Surface characteristics of orthodontic adhesives and effects on streptococcal adhesion

Corrosion-induced changes in surface properties and roughness of orthodontic wires

INTRODUCTION

This study aimed to investigate the surface free energy and surface roughness (SR) of metallic alloys under the influence of acid solutions.

METHODS

The experiment involved the use of 270 rectangular wire samples measuring 0.019 × 0.025-in. These samples were sourced from 3 different commercial brands: Dentsply GAC, American Orthodontics, and Orthoclassic. This in vitro study categorized the samples into 3 groups based on the solutions employed: deionized water, citric acid, and phosphoric acid. Each group consisted of 90 samples, with 30 samples representing each type of alloy-stainless steel, nickel-titanium, and titanium molybdenum alloy (TMA). The wire segments were immersed in their respective solutions for 72 hours at a controlled temperature of 37°C, with continuous orbital agitation at 130 rpm. After the immersion period, the study analyzed both surface free energy and SR. The mean values obtained were subjected to an analysis of variance at a significance level of 5%.

RESULTS

All alloys displayed hydrophobic behavior, as indicated by interaction free energy values <0. In acidic environments (phosphoric acid and citric acid), significant differences were observed among different brands and alloys, affecting surface energy and interaction free energy. Variations in SR among metallic alloys included steel with the lowest SR variations, followed by nickel-titanium and TMA. Notably, the TMA alloy stood out with significantly higher surface energy compared with that of the other alloys (P <0.001).

CONCLUSIONS

In this study, all examined alloys demonstrated a hydrophobic nature, suggesting a limited attraction to water. Notably, TMA exhibited the least hydrophobic behavior among the alloys studied. However, when exposed to citric acid, TMA displayed the most substantial alterations in its surface properties. These results underscored the significance of accounting for the distinctive properties of each alloy and their responses to diverse challenges, such as exposure to acidic solutions, during the selection of orthodontic wires for orthodontics treatment.

Effect of the addition of silver nanoparticles on the mechanical properties of an orthodontic adhesive

Objectives

This study evaluated the effects of adding silver nanoparticles on the shear bond strength, microhardness, and surface roughness of orthodontic adhesives.

Material and Methods

Fifty upper premolars were randomly allocated to five groups (n = 10). Orthodontic brackets were bonded with silver nanoparticle (AgNP)-modified adhesives (1 %, 0.5 %, 0.1 %, 0.05 %), and conventional adhesive was used as a control. The shear bond strength was recorded using a universal testing machine, and the adhesive remnant index was evaluated using a stereomicroscope. Ten discs of each adhesive were subjected to the microhardness and surface roughness tests. The Vickers microhardness values were measured under a constant load of 100 g for 30 s using a microhardness tester. The samples were analyzed using a surface profilometer, and the arithmetic average roughness was used as the measurement parameter. Data were analyzed using one-way analysis of variance and chi-square tests. A significance level of 5 % was considered significant.

Results

AgNP concentration > 0.1 % significantly reduced the shear bond strength (p < 0.05). At higher AgNP concentration, the bonding failure pattern occurred mainly at the bracket-resin interface. The Vickers microhardness increased with increasing concentration, and significant differences were observed between the group with 1 % AgNP and the other groups (p < 0.05). The average roughness values were similar between the groups with AgNP concentrations > 0.1 % (p > 0.05).

Conclusion

The incorporation of AgNP into an orthodontic adhesive has the potential to decrease the shear bond strength while increasing the microhardness and surface roughness.

Improving the Antibacterial Properties of Dental Bonding Materials Loaded with Silver Compounds

Biofilm accumulation, the appearance of white spot lesions and the development of secondary caries are the main complications in orthodontic patients. A promising approach to fight this situation is the development of adhesive cements with improved antibacterial properties. The aim of the present study was to evaluate the possibility of improving the antibacterial properties of glass ionomer cements by incorporating different types of antimicrobial compounds without altering their physical and mechanical properties. Different concentrations of silver carbonate (SC) and an inorganic glass with encapsulated silver were added to the glass ionomer cement, as well as chitosan, to achieve synergistic antibacterial activity. Variations in the antibacterial capacity were evaluated using the agar diffusion test; the potential alteration of the physical and mechanical properties of the material was analyzed by the shear bond strength test. SEM characterization and colorimetric evaluation were also conducted. Samples of SC up to 1% and inorganic glass with encapsulated silver up to 5% showed significant improvement in their antibacterial ability without compromising shear strength. The highest antimicrobial activity was observed for Lactobacillus acidophilus, with inhibition zones of 3.8 and 3.1 mm for SC and inorganic glass, respectively. The characterization of the samples did not detect any major structural changes between the different samples. The only group that underwent a noticeable color change was the group with SC. The results show that the incorporation of silver carbonate and inorganic glass with encapsulated silver provided the glass ionomer cement with an antibacterial capacity without compromising the bond strength and without modifying the structure of the material.

