Orthodontic cement with protein-repellent and antibacterial properties and the release of calcium and phosphate ions

ObjectivesWhite spot lesions often occur in orthodontic treatments. The objective of this study was to develop a novel resin-modified glass ionomer cement (RMGI) as an orthodontic cement with protein-repellent, antibacterial and remineralization capabilities.MethodsProtein-repellent 2-methacryloyloxyethyl phosphorylcholine (MPC), antibacterial dimethylaminohexadecyl methacrylate (DMAHDM), nanoparticles of silver (NAg), and nanoparticles of amorphous calcium phosphate (NACP) were incorporated into a RMGI. Enamel shear bond strength (SBS) was determined. Calcium (Ca) and phosphate (P) ion releases were measured. Protein adsorption onto specimens was determined by a micro bicinchoninic acid method. A dental plaque microcosm biofilm model was tested.ResultsIncreasing the NACP filler level increased the Ca and P ion release. Decreasing the solution pH increased the ion release. Incorporating MPC into RMGI reduced protein adsorption, which was an order of magnitude less than that of commercial controls. Adding DMAHDM and NAg into RMGI yielded a strong antibacterial function, greatly reducing biofilm viability and acid production. Biofilm CFU counts on the multifunctional orthodontic cement were 3 orders of magnitude less than that of commercial control (p < 0.05). These benefits were achieved without compromising the enamel shear bond strength (p > 0.1).ConclusionsA novel multifunctional orthodontic cement was developed with strong antibacterial and protein-repellent capabilities for preventing enamel demineralization.Clinical significanceThe new cement is promising to prevent white spot lesions in orthodontic treatments. The method of incorporating four bioactive agents may have wide applicability to the development of other bioactive dental materials to inhibit caries.