Effect of Dentin Pretreatment with Chlorhexidine on Push-Out Bond Strength of Composite Restorations in Severely Damaged Primary Anterior Teeth

  • Shabnam Milani Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  • Bahman Seraj Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  • Zahra Khoshlafz Private Practice, Hamadan, Iran
  • Niusha Abazarian Mail Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
Chlorhexidine, Dental Bonding, Tooth, Deciduous


Objectives: Achieving durable restorations with adequate strength in severely damaged primary anterior teeth in children is a priority. The aim of this study was to investigate the effect of dentin pretreatment with chlorhexidine on push-out bond strength of composite restorations.
Materials and Methods: In this in vitro experimental study, 56 extracted primary anterior teeth were randomly divided into 4 groups: (1) saline and total-etch bonding agent, (2) chlorhexidine and total-etch bonding agent, (3) saline and self-etch bonding agent, and (4) chlorhexidine and self-etch bonding agent. After the application of bonding agents, the post space was filled with Z250 composite resin. Following thermocycling of the samples, the push-out test was performed using a universal testing machine, and the results were analyzed with two-way ANOVA.
Results: The mean push-out bond strength values in groups 1 to 4 were 5.7, 8.39, 5.35, and 7 MPa, respectively. Chlorhexidine groups had significant differences with saline groups in bond strength (P<0.05) but there was no statistically significant difference between the self-etch and total-etch bonding agents in the groups (P>0.05).
Conclusion: Both types of bonding agents (self-etch and total-etch) exhibited favorable results in radicular dentin of primary anterior teeth; however, pre-treatment with chlorhexidine increased the push-out bond strength of composite restorations in primary anterior teeth.


