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Attempts to produce resin composite with antibacterial properties by incorporation of an antibacterial agent such as chlorhexidine have been reported, but problems can arise due to release of the inhibitory agent from the composite. Such problems may include toxic effects, influence on mechanical properties, and loss of effectiveness. A new monomer, methacryloyloxydodecylpyridinium bromide (MDPB), was synthesized by combining an antibacterial agent and methacryloyl group. The monomer was incorporated into resin composite to develop a non-releasing antibacterial composite. The ability of composite incorporating MDPB to inhibit growth and plaque accumulation by Streptococcus mutans in vitro was assayed, elution of antibacterial components from the material was investigated, and the influence of incorporation of MDPB on the mechanical properties of composite was studied. Uncured MDPB revealed antibacterial activity against S. mutans and six other species of oral streptococci, with the minimum inhibitory concentration for S. mutans being comparable with that of triclosan. After composite incorporating MDPB was cured, no elution of the antibacterial components was observed from the material, even after 90 days' immersion in water or other solvents. Growth of S. mutans on agar under specimens of MDPB-containing composite was inhibited compared with controls. In a bacterial accumulation study, S. mutans accumulated to a lesser degree on the surface of composite incorporating MDPB (p < 0.05) than on control. Incorporation of MDPB had no significant influence on the mechanical properties of the composite.

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Restorative materials in the new era should be "bio-active", and antibacterial effects are highlighted as one of the important properties. In order to achieve resin-based restoratives with antibacterial effects, an antibacterial monomer MDPB has been developed. The primer incorporating MDPB demonstrated cavity-disinfecting effects, and the world's first antibacterial adhesive system employing the MDPB-containing primer was successfully commercialized. MDPB is potentially applicable to various restoratives since immobilization of the antibacterial component by polymerization of MDPB enables no deterioration in mechanical properties of cured resins and exhibition of inhibitory effects against bacterial growth on their surfaces. For glass-ionomer cements used for atraumatic restorative treatment, the approach to provide antibacterial activity has been attempted by addition of chlorhexidine. Incorporation of 1％ chlorhexidine diacetate was found to be optimal to give appropriate antibacterial and physical properties, being effective to reduce the bacteria in affected and infected dentin in vivo.

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