Comparison of Dentin Microshear Bond Strength of Chlorhexidine on Two Step Self-etch Adhesives with and without Fluoride after 6-month storage in water

Document Type : Original Article


1 Assistant professor of Odontología Operativa.Department of Odontología Operativa, Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Resident of Odontología Operativa.Department of Odontología Operativa, Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Assistant Professor of Odontología Operativa.Department of Odontología Operativa, Faculty of Dentistry, University of Medical Sciences Kohgiluyeh Boyer Ahmad, Yasouj, Iran.


Background and Objective: Regarding the possible leakage of the bacteria in the cavity; the use of antibacterial agents such as chlorhexidine in the adhesive restorations has been proposed. However, the effect of this process on the long-term bond strength to the dentin has not been studied completely. This study assessed the effects of chlorhexidine on the dentine micro-shear bond strength of two-stage self-etch adhesives with and without fluoride after 6-month storage in water.
Subjects and Methods: In this in vitro study, 40 extracted human mandibular third molars were obtained and after dentin exposure and polishing with silicone carbide for standard smear layer preparation; they were assigned into 4 groups. With or without using chlorhexidine adhesives of Clearfil SE Bond and Clearfil Liner Bond F were applied to the dentin surface and the teeth were restored with Z250 composite. The teeth were incubated for 6 months at 37 °C temperature and 100% moisture and received 1000 thermal cycles. The microshear bond strength of the specimens was determined and their fracture patterns were determined by streomicroscope. The data were analyzed by one-sided analysis of variances test while the paired comparisons were done by Tukey test. 
Results: Application of chlorhexidine at dentin surface since performing by adhesive sel-fetch did not cause any seriouse adverse effects on bond strength. Mean±standard deviation of the bond strength values with and without the application of chlorhexidine for the Clearfil SE Bond were 20.66±3.27 and17.48±7.11 MPa. The figures were 31.63±7.33  and 31.42±11.39 MPa for Clearfil Liner Bond F adhesive (P>0/05).
Conclusion:Because of antibaterial effect of chlorhexidine and having no negative effect on bond strength; surface preparation with this agent beside using fluoride-containing adhesives is suggested to eradicate the existing bacteria and decreases microleakage in the clinical condition without compromising bond strerngth.