1. Zou J, Meng M, Law CS, Rao Y, Zhou X. Common dental diseases in children and malocclusion. Int J Oral Sci 2018 Mar;10(1); 1-7.
2. Malekafzali B, Beheshti M, Mirkarimi M, Ahmadi R. Treatment of early childhood caries: A literature review. J Islam Dent Assoc Iran 2010;21(4):301-13.
3. Chunawalla YK, Zingade SS, Bijle MN, Thanawalla EA. Glass fiber reinforced composite resin post & core in decayed primary anterior teeth–A case report. Int J Clin Dent. 2011 May;2(1).55-9.
4. Verma L, Passi S. Glass fiber-reinforced composite post and core used in decayed primary anterior teeth: a case report. Case Rep Dent 2011;2011:864254.
5. Mendes FM, De Benedetto MS, del Conte Zardetto CG, Wanderley MT, Correa MS. Resin composite restoration in primary anterior teeth using short-post technique and strip crowns: A case report. Quintessence Int. 2004 Oct;35(9):689-92.
6. Eshghi A, Kowsari-Isfahan R, Khoroushi M. Evaluation of three restorative techniques for primary anterior teeth with extensive carious lesions: A 1-year clinical study. J Dent Child (Chic) 2013 May-Aug;80(2):80-7.
7. Eshghi A, Kowsari Esfahan R, Khoroushi M. A simple method for reconstruction of severely damaged primary anterior teeth. Dent Res J (Isfahan) 2011 Oct;8(4):221-5.
8. Bolaños-Carmona V, González-López S, Briones-Luján T, De Haro-Muñoz C, José C. Effects of etching time of primary dentin on interface morphology and microtensile bond strength. Dent Mater 2006 Dec;22(12):1121-9.
9. Bijelic J, Garoushi S, Vallittu PK, Lassila LV. Short fiber reinforced composite in restoring severely damaged incisors. Acta Odontol Scand 2013 Sep;71(5):1221-31.
10. Pollard MA, Curzon JA, Fenlon WL. Restoration of decayed primary incisors using strip crowns. Dent Update 1991 May;18(4):150-2.
11. Memarpour M, Shafiei F, Abbaszadeh M. Retentive strength of different intracanal posts in restorations of anterior primary teeth: an in vitro study. Restor Dent Endod 2013 Nov;38(4):215-21.
12. Casas MJ, Kenny DJ, Johnston DH, Judd PL. Long-term outcomes of primary molar ferric sulfate pulpotomy and root canal therapy. Pediatr Dent 2004 Jan-Feb;26(1):44-8.
13. Torres CP, Corona SAM, Ramos RP, Palma-Dibb RG, Borsatto MC. Bond strength of self-etching primer and total-etch adhesive systems to primary dentin. J Dent Child (Chic) 2004 May-Aug;71(2):131-4.
14. Carrilho MR, Carvalho RM, De Goes MF, Di Hipolito V, Geraldeli S, Tay FR, et al. Chlorhexidine preserves dentin bond in vitro. J Dent Res 2007 Jan;86(1):90-4.
15. Afshar H, Baradaran Nakhjavani Y, Rahro Taban S, Baniameri Z, Nahvi A. Bond strength of 5th, 6th and 7th generation bonding agents to intracanal dentin of primary teeth. J Dent (Tehran). 2015 Feb;12(2):90-8.
16. Montagner AF, Sarkis-Onofre R, Pereira-Cenci T, Cenci MS. MMP inhibitors on dentin stability: A systematic review and meta-analysis. J Dent Res 2014 Aug;93(8):733-43.
17. Erdemir A, Ari H, Güngüneş H, Belli S. Effect of medications for root canal treatment on bonding to root canal dentin. J Endod 2004 Feb;30(2):113-6.
18. Kim YH, Shin DH. Effect of chlorhexidine application on the bond strength of resin core to axial dentin in endodontic cavity. Restor Dent Endod 2012 Nov; 37(4):207-14.
19. Albaladejo A, Osorio R, Toledano M, Ferrari M. Hybrid layers of etch-and-rinse versus self-etching adhesive systems. Med Oral Patol Oral Cir Bucal 2010 Jan;15(1):e112-8.
20. Sakaguchi Ronald L, Power John M. Craig's restorative dental materials. 13th ed., Philadelphia: Mosby; 2012: chapter 13:329.
21. Atash R, van Den Abbeele A. Bond strengths of eight contemporary adhesives to enamel and to dentine: an in vitro study on bovine primary teeth. Int J Paediatr Dent 2005 Jul;15(4):264-73.
22. Uekusa S, Yamaguchi K, Miyazaki M, Tsubota K, Kurokawa H, Hosoya Y. Bonding efficacy of single-step self-etch systems to sound primary and permanent tooth dentin. Oper Dent 2006 Sep-Oct;31(5):569-76.
23. Agostini FG, Kaaden C, Powers J. Bond strength of self-etching primers to enamel and dentin of primary teeth. Pediatr Dent 2001 Nov-Dec;23(6):481-6.
24. Yaseen SM, Subba Reddy VV. Comparative evaluation of shear bond strength of two self-etching adhesives (sixth and seventh generation) on dentin of primary and permanent teeth: an in vitro study. J Indian Soc Pedod Prev Dent 2009 Jan-Mar;27(1):33-8.
25. Ricci HA, Sanabe ME, de Souza Costa CA, Hebling J. Bond strength of two-step etch-and-rinse adhesive systems to the dentin of primary and permanent teeth. J Clin Pediatr Dent 2010 Winter;35(2):163-8.
26. Shirinzad M, Mohammadi Z, Rezaei Sufi L, Rasekh M. Comparison of the effect of several canal irrigant solutions on quartz fiber posts bonded with resin cement. J. Mashhad Dent. Sch. 2012;36(2):133-40.
How to Cite
Milani S, Seraj B, Khoshlafz Z, Abazarian N. Effect of Dentin Pretreatment with Chlorhexidine on Push-Out Bond Strength of Composite Restorations in Severely Damaged Primary Anterior Teeth. Front Dent. 17.
Original Article