A prospective randomized clinical trial and an in vitro evaluation of the microtensile bond strength of a chlorhexidine-containing dentin bonding agent and a bulk fill composite material in primary teeth

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OBJECTIVES: This study aimed to assess the microtensile bond strength of a chlorhexidine-containing dentin bonding agent compared with a standard adhesive, and to investigate its clinical success in Class II cavities in primary teeth, with a 12-month follow-up. MATERIALS AND METHODS: The study consisted of two parts: a prospective, single-blind, split-mouth randomized controlled clinical trial and an in vitro laboratory evaluation. Ethical approval were obtained for the both parts of the study. Forty pediatric patients (aged 5-9 years) with primary molars requiring Class II restorations were included in the clinical trial, where bulk-fill restorations bonded with a chlorhexidine-containing adhesive and a standard adhesive were evaluated based on FDI criteria at 3-month intervals for 12 months. he in vitro study examined the microtensile bond strength (µTBS) of immediate and thermally aged specimens prepared with bulk-fill composite materials and adhesives with or without chlorhexidine.The data were analyzed using Mann Whitney U test for in-vivo, ANOVA test followed by Tukey's post hoc and Chi-square test for in-vitro study (p = 0.05). RESULTS: Clinically, both adhesives showed similar success rates (%100) across all FDI evaluation parameters after 12 months (p > 0.05). The chlorhexidine-containing adhesive demonstrated significantly higher microtensile bond strength than the standard adhesive in both immediate and aged samples (p < 0.05). CONCLUSIONS: The chlorhexidine-containing adhesive showed promising clinical success and improved bond strength compared to the standard adhesive. Longer follow-ups are needed to confirm its long-term durability."Incorporating chlorhexidine simplifies restorative procedures without compromising performance. CLINICAL RELEVANCE: Chlorhexidine-containing adhesives may improve bond durability and procedural efficiency in pediatric dentistry, offering a practical and effective alternative for restoring primary molars. TRIAL REGISTRATION: Invivo part of the study was registered in a public trial registry, www. CLINICALTRIALS: gov (#NCT06257108). Registration Date 2nd. May 2024 (Retrospectively registered).