Managing oral biofilms to avoid enamel demineralization during fixed orthodontic treatment

Enamel demineralization represents the most prevalent complication arising from fixed orthodontic treatment. Its main etiology is the development of cariogenic biofilms formed around orthodontic appliances. Ordinarily, oral biofilms exist in a dynamic equilibrium with the host's defense mechanisms. However, the equilibrium can be disrupted by environmental changes, such as the introduction of a fixed orthodontic appliance, resulting in a shift in the biofilm's microbial composition from non-pathogenic to pathogenic. This alteration leads to an increased prevalence of cariogenic bacteria, notably mutans streptococci, within the biofilm. This article examines the relationships between oral biofilms and orthodontic appliances, with a particular focus on strategies for effectively managing oral biofilms to mitigate enamel demineralization around orthodontic appliances.

Bond strength, degree of conversion, and microorganism adhesion using different bracket-to-enamel bonding protocols

PURPOSE

This study aimed to evaluate the effect of bonding protocols and the type of orthodontic resin on the adhesion of microorganisms, degree of conversion (DC), and shear bond strength (SBS) of metallic brackets to enamel.

METHODS

A total of 60 bovine incisors were prepared and randomly divided into 6 groups (n = 10): "bonding protocol" (A: phosphoric acid; AXT: A+Transbond™ XT primer adhesive [all Transbond™ products from 3M Unitek, Monrovia, CA, USA]; and SE: Transbond™ Plus Self Etching Primer) and "orthodontic resin" (XT: Transbond™ XT adhesive paste and CC: Transbond™ Plus Color Change). After bonding, the samples were subjected to thermocycling (5000 cycles) and to the SBS test. Bond failures were classified according to the adhesive remnant index (ARI). Next, 60 enamel blocks were sterilized in ethylene oxide in order to perform the CFU (Streptococcus mutans) assay in vitro to analyze the colony forming units (CFU/mL). Then, 60 discs of each orthodontic resin were made to measure the DC. The SBS (MPa), CFU/mL, and DC (%) data were statistically analyzed by two-way analysis of variance and Tukey's test (5%) was performed for the DC.

RESULTS

CFU and SBS revealed no significance for all factors (P > 0.05). Tukey's test showed that A_XT (acid+Transbond™ XT adhesive paste) presented the highest DC (70.38% ± 10.5), while AXT_XT (acid+Transbond™ XT primer adhesive+Transbond™ XT adhesive paste) showed the lowest (23.47% ± 10.4). An ARI score of 2 was more frequent for the CC resin and an ARI score of 4 for the XT resin.

CONCLUSION

The CC resin does not reduce adhesion of S. mutans around orthodontic brackets and the bonding protocol did not influence the SBS, although the SE and A_XT groups contributed to a better DC.

Dual function of anti-biofilm and modulating biofilm equilibrium of orthodontic cement containing quaternary ammonium salt

The objectives of this study were to incorporate dimethylaminohexadecyl methacrylate (DMAHDM) into resin-modified glass ionomer cement (RMGI) to develop a novel orthodontic cement which endowed RMGI with strong antibacterial ability and investigated its modulation biofilm equilibrium from cariogenic state to non-cariogenic state for the first time. Cariogenic Streptococcus mutans (S. mutans), and non-cariogenic Streptococcus sanguinis (S. sanguinis) and Streptococcus gordonii (S. gordonii) were selected to form a tri-species biofilm model. RMGI incorporated with different mass fraction of DMAHDM was examined: biofilm colony-forming units, metabolic activity, live/dead staining, lactic acid and exopolysaccharides productions. TaqMan real-time polymerase chain reaction was used to determine changes of biofilm species compositions. The results showed RMGI containing 3% DMAHDM achieved strong antibacterial ability and suppressed the cariogenic species in biofilm, modulating biofilm equilibrium from cariogenic state to non-cariogenic state tendency. The novel bioactive cement containing DMAHDM is promising in fixed orthodontic treatments and protecting tooth enamel.

