Enamel demineralization is one of the most undesired side effects of fixed orthodontic treatment, which will lead to white spot lesions (WSLs) on tooth surfaces. The development of WSLs is due to prolonged accumulation of bacterial plaque and associated acid production. Self-etching adhesives have been used in orthodontic treatments with several advantages over the more traditional acid-etch method. However, current self-etching adhesives in orthodontic treatments have no antibacterial activity. The objectives of this study were to develop a self-etching and antibacterial orthodontic adhesive, and to investigate its enamel bond strength and antibacterial properties. A novel quaternary ammonium monomer dimethylaminohexadecyl methacrylate (DMAHDM) was incorporated into a commercial self-etching adhesive (Adper Easy One, 3M). It showed that the 5% DMAHDM appeared to be optimal in obtaining the strongest antibacterial function without compromising the enamel bond strength both at 15 min and after 30 days of immersion plus thermal cycling.

Enamel demineralization is the most undesired side-effect of fixed orthodontic treatments. This study were to develop a novel adhesive that is self-etching instead of using the traditional etching method, and to form a sealant on the enamel to prevent demineralization. 2-methacryloyloxyethyl phosphorylcholine (MPC) and quaternary ammonium dimethylaminohexadecyl methacrylate (DMAHDM) were mixed into a self-etch adhesive (Adper Easy One, 3M, St. Paul, MN, USA; referred to as AEO). Enamel shear bond strength (SBS) was measured. Protein adsorption onto the resins was measured. An oral microcosm biofilm model with saliva was tested. Incorporation of 7.5% MPC and 5% DMAHDM into AEO did not reduce the SBS (p>0.1). AEO with 7.5% MPC+5% DMAHDM had protein adsorption that was only 1/18 that of AEO control. AEO with 7.5% MPC+5% DAMHDM had much stronger antibacterial properties (p<0.05). In conclusion, the new self-etch adhesive with MPC and DAMHDM greatly reduced protein adsorption and inhibited biofilm viability.