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In vivo Preservation of the Hybrid Layer by Chlorhexidine

¹ Department of Restorative Dentistry, Dental Materials Area, University of Campinas, Piracicaba School of Dentistry, Piracicaba/SP, Brazil;
² Department of Oral Biology and Maxillofacial Pathology,
⁴ Department of Endodontics, School of Dentistry, Medical College of Georgia, Augusta, GA 30912-1129, USA;
³ Department of Operative Dentistry, School of Dentistry, University of Iowa, Iowa City, IA, USA;
⁵ Department of Prosthodontics, University of São Paulo, Bauru School of Dentistry, Bauru/SP, Brazil;
⁶ Institute of Dentistry, University of Helsinki and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital (HUCU), Helsinki, Finland;
⁷ Department of Operative Dentistry, University of Guarulhos, School of Dentistry, Guarulhos/SP, Brazil;
⁸ Department of Orthodontics and Pediatric Dentistry, University of São Paulo State, Araraquara Dental School, Araraquara/SP, Brazil;
⁹ Department of SAU and FAL, University of Bologna, Bologna, Italy; and
¹⁰ Division of Dental Sciences and Biomaterials, Department of Biomedicine, University of Trieste, Trieste, Italy

^* corresponding author, DPASHLEY{at}mail.mcg.edu

Host-derived proteases have been reported to degrade the collagen matrix of incompletely-resin-infiltrated dentin. This study tested the hypothesis that interfacial degradation of resin-dentin bonds may be prevented or delayed by the application of chlorhexidine (CHX), a matrix metalloproteinase inhibitor, to dentin after phosphoric acid-etching. Contralateral pairs of resin-bonded Class I restorations in non-carious third molars were kept under intra-oral function for 14 months. Preservation of resin-dentin bonds was assessed by microtensile bond strength tests and TEM examination. In vivo bond strength remained stable in the CHX-treated specimens, while bond strength decreased significantly in control teeth. Resin-infiltrated dentin in CHX-treated specimens exhibited normal structural integrity of the collagen network. Conversely, progressive disintegration of the fibrillar network was identified in control specimens. Auto-degradation of collagen matrices can occur in resin-infiltrated dentin, but may be prevented by the application of a synthetic protease inhibitor, such as chlorhexidine.

KEY WORDS: etch-and-rinse adhesive • in vivo • hybrid layer • degradation • chlorhexidine • MMP