Adhesive systems modified with antimicrobial agents: a literature review

Abstract

Secondary caries is the primary cause of restoration failure. Thus, the development of adhesives with antimicrobial action is an advantageous option for their inhibition. However, this effect must be proven, as well as that the additional benefit does not interfere with material mechanical properties or biocompatibility. We analyzed adhesives with antimicrobial action by microbiological tests, bond strength, degree of conversion, and cytotoxicity. We analyzed 32 studies with commercially available antimicrobial adhesives (Clearfil™ SE Protect Bond/ MDPB, Gluma 2Bond/ glutaraldehyde, Peak Universal Bond/chlorhexidine), and experimental materials or commercial adhesives modified with antimicrobial agents, including materials with quaternary ammonium methacrylate (QAM) [dimethylaminododecyl methacrylate (DMADDM) and dimethylaminohexadecyl methacrylate (DMAHDM)], nanoparticles [silver (NAg), titanium dioxide (TiO2), zinc oxide (ZnO)], silver or zinc doped bioactive active glass (BAG), titanium, copper iodide, and compounds such as triclosan, quercetin, grape seed extract, among others. The use of antimicrobial agents is a favorable perspective for the functionalization of adhesive systems to inhibit secondary caries. However, more clinical studies need to prove the efficacy of these materials.