Developing a Novel Enamel Adhesive with Amorphous Calcium Phosphate and Silver Nanoparticles to Prevent Demineralization during Orthodontic Treatment

During fixed orthodontic treatment, white spot lesions are prevalent issues associated with cariogenic bacteria. This study aims to construct an orthodontic adhesive containing nanoparticles of amorphous calcium phosphate-polydopamine-Ag (NPA) fillers to combat white spot lesions. The NPA fillers were prepared and characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS). The biocompatibility of the fillers was evaluated. A colony counting test evaluated the antibacterial property of the fillers against Streptococcus mutans (S. mutans). NPA fillers were mixed with orthodontic adhesive (Transbond XT) at different weight ratios (0, 0.1, 0.2, 0.3, and 0.5 wt.%). The shear bond strength and antibacterial properties were then further investigated. The results showed that NPA was prepared successfully, with good antibacterial properties. The cell survival rate of all groups of fillers was higher than 70%, showing good biocompatibility. Moreover, the shear bond strength of the orthodontic adhesive with 0.2 wt.% NPA fillers was 11.89 +/- 1.27 MPa, meeting the minimal clinical bond strength requirements of 7.8 MPa. Furthermore, the orthodontic adhesive resin blocks and the extract displayed good antibacterial properties, with the number of colonies decreasing significantly (p < 0.001). Taken together, we think that an orthodontic adhesive with NPA may have a good application potential for the prevention and treatment of white spot lesions.