Influence of the chlorhexidine application on adhesive interface stability: literature review

Abstract

There is a consensus that dentine/resin bonding deteriorates over time, and such degradation is one of the main reasons for limiting adhesive restoration longevity. Enzymes known as matrix metalloproteinases (MMPs) are responsible by enzymatic degradation of collagen fibrils without protection, which are present in the resin-dentine interface. Therefore, these enzymes are involved in the process of adhesive interface degradation. Currently, studies point out chlorhexidine digluconate has antiproteolytic function by inhibiting the action of MMPS. Thus, it is thought this substance application prior to the use of bonding agents could slow the process of degradation of the tooth-restoration interface, resulting in longevity. Objective: To review the literature on the influence of chlorhexidine application on the stability of the adhesive interface. Literature review: Chlorhexidine digluconate proprieties and its application in Dentistry were discussed. Next, hybrid layer formation and degradation was discussed and the mechanism of action of chlorhexidine on preserving this layer was detailed. Finally, scientific studies from the last six years were analyzed on the performance of adhesive systems after chlorhexidine application. Results: Considering the results of reviewed studies, it can be concluded that chlorhexidine application did not interfere on the immediate bond strength to dentin and hybrid layer degradation over time occurred later and/or with lower intensity. Conclusion: Chlorhexidine application interferes positively when incorporated into the adhesion protocols, by promoting hybrid layer stability over time.