The effect of antimicrobial agents on bond strength of orthodontic adhesives: a meta‐analysis of in vitro studies

Abstract

Antimicrobial orthodontic adhesives aim to reduce white spot lesions' incidence in orthodontic patients, but they should not jeopardizing its properties. Systematic review and meta-analysis were performed to answer the question whether the association of antimicrobial agents with orthodontic adhesives compromises its mechanical properties and whether there is a superior antimicrobial agent. PubMed and Scopus databases. In vitro studies comparing shear bond strength of conventional photo-activated orthodontic adhesives to antimicrobial photo-activated orthodontic adhesives were considered eligible. Search terms included the following: orthodontics, orthodontic, antimicrobial, antibacterial, bactericidal, adhesive, resin, resin composite, bonding agent, bonding system, and bond strength. The searches yielded 494 citations, which turned into 467 after duplicates were discarded. Titles and abstracts were read and 13 publications were selected for full-text reading. Twelve studies were included in the meta-analysis. The global analysis showed no statistically significant difference between control and experimental groups. In the subgroup analysis, only the chlorhexidine subgroup showed a statistically significant difference, where the control groups had higher bond strength than the experimental groups. Many studies on in vitro orthodontic bond strength fail to report test conditions that could affect their outcomes. The pooled in vitro data suggest that adding an antimicrobial agent to an orthodontic adhesive system does not influence bond strength to enamel. It is not possible to state which antimicrobial agent is better to be associated.

Polymerisation, antibacterial and bioactivity properties of experimental orthodontic adhesives containing triclosan-loaded halloysite nanotubes

“…adhesive mode compared to other groups in this study (Figure 2). However, our results are in accordance with the results of a recent meta-analysis [25], where it is affirmed that the incorporation of antimicrobial agents into an orthodontic adhesive does not influence bond strength to enamel. It was also demonstrated that higher SBS may lead to sound enamel loss during bracket debonding [26].…”

Effect of silver nanoparticles on the physicochemical and antimicrobial properties of an orthodontic adhesive

“…Recently, a systematic review 5 demonstrated that the incorporation of antibacterial agents into orthodontic adhesives showed no difference in shear bond strength. One related study 6 performed antibacterial growth assay in liquid media with 250 and 500 ppm of silver nanoparticles against S. mutans without compromising shear bond strength; however, no significant antibacterial growth was found after 24 h. Instead, in our study the inhibitory growth effect of silver nanoparticles was achieved with amounts of 500, 800, and 1500 ppm.…”

Laboratory evaluation of the effect of unfilled resin after the use of self-etch and total-etch dentin adhesives on the Shear Bond Strength of composite to dentin

“…According to the literature, bond strength is higher in increased solvent-free adhesive systems, while the rate of leakage is likely to decrease with the use of additional layers (8). Another research in this regard suggested the use of two layers of self-etching primers to facilitate the bonding process (17); as such, the bond strength could improve with increased number of overlying layers in two all-in-one adhesive systems. According to the results of the current study, storage of samples in artificial saliva for three months without the use of margin bond reduced the SBS rate in all adhesive systems, while it significantly increased the SBS rate of the SBMP adhesive, and this increase was not considered significant in the SBS rate of the Clearfil SE bond.…”