Objectives: Atraumatic restorative treatment (ART) involves the removal of carious tooth tissues with hand instruments, and improvement of filling materials for the restoration with greater success rate is important. The purpose of this study was to evaluate antibacterial and physical properties of glass-ionomer cements (GIC) incorporating chlorhexidine (CHX), and to determine the optimal concentration of CHX incorporation. Methods: CHX diacetate in combination with CHX dihydrochloride was added to the powder of control GIC (Fuji IX, GC) at the concentrations of 1/0, 2/0, 3/0, 1/1, or 2/2 (wt%). Antibacterial activity of each cement against Streptococcus mutans, Lactobacillus casei or Actinomyces viscosus was examined by agar disc-diffusion methods, and release of CHX was analyzed by HPLC. Compressive strength, bond strength to enamel and dentin, and setting time were measured and compared with those of the controls. Results: All experimental GICs exhibited inhibition of three bacteria during and after setting, but the sizes of inhibition zones and the concentrations of CHX released from the materials were not dependent upon CHX content. Incorporation of CHX diacetate at 2% or greater significantly decreased the compressive strength and bond strength to dentin compared with the control (p<0.05, ANOVA, Fisher's PLSD test), although setting time was extended a little by the addition of CHX at any concentrations. Conclusion: The results demonstrate that experimental GICs incorporating CHX were effective to inhibit caries-associated bacteria, and that the incorporation of 1% CHX diacetate is optimal to give appropriate physical properties. This work was supported in part by a Grant-in-Aid for Scientific Research (13470402) from the Japan Society for the Promotion of Science.

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