Bacterial and Cellular Response to Yellow-Shaded Surface Modifications for Dental Implant Abutments

Dental implants have dramatically changed the rehabilitation procedures in dental prostheses but are hindered by the possible onset of peri-implantitis. This paper aims to assess whether an anodization process applied to clinically used surfaces could enhance the adhesion of fibroblasts and reduce bacterial adhesion using as a reference the untreated machined surface. To this purpose, four different surfaces were prepared: (i) machined (MAC), (ii) machined and anodized (Y-MAC), (iii) anodized after sand-blasting and acid etching treatment (Y-SL), and (iv) anodized after double acid etching (Y-DM). All specimens were characterized by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). Moreover, the mean contact angle in both water and diiodomethane as well as surface free energy calculation was assessed. To evaluate changes in terms of biological responses, we investigated the adhesion of Streptococcus sanguinis (S. sanguinis) and Enterococcus faecalis (E. faecalis), fetal bovine serum (FBS) adsorption, and the early response of fibroblasts in terms of cell adhesion and viability. We found that the anodization reduced bacterial adhesion, while roughened surfaces outperformed the machined ones for protein adsorption, fibroblast adhesion, and viability independently of the treatment. It can be concluded that surface modification techniques such as anodization are valuable options to enhance the performance of dental implants.

Effect of different polishing techniques on surface properties and bacterial adhesion on resin-ceramic CAD/CAM materials

OBJECTIVES

The aim of this study is to evaluate the adhesion of Streptococcus mutans on the surface of CAD/CAM materials with various surface treatments.

METHODS

Vita Enamic, Lava Ultimate, and Cerasmart materials were used in this study. A total of 90 samples were prepared (n = 10). After various finishing and polishing procedures (non-polished, manual polished, and glazed), surface roughness (SR) measurements, surface free energy (SFE), and elemental and topographic analysis with FIB-SEM/EDX were used to evaluate the samples' surface properties. To improve bacterial adhesion, CAD/CAM materials were covered with sterile artificial saliva containing mucin for pellicle formation and incubated for 1 h at 37 °C. Bacteria were then inoculated into the pellicle-coated specimens, and incubation was performed at 37 °C for 24 h. Bacterial adhesion was determined as × 10⁵ CFU/mL and monitored using FIB-SEM analysis. The Kolmogorov-Smirnov test was used to statistically analyze the normality of the distribution; the groups were then compared using one-way ANOVA and Tukey's test.

RESULTS

The SR of the control group was statistically higher in all materials (p < 0.05). There were no statistically significant differences in SR between all materials in the non-polished and manual polished groups (p > 0.05). The Vita Enamic control group exhibited the highest SFE value. The highest S. mutans adhesion was observed in non-polished (p < 0.05). Vita Enamic samples had higher CFU than other groups.

CONCLUSIONS

Non-polished surfaces showed higher SR and bacterial adhesion. Polishing processes affected the surface properties and bacterial adhesion.

CLINICAL RELEVANCE

Care must be taken in polishing restorations to minimize the risk of bacterial adhesion and recurrent caries.

TRIAL REGISTRATION

In this study, the materials used for dental treatments are in vitro evaluated. Due to that, this study is not registered to clinical trials.

Surface Properties of Ti6Al7Nb Alloy: Surface Free Energy and Bacteria Adhesion

The laser micro-machining was carried out on a station equipped with a TruMicro 5325c laser emitting ultraviolet radiation (343 nm wavelength) in picosecond pulses. On the surface of the Ti6Al7Nb alloy, dimple texturing with a constant diameter of ~200 μm, different depths (from ~5 to ~78 μm) and density (from 10% to 50%) were produced. The value of surface free energy was determined with the Owens–Wendt method using two measuring liquids: distilled water and diodomethane. The Staphylococcus epidermidis strain was used to test the adhesion of bacteria. It was found that the surface free energy value is influenced by both of the texture parameters (density, depth). The density also affects the potential for biofilm formation. Based on the analysis, it was shown that with an increase in surface free energy, the number of adhering microorganisms increases exponentially. Moreover, the study shows that there is a correlation between the number of adhering microorganisms and surface free energy.

