Two-year clinical evaluation of chlorhexidine incorporation in two-step self-etch adhesive

The aim of this 24-month double-blind randomized paired-tooth clinical study was to evaluate the 2-year clinical performance of two self-etch adhesives containing or not chlorhexidine digluconate (CHX) in non-carious cervical lesions (NCCLs).

Twenty-two patients, with at least four NCCLs, participated in this study. After sample size calculation, 126 restorations were assigned to one of the following groups: CSE--Clearfil SE Bond (Kuraray); CSE/CHX--Clearfil SE Bond+CHX; ADS--AdheSE (Ivoclar Vivadent); and ADS/CHX--AdheSE+CHX. The composite resin Filtek Z-250 composite (3M ESPE) was placed incrementally by one expert operator. The restorations were evaluated at baseline and after 2 years using the modified USPHS criteria. Statistical analyses were performed with Friedman repeated measures ANOVA by rank and Fisher exact test for significance in each pair (α=0.05).

No significant difference was observed between baseline and 2-year for any criteria when adhesives with and without the addition of CHX were compared (p>0.05). ADS and ADS/CHX resulted in lower retention rates (82% on average) than CSE and CSE/CHX (97%) (p=0.02).

The inclusion of CHX into the primer of both self-etch systems did not add clinical advantages over the 2-year period. Clearfil SE Bond resulted in better retention rate than AdheSE.

It is more important to choose a gold standard self-etch adhesive, like a Clearfil SE Bond, than to consider the inclusion of CHX in the self-etch adhesives.