Aim: The study aimed to evaluate the protective effect of bioactive primer over chemical primers in and around the margins of class V composite restorations.
Materials and methods: A total of 30 extracted mandibular premolars were chosen. These specimens were randomly divided into three groups (10 samples in each). At first, class V cavity was prepared, and cavity walls were then pretreated with 4-(2-hydroxyethyl)-1-pperazineethanesulfonic acid (HEPES) buffer solution (group I), chlorhexidine (CHX) digluconate (group II), and extract of an enriched fraction of green tea (group III). The in vitro model with Streptococcus mutans [25175 American Type Culture Collection (ATCC)] was incubated for a period of 4 days. The dentin and enamel margins of the cavity walls were analyzed by fluorescence microscopy analysis.
Results: The comparison of the mean distance from restoration in the dentinal region and also in the enamel region revealed that the distance at which the initial lesion was seen was approximately similar in all groups, while group III green tea extract (GTE) showed a zone of inhibition adjacent to restoration, which indicated the protective effect of green tea extract primer. Whereas mean lesion depth in the enamel and dentin region showed that lesion depth was less for group III compared to the other two groups. Therefore overall result demonstrated that the green tea extract primer significantly inhibited the development of secondary caries adjacent to the dentin resin interface at cavity walls. At the same time, no significant inhibition was observed in the enamel margins of cavity walls.
Conclusion: Application of a green tea extract primer inhibited secondary caries formation. Neither the application of CHX nor HEPES buffer had much effect on the inhibitory effect on secondary caries.
Clinical significance: Within the limitation of this study, green tea extract has shown the potential to be used in preventing the development of secondary caries. While current chemical primers were less effective, more potent chemical agents needed to develop as an alternative in the inhibition of secondary caries.
Kreth J, Zhang Y, Herzberg MC. Streptococcal antagonism in oral biofilms: streptococcus sanguinis and streptococcus gordonii interference with Streptococcus mutans. J Bacteriol 2008;190(13):4632–4640. DOI: 10.1128/JB.00276-08
Garcia-Godoy F, Hicks MJ. Maintaining the integrity of the enamell surface: the role of dental biofilm, saliva and preventive agents in enamel demineralization and remineralization. J Am Dent Assoc 2008;139:25S–34S.
Awadalla HI, Ragab MH, Fayed MT, et al. Evaluation of the effect of green tea on dental caries and composite restorations. TAF Prev Med Bull 2011;10(3):269–274. DOI: 10.5455/pmb.20110309114912
Cenci M, Demarco F, Carvalho RD. Class II composite resin restorations with two polymerization techniques: relationship between microtensile bond strength and marginal leakage. J Dent 2005;33(7):603–610. DOI: 10.1016/j.jdent.2005.01.001
Loguercio AD, Reis A, Filho LER, et al. One-year clinical evaluation of posterior packable resin composite restorations. Oper Dent 2001;26(5):427–434. PMID: 11551005.
Nedeljkovic I, Teughels W, Munck JD, et al. Is secondary caries with composites a material-based problem? Dent Mater 2015;31(11):e247–e277. DOI: 10.1016/j.dental.2015.09.001
Kakaboura A, Rahiotis C, Watts D, et al. 3D-marginal adaptation versus setting shrinkage in light-cured microhybrid resin composites. Dent Mater 2007;23(3):272–278. DOI: 10.1016/j.dental.2006.01.020
Hotta M, Kondoh K, Kamemizu H. Effect of primers on bonding agent polymerization. J Oral Rehabil 1998;25(10):792–799. DOI: 10.1046/j.1365-2842.1998.00309.x
Bedran-Russo AK, Pauli GF, Chen SN, et al. Dentin biomodification: strategies, renewable resources and clinical applications. Dent Mater 2014;30(1):62–76. DOI: 10.1016/j.dental.2013.10.012
Nagpal R, Singh PP, Singh S, et al. Proanthocyanidin: a natural dentin biomodifier in adhesive dentistry. J Rest Dent 2016;4(1):1–6. DOI: 10.4103/2321-4619.176013
Salama MT, Alsughier ZA. Effect of green tea extract mouthwash on salivary Streptococcus mutans counts in a group of preschool children: an in vivo study. Int J Clin Pediatr Dent 2019;12(2):133–138. DOI: 10.5005/jp-journals-10005-1610
