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

Resumo

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.