Abstract
The objective of this work was to determine the effect of different concentrations of chlorhexidine digluconate (CHX) on setting time, surface hardness, maximum tensile bond strength and antibacterial activity of a glass ionomer cement (GIC). The material used as control was Ketac Molar Easymix GIC. CHX was incorporated into the GIC during its manipulation at concentrations of 0.5, 1.0 and 2.0%. Antimicrobial activity against S. mutans and L. acidophilus was evaluated by means of agar diffusion test. Tensile bond strength data were analyzed statistically using Analysis of variance and Tukey's test. Setting time, Vickers hardness and agar diffusion test were analyzed using Kruskal-Wallis and Mann-Whitney tests at a significance level of 5%. It was observed that adding CHX at concentrations of 1% and 2% increased significantly the setting time of the material (p=0.012 and p=0.003, respectively). There was no significant difference between control and 0.5% CHX groups regarding the setting time. Addition of 2% CHX decreased significantly the surface hardness in relation to the control group (p=0.009), followed by the 1% CHX group (p=0.009). The tensile bond strength of the material also decreased significantly after adding CHX at a concentration of 2% (p=0.001). Addition of CHX promoted formation of an inhibition halo in both bacterial strains for all concentrations. The results showed that the best option for clinical use of GIC with CHX is at 0.5% concentration, since antibacterial activity increased and the physical-mechanical properties remained unchanged.
Highlights
Despite the continuous advance of the preventive and technological methods, the caries disease still has a high prevalence and epidemiological studies show that populations at high social risk are the most affected by such an oral condition [1].The atraumatic restorative treatment (ART) is an option of dental treatment providing assistance to the most vulnerable populations, having a high impact on public health, as prevention and treatment are offered to a large segment of the world’s population at low cost; [2]
This technique is based on the philosophy of minimal intervention and consists of removing the infected dentin by manual instruments, followed by filling the cavity with adhesive restorative material, preferably the glass ionomer cement (GIC) [3]
High-viscosity GIC is the material of choice for the ART technique, since it adheres chemically to the dental structures and releases fluoride, which contributes to the reduction in the amount of residual bacteria in restored cavities [15], and favors re-mineralization of the affected dentin [10]
Summary
The atraumatic restorative treatment (ART) is an option of dental treatment providing assistance to the most vulnerable populations, having a high impact on public health, as prevention and treatment are offered to a large segment of the world’s population at low cost; [2]. This technique is based on the philosophy of minimal intervention and consists of removing the infected dentin by manual instruments, followed by filling the cavity with adhesive restorative material, preferably the glass ionomer cement (GIC) [3]. Studies reported that the prevalence rates of secondary caries for 3 to 6 years were 1.5% and 2.4% [5,6], and that the percentage of restoration failures in permanent dentition ranged from 4 to 5%, which represents a good technical result [7]
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