Vyas T, Nagi R, Bhatia A, et al. Therapeutic effects of green tea as an antioxidant on oral health- a review. J Family Med Prim Care 2021;10(11):3998–4001. DOI: 10.4103/jfmpc.jfmpc_943_21
Lee MJ, Lambert JD, Prabhu S, et al. Delivery of tea polyphenols to the oral cavity by green tea leaves and black tea extract. Cancer Epidemiol Biomarkers Prev 2004;13(1):132–137. DOI: 10.1158/1055-9965.epi-03-0040
Kim GE, Leme-Kraus AA, Phansalkar R, et al. Effect of bioactive primers on bacterial-induced secondary caries at the tooth-resin interface. Oper Dent 2017;42(2):196–202. DOI: 10.2341/16-107-L
Castellan CS, Pereira PN, Grande RHM, et al. Mechanical characterization of proanthocyanidin-dentin matrix interaction. Dent Mater 2010;26(10):968–973. DOI: 10.1016/j.dental.2010.06.001
Mazzoni A, Angeloni V, Apolonio FM, et al. Effect of carbodiimide (EDC) on the bond stability of etch-and-rinse adhesive systems. Dent Mater 2013;29(10):1040–1047. DOI: 10.1016/j.dental.2013.07.010
Sartori N, Stolf SC, Silva SB, et al. Influence of chlorhexidine digluconate on the clinical performance of adhesive restorations: a 3-year follow-up. J Dent 2013;41(12):1188–1195. DOI: 10.1016/j.jdent.2013.09.004
Hayati F, Okada A, Kitasako Y, et al. An artificial biofilm induced secondary caries model for in vitro studies. Aust Dent J 2011;56(1):40–47. DOI: 10.1111/j.1834-7819.2010.01284.x
Fontana M, Dunipace AJ, Gregory RL, et al. An in vitro microbial model for studying secondary caries formation. Caries Res 1996;30(2):112–118. DOI: 10.1159/000262146
Fontana M, Gonzalez-Cabezas C, Haider A, et al. Inhibition of secondary caries lesion progression using fluoride varnish. Caries Res 2002;36(2):129–135. DOI: 10.1159/000057871
Kubo S, Yokota H, Sata Y, et al. The effect of flexural load cycling on the microleakage of cervical resin composites. Oper Dent 2001;26(5):451–459. PMID: 11551009.
Chacko SM, Thambi PT, Kuttan R, et al. Beneficial effects of green tea: a literature review. Chin Med 2010;5:13. DOI: 10.1186/1749-8546-5-13
Otake S, Makimura M, Kuroki T, et al. Anticaries effects of polyphenolic compounds from Japanese green tea. Caries Res 25(6):438–443. DOI: 10.1159/000261407
Ferrazzano GF, Amato I, Ingenito A, et al. Plant polyphenols and their anti-cariogenic properties: a review. Molecules 2011;16(2):1486–1507. DOI: 10.3390/molecules16021486
Ferrazzano GF, Amato I, Ingenito A, et al. Anti-cariogenic effects of polyphenols from plant stimulant beverages (cocoa, coffee, tea). Fitoterapia 2009;80(5):255–262. DOI: 10.1016/j.fitote.2009.04.006
Reynolds EC, Black CL. Cariogenicity of a confection supplemented with sodium caseinate at a palatable level. Caries Res 1989;23(5):368–370. DOI: 10.1159/000261209
Smullen J, Koutsou GA, Foster HA, et al. The antibacterial activity of plant extracts containing polyphenols against Streptococcus mutans. Caries Res 2007;41(5):342–349. DOI: 10.1159/000104791
Saito N. Anti-caries effects of polyphenol compound from Camellia sinensis. Nichidai Koko Kagaku 1990;16(2):154–163. PMID: 2135607.
Russell AD. Chlorhexidine: antibacterial action and bacterial resistance. Infection 1986;14(5);212–215. DOI: 10.1007/BF01644264
Ercan E, Erdemir A, Zorba YO, et al. Effect of different cavity disinfectants on shear bond strength of composite resin to dentin. J Adhes Dent 2009;11(5):343–346. PMID: 19841759.
Elkassas DW, Fawzi EM, Zohairy AE. The effect of cavity disinfectants on the micro-shear bond strength of dentin adhesives. Eur J Dent 2014;8(2):184–190. DOI: 10.4103/1305-7456.130596
Menendez A, Li F, Michalek SM, et al. Comparative analysis of the antibacterial effects of combined mouth rinses on Streptococcus mutans. Oral Microbiol Immunol 2005;20(1):31–34. DOI: 10.1111/j.1399-302x.2004.00189.x
Salehi P, Danaie Sh M. Comparison of antibacterial effects of persica mouthwash with chlorhexidine on Streptococcus mutans in orthodontic patients. DARU J Pharm Sci 2006;14:169–174. Corpus ID: 56350727.
Zhou W, Peng X, Zhou X, et al. Novel nanocomposite inhibiting caries at the enamel restoration margins in an in vitro saliva-derived biofilm secondary caries model. Int J Mol Sci 2020;21(17):6369. DOI: 10.3390/ijms21176369
Bridi EC, Amaral FLBD, Franca FMG, et al. Inhibition of demineralization around the enamel-dentin/restoration interface after dentin pretreatment with TiF4 and self-etching adhesive systems. Clin Oral Investig 2016;20(4):857–863. DOI: 10.1007/s00784-015-1573-6