Incorporation of Arginine to Commercial Orthodontic Light-Cured Resin Cements-Physical, Adhesive, and Antibacterial Properties

(1) Background: The amino acid arginine is now receiving great attention due to its potential anti-caries benefits. The purpose of this in vitro study was to evaluate the shear bond strength (SBS), ultimate tensile strength (UTS), and antimicrobial potential (CFU) of two arginine-containing orthodontic resin cements. (2) Methods: Forty bovine incisors were separated into four groups (n = 10): Orthocem, Orthocem + arginine (2.5 wt%), Transbond XT, and Transbond XT + arginine (2.5 wt%). The brackets were fixed to the flat surface of the enamel, and after 24 h the SBS was evaluated using the universal testing machine (Instron). For the UTS test, hourglass samples (n = 10) were made and tested in a mini-testing machine (OM-100, Odeme). For the antibacterial test (colony forming unit-CFU), six cement discs from each group were made and exposed to Streptococcus mutans UA159 biofilm for 7 days. The microbiological experiment was performed by serial and triplicate dilutions. The data from each test were statistically analyzed using a two-way ANOVA, followed by Tukey’s test (α = 0.05). (3) Results: The enamel SBS mean values of Transbond XT were statistically higher than those of Orthocem, both with and without arginine (p = 0.02033). There was no significant difference in the SBS mean values between the orthodontic resin cements, either with or without arginine (p = 0.29869). The UTS of the Transbond XT was statistically higher than the Orthocem, but the addition of arginine at 2.5 wt% did not influence the UTS for either resin cement. The Orthocem + arginine orthodontic resin cement was able to significantly reduce S. mutans growth, but no difference was observed for the Transbond XT (p = 0.03439). (4) Conclusion: The incorporation of arginine to commercial orthodontic resin cements may be an efficient preventive strategy to reduce bacterial growth without compromising their adhesive and mechanical properties.

Assessment of Streptococcus mutans biofilms on orthodontic adhesives over 7 days

INTRODUCTION

The purpose of this study was to compare the metabolism of Streptococcus mutans biofilms after 1-7 days of growth on different orthodontic adhesives.

METHODS

Specimens of 6 commercial orthodontic adhesives were fabricated in custom-made molds and polymerized using a light-emitting diode light-curing unit. Bioluminescent S mutans (UA159:JM10) biofilms were grown on ultraviolet-sterilized specimens for 1, 3, 5, and 7 days (n = 18 biofilms/d/product) in anaerobic conditions at 37°C. The metabolism of biofilms (relative luminescence unit [RLU]) was measured 0, 2, 4, and 6 minutes after exposure to D-luciferin solution using a microplate reader. A linear mixed-effects model was used to analyze the logarithm of RLU (log RLU). The model included fixed effects of products, days, and minutes. Tukey-Kramer post-hoc tests were then performed on the significant predictors of log RLU (α = 0.05).

RESULTS

Days (P <0.0001) and minutes (P <0.0001) were independent predictors of log RLU, but the products were not (P = 0.5869). After adjusting for minutes, the log RLU was analyzed with a post-hoc test, and all differences between days were significant with the exceptions of day 3 from day 5 (P = 0.0731) and day 5 from day 7 (P = 0.8802). After adjusting for day, log RLU was analyzed with a post-hoc test and all differences in minutes were significant.

CONCLUSIONS

No significant differences in the metabolism of S mutans biofilms were observed among the 6 orthodontic adhesives. Biofilms that were grown for 3 days demonstrated the highest levels of biofilm metabolism as evidenced by higher mean log RLU values relative to 1, 5, and 7-day growth durations.

