Chlorhexidine Incorporated Into The Adhesive System Composition On Bond Strength Meta-analysis And Microscopic Root Canal Therapy Diseases Report

Objective: To evaluate the effect of one of the inhibitors of matrix metalloproteinase(MMPS),chlorhexidine,incorporated into the adhesive system on the stability of immediate and long-term resin-dentin bond strength and provide a scientific basis for the stabilization of dentin bond interface of chlorhexidine to guide clinical work.Methods: We searched PubMed,Embase,Cochrane library,ISI Web of Science,ClinicalTrials.gov,and CNKI Data electronic databases until October 1,2017,without date and language restriction.In terms of reviewing reference lists,the references of all included articles were searched for further relevant studies that could fulfill the inclusion criteria.Inclusion criteria:Included randomized controlled trials of incorporating chlorhexidine into the adhesive system,including a comparative study of controls.including total-etching and self-etching adhesive systems: Including chlorhexidine incorporated into self-etching primer,total-etching primer,self-etching bonding agent,total-etching bonding agent.Including a matrix metalloproteinase(MMPS)inhibitor:chlorhexidine.Exclusion criteria:exclusion of all matrix metalloproteinase(MMPS)inhibitors other than chlorhexidine,excluding the chlorhexidine incorporated into the adhesive system on the fiber pile bond strength.Three researchers conducted a literature search and review.There are three steps in total.Step 1: The titles and abstracts are reviewed independently by two authors,and further reviews are selected if They think the inclusion criteria.Step 2: Including the two authors for inclusion in the document if consensus is reached.And if no consensus is reached,leave the summary for further evaluation.Step 3: Analyzing the differences in step 2 with the third author and discuss whether to include them.Data were extracted and data extraction Program was designed by two authors.One author extracted data about chlorhexidine incorporated into self-etching and total-etching adhesive systems from the article,the second authors review the data.Evaluate the quality of the including articles.bias risk assessment of including articles was evaluated by RevMan5.3 software.Risk assessments of bias were performed on randomized controlled trials included in the Cochrane Reviewer Manual 5.1.0.RevMan5.3 software was used for data analysis.The results of analysis may have a high degree of heterogeneity,therefore we divided into self-etching and total-etching adhesive systems,chlorhexidine incorporated into primer and bonding agent for subgroup analysis to explore the consequences of the effects.Results: 10 articles were selected from 285 possible eligible articles for metaanalysis,41 sets of data were analyzed for meta-analysis.chlorhexidine incorporated into adhesive system immediately measured the bond strength:0.1%,0.2%,0.5%,1%,2% CHX did not affect the bond strength(P>0.05)compared with the control group.However,0.05% concentration of CHX adversely affected bond strength(P <0.05)compared with control(without CHX).Chlorhexidine incorporated into adhesive system for 12 months measured the bond strength:0.1%,0.2% CHX increased bond strength compared with the control group(P <0.05).CONCLUSION: The use of 0.1% and 0.2% CHX does not adversely affect the immediate bond strength,Both 0.1% and 0.2% CHX maintain a 12 months bond strength stability,however,this trend does not represent a longer period of aging.In vitro clinical trials,CHX incorporated into both self-etching and total-etching adhesive systems to can maintain the stability of bond strength.Due to limited clinical data,further studies are needed to confirm the beneficial use of MMPs inhibitors.