Long-Term Antibacterial Efficacy of Cetylpyridinium Chloride-Montmorillonite Containing PMMA Resin Cement

Abstract

Despite being able to adhesively restore teeth, adhesives and cement do not possess any anticariogenic protection potential, by which caries recurrence may still occur and reduce the clinical lifetime of adhesive restorations. Several antibacterial agents have been incorporated into dental adhesives and cement to render them anticariogenic. Due to an additional therapeutic effect, such materials are classified as ‘dental combination products’ with more strict market regulations. We incorporated cetylpyridinium chloride (CPC), often used for oral hygiene applications, into montmorillonite (CPC-Mont), the latter to serve as a carrier for controlled CPC release. CPC-Mont incorporated into tissue conditioner has been approved by the Pharmaceuticals and Medical Devices Agency (PmontMDA) in Japan. To produce a clinically effective dental cement with the antibacterial potential to prevent secondary caries, we incorporated CPC-Mont into PMMA resin cement. We measured the flexural strength, shear bond strength onto dentin, CPC release, and the biofilm-inhibition potential of the experimental CPC-Mont-containing PMMA cement. An 8 and 10 wt% CPC-Mont concentration revealed the antibacterial potential without reducing the mechanical properties of the PMMA cement.

Montmorillonite in dentistry: a review of advances in research and potential clinical applications

“…Yamamoto et al (2022) conducted a similar study and found that concentrations of 5%-7.5% CPC -modified MMT (MMT-CPC) by weight could effectively prevent the formation of biofilms without affecting mechanical strength or bonding properties. The result was further supported by another study [44], concluding that dental cement containing MMT-CPC released CPC to prevent biofilm growth for up to two months. Notably, despite being stored in water for six months, antibacterial properties were still demonstrable [44].…”

“…The result was further supported by another study [44], concluding that dental cement containing MMT-CPC released CPC to prevent biofilm growth for up to two months. Notably, despite being stored in water for six months, antibacterial properties were still demonstrable [44]. In another study, Otsubo et al demonstrated MMTs ability to incorporate CPC, and its capacity to deliver CPC in composites formulated with resins for orthodontic applications [91].…”

“…Dental adhesives and cements generally do not contain antibacterial agents, which may result in caries recurrence and reduce the restorative material's lifespan. MMT has frequently been used as a carrier for CPC, and is widely used in oral hygienic products such as in dental adhesives and cements [44,89,90].…”

“…In another study, Otsubo et al demonstrated MMTs ability to incorporate CPC, and its capacity to deliver CPC in composites formulated with resins for orthodontic applications [91]. Nevertheless, more studies are necessary to determine if this type of cement is effective against secondary caries prevention in clinical settings, as well as determining long-term efficacy [44].…”

Cholesterol-Bearing Polysaccharide-Based Nanogels for Development of Novel Immunotherapy and Regenerative Medicine

“…Conjugating the non-biodegradable polymer poly(methyl methacrylate) (PMMA) with antimicrobial agents has been established as a treatment for periprosthetic joint infection [ 86 ]. Several antibacterial agents have been incorporated into dental adhesives and cement to render them anticariogenic [ 87 ]. Conversely, research on imparting antibacterial properties to the biodegradable polymer PLGA/β-TCP composite is still in the development stage [ 88 ].…”