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      Evaluación de la resistencia adhesiva de una resina compuesta a dentina tratada con clorhexidina y terapia fotodinámica. estudio in vitro Translated title: Evaluation of the adhesive resistance of a composite resin to dentin treated with chlorhexidine and photodynamic therapy. in vitro study

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          RESUMEN

          Introducción:

          La terapia fotodinámica consiste en la aplicación de una luz con una adecuada longitud de onda sobre las cavidades, previa a la colocación de un agente fotosensibilizador, el cual tiene como finalidad eliminar restos de microorganismos remanentes luego de la instrumentación.

          Objetivo:

          Evaluar la resistencia adhesiva a dentina tratada con clorhexidina al 2% y terapia fotodinámica con diodo 660 nm, previa a la inserción de resina compuesta.

          Materiales y métodos:

          En este estudio experimental in vitro, se recolectó 60 incisivos mandibulares bovinos que recibieron un desgaste de la dentina. Las muestras se dividieron en 3 grupos (20 c/u): control (sin terapia), clorhexidina al 2% y láser diodo 660nm (fotosensibilizador de azul de metileno). La resistencia adhesiva fue medida por una prueba de cizallamiento comparado con la Prueba de Kruskal-Wallis y post-hoc de comparación por parejas.

          Resultados:

          Los valores promedio de mayor a menor resultaron con la CHX (14,82 ± 3,14), seguido del láser diodo 660 nm (14,77 ± 4,02) y el grupo control (9,25 ± 1,16). Los grupos láser diodo 660 nm y CHX al 2% obtuvieron valores similares (P > 0,05), pero significativamente más altos con respecto al grupo control (P < 0,001). Conclusión: La terapia fotodinámica aumentó la resistencia adhesiva, al igual que la clorhexidina, en comparación con el grupo control.

          ABSTRACT

          Introduction:

          Photodynamic therapy consists of the application of a light with an adequate wavelength on the cavities prior to the application of a photosensitizing agent, with the purpose of eliminating remnants of microorganisms remaining after instrumentation.

          Objective:

          Evaluate the adhesive resistance to dentin treated with 2% chlorhexidine and photodynamic therapy with a 660nm diode prior to the insertion of composite resin.

          Materials an Methods:

          In this in vitro experimental study, 60 bovine mandibular incisors were collected, After dentin wear, the samples were divided into 3 groups, with 20 samples per group: control group (no therapy was applied), 2% chlorhexidine, and 660nm diode laser (photosensitizer: methylene blue). Adhesive strength test was measured by shear test compared to kruskall-wallis test and post-hoc pairwise comparison.

          Results:

          The average values from highest to lowest result with the CHX (14.82 ± 3.14), followed by the 660nm diode laser (14.77 ± 4.02) and the control group (9.25 ± 1.16). Similar groups of 660 nm diode laser and 2% CHX changed values (P>0.05), but significantly higher than the control group (P<0.001). Conclusion: Photodynamic therapy increased adhesive resistance as well as chlorhexidine, both therapies presented an increase in adhesive resistance compared to the control group.

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          Most cited references37

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          Systematic review of the chemical composition of contemporary dental adhesives.

          Dental adhesives are designed to bond composite resins to enamel and dentin. Their chemical formulation determines to a large extent their adhesive performance in clinic. Irrespective of the number of bottles, an adhesive system typically contains resin monomers, curing initiators, inhibitors or stabilizers, solvents and sometimes inorganic filler. Each one of these components has a specific function. The aim of this article is to systematically review the ingredients commonly used in current dental adhesives as well as the properties of these ingredients. This paper includes an extensive table with the chemical formulation of contemporary dental adhesives.
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            Photodynamic therapy in dentistry.

            Photodynamic therapy (PDT), also known as photoradiation therapy, phototherapy, or photochemotherapy, involves the use of a photoactive dye (photosensitizer) that is activated by exposure to light of a specific wavelength in the presence of oxygen. The transfer of energy from the activated photosensitizer to available oxygen results in the formation of toxic oxygen species, such as singlet oxygen and free radicals. These very reactive chemical species can damage proteins, lipids, nucleic acids, and other cellular components. Applications of PDT in dentistry are growing rapidly: the treatment of oral cancer, bacterial and fungal infection therapies, and the photodynamic diagnosis (PDD) of the malignant transformation of oral lesions. PDT has shown potential in the treatment of oral leukoplakia, oral lichen planus, and head and neck cancer. Photodynamic antimicrobial chemotherapy (PACT) has been efficacious in the treatment of bacterial, fungal, parasitic, and viral infections. The absence of genotoxic and mutagenic effects of PDT is an important factor for long-term safety during treatment. PDT also represents a novel therapeutic approach in the management of oral biofilms. Disruption of plaque structure has important consequences for homeostasis within the biofilm. Studies are now leading toward selective photosensitizers, since killing the entire flora leaves patients open to opportunistic infections. Dentists deal with oral infections on a regular basis. The oral cavity is especially suitable for PACT, because it is relatively accessible to illumination.
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              Role of dentin MMPs in caries progression and bond stability.

