vitro studies. Oper Dent. 2014 Jan-Feb;39(1):E31-44.
21. Jones P.M. COMBINE: Stata Module to Combine n, Mean, and SD from Two Groups According to the Cochrane-RECOMMENDED Formula for Meta-Analyses. [(accessed on 2 March 2021)];2011 Available online: https://ideas.repec.org/c/boc/bocode/s457265.html
22. Ersin NK, Candan U, Aykut A, Eronat C, Belli S. No adverse effect to bonding following caries disinfection with chlorhexidine. J Dent Child (Chic). 2009 Jan-Apr;76(1):20-7.
23. Kapdan A, Öztaş N. Effects of chlorhexidine and gaseous ozone on microleakage and on the bond strength of dentin bonding agents with compomer restoration on primary teeth. J Dent Sci. 2015;10(1):46-54.
24. Lenzi TL, Tedesco TK, Soares FZM, Loguercio AD, de Oliveira Rocha R. Chlorhexidine application for bond strength preservation in artificially-created caries-affected primary dentin. Int J Adhes Adhes. 2014;54:51-6.
25. Manfro AR, Reis A, Loguercio AD, Imparato JC, Raggio DP. Effect of different concentrations of chlorhexidine on bond strength of primary dentin. Pediatr Dent. 2012 Mar-Apr;34(2):e11-5.
26. Oznurhan F, Ozturk C, Ekci ES. Effects of different cavity-disinfectants and potassium titanyl phosphate laser on microtensile bond strength to primary dentin. Niger J Clin Pract. 2015 May-Jun;18(3):400-4.
27. Vieira Rde S, da Silva IA Jr. Bond strength to primary tooth dentin following disinfection with a chlorhexidine solution: an in vitro study. Pediatr Dent. 2003 Jan-Feb;25(1):49-52.
28. van Strijp AJ, Jansen DC, DeGroot J, ten Cate JM, Everts V. Host-derived proteinases and degradation of dentine collagen in situ. Caries Res. 2003 Jan-Feb;37(1):58-65.
29. Zhang SC, Kern M. The role of host-derived dentinal matrix metalloproteinases in reducing dentin bonding of resin adhesives. Int J Oral Sci. 2009 Dec;1(4):163-76.
30. Mazzoni A, Mannello F, Tay FR, Tonti GA, Papa S, Mazzotti G, Di Lenarda R, Pashley DH, Breschi L. Zymographic analysis and characterization of MMP-2 and -9 forms in human sound dentin. J Dent Res. 2007 May;86(5):436-40.
31. Mazzoni A, Pashley DH, Nishitani Y, Breschi L, Mannello F, Tjäderhane L, Toledano M, Pashley EL, Tay FR. Reactivation of inactivated endogenous proteolytic activities in phosphoric acid-etched dentine by etch-and-rinse adhesives. Biomaterials. 2006 Sep;27(25):4470-6.
32. Chaussain C, Boukpessi T, Khaddam M, Tjaderhane L, George A, Menashi S. Dentin matrix degradation by host matrix metalloproteinases: inhibition and clinical perspectives toward regeneration. Front Physiol. 2013 Nov 1;4:308.
33. Loguercio AD, Stanislawczuk R, Polli LG, Costa JA, Michel MD, Reis A. Influence of chlorhexidine digluconate concentration and application time on resin-dentin bond strength durability. Eur J Oral Sci. 2009 Oct;117(5):587-96.
34. Moon PC, Weaver J, Brooks CN. Review of matrix metalloproteinases' effect on the hybrid dentin bond layer stability and chlorhexidine clinical use to prevent bond failure. Open Dent J. 2010 Jul 20;4:147-52.
35. Osorio R, Yamauti M, Osorio E, Ruiz-Requena ME, Pashley D, Tay F, et al. Effect of dentin etching and chlorhexidine application on metalloproteinase-mediated collagen degradation. Eur J Oral Sci. 2011 Feb;119(1):79-85.
36. Breschi L, Mazzoni A, Nato F, Carrilho M, Visintini E, Tjäderhane L, et al. Chlorhexidine stabilizes the adhesive interface: a 2-year in vitro study. Dent Mater. 2010 Apr;26(4):320-5.
37. Stanislawczuk R, Amaral RC, Zander-Grande C, Gagler D, Reis A, Loguercio AD. Chlorhexidine-containing acid conditioner preserves the longevity of resin-dentin bonds. Oper Dent. 2009 Jul-Aug;34(4):481-90.
38. Zhou J, Tan J, Yang X, Xu X, Li D, Chen L. MMP-inhibitory effect of chlorhexidine applied in a self-etching adhesive. J Adhes Dent. 2011 Apr;13(2):111-5.
39. Gunaydin Z, Yazici AR, Cehreli ZC. In Vivo and In Vitro Effects of Chlorhexidine Pretreatment on Immediate and Aged Dentin Bond Strengths. Oper Dent. 2016 May-Jun;41(3):258-67.
40. Campos EA, Correr GM, Leonardi DP, Pizzatto E, Morais EC. Influence of chlorhexidine concentration on microtensile bond strength of contemporary adhesive systems. Braz Oral Res. 2009 Jul-Sep;23(3):340-5.
41. Hiraishi N, Yiu CK, King NM, Tay FR. Effect of 2% chlorhexidine on dentin microtensile bond strengths and nanoleakage of luting cements. J Dent. 2009 Jun;37(6):440-8.
42. Ricci HA, Sanabe ME, de Souza Costa CA, Pashley DH, Hebling J. Chlorhexidine increases the longevity of in vivo resin-dentin bonds. Eur J Oral Sci. 2010 Aug;118(4):411-6.
43. Hajizadeh H, Ghavamnasiri M, Majidinia S. Randomized clinical evaluation of the effect of chlorhexidine on postoperative sensitivity of posterior composite resin restorations. Quintessence Int. 2013 Nov-Dec;44(10):793-8.
44. Liu Y, Tjäderhane L, Breschi L, Mazzoni A, Li N, Mao J, Pashley DH, et al. Limitations in bonding to dentin and experimental strategies to prevent bond degradation. J Dent Res. 2011 Aug;90(8):953-68.
45. Carrilho MR, Carvalho RM, Sousa EN, Nicolau J, Breschi L, Mazzoni A, et al. Substantivity of chlorhexidine to human dentin. Dent Mater. 2010 Aug;26(8):779-85.
46. Costa AR, Naves LZ, Garcia-Godoy F, Tsuzuki FM, Correr AB, Correr-Sobrinho L, Puppin-Rontani RM. CHX Stabilizes the Resin/demineralized Dentin Interface. Braz Dent J. 2021 Jul-Aug;32(4):106-15.
| Issue | Vol 19 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v19i39.11749 | |
| Keywords | ||
| Dental Stress Analysis Chlorhexidine Tooth Deciduous | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Ebrahimi M, Majidinia S, Sarraf A. Effect of Chlorhexidine on Immediate and Delayed Bond Strength between Resin and Dentin of Primary Teeth: A Systematic Review and Meta-Analysis. Front Dent. 2022;19.
