Klorheksidin uygulamasının bulk-fill ve nanofil kompozitlerin tamir bağlanma dayanımı üzerine etkisi

Amaç: Bu çalışmanın amacı klorheksidin uygulamasının nanofil ve bulk-fill kompozitlerin tamir bağlanma dayanımı üzerine etkisini değerlendirmektirGereç ve Yöntemler: Çalışmamızda kullanılmak üzere oluşturulan akrilik bloklar üzerinde 160 adet kavite hazırlandı. Kavitelerin yarısı nanofil kompozitlerle (Filtek Ultimate) doldurulurken yarısı da bulk-fill kompozitlerle (Tetric EvoCeram Bulkfill) dolduruldu. Bütün örnekler 1 hafta 37ºC distile suda bekletildikten sonra her restoratif materyalin örnekleri başlıca 2 deney grubuna ayrıldı. Grup 1’de örnekler 60 saniye klorheksidin uygulamasına maruz bırakıldı. Grup 2’deki örneklere ise bir uygulama yapılmadı (kontrol). Restoratif materyallerin uygun adezivleri her iki grupta ara tamir ajanı olarak uygulandı. Her gruptan örneklerin yarısı test öncesi termal siklusa ( 5000 siklus, 5-55 ºC, kalma süresi 30 saniye, transfer zamanı 15 saniye) maruz bırakıldı, diğer yarısı hemen teste alınarak tamir bağlanma dayanımı makaslama testi ile değerlendirildi. Deney gruplarının makaslama bağlanma dayanımı analiz etmek için çift yönlü ANOVA testi kullanıldı. Önemlilik seviyesi (p<0.05) alındı. Bağlanma dayanımı testi sonrasında oluşan kırık tipleri optik loop ile incelendi ve gruplara ayrıldı. Kırık tipleri ayrıca Taramalı Elektron Mikroskobu ile görüntülendi.Bulgular: Klorheksidin ve termal siklus uygulaması tamir bağlanma dayanımını anlamlı bir şekilde etkilememiştir (p>0.05). Bulk-fill kompozitler daha düşük tamir bağlanma dayanımı göstermiştir. En yüksek bağlanma değeri Nanofil kompozitlerle 24 saat sonra kontrol grubunda elde edilirken en düşük değer klorheksidin uygulaması sonrası termal siklus yapılan Bulk-fill kompozitlerde bulunmuştur. Mix tip kırılmalar en fazla rastlanan tip kırılmalar olmuştur. Sonuçlar: Bu in vitro çalışmanın sınırları içinde klorheksidin ve ek olarak uygulanan termal siklus ile yaşlandırma metodu bulk-fill ve nanofil bazlı kompozitlerin tamir bağlanma dayanımını etkilememiştir.

Anahtar Kelimeler:

Bulk-fill kompozit, klorheksidin, kompozit tamiri, nanofil kompozit, termal siklus

The effect of chlorhexidin application on repair bond strenght of bulk-fill and nanofilled composites

Background: The aim of this study was to evaluate the effect of chlorhexidine application on the repair bond strength of nanofilled and bulk-fill composites.Methods: 160 cavities were prepared on acrylic blocks. Half of the cavities were filled with nanofilled composites while half were filled with bulk-fill composites. All samples were stored in distilled water at 37°C for 1 week, and then samples of each restorative material were divided into 2 experimental groups. In Group 1, the samples were exposed to chlorhexidine for 60 seconds. In Group 2, there was no application (control). Appropriate adhesives of restorative materials were applied as intermediate repair agents in both groups. Half of the samples from each group were exposed to the pre-test thermal cycle (5000 cycles, 5-55ºC, residence time of 30 seconds, transfer time of 15 seconds); the other half was immediately taken to the test and evaluated by repair bond strength shear test. Two-way ANOVA test was used to analyze the shear bond strength of the experimental groups. Significance level (p<0.05) was taken. The failure types formed after shear test were examined by optical loop and divided into groups. Failure types were also displayed with a Scanning Electron Microscope.Results: Chlorhexidine and thermal cycling did not significantly affect repair bond strength (p> 0.05). Bulk-fill composites showed lower repair bond strength. Mix type failures are the most common type.Conclusion: Chlorhexidine and additionally applied thermal cycle within the limits of this in vitro study did not affect the repair bond strength of bulk-fill and nanofilled composites.

