ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Chlorhexidine Treatment After Etching Leads to Decreased Microleakage of Final Restorations in Class V Lesions
Clinical Question In patients with Class V lesions, does application of chlorhexidine after etching of the preparation, compared to application of chlorhexidine prior to etching, result in less microleakage of the final restoration? 
Clinical Bottom Line In a patient presenting with a Class V lesion, it has been observed that application of chlorhexidine after etching leads to a decreased amount of microleakage of the final restoration compared to lesions that were pretreated with chlorhexidine prior to the restoration procedure.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 28127314Saffarpour/2016160 human third molarsLaboratory Study
Key resultsThere was a significant difference between the etching+chlorhexidine group (G1) and chlorhexidine+rinse+etch group (G4) in terms of the final microleakage of the restoration. After thermocycling, G1 showed significantly less microleakage at the dentinal margin than G4 (P=0.002).
Evidence Search ("chlorhexidine"[MeSH Terms] OR "chlorhexidine"[All Fields]) AND class[All Fields] AND V[All Fields] AND microleakage[All Fields]
Comments on
The Evidence
All of the clinical trials used human teeth that were randomly distributed into different testing groups. All groups were treated similarly and proper controls were in place for the research projects. It should be noted that a laboratory study does not exactly mimic the oral environment in vivo and these results may not be predictive. While thermocycling may imitate some aspects of the oral environment, there are still many unaccounted factors, such as variations in oral pH, mastication, parafunctional habits, and the composition of bacterial flora that could alter the observed results.
Applicability Chlorhexidine is relatively inexpensive and is readily available for use by dental schools and general dentists in private practice. However, there have recently been concerns raised over its potential for causing allergic reactions in patients intraorally. There is also the issue of the chlorhexidine being an additional expense and time-consuming step for dentists that have already grown accustomed to not using it during restorative procedures. These concerns could limit the overall use of chlorhexidine in dentistry.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry) (Restorative Dentistry)
Keywords Class V; Chlorhexidine; microleakage
ID# 3229
Date of submission: 06/09/2017spacer
E-mail oldhamm@livemail.uthscsa.edu
Author Maxwell Oldham
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Erica R. Oliveira, DDS, MPH
Faculty mentor/Co-author e-mail oliveirae@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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