Abstract

ObjectivesSecondary caries at the tooth-restoration margins is a primary reason for restoration failure. Cracks at the margins lead to leakage which can trap bacteria, producing acids to cause caries. To date, there has been no report on developing an adhesive resin that has self-healing, antibacterial and remineralizing capabilities. The objectives of this study were to: (1) develop the first self-healing adhesive with antimicrobial and remineralizing capabilities, and (2) investigate the effects of incorporating microcapsules, dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP) for the first time. MethodsSelf-healing microcapsules were synthesized with poly(urea-formaldehyde) (PUF) shells containing triethylene glycol dimethacrylate (TEGDMA) as the healing liquid. The new adhesive contained 7.5% microcapsules, 10% DMAHDM and 20% NACP. A single edge V-notched beam (SEVNB) method was used to measure the fracture toughness KIC and the autonomous crack-healing efficiency. An oral plaque microcosm biofilm model was tested. ResultsThe new self-healing, antimicrobial and remineralizing dental adhesive matched the dentin bond strength of a commercial control (p > 0.1). The new adhesive achieved successful crack-healing, with an excellent KIC recovery of 67%. The new adhesive had strong antimicrobial activity, reducing biofilm colony-forming units by four orders of magnitude, and reducing biofilm acid production to 1/100th that of biofilms on the commercial control resin. ConclusionsA self-healing adhesive with antibacterial and remineralizing capabilities was developed for the first time. Excellent dentin bond strength, autonomous crack-healing and KIC recovery, and strong anti-biofilm properties were achieved for the new adhesive resin. Clinical significanceThe novel method of using triple agents (self-healing microcapsules + DMAHDM + NACP) is promising for applications in dental adhesives, cements, sealants and composites to combat the two main challenges: fracture and secondary caries.

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