1-Brannstrom M. The cause of post restorative sensitivity and its prevention. J Endod. 1986;12(10):475-481.
2-Boston DW, Graver HT. Histological study of an acid red caries-disclosing dye. Oper Dent .1989;14(4):186-192.
3-Schouboe T, Macdonald JB. Prolonged viability of organisms sealed in dentinal caries. Arch Oral Biol. 1962;7:525-526.
4-Leung RL, Loesche WJ, Charbeneau GT. Effect of Dycal on bacteria in deep carious lesions. J Am Dent Assoc.1980;100(2):193-197.
5-Ersin NK, Uzel A, Aykut A, Candan U, Eronat C. Inhibition of cultivable bacteria by chlorhexidine treatment of dentin lesions treated with the ART technique. Caries Res.2006;40:172–177
6-Fure  Fure S, Emilson CG. Effect of chlorhexidine gel treatment supplemented with chlorhexidine varnish and resin on mutans streptococci and actinomyces on the root surfaces. Caries Res 1990;24:242-247.
7-Agrawal N, Agrawal H, Patel P. Effect of cavity disinfection with chlorhexidine on microleakage of composite restorations using total etch and self-etch single bottle adhesive systems: an in-vitro study. Int J Healthcare & Biomed Res 2013;2(1):43-47.
8-Matthigs Matthijs S, Adriaens PA. Chlorhexidine varnishes: A review. J Clin Periodontol 2002;29(1):1-8.
9-Baseren M, Yazici R, Ozalp M, Dayangac B. Antibacterial activity of different generation dentin-bonding system. Quintessence Int .2005; 36(5):339-344.
10-Nishitani Y, Yoshiyama M, Wadgaonkar B, Breschi L, Mannello F, Pashley DH. Activation of gelatinolytic / collagenolytic activity in dentin by self-etching adhesives. Eur J Oral Sci. 2006;114(2):160-166.
11-Tay FR, Pashley DH, Loushine RJ, Weller RN, Monticelli F, Osorio R. Self-etching adhesives increase collagenolytic activity in the radicular dentin. J Endod .2006;32(9):862-868.
12-Heyman H O,Swift JR E,Ritter A.Sturdevants Art and Science of operative dentistry.6th ed.St.louis:Mosby;2013; 129.
13-Pashey DH, Carvalho RM. Dentin permeability and dentin adhesion. J Dent .1997;25:355-372.
14-Li F, Chen J, Chai Z, Xiao Y, Fang M, Ma S. Effect of a dental adhesive incorporating antibacterial monomer on the growth, adherence and membrane integrity of streptococcus mutans. J Dent .2009;37:289-296.
15-Svanberg M,Westergren G. Effect of snF2 ,administered as mouthrinese or topically applied on streptococcus mutans, streptococcus sanguis and lactobacilli in dental plaque and saliva. Scand J Dent Res .1983(2);123-129.
16-Tay FR, Sano H, Carvalho R. An ultra-structural study of the influence of acidity of self-etching primers and smear layer thickness on bonding to intact dentin. J Adhes Dent .2000;2:83-98.
17-Peumans M, De-Munck J, van-Landuty KL. Eight–year clinical evaluation of a 2-step self-etch adhesive with and without selective enamel etching. Dent Mater. 2010;26:1176-1184.
18-Thanaratikul B,Santiwong B.Self etch or etch and rins mode did not effect the microshear bond strength of a universal adhesive to primary dentin.Dent Mater J.2016;35(2):174-9.
19-Da Cunha SR,Ramos PA.Effects of different radiation doses on the bond strengths of two different adhesive systems to enamel and dentin.J Adhes Dent .2016;18(2):151-6.
20-Shafie F, Armaghan A, Alavi AA. Effect of chlorhexidine on bonding durability of two self-etching adhesives with and without antibacterial agent to dentin. Dent Res J .2013;10(6):795–801.
21-Manfro J,Reis A.Effect of chlorhexidine concentration on the bond strength to dentin in primary teeth.Rev Odonto Cienc.2010;25(1)88-91.
22-Brackett WW, Tay FR, Brackett MG, Dib A, Sword RJ, Pashley DH. The effect of chlorhexidine on dentin hybrid layers in vivo. Oper Dent .2007;32:107–111.
23-Hebling J, Pashley DH, Tjäderhane L, Tay FR. Chlorhexidine arrests subclinical degradation of dentin hybrid layers in vivo. J Dent Res .2005; 84(8):741-746.
24-Carrilho MR, Geraldeli S, Tay F, de-Goes MF, Carvalho RM, Tjäderhane L. In vivo preservation of the hybrid layer by chlorhexidine. J Dent Res. 2007;86(6):529-533.
25-Zhou J, Tan J, Chen L, Li D, Tan Y. The incorporation of chlorhexidine in a two-step self-etching adhesive preserves dentin bond in vitro. J Dent. 2009;37:807-812.
26-de Castro FLA, de Andrade MF, Duarte Junior SLL, Geraldo Vaz L. Effect of 2% chlorhexidine on microtensile bond strength of composite to dentin. J Adhes Dent .2003;5:129-138.
28-Perdigao J, Denehy GE, Swift EJ Jr. Effects of chlorhexidine on dentin surfaces and shear bond strengths. Am J Dent .1994;7(2):81-84.
29-Mobarak EH. Effect of chlorhexidine pretreatment on bond strength durability of caries-affected dentin over 2-year aging in artificial saliva and under simulated intrapulpal pressure. Oper Dent. 2011;36:649-660.
30-Ercan E, Erdemir A, Zorba YO, Eldeniz AU, Dalli M, Ince B, et al. Effect of different cavity disinfectants on shear bond strength of composite resin to dentin. J Adhes Dent. 2009;11:343-346.
31-Say EC, Koray F, Tarim B, Soyman M, Gulmez T. In vitro effect of cavity disinfectants on the bond strength of dentin bonding systems. Quintessence Int .2004;35(1):56-60
32-Hiraishi N, Yiu CK, King NM, Tay FR. Effect of chlorhexidine incorporation into a self-etching primer on dentine bond strength of a luting cement. J Dent .2010;38:496-502.
33-Toba S, Pereira PNR, Nikaido T, Tagami J. Effect of topical application of fluoride gel on artificial secondary caries inhibition. Inter Chin J Dent .2003;3:53-61.
34-Itota T, Torii Y, Nakabo S, Tashiro Y, Konishi N, Nagamine M, Yoshiyama M. Effect of fluoride-releasing adhesive system on decalcified dentin. J Oral Rehabil. 2003;30:178-183.
35-Carvalho RM, Chersoni S, Frankenberger R, Pashley DH, Prati C, Tay FR. A challenge to the conventional wisdom that simultaneous etching and resin infiltration always occurs in self-etch adhesives. Biomaterials. 2005;26:1035-1042.
36-Shinohara MS, De Goes MF, Schneider LF, Ferracane JL, Pereira PN, Di-Hipólito V, Nikaido T. Fluoride-containing adhesive: durability on dentin bonding. Dent Mater .2009;25:1383-139.
37-Nakajima M, Okuda M, Ogata M, Pereira PNR, Tagami J, Pashley DH. The durability of a fluoride-releasing resin adhesive system to dentin. Opera Dent .2003;28:186-192.
38-Mathewson RJ, Primosch RE. Fundamentals of pediatric dentistry. Quintessence Publishing Co. Inc. 3rd Ed. 1995;Chap3:105-118.
39-Nizel A, Papas AS. Nutrition in clinical dentistry. Philadelphia. WB Saunders. 3rd ed. 1989;167-210.
40-Cal E, Türkün LS, Türkün M, Toman M, Toksavul S. Effect of an antibacterial adhesive on the bond strength of three different luting resin composites. J Dent. 2006;34:372–380.
41-Cobanoglu N, Ozturk B, Sengun A, Cetin AR, Ozer F. Effect of accelerated aging on the bonding performance of fluoridated adhesive resins. Dent Mater J .2014;33(1):92–97.