상아질 접착에서의 Chlorhexidine의 효과

Abstract

This review examines the fundamental mechanism of dentin-resin bond degradation, considers the factors related with this event and furthermore, describes the more practical way to prevent the degradation followed by restoration failure. In spite of rapid development of dental adhesive, dentin-resin bond stability and durability are still major challenge to clinicians. Bacause dentin has unique environments, which are humid and moist, compared to enamel, it is difficult to acquire complete bond. Also presence of endogeneous matrix-metalloproteinases (MMPs) in dentin substrate plays a crucial role in the degradation. So, in order to prevent the degradation, complete infiltration of resin monomer to moist dentin substrate and inhibition of MMPs are essential in bonding process. There are multiple in vivo and in vitro reports showing that the durability and longevity of the dentin-resin bond interface is increased when nonspecific enzyme inhibitors, especially Chlorhexidine (CHX) are used. Among many synthetic inhibitors, chlorhexidine (CHX) is the most widely used MMPs-inhibitor because of its ‘substantivity’. Via its cationic-chelation mechanism, it inhibits MMPs (especially MMP-2, -9) effectively and consequently, reduces nanoleakage and increases bond stability. Also the use of CHX does not affect the immediate bond strength overall and gives no harm to mechanical properties of following adhesive resin. To sum up, the adoption of CHX is recommended as means of improving bond stability at this time.