Keywords:

Bulk-fill composite, chlorhexidine, composite repair, nanofilled composite, thermal cycle,

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Hickel R, Manhart J, Garcia-Godoy F. Clinical results and new developments of direct posterior restorations.Am J Dent 2000;13:41D-54D.
Manhart J, Garcia-Godoy F, Hickel R. Direct posterior restorations: clinical results and new developments. Dent Clin North Am 2002; 46(2):303-39.
Bayne SC, Heymann HO, Swift EJ, Jr. Update on dental composite restorations. J Am Dent Assoc 1994;125(6):687-701.
Soncini JA, Maserejian NN, Trachtenberg F, Tavares M, Hayes C. The longevity of amalgam versus compomer/composite restorations in posterior primary and permanent teeth: findings From the New England Children's Amalgam Trial. J Am Dent Assoc 2007;138(6):763-72.
Davis N. A nanotechnology composite. Compend Contin Educ Dent 2003; 24: 662-70.
Mitra SB, Wu D, Holmes BN. An application of nanotechnology in advanced dental materials. J Am Dent Assoc 2003; 134: 1382-90.
Duke ES. Has dentistry moved into the nanotechnology era? Compend Contin Educ Dent 2003; 24: 380-2.
Schmidt G, Malwitz M. Properties of polymer-nanoparticle composites. Curr Opin Coll Int Sci 2003; 8:103-8.5.
Lazarchik, D.A., et al., Hardness comparison of bulk-filled/transtooth and incremental-filled/occlusally irradiated composite resins. The Journal of prosthetic dentistry, 2007. 98(2):129-140.
El-Safty, S., N. Silikas, and D. Watts, Creep deformation of restorative resin-composites intended for bulk-fill placement. Dental Materials, 2012. 28(8): 928-935.
El-Damanhoury, H. and J. Platt, Polymerization shrinkage stress kinetics and related properties of bulk-fill resin composites. Operative dentistry, 2014. 39(4): 374-382.
Park, J., et al., How should composite be layered to reduce shrinkage stress: incremental or bulk filling? Dental Materials, 2008. 24(11): 1501-1505.
Mjor IA. Repair versus replacement of failed restorations. Int Dent J 1993;43(5):466-72.
Dall'Oca S, Papacchini F, Goracci C, Cury AH, Suh BI, Tay FR, et al. Effect of oxygen inhibition on composite repair strength over time. J Biomed Mater Res B Appl Biomater 2007;81(2):493-8.
Papacchini F, Dall'Oca S, Chieffi N, Goracci C, Sadek FT, Suh BI, et al. Composite-to-composite microtensile bond strength in the repair of a microfilled hybrid resin: effect of surface treatment and oxygen inhibition. J Adhes Dent 2007 Feb;9(1):25-31.
Gultz J, Do L, Boylan R, Kaim J, Scherer W. Antimicrobial activity of cavity disinfectants. Gen Dent 1998; 47: 187-190.
Kapdan A, Öztaş N, Sümer Z. Comparing the antibacterial activity of gaseous ozone and chlorhexidine solution on a tooth cavity model. J Clin Exp Dent 2013; 5: e133-137.
Türkün M, Türkün LS, Çelik EU, Ates M. Bactericidal effect of Er, Cr: YSGG laser on Streptococcus mutans. Dent Mater J 2006; 25: 81-86.
Newbrun E. Preventing dental caries: breaking the chain of transmission. J Am Dent Assoc 1992; 123: 55-59.
Gomes BP, Souza SF, Ferraz CC, Teixeira FB, Zaia AA, Valdrighi L, Souza-Filho FJ. Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro. Int Endod J 2003; 36: 267-275.
