An in vitro evaluation of microleakage of resin based composites bonded to chlorhexidine-pretreated dentin by different protocols of a universal adhesive system

PURPOSE: This study compared microleakage of different resin based composite (RBC) materials bonded to dentin, after chlorhexidine (CHX) application, by different adhesion protocols of a universal adhesive system. METHODS: Class V cavities were prepared on the buccal and lingual surfaces of 40 premolar teeth. The “etch-and-rinse” technique of a universal bond adhesive system (Single Bond Universal Adhesive) was used on buccal preparations, while the “self-etch” protocol was used on the lingual surfaces. Two RBCs, one bulk fill (Filtek Bulk Fill [FBF]) and one conventional (Filtek Z350 XT [Z350XT]), were used. Teeth were divided into two groups of 20 teeth each, 10 per each RBC (n = 10): (1) control; and (2) pretreatment with 2% CHX. For FBF groups, teeth were restored with a single increment; however, for Z350XT, a layering technique was used. Teeth were aged by thermo-cycling and prepared for microleakage testing. Dye penetration was evaluated and scored from 0 to 4. Data were analyzed at a significance level of P < 0.05. RESULTS: The highest microleakage mean scores were found in the control group of the etched margins for both RBCs (2.80 ± 1.033 FBF and 2.10 ± 1.370 Z350XT). The CHX-pretreated group showed significantly lower microleakage than the control for FBF only (P = 0.008). No significant difference was found between groups for the “self-etch” protocol (χ(2) = 0.884, P = 0.08). No significant differences were found between FBF and Z350XT in all study groups (P > 0.2). CONCLUSIONS: When the “self-etch” protocol of the universal adhesive system was used, dentin microleakage was not affected by CHX-pretreatment when teeth were restored with bulk fill or conventional RBCs. In the “etch-and-rinse” protocol, CHX application improved the marginal seal before restoration with bulk fill material. However, in the absence of CHX, the “etch-and-rinse” protocol negatively affected marginal integrity.