Bin-Shuwaish Mohammed S, AlHussaini Alhanouf A, AlHudaithy Lina H, AlDukhiel Shamma A, Al-Jamhan Abdullah S
Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia.
Department of Pediatric Dentistry, Tufts University School of Dental Medicine, Boston, USA.
Saudi Dent J. 2021 Nov;33(7):503-510. doi: 10.1016/j.sdentj.2020.09.006. Epub 2020 Oct 1.
This study compared microleakage of different resin based composite (RBC) materials bonded to dentin, after chlorhexidine (CHX) application, by different adhesion protocols of a universal adhesive system.
Class V cavities were prepared on the buccal and lingual surfaces of 40 premolar teeth. The "etch-and-rinse" technique of a universal bond adhesive system (Single Bond Universal Adhesive) was used on buccal preparations, while the "self-etch" protocol was used on the lingual surfaces. Two RBCs, one bulk fill (Filtek Bulk Fill [FBF]) and one conventional (Filtek Z350 XT [Z350XT]), were used. Teeth were divided into two groups of 20 teeth each, 10 per each RBC (n = 10): (1) control; and (2) pretreatment with 2% CHX. For FBF groups, teeth were restored with a single increment; however, for Z350XT, a layering technique was used. Teeth were aged by thermo-cycling and prepared for microleakage testing. Dye penetration was evaluated and scored from 0 to 4. Data were analyzed at a significance level of < 0.05.
The highest microleakage mean scores were found in the control group of the etched margins for both RBCs (2.80 ± 1.033 FBF and 2.10 ± 1.370 Z350XT). The CHX-pretreated group showed significantly lower microleakage than the control for FBF only ( = 0.008). No significant difference was found between groups for the "self-etch" protocol (χ = 0.884, = 0.08). No significant differences were found between FBF and Z350XT in all study groups ( > 0.2).
When the "self-etch" protocol of the universal adhesive system was used, dentin microleakage was not affected by CHX-pretreatment when teeth were restored with bulk fill or conventional RBCs. In the "etch-and-rinse" protocol, CHX application improved the marginal seal before restoration with bulk fill material. However, in the absence of CHX, the "etch-and-rinse" protocol negatively affected marginal integrity.
本研究比较了在使用通用粘结系统的不同粘结方案下，应用洗必泰（CHX）后，不同树脂基复合材料（RBC）与牙本质粘结的微渗漏情况。
在40颗前磨牙的颊面和舌面制备V类洞。颊面制备使用通用粘结剂系统（单键通用粘结剂）的“酸蚀冲洗”技术，而舌面使用“自酸蚀”方案。使用两种RBC，一种是大块充填材料（Filtek Bulk Fill [FBF]），另一种是传统材料（Filtek Z350 XT [Z350XT]）。牙齿分为两组，每组20颗，每种RBC各10颗（n = 10）：（1）对照组；（2）用2% CHX预处理组。对于FBF组牙齿，采用单次增量修复；然而，对于Z350XT组，采用分层技术。通过热循环使牙齿老化并准备进行微渗漏测试。评估染料渗透情况并从0到4进行评分。在显著性水平<0.05下分析数据。
两种RBC的蚀刻边缘对照组中均发现最高微渗漏平均评分（FBF为2.80±1.033，Z350XT为2.10±1.370）。CHX预处理组仅在FBF组中显示出显著低于对照组的微渗漏（P = 0.008）。“自酸蚀”方案组间未发现显著差异（χ = 0.884，P = 0.08）。所有研究组中FBF和Z350XT之间均未发现显著差异（P>0.2）。
当使用通用粘结系统的“自酸蚀”方案时，在用大块充填或传统RBC修复牙齿时，CHX预处理不会影响牙本质微渗漏。在“酸蚀冲洗”方案中，应用CHX可改善使用大块充填材料修复前的边缘封闭。然而，在未使用CHX的情况下，“酸蚀冲洗”方案会对边缘完整性产生负面影响。
