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Purpose: This study compared a 2%-CHX dentin pre-treatment with three CHX adhesives (experimentally admixed 0.1% CHX in primer or bonding agent, or industrially added 0.2% CHX in universal adhesive) by evaluating dentin bond strengths after biological loading in a fully automated artificial mouth model. Materials and Methods: The occlusal dentin of 50 freshly extracted human third molars was exposed, and the teeth were randomly assigned to 5 groups according to the adhesive protocol (n = 10): 1. control, Scotchbond Multipurpose (3M Oral Care; CTRL); 2. 2% CHX dentin pre-treatment (DENT); 3. 0.1% CHX experimentally admixed into the primer (PRIM); 4. 0.1% CHX experimentally admixed into the bonding agent (BOND); 5. Peak Universal Bond containing 0.2% CHX (Ultradent; PEAK). The teeth were restored with composite resin. Microtensile bond strength testing (bonding area 0.46 mm2 ± 0.04 mm2, crosshead speed 1 mm/min) was performed after 24-h storage in distilled water (baseline) or after 2-day biological loading with S. mutans (demineralization 1 h / remineralization 5 h). The mode of fracture was recorded and exemplary sticks were evaluated under SEM. Results: CTRL exhibited significantly higher μTBS at baseline in comparison to PRIM (p = 0.000), BOND (p = 0.002), and PEAK (p = 0.000). After undergoing the caries model, CTRL demonstrated significantly lower μTBS compared to DENT (p = 0.000), PRIM (p = 0.008), and PEAK (p = 0.000). The same behavior was observed for BOND vs DENT (p = 0.000), PRIM (p = 0.003), and PEAK (p = 0.001). After biological loading, DENT (p = 0.041), PRIM (p = 0.000), and BOND (p = 0.000) exhibited significantly fewer adhesive fractures than CTRL. Conclusions: CHX addition to the primer protects dentin bond strength from declining after biological loading. Thus, it may offer some clinical advantage in terms of secondary caries inhibition around composite restorations. However, since loss of adhesion at baseline was less when 2% CHX was used as a dentin pre-treatment, it can be suggested as a safer option. so that bonding is not undermined by potential chemical interactions from CHX with the adhesives. Keywords: biofilm, biological loading, bond durability, cariology, chlorhexidine gluconate, dentin bonding, microtensile bond strength

Adhesive dentistry dominates the spectrum of restorative dentistry today. While there have been significant improvements in composites as well as adhesive systems, certain fundamental prerequisites are still essential to be clinically successful. This review highlights the 10 most important aspects of modern adhesive technology based on the "most popular" mistakes in the clinical protocol: Indication, Contamination, Moisture Control, Evaporation, Polymerization, Dentine Sclerosis, MMP Hype, Preparation, Repair and Function. If these 10 points are successfully addressed, the probability of success in the adhesive technique reaches almost 100%. Keywords: MMPs, adhesives, contamination, resin composites, technique sensitivity

Adhäsive Zahnmedizin beherrscht heute das Spektrum der restaurativen Zahnerhaltung. Bei Kompositen ebenso wie Adhäsivsystemen hat es zwar signifikante Verbesserungen gegeben, bestimmte fundamentale Grundvoraussetzungen sind aber noch immer unabdingbar, um klinisch erfolgreich zu sein. Diese Übersicht beleuchtet die 10 wichtigsten Aspekte moderner Adhäsivtechnik anhand der "beliebtesten" Fehler im klinischen Protokoll: Indikation, Kontamination, Feuchtigkeitskontrolle, Evaporation, Polymerisation, Dentinsklerose, MMP-Hype, Präparation, Reparatur und Funktion. Werden diese 10 Punkte erfolgreich adressiert, erreicht die Erfolgswahrscheinlichkeit in der Adhäsivtechnik nahezu 100 %. Keywords: Adhäsive, Komposit, Kontamination, MMPs, Techniksensitivität

Anträge zur Hauptversammlung der Deutschen Gesellschaft für Zahn-, Mund- und Kieferheilkunde am Donnerstag, 4. November 2021 in Frankfurt.