The use of chlorhexidine as a matrix metalloproteinase inhibitor to increase the longevity of composite resin restorations: an integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i15.22642

Keywords:

Metalloproteinase matrix; Chlorhexidine; Hybrid layer; Adhesion; Composite resin.

Abstract

Currently, one of the greatest challenges for adhesive dentistry is to maintain the integrity of the hybrid layer in restorations. It is known that the complicating factor is related to the action of matrix metalloproteinase (MMP), which degrade unprotected collagen filaments. It is understood that chlorhexidine (CHX) behaves in an inhibitory manner on this enzyme, changing its structure and chelating the metal ions essential for its activation, which would break this degradation sequence. One of the aims of this study was to describe, based on the literature, the influence of the use of CHX prior to the application of the adhesive system on the conservation of the hybrid layer and, consequently, on the improvement of composite resin bonding.  Another purpose is to verify, among the adhesive systems, if any elucidates better results after the application of CHX and to understand if, in the long term, this inhibition is maintained. This research was carried out as an integrative literature review, and is purely basic in nature. To this end, a search was conducted in the "PubMed-NCBI" database with the search terms: ((chlorhexidine) and (matrix metalloproteinase inhibitors)) or (mmp) and (adhesives) considering publications from the last 10 years. Given the data collected it is clear that this is still a subject that requires further and longer scientific evidence due to the heterogeneity of results between authors. However, no study has shown that the use of inhibitors is detrimental to the longevity of the restoration.

References

Baehni, P. C., & Takeuchi, Y. (2003). Anti-plaque agents in the prevention of biofilm-associated oral diseases. Oral diseases, 9 Suppl 1, 23–29. https://doi.org/10.1034/j.1601-0825.9.s1.5.x

Bounocore M. G. (1955). A simple method of increasing the adhesion of acrylic filling materials to enamel surfaces. Journal of dental research, 34(6), 849–853. https://doi.org/10.1177/00220345550340060801

Estrela, C. (2018). Metodologia Científica: Ciência, Ensino, Pesquisa. Editora Artes Médicas.

Favetti, M., Schroeder, T., Montagner, A. F., Correa, M. B., Pereira-Cenci, T., & Cenci, M. S. (2017). Effectiveness of pre-treatment with chlorhexidine in restoration retention: A 36-month follow-up randomized clinical trial. Journal of dentistry, 60, 44–49. https://doi.org/10.1016/j.jdent.2017.02.014

Göstemeyer, G., & Schwendicke, F. (2016). Inhibition of hybrid layer degradation by cavity pretreatment: Meta- and trial sequential analysis. Journal of dentistry, 49, 14–21. https://doi.org/10.1016/j.jdent.2016.04.007

Hamdan-Nassar, T., Bellot-Arcís, C., Paredes-Gallardo, V., García-Sanz, V., Pascual-Moscardó, A., Almerich-Silla, JM, & Montiel-Company, JM (2019). Efeito da clorexidina a 2% após o condicionamento ácido na resistência de união à microtração de restaurações de resina: uma meta-análise. Medicina (Kaunas, Lituânia), 55 (12), 769. https://doi.org/10.3390/medicina55120769

Hashimoto, M., Fujita, S., Nagano, F., Ohno, H., & Endo, K. (2010). Ten-years degradation of resin-dentin bonds. European journal of oral sciences, 118(4), 404–410. https://doi.org/10.1111/j.1600-0722.2010.00744.x

Kiuru, O., Sinervo, J., Vähänikkilä, H., Anttonen, V., & Tjäderhane, L. (2021). MMP Inhibitors and Dentin Bonding: Systematic Review and Meta-Analysis. International journal of dentistry, 2021, 9949699. https://doi.org/10.1155/2021/9949699

Li, H., Li, T., Li, X., Zhang, Z., Li, P., & Li, Z. (2015). Morphological effects of MMPs inhibitors on the dentin bonding. International journal of clinical and experimental medicine, 8(7), 10793–10803. Retrieved 19/10/2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565256/

Liu, Y., Tjäderhane, L., Breschi, L., Mazzoni, A., Li, N., Mao, J., Pashley, D. H., & Tay, F. R. (2011). Limitations in bonding to dentin and experimental strategies to prevent bond degradation. Journal of dental research, 90(8), 953–968. https://doi.org/10.1177/0022034510391799

Lobo, T. R. S. (2013). Influência do uso do digluconato de clorexidina como inibidor de metaloproteinase na resistência adesiva e dureza da camada híbrida e camada de adesivo. Dissertação de Mestrado, Faculdade de Odontologia, Universidade de São Paulo, São Paulo. Doi: 10.11606/D.23.2013.tde-17122013-155843

Martins, G. C, Franco, A. P. G. O., Godoy, E. P., Maluf, D. R., Gomes, J. C., & Gomes, O. M. M. Adesivos Dentinários. Revista Gaúcha de Odontologia, 56(4), 429-436, 2008. Retrieved 19/10/2021, from http://www.revistargo.com.br/include/getdoc.php?id=2917&article=790&mode=pdf

Maya, J. J., Ruiz, S. J., Pacheco, R., Valderrama, S. L., & Villegas, M. V. (2011) Papel da clorexidina na prevenção de infecções relacionadas aos cuidados de saúde. Infectio, 15(2), 98-107, Retrieved 19/10/2021, from https://www.revistainfectio.org/index.php/infectio/article/view/12

Mazzoni, A., Tjäderhane, L., Checchi, V., Di Lenarda, R., Salo, T., Tay, FR, Pashley, DH, & Breschi, L. (2015). Papel das MMPs de dentina na progressão da cárie e na estabilidade da união. Journal of Dental Research , 94(2), 241-251. https://doi.org/10.1177/0022034514562833

