Copper-enabled biofunctional dental adhesives: A systematic review of interfacial stability, enzymatic inhibition, and clinical performance

Basualdo Allende J.; Pardo-Díaz C.; Jorquera G.; Gutiérrez M.F.; Pomacóndor-Hernández C.; Fernández Godoy E.; Loguercio A.D. · International Journal of Adhesion and Adhesives (2026) · DOI: 10.1016/j.ijadhadh.2026.104392

Resumen

This systematic review synthesized the available laboratory, in situ/ex vivo, and clinical evidence on copper-modified dental adhesive systems, with emphasis on antibacterial activity, resin–dentin interfacial stability, enzymatic inhibition, and clinical performance. A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, and the Cochrane Library in accordance with PRISMA 2020. Experimental and clinical publications assessing copper-containing adhesive systems were included. Study selection, data extraction, and risk-of-bias assessment were performed independently by two reviewers using RoBDEMAT for laboratory studies and Risk of Bias(RoB) 2 .0 for clinical trials. Owing to substantial heterogeneity in copper formulations, adhesive systems, aging protocols, outcome measures, and partially overlapping clinical cohorts, meta-analysis was not performed and findings were synthesized narratively. Twenty-one publications were included, comprising laboratory investigations, one in situ/ex vivo model, and clinical publications derived from a limited number of independent participant cohorts. Laboratory evidence indicated that copper incorporation may reduce matrix metalloproteinase-related activity, nanoleakage, and interfacial degradation, while generally preserving immediate bond strength and polymerization-related properties. Antibacterial effects were consistently observed in vitro, although their magnitude was formulation- and concentration-dependent. In contrast, clinical evidence showed that copper-modified adhesives achieved restoration retention, marginal adaptation, marginal staining, postoperative sensitivity, and secondary caries outcomes broadly comparable to conventional adhesives over follow-up periods ranging from 4 weeks to 6 years. A short-term benefit reported for self-etch copper-containing adhesives at 18 months was not consistently maintained at longer follow-ups and should therefore be interpreted cautiously. Overall, copper-modified adhesive systems show promising mechanistic and interfacial effects, but current clinical evidence does not demonstrate consistent superiority over conventional adhesives for restoration survival, marginal integrity, or secondary caries prevention.

Instituciones: Universidad Científica del Sur