School of Dentistry, Department of Restorative Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil.
J Dent. 2011 Jan;39(1):40-7. doi: 10.1016/j.jdent.2010.10.001. Epub 2010 Oct 29.
This study evaluated the effect of 2% chlorhexidine-containing acid (Ac/CHX) and 2% chlorhexidine digluconate solution (CHX) on immediate (IM) and 2-year (2Y) resin-dentin bond strength (BS) and silver nitrate uptake (SNU) for two simplified etch-and-rinse adhesives.
Forty-two caries-free extracted molars had a flat dentin surface exposed. In the control groups (groups 1), the surfaces were acid etched with conventional phosphoric acid and the adhesives Prime&Bond NT (PB) or Adper Single Bond 2 (SB) was applied after rinsing, drying and rewetting with water. In groups 2, Ac/CHX groups the adhesives were applied in a similar manner; however a 2% CHX-containing acid was previously applied. In groups 3, the adhesives were applied according to the control group; however the rewetting procedure was performed with an aqueous solution of 2% CHX for 60s. Composite build-ups were constructed incrementally and microtensile specimens (0.8mm(2)) were prepared for microtensile bond strength testing in the IM or 2Y periods at 0.5mm/min. For SNU, 2 bonded sticks from each tooth were coated with nail varnish, placed in the silver nitrate, polished down with SiC papers and analysed by EDX-SEM. The data from each adhesive was submitted to a two-way repeated measures ANOVA and Tukey's test (α=0.05).
After 2Y, significant reductions of BS were observed for both adhesives in the control group (p<0.05). In Ac/CHX or CHX groups the BS remained stable for both systems. SNU was more evident in the control than in the experimental groups (p<0.05) both in IM and 2Y periods. The use of CHX in an aqueous solution or associated with the acid conditioner was effective to reduce the degradation of dentin bonds over a 2-year period.
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.
本研究评估了 2%盐酸氯己定(Ac/CHX)和 2%葡萄糖酸氯己定溶液(CHX)对两种简化酸蚀-冲洗型粘结剂即刻(IM)和 2 年(2Y)树脂-牙本质粘结强度(BS)和硝酸银摄取(SNU)的影响。
42 颗无龋磨牙暴露平坦的牙本质表面。在对照组(第 1 组)中,用传统磷酸酸蚀表面,在冲洗、干燥和用去离子水重新润湿后,使用 Prime&Bond NT(PB)或 Adper Single Bond 2(SB)粘结剂。在 Ac/CHX 组中,以类似的方式应用粘结剂;然而,之前应用了 2%含 CHX 的酸。在第 3 组中,粘结剂以对照组的方式应用;然而,重新润湿步骤是用 2%CHX 的水溶液进行 60s。复合修复体以增量方式构建,并在 IM 或 2Y 期以 0.5mm/min 的速度制备 0.8mm(2)的微拉伸试件进行微拉伸粘结强度测试。对于 SNU,从每颗牙齿上取 2 个粘结棒用指甲油涂覆,置于硝酸银中,用 SiC 纸抛光后,用 EDX-SEM 进行分析。每个粘结剂的数据均采用双向重复测量方差分析和 Tukey 检验(α=0.05)。
在 2Y 时,对照组中两种粘结剂的 BS 均显著降低(p<0.05)。在 Ac/CHX 或 CHX 组中,两种系统的 BS 均保持稳定。与实验组相比,IM 和 2Y 期时,对照组的 SNU 更明显(p<0.05)。在水溶液中或与酸处理剂联合使用 CHX 可有效减少牙本质粘结剂在 2 年内的降解。
在酸性处理剂中添加葡萄糖酸氯己定可能是一种很好的工具,可在无需额外步骤的情况下增加混合层胶原纤维对宿主来源的金属蛋白酶的长期稳定性,而无需额外步骤用于粘结方案。