Medeiros, A. F., Avelar, W. V., Lima, D. A., Queiroz, A. M., Campos, F., Vasconcelos, R. G., & Vasconcelos, M. G. (2019) Os efeitos das Metaloproteinases da matriz extracelular - MMPS e clorexidina no mecanismo de adesão dentária. Rev. Salusvita, 38(4), 1127-1149. Retrieved 19/10/2021, from https://secure.unisagrado.edu.br/static/biblioteca/salusvita/salusvita_v38_n4_2019/salusvita_v38_n4_2019_art_17.pdf

Montagner, A. F., Sarkis-Onofre, R., Pereira-Cenci, T., & Cenci, M. S. (2014). MMP Inhibitors on Dentin Stability: A Systematic Review and Meta-analysis. Journal of dental research, 93(8), 733–743. https://doi.org/10.1177/0022034514538046

Moraes, I., do Nascimento, T. G., da Silva, A. T., de Lira, L., Parolia, A., & Porto, I. (2020). Inhibition of matrix metalloproteinases: a troubleshooting for dentin adhesion. Restorative dentistry & endodontics, 45(3), e31. https://doi.org/10.5395/rde.2020.45.e31

Ou, Q., Hu, Y., Yao, S., Wang, Y., & Lin, X. (2018). Effect of matrix metalloproteinase 8 inhibitor on resin-dentin bonds. Dental materials : official publication of the Academy of Dental Materials, 34(5), 756–763. https://doi.org/10.1016/j.dental.2018.01.027

Pashley, D. H., Tay, F. R., Yiu, C., Hashimoto, M., Breschi, L., Carvalho, R. M., & Ito, S. (2004). Collagen degradation by host-derived enzymes during aging. Journal of dental research, 83(3), 216–221. https://doi.org/10.1177/154405910408300306

Rajkumar, D. S., & Mariswamy, A. B. (2021). Comparative evaluation of Emblica officinalis as an etchant and an MMP inhibitor with orthophosphoric acid and chlorhexidine on the microshear bond strength of composite resin: an ex vivo study. Restorative dentistry & endodontics, 46(3), e36. https://doi.org/10.5395/rde.2021.46.e36

Reis, A.; Loguercio, A. D. (2007) Materiais Dentários Restauradores Diretos: dos Fundamentos à Aplicação Clínica (1ª ed) São Paulo: Santos Editora.

Schimidt, M. F. (2019) Sistemas adesivos e suas abordagens atuais na resistências de união à dentina. 2019. 24 f. Dissertação (Trabalhos de Conclusão de Curso de Graduação de Odontologia) Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Rio Grande Do Sul, Brasil. Disponível: https://lume.ufrgs.br/handle/10183/205709

Strobel, S., & Hellwig, E. (2015). The effects of matrix-metallo- proteinases and chlorhexidine on the adhesive bond. Swiss dental journal, 125(2), 134–145. Retrieved 19/10/2021, from https://www.sso.ch/fileadmin/pubmed/sdj-2015-02-01.pdf

Silva, E., Vasconcelos, M., & Vasconcelos, R. (2019). Influência de inibidores de metaloproteinases na degradação da camada híbrida. Revista Da Faculdade De Odontologia - UPF, 24(1), 162-169. https://doi.org/10.5335/rfo.v24i1.9119

Tekçe, N., Tuncer, S., Demirci, M., & Balci, S. (2016). Do matrix metalloproteinase inhibitors improve the bond durability of universal dental adhesives?. Scanning, 38(6), 535–544. https://doi.org/10.1002/sca.21293

Ten Cate, A. R. (1994) Oral Histology. Development, Structure and Function (4 ed.) Mosby, St. Louis.

Tjäderhane, L., Nascimento, F. D., Breschi, L., Mazzoni, A., Tersariol, I. L., Geraldeli, S., Tezvergil-Mutluay, A., Carrilho, M. R., Carvalho, R. M., Tay, F. R., & Pashley, D. H. (2013). Optimizing dentin bond durability: control of collagen degradation by matrix metalloproteinases and cysteine cathepsins. Dental materials: official publication of the Academy of Dental Materials, 29(1), 116–135. https://doi.org/10.1016/j.dental.2012.08.004

Tran, X. V., & Tran, K. Q. (2021). Microleakage and characteristics of resin-tooth tissues interface of a self-etch and an etch-and-rinse adhesive systems. Restorative dentistry & endodontics, 46(2), e30. https://doi.org/10.5395/rde.2021.46.e30

Zheng, P., & Chen, H. (2017). Evaluate the effect of different mmps inhibitors on adhesive physical properties of dental adhesives, bond strength and mmp substarte activity. Scientific reports, 7(1), 4975. https://doi.org/10.1038/s41598-017-04340-1

Zheng, P., Zaruba, M., Attin, T., & Wiegand, A. (2015). Effect of different matrix metalloproteinase inhibitors on microtensile bond strength of an etch-and-rinse and a self-etching adhesive to dentin. Operative dentistry, 40(1), 80–86. https://doi.org/10.2341/13-162-L

Published

20/11/2021

How to Cite

COSTA, L. C. P.; REIS, L. Q. C.; MELO , M. V.; CAIXETA, M. E. de O. .; ORSOLIN, P. C. .; ANDRADE, R. S. de . The use of chlorhexidine as a matrix metalloproteinase inhibitor to increase the longevity of composite resin restorations: an integrative review. Research, Society and Development, [S. l.], v. 10, n. 15, p. e80101522642, 2021. DOI: 10.33448/rsd-v10i15.22642. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/22642. Acesso em: 19 dec. 2024.

Issue

Section

Review Article