Effect of Saliva Contamination on Different Orthodontic Primers

Achieving reliable orthodontic bracket bonding in the presence of saliva contamination remains a significant clinical challenge. This systematic review evaluates the effect of saliva contamination on the performance of conventional primers, self-etching primers (SEPs), and moisture-insensitive primers (MIPs) used in orthodontic bonding. A comprehensive search of electronic databases identified clinical and laboratory studies published between 2002 and 2024 that assessed bond strength, bracket failure rates, moisture tolerance, enamel preservation, and adjunctive antibacterial or remineralizing properties. The findings indicate that while conventional etch-and-rinse primers demonstrate high bond strength under ideal dry conditions, their performance is adversely affected by saliva contamination. In contrast, SEPs and MIPs show greater tolerance to moisture, with comparable clinical bracket survival rates and reduced technique sensitivity. Emerging primer modifications incorporating antibacterial agents and remineralizing components demonstrate promising enamel-protective benefits without compromising bond strength.