Effectiveness of pre-treatment with chlorhexidine in restoration retention: A 36-month follow-up randomized clinical trial

J Dent. 2017 May:60:44-49. doi: 10.1016/j.jdent.2017.02.014. Epub 2017 Feb 22.

Abstract

Objectives: This study evaluated the effect of the pre-treatment with 2% chlorhexidine digluconate (CHX) as coadjutant in restoration retention of noncarious cervical lesions (NCCL), after 36 months of follow-up.

Methods: A randomized controlled split-mouth and triple-blind (operators, patients and evaluator) trial was carried out. Patients (n=42) with at least two non-carious cervical lesions were included. The teeth with NCCL were randomly assigned to two treatment groups: application of 2% CHX (experimental group) or a placebo solution (control group) for 60s after acid etching and before the adhesive application. A trained and calibrated examiner evaluated the restorations at baseline (1 week) and at each recall (6, 12, 24 and 36 months) using the FDI criteria. A total of 225 restorations were evaluated after 36-month follow-up. Data were subjected to survival analysis using the Kaplan-Meier method, and the log-rank test was used to evaluate the existence of differences between the survival curves (α=0.05).

Results: The restorations survival rate after 36 months of follow-up was 76.1%. There was no difference in the retention and failure rates between the experimental and the control group (p=0.968). There was an increased failure trend when restorations were located subgingival compared to those at the gingival level or supragingival.

Conclusion: The pre-treatment with 2% chlorhexidine digluconate did not promote further restoration retention of noncarious cervical lesions.

Clinical significance: The cavity pre-treatment with chlorhexidine for inhibition of hybrid layer degradation does not add any beneficial effect to the clinical performance of restorations.

Keywords: Adhesive system; Chlorhexidine; Dental restoration; MMP inhibitor; Noncarious cervical lesions; Randomized controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Chlorhexidine / administration & dosage*
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / therapeutic use
  • Composite Resins / therapeutic use*
  • Dental Bonding / methods
  • Dental Cements
  • Dental Materials / therapeutic use
  • Dental Restoration Failure
  • Dental Restoration, Permanent* / classification
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Placebos
  • Time Factors
  • Tooth Cervix / pathology
  • Tooth Wear / therapy*
  • Treatment Outcome

Substances

  • Composite Resins
  • Dental Cements
  • Dental Materials
  • Placebos
  • chlorhexidine gluconate
  • Chlorhexidine