A Novel Graphite Fluoride/Bioactive Glass-containing Orthodontic Primer with Antibacterial and Remineralization Properties: An In-vitro Study

Purpose: This study aimed to develop a novel orthodontic primer that incorporated graphite fluoride (GF) and Bioactive glass (BAG) and to investigate its cell viability, bonding strength, and enamel damage, as well as its antibacterial and remineralization properties.
Materials and Methods: Nine groups were prepared by adding different concentrations of GF (1, 2, and 4 wt.%) and BAG (1, 3, and 5 wt.%) to Transbond™ XT orthodontic primer. The prepared primers were compared to the control primer in terms of cell viability, shear bond strength (SBS), adhesive remnant index (ARI), enamel damage index (EDI), and antibacterial test. Then, the groups with better antibacterial properties (GFBAG 1-1, GFBAG 4-1, GFBAG 4-3, GFBAG 4-5) were evaluated for the remineralization properties.
Results: All the prepared orthodontic primers with different concentrations of GF/BAG revealed acceptable cell viability levels, with comparable SBS and ARI values to the control primer (p>0.05). Simultaneously, the EDI was reduced, while the antibacterial properties were significantly enhanced when compared to the control group (p0.05). The result of remineralization properties revealed that the selected groups had significantly higher remineralization ability than the control group; this was most pronounced in the GFBAG 4-3 group.
Conclusions: All the prepared GF/BAG orthodontic primers are biologically safe with adequate SBS, ARI, and EDI values for clinical application with enhanced antibacterial properties. The GFBAG 4-3 experimental primer reveals the best antibacterial and remineralization properties which require further in-vitro and in-vivo investigations as a preventive measure of white spot lesions.