Statement of problem

A consensus on whether or how to treat eroded dentin to bond to composite resins is lacking. The role of gels containing chlorhexidine (CHX), epigallocatechin-3-gallate (EGCG), and proanthocyanidin (PAC) in controlling erosive wear progression needs to be evaluated for bonding.

Purpose

The purpose of this in vitro study was to evaluate the effect of gels containing antiproteolytic agents (CHX or EGCG) or an antiproteolytic and also collagen crosslinking agent (PAC) to control tooth wear progression on the microtensile bond strength (μTBS) of an adhesive system plus a composite resin to simulated eroded dentin.

Material and methods

Superficial occlusal dentin surfaces obtained from sectioned third molars were ground with SiC paper (600-grit; 1 minute; N-normal dentin) or subsequently submitted to an initial erosive challenge (Coca-Cola; 5 minutes). They then received one of the following treatments: application of a placebo (P), a 0.12% CHX digluconate, an EGCG at 400 μM, or a 10% PAC gel (vehicle: hydroxyethylcellulose, propylene glycol, methylparaben, imidazolidinyl urea, and deionized water; active principle: as per the experimental groups when applicable) or no treatment (C: control). Initially demineralized dentin was also submitted to pH cycling (Coca-Cola; 5 minutes, 3×/day, 5 days) to simulate eroded dentin (E). After acid etching all the specimens, adhesive Adper Single Bond 2 was applied, and composite resin (Filtek Z350 XT) was placed. After 24 hours storage in distilled water at 37 °C, the specimens were sectioned into beams, and the μTBS was tested at 0.5 mm/minute. The μTBS values obtained were evaluated considering each tooth as an experimental unit, and 2-way ANOVA and the Tukey post hoc test for multiple comparisons were applied (α=.05).

Results

Immediate μTBS values for the eroded dentin were always lower than those for the normal dentin, irrespective of whether any of the gels were applied for wear control.

Conclusions

CHX, EGCG, PAC, and placebo gels, applied after the initial demineralization and before the pH cycling to simulate the eroded dentin, had a similar effect on the μTBS of the adhesive system plus the composite resin to simulated eroded dentin when compared with nonapplication (control).

中文翻译：

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应用含有洗必泰，表没食子儿茶素-3-没食子酸酯或原花青素的凝胶来控制牙齿的磨损进程是否可以改善与侵蚀的牙本质的粘结强度？

问题陈述

对于是否或如何治疗侵蚀的牙本质以粘结到复合树脂尚无共识。需要评估含有洗必泰（CHX），表没食子儿茶素-3-没食子酸酯（EGCG）和原花色素（PAC）的凝胶在控制侵蚀性磨损过程中的作用。

目的

这项体外研究的目的是评估含有抗蛋白水解剂（CHX或EGCG）或抗蛋白水解剂以及胶原蛋白交联剂（PAC）的凝胶，以控制牙齿磨损对牙齿微拉伸强度（μTBS）的影响。粘合剂体系加复合树脂来模拟侵蚀的牙本质。

材料与方法

使用SiC纸（600砂砾； 1分钟； N-正常牙本质）对从切开的第三磨牙得到的表面咬合牙本质表面进行研磨，或随后对其进行初步侵蚀（可口可乐； 5分钟）。然后，他们接受以下治疗之一：施用安慰剂（P），0.12％CHX二葡萄糖酸酯，400μM的EGCG或10％PAC凝胶（载体：羟乙基纤维素，丙二醇，对羟基苯甲酸甲酯，咪唑啉基脲和去离子水；有效成分：根据实验组（如果适用））或不进行处理（C：对照）。最初将脱盐的牙本质也进行pH循环（可口可乐； 5分钟，3x /天，5天）以模拟侵蚀的牙本质（E）。酸蚀所有样品后，施加粘合剂Adper Single Bond 2，并放置复合树脂（Filtek Z350 XT）。在37°C的蒸馏水中储存24小时后，将样品切成束，以0.5 mm / min的速度测试μTBS。以每个牙齿为实验单位评估获得的μTBS值，并应用2-way ANOVA和Tukey post hoc测试进行多次比较（α= .05）。

结果

无论是否使用任何凝胶进行磨损控制，侵蚀的牙本质的即时μTBS值始终低于正常牙本质的μTBS值。

结论

CHX，EGCG，PAC和安慰剂凝胶在初始脱盐后和pH循环之前用于模拟侵蚀的牙本质，对胶粘剂系统的μTBS以及与模拟侵蚀的牙本质的复合树脂相比具有类似的影响（控制）。