In Vitro Evaluation of Structural Factors Favouring Bacterial Adhesion on Orthodontic Adhesive Resins

Bacterial adhesion to the surface of orthodontic materials is an important step in the formation and proliferation of plaque bacteria, which is responsible for enamel demineralization and periodontium pathologies. With the intent of investigating if adhesive resins used for bracket bonding are prone to bacteria colonization, the surface roughness of these materials has been analyzed, combining information with a novel methodology to observe the internal structures of orthodontic composites. Scanning electron microscopy, combined with focus ion bean micromachining and stylus profilometry analyses, were performed to evaluate the compositional factors that can influence specific pivotal properties facilitating the adhesion of bacteria to the surface, such as surface roughness and robustness of three orthodontic adhesive composite resins. To confirm these findings, contact angle measurements and bacteria incubation on resin slide have been performed, evaluating similarities and differences in the final achievement. In particular, the morphological features that determine an increase in the resins surface wettability and influence the bacterial adhesion are the subject of speculation. Finally, the focused ion beam technique has been proposed as a valuable tool to combine information coming from surface roughness with specific the internal structures of the polymers.

Comparison of microbial adhesion and biofilm formation on orthodontic wax materials; an in vitro study

Background/purpose

Orthodontic wax materials are available on the dental market and are given by orthodontists due to pain, sores and irritation caused by treatment. The aim of the study was to compare biofilm formation and microbial adhesion at different time points on different protective materials used against orthodontic wounds in vitro.

Materials and methods

Microbial adhesion and biofilm formation were evaluated against Streptococcus mutans ATCC 25175 and Lactobacillus acidophilus ATCC 4356 standard strains on orthodontic wax materials at the 0, 24th, 48th, 72nd, 96th and 120th hour. The Kruskal Wallis test and Bonferroni test were used for statistical evaluations. Statistical significance was set at p < 0.05.

Results

It was observed that S. mutans formed statistically significantly more biofilm on OrthoDots®CLEAR (OrVance) than Ora-Aid (TBM Corporation) at the 48th hour (p < 0.05). Furthermore, L. acidophilus formed statistically significantly more biofilm on OrthoDots®CLEAR (OrVance) than Brace Gard®(Infa-Lab Inc.) at the 72nd, 96th and 120th hours (p < 0.05).

Conclusion

Significant differences were noted among the different orthodontic wax materials and both S. mutans and L. acidophilus created biofilm on all waxes at different time points in vitro. To prevent biofilm formation, these waxes need to be refreshed and should not be used for more than 24 h. According to our study, biofilm production performances of pathogens on Brace Gard®(Infa-Lab Inc.) are minimal and therefore it may be a better option to use in clinics. However, to our knowledge, this is the first study investigating biofilm formation on waxes and more studies are needed in this field.

Effect of high concentration nano-hydroxyapatite serum on shear bond strength of metal brackets following three different enamel surface preparation methods: An in vitro study

OBJECTIVE

White spot lesion (WSL) is one of the most important complications of fixed orthodontic treatment. Many methods have been studied to prevent this problem. This study is aimed to investigate the effect of high concentration nano-hydroxyapatite (nHAP) on shear bond strength (SBS) of metal brackets and Adhesive Remnant Index (ARI) score in different preparation methods.

MATERIAL AND METHODS

Sixty human premolars, which were extracted for orthodontic reasons were included in this in vitro study. The teeth were randomly divided into 4 groups of 15 each: one control group and three nHAP groups. After applying nHAP for 2 to 3 minutes daily for 10 days, the groups 2 to 4 underwent sandblasting using 50μm aluminium oxide and 30 seconds etching, 60 and 30 seconds etching, respectively, and the brackets were then bonded to the teeth. After debonding, SBS and ARI scores were recorded. Data were analysed using the ANOVA test and posthoc test for pairwise comparisons.

RESULTS

No significant difference was observed in SBS between the control group and the nHAP groups. The sandblasted teeth showed significantly higher SBS than the 30 seconds etching after nHAP application (P=0.02). The teeth etched for 60 seconds showed a significantly higher ARI score than the 30 seconds etched teeth with (P=0.003) or without (P<0.001) nHAP application.

CONCLUSIONS

The use of nHAP before bracket bonding can be considered as a caries preventive method since it did not compromise the SBS. Sixty seconds etching is recommended for less likely damage to the enamel after debonding.