              Dentin can be described as a biological composite with collagen matrix embedded with nanosized hydroxyapatite mineral crystallites. Matrix metalloproteinases (MMPs) and cysteine cathepsins are families of endopeptidases. Enzymes of both families are present in dentin and collectively capable of degrading virtually all extracellular matrix components. This review describes these enzymes and their presence in dentin, mainly focusing on their role in dentin caries pathogenesis and loss of collagen in the adhesive hybrid layer under composite restorations. MMPs and cysteine cathepsins present in saliva, mineralized dentin, and/or dentinal fluid may affect the dentin caries process at the early phases of demineralization. Changes in collagen and noncollagenous protein structure may participate in observed decreases in mechanical properties of caries-affected dentin and reduce the ability of caries-affected dentin to remineralize. These endogenous enzymes also remain entrapped within the hybrid layer during the resin infiltration process, and the acidic bonding agents themselves (irrespective of whether they are etch-and-rinse or self-etch) can activate these endogenous protease proforms. Since resin impregnation is frequently incomplete, denuded collagen matrices associated with free water (which serves as a collagen cleavage reagent for these endogenous hydrolase enzymes) can be enzymatically disrupted, finally contributing to the degradation of the hybrid layer. There are multiple in vitro and in vivo reports showing that the longevity of the adhesive interface is increased when nonspecific enzyme-inhibiting strategies are used. Different chemicals (i.e., chlorhexidine, galardin, and benzalkonium chloride) or collagen cross-linker agents have been successfully employed as therapeutic primers in the bonding procedure. In addition, the incorporation of enzyme inhibitors (i.e., quaternary ammonium methacrylates) into the resin blends has been recently promoted. This review will describe MMP functions in caries and hybrid layer degradation and explore the potential therapeutic role of MMP inhibitors for the development of improved intervention strategies for MMP-related oral diseases.
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                Author and article information

                Contributors
                Role: Role: Role:
                Role: Role: Role:
                Journal
                Rev Cient Odontol (Lima)
                Rev Cient Odontol (Lima)
                odontologica
                Revista Científica Odontológica
                Universidad Científica del Sur
                2310-2594
                2523-2754
                26 March 2023
                Jan-Mar 2023
                : 11
                : 1
                : e142
                Affiliations
                [1 ] original Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. joaquinhuarote@hotmail.com normalizedUniversidad Científica del Sur orgdiv1Carrera de Estomatología orgnameUniversidad Científica del Sur Lima, Peru joaquinhuarote@ 123456hotmail.com
                [2 ] original Departamento de Ciencias de la Salud, Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. jlugo@cientifica.edu.pe normalizedUniversidad Científica del Sur orgdiv2Departamento de Ciencias de la Salud orgdiv1Carrera de Estomatología orgnameUniversidad Científica del Sur Lima, Peru jlugo@ 123456cientifica.edu.pe
                Author notes
                * Autor corresponsal: Jocelyn Graciela Lugo Varillas jlugo@ 123456cientifica.edu.pe

                Contribución de autoría: Ambos autores participaron en la concepción y redacción del documento, la revisión crítica y la aprobación de su versión final

                Conflicto de intereses: Los autores declaran no tener algún conflicto de intereses

                Author information
                https://orcid.org/0000-0002-2401-7347
                https://orcid.org/0000-0002-7723-3609
                Article
                10.21142/2523-2754-1101-2023-142
                10809960
                38288315
                156b6f0d-4fd1-4f3b-89be-23c49cbb6b0d

                Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons

                History
                : 25 January 2023
                : 15 March 2023
                Page count
                Figures: 7, Tables: 3, Equations: 0, References: 37, Pages: 0
                Categories
                Artículo Original

                resistencia adhesiva,clorhexidina,terapia fotodinámica,resina compuesta,strenght bond,clorhexidine,photodinamic therapy,composite

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