Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Eur Rev Med Pharmacol Sci. 2024 Jan;28(1):39-48. doi: 10.26355/eurrev_202401_34889.
OBJECTIVE: The aim of the study was to assess the disinfection efficacy, bond integrity, and nano hardness of caries-affected dentin (CAD) surface bonded to resin cement when disinfected with chlorhexidine (CHX), Methylene blue activated by Photodynamic therapy (MB-PDT), chitosan, silver diamine fluoride (SDF), chitosan activated by PDT, and SDF-diode laser against S. mutans. MATERIALS AND METHODS: A total of 60 human mandibular molars were extracted non-traumatically and gathered using ICDAS criteria. The dentin surface was prepared, leaving CAD to receive a disinfection procedure. After inoculation with S. mutans, the CAD samples were divided into six groups and disinfected with various disinfectants (n = 10) CHX, MB-PDT, chitosan, chitosan-PDT, SDF, and SDF+ diode laser. Survival rates of S. mutans were analyzed following the restoration of samples with resin cement via the etch and rinse method to assess SBS. Also, nano hardness was analyzed. Statistical analysis was performed by using the ANOVA and the Tukey multiple test (p<0.05). The Kruskal-Wallis test was used to evaluate the change in survival rate. RESULTS: Related to the survival rates, the SDF+ diode laser displayed the highest reduction in S. mutans levels and chitosan presented the lowest level of disinfection. The intergroup comparison revealed that CHX and chitosan-PDT displayed comparable outcomes of S. mutans survival rate to that of SDF+ diode laser (p>0.05). Likewise, MB-PDT and SDF displayed a comparable survival rate of S. mutans to Chitosan disinfection (p>0.05). Considering SBS and nano hardness, the highest SBS and NH were exhibited by the SDF+ diode laser, and the lowest SBS and NH values were exhibited by MB-PDT. The intragroup comparison revealed that CAD specimens disinfected with Chitosan-PDT showed comparable SBS and NH values to the SDF+ diode laser (p>0.05). CHX, chitosan, and SDF exhibited bond values and NH comparable to MB-PDT (p<0.05). CONCLUSIONS: Synergistic use of Silver diamine fluoride with diode laser and chitosan activated by PDT can be used as an alternative to CHX for controlling S. mutans growth, promoting enhanced bond efficacy and nano hardness for bonding resin cement to the caries-affected dentin.
目的：本研究旨在评估氯己定（CHX）、光动力疗法激活亚甲蓝（MB-PDT）、壳聚糖、银胺氟化物（SDF）、光动力疗法激活壳聚糖和 SDF-二极管激光对受龋影响牙本质（CAD）表面粘接的树脂水泥的消毒效果、粘接完整性和纳米硬度，以及对 S. mutans 的消毒效果。
材料和方法：共从非创伤性提取 60 颗下颌磨牙，使用 ICDAS 标准收集。准备牙本质表面，留下 CAD 接受消毒程序。在接种 S. mutans 后，将 CAD 样本分为六组，用各种消毒剂（n = 10）CHX、MB-PDT、壳聚糖、壳聚糖-PDT、SDF 和 SDF-二极管激光进行消毒。通过蚀刻和冲洗法用树脂水泥修复样本后，分析 SBS 以分析 S. mutans 的存活率。还分析了纳米硬度。使用方差分析和 Tukey 多重检验（p<0.05）进行统计分析。使用 Kruskal-Wallis 检验评估生存率的变化。
结果：与生存率相关，SDF-二极管激光对 S. mutans 水平的降低效果最高，壳聚糖的消毒效果最低。组间比较显示，CHX 和壳聚糖-PDT 对 S. mutans 存活率的结果与 SDF-二极管激光相似（p>0.05）。同样，MB-PDT 和 SDF 对 S. mutans 的存活率与壳聚糖消毒相似（p>0.05）。考虑到 SBS 和纳米硬度，SDF-二极管激光表现出最高的 SBS 和 NH，而 MB-PDT 表现出最低的 SBS 和 NH 值。组内比较显示，用壳聚糖-PDT 消毒的 CAD 标本与 SDF-二极管激光的 SBS 和 NH 值相似（p>0.05）。CHX、壳聚糖和 SDF 的粘结值和 NH 与 MB-PDT 相似（p<0.05）。
结论：银胺氟化物与二极管激光联合使用以及光动力疗法激活壳聚糖可替代 CHX 用于控制 S. mutans 的生长，增强粘结树脂水泥与受龋影响牙本质的粘结效果和纳米硬度。
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