Bio-Interactive Zwitterionic Dental Biomaterials for Improving Biofilm Resistance: Characteristics and Applications

Biofilms are formed on surfaces inside the oral cavity covered by the acquired pellicle and develop into a complex, dynamic, microbial environment. Oral biofilm is a causative factor of dental and periodontal diseases. Accordingly, novel materials that can resist biofilm formation have attracted significant attention. Zwitterionic polymers (ZPs) have unique features that resist protein adhesion and prevent biofilm formation while maintaining biocompatibility. Recent literature has reflected a rapid increase in the application of ZPs as coatings and additives with promising outcomes. In this review, we briefly introduce ZPs and their mechanism of antifouling action, properties of human oral biofilms, and present trends in anti-biofouling, zwitterionic, dental materials. Furthermore, we highlight the existing challenges in the standardization of biofilm research and the future of antifouling, zwitterated, dental materials.

Enamel preservation during composite removal after orthodontic debonding comparing hydroabrasion with rotary instruments

The aim of the present study was to evaluate how hydroabrasion performs during composite removal. A standardized amount of composite was bonded to 40 enamel surfaces of extracted third molars, then removed with either a tungsten carbide bur mounted on a micro-motor handpiece without irrigation, a tungsten carbide bur mounted on a micro-motor handpiece with irrigation, a tungsten carbide bur mounted on an air-rotor handpiece, or hydroabrasion. The four treatment methods were compared using the enamel-surface-index and the adhesive-remnant-index and performing a Kruskal-Wallis statistical test to detect differences between each method' scores. Hydroabrasion produced significantly less damage to the enamel surface compared to the other three methods. Hydroabrasion was the cleaning method that produced less damages to the enamel surface, at a cost of a less efficient composite removal than tungsten carbide burs on micro-motor handpiece.

Surface properties and bacterial adhesion of bulk-fill composite resins

OBJECTIVES

The aim of the present study was to evaluate the Streptococcus mutans and Streptococcus mitis adhesion and related surface properties of bulk-fill resin composite.

METHODS

Four novel bulk-fill composite with different composition were used; Sonic Fill-2 (KSF), Filtek BulkFill (FBF), Admira Fusion X-tra (AFX), Beautifil Bulk Restorative (SBB) and a control group (glass) were included in the study. After standardized surface polishing procedure, surface properties of composite specimens were evaluated using surface roughness (SR) measurements by a profilometer, hydrophobicity and surface free energy (SFE) analyses, elemental and topographic analyses by SEM-EDS. To evaluate the bacterial adhesion, composite specimens were immersed in artificial saliva and mucin for pellicle development. After 1-h immersion, bacterial suspension was added to the pellicle-coated specimens, which were incubated at 37 °C in 5% CO₂ atmosphere for 24 h. Adhered bacteria counts were determined as x10⁸ Cfu/ml. Bacterial adhesion was also investigated using confocal laser scanning microscopy.

RESULTS

No statistically significant differences were found among bulk fill composites in terms of surface roughness while glass showed the lowest Ra values. The lowest contact angle values were found in the control group and Sonic Fill-2 while the highest SFE values were observed in these materials. No statistically significant differences were found between the S. mutans counts. For S. Mitis adhesion, the highest value was found in Sonic Fill-2 and no significant differences were observed between the other groups.

CONCLUSIONS

SR of bulk-fill composite resins had no effect on bacterial adhesion. However, bacterial adhesion increased with higher SFE values.

CLINICAL SIGNIFICANCE

Although the surface roughness of composites used in the study is similar, in clinically, S. mitis adhesion may be more in the KSF group because of high surface free energy.

Evaluation of the Effect of Propolis Nanoparticles on Antimicrobial Properties and Shear Bond Strength of Orthodontic Composite Bonded to Bovine Enamel

Objectives:

We aimed to investigate the effects of propolis nanoparticles (prpNPs) on antimicrobial property and shear bond strength (SBS) of orthodontic composite bonded to bovine enamel.

Materials and Methods:

Sixty bovine teeth were randomly divided into five groups (n=12). PrpNPs were prepared at concentrations of 0% (control), 1%, 2%, 5%, and 10% in Transbond XT composite to bond stainless steel brackets to the teeth. SBS between brackets and teeth was measured using a universal testing machine. After debonding, the adhesive remnant index (ARI) on bracket bases was measured. In the microbial test, composites with the aforementioned concentrations of prpNPs were cured in metal discs. The bacteria included Streptococcus mutans (S. mutans), Streptococcus sanguinis (S. sanguinis), and Lactobacillus acidophilus (L. acidophilus), and antimicrobial effects of prpNPs were investigated by anti-biofilm, disc agar diffusion and eluted component tests.

Results:

The 10% prpNPs group showed the lowest SBS. Colony growths of S. mutans and S. sanguinis at all concentrations (except for 1%) was significantly lower than the control group. L. acidophilus colony growth was significantly reduced at 5% and 10% concentrations. Growth inhibition zone developed at 2%, 5%, and 10% concentrations for S. mutans and S. sanguinis. The lowest numbers of S. mutans and S. sanguinis colonies at all concentrations were observed on day 15. L. acidophilus colonies decreased significantly at all concentrations (except for 1%) until day 30.

Conclusion:

Nano propolis has a significant antimicrobial effect at 2% and 5% concentrations, and the SBS is maintained within the acceptable clinical range.

Polymerisation, antibacterial and bioactivity properties of experimental orthodontic adhesives containing triclosan-loaded halloysite nanotubes

OBJECTIVE

To evaluate the immediate enamel bond strength, in situ degree of conversion and the polymerisation rate of three experimental orthodontic adhesives containing triclosan-loaded halloysite nanotubes. The antibacterial and bioactivity properties of such experimental materials were also assessed.

MATERIALS AND METHODS

Three experimental orthodontic adhesives were formulated by incorporating triclosan-loaded halloysite nanotubes (TCN-HNT) at different concentrations (5wt%, 10wt% and 20wt%) into a resin blend (Control). The maximum polymerisation rate of the tested adhesives was evaluated trough FTIR, while Raman was used to analyse the in situ degree of conversion (DC) at the bracket/enamel interface. The shear bond strength (SBS) of the enamel-bonded specimens was assessed at 24h. The antibacterial properties of the experimental materials against S. Mutans were evaluate up to 72h, while, their bioactivity was evaluated after 14days of artificial saliva (AS) storage through SEM-EDS and Raman spectromicroscopy.

RESULTS

Incorporation of TCN-HNT increased the polymerisation properties without interfering with the immediate bonding properties of the experimental adhesives. All experimental adhesives containing TCN-HNT inhibited bacterial growth at 24h, and induced mineral deposition after 14days of AS storage. At 72h, only the experimental system containing 20% TCN-HNT maintained such a capability.

CONCLUSIONS

Adhesives doped with TCN-HNT present improved polymerisation properties and suitable bonding performance. However, only the adhesives containing TCN-HNT >10% might promote long-term antibacterial activity and reliable mineral deposition.

CLINICAL SIGNIFICANCE

The use of adhesives containing triclosan-loaded halloysite represents a promising "smart" approach to bond orthodontic brackets and bands; these might prevent enamel demineralisation and induce enamel remineralisation during the treatment.

Novel orthodontic cement containing dimethylaminohexadecyl methacrylate with strong antibacterial capability

Orthodontic treatments increase the incidence of white spot lesions. The objectives of this study were to develop an antibacterial orthodontic cement to inhibit demineralization, and to evaluate its enamel shear bond strength and anti-biofilm properties. Novel antibacterial monomer dimethylaminohexadecyl methacrylate (DMAHDM) was synthesized and incorporated into Transbond XT at 0, 1.5 and 3% by mass. Anti-biofilm activity was assessed using a human dental plaque microcosm biofilm model. Shear bond strength and adhesive remnant index were also tested. Biofilm activity precipitously dropped when contacting orthodontic cement with DMAHDM. Orthodontic cement containing 3% DMAHDM significantly reduced biofilm metabolic activity and lactic acid production (p<0.05), and decreased biofilm colony-forming unit (CFU) by two log. Water-aging for 90 days had no adverse influence on enamel shear bond strength (p>0.1). By incorporating DMAHDM into Transbond XT for the first time, the modified orthodontic cement obtained a strong antibacterial capability without compromising the enamel bond strength.

Novel multifunctional dental cement to prevent enamel demineralization near orthodontic brackets

OBJECTIVES

White spot lesions due to biofilm acid-induced enamel demineralization are prevalent in orthodontic treatments. The aim of this study was to develop a novel bioactive multifunctional cement with protein-repellent, antibacterial and remineralizing capabilities, and investigate the effects on enamel hardness and lesion depth in vitro for the first time.

MATERIALS AND METHODS