Effectiveness of adhesive containing MDPB: A practice-based clinical trial

Area of Science:

• Dental Materials Science
• Clinical Dentistry
• Restorative Dentistry

Background:

• Dental caries remains a significant oral health concern, necessitating effective restorative materials.
• Antimicrobial agents incorporated into dental adhesives aim to prevent secondary caries and improve restoration longevity.
• The quaternary ammonium salt MDPB is a novel antibacterial monomer explored for its potential in dental adhesives.

Purpose of the Study:

• To prospectively evaluate the longevity of composite restorations using an adhesive containing the antibacterial monomer MDPB versus a conventional control adhesive.
• To compare the incidence of general restoration failure and failure due to secondary caries between the two adhesive groups.
• To assess the clinical performance of MDPB-containing adhesives in a general dental practice setting.

Main Methods:

• A prospective, practice-based trial involving 9 general dental practices in the Netherlands.
• 10,151 composite restorations were placed using either Adhesive P (containing MDPB) or Adhesive S (control).
• Data on patient factors, restoration details, and subsequent interventions over up to 6.29 years were analyzed using Cox regression.

Main Results:

• A total of 10,151 restorations were placed, with 4,591 using Adhesive P and 5,560 using Adhesive S.
• After a median observation time of 3.74 years, no significant difference in general failure or failure due to secondary caries was found between the MDPB-containing adhesive and the control.
• Cox regression analysis, corrected for age, tooth type, and caries risk, confirmed these findings.

Conclusions:

• Composite restorations utilizing an adhesive with the antibacterial monomer MDPB demonstrated comparable longevity and failure rates to those made with a conventional adhesive.
• The incorporation of MDPB into dental adhesives did not significantly reduce failures attributed to secondary caries in this clinical trial.
• Further research may be warranted to explore alternative or adjunct strategies for enhanced caries prevention in dental restorations.