Li J. Effects of surface properties on bond strength between layers of newly cured dental composites. J Oral Rehabil 1997;24(5):358-60.12.
Rosales-Leal JI. Microleakage of Class V composite restorations placed with etch-and-rinse and self-etching adhesives before and after thermocycling. Journal of Adhesive Dentistry 2007; 9:255.
Amaral FL, Colucci V, PALMA‐DIBB RG, Corona SA. Assessment of in vitro methods used to promote adhesive interface degradation: a critical review. Journal of Esthetic and Restorative Dentistry 2007; 19(6):340-353
Mjor, I.A., J.E. Moorhead, and J.E. Dahl, Reasons for replacement of restorations in permanent teeth in general dental practice. Int Dent J, 2000; 50(6):361-6.
Mjor, I.A. and V.V. Gordan, Failure, repair, refurbishing and longevity of restorations. Oper Dent 2002; 27(5): 528-34.
Kidd, E.A., D.N. Ricketts, and D. Beighton, Criteria for caries removal at the enamel-dentine junction: a clinical and microbiological study. Br Dent J 1996; 180:287-91.
de Castro FL, de Andrade MF, Duarte Júnior SL, Vaz LG, Ahid FJ. Effect of 2% chlorhexidine on microtensile bond strength of composite to dentin. J Adhes Dent 2003; 5: 129- 138.
Mobarak EH, El-Korashy DI, Pashley DH. Effect of chlorhexidine concentrations on micro-shear bond strength of self-etch adhesive to normal and caries-affected dentin. Am J Dent 2010; 23: 217-222
Di Hipólito V, Rodrigues FP, Piveta FB, Azevedo Lda C, Bruschi Alonso RC, Silikas N, Carvalho RM, De Goes MF, Perlatti D’Alpino PH. Effectiveness of self-adhesive luting cements in bonding to chlorhexidine treated dentin. Dent Mater 2012; 28: 495-501
Moorthy, A., Hogg, C.H., Dowling, A.H., Grufferty, B.F., Benetti, A.R., Fleming, G.J. Cuspal deflection and microleakage in premolar teeth restored with bulk-fill flowable resin-based composite base materials. J Dent 2012; 40: 500-505.
Ilie, N. and R. Hickel, Investigations on mechanical behaviour of dental composites. Clin Oral Invest 2009; 13(4): 427-38.
Bottenberg, P., et al., A prospective randomized clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: Five-year results. J Dent 2009; 37(3):198-203.
Vural U, Kerimova L, Baltacioglu İH, Kiremitçi A Bond strength of dental nanocomposites repaired with a bulkfill composite. J Clin Exp Dent 2017; 9(3):437-442.
Ozcan M, Corazza PH et al., Repair bond strength of microhybrid, nanohybrid and nanofilled resin composites: effect of substrate resin type, surface conditioning and ageing. Clin Oral Invest 2013; 17: 1751-1758
Soderholm KJ, Zigan M, Ragan M, Fischlschweiger W, Bergman M, Hydrolytic degradation of dental composites. J Dent Res 1984;63:1248–1254
Bagheri R, Tyas MJ, Burrow MF, Subsurface degradation of resin-based composites. Dent Mater 2007; 23:944–951
Erdemir A, Eldeniz A, Belli S, Kompozit rezinlerin tamirinde farklı bonding sistemlerin kullanılması. Cumhuriyet Dental Journal 2004; 7(1):7-10
Irmak O, Kompozit reçinelerin farklı adeziv esaslı bağlayıcı ajanlar ile onarımında mikro-makaslama kuvvetlerinin bağlanma dayanımına etkisi. İstanbul Üniv Diş Hek Fak Derg. 2017;47(1):17-27
Papacchini F, Toledano M, Monticelli F, Osorio R, Radovic I, Polimeni A, et al. Hydrolytic stability of composite repair bond. Eur J Oral Sci 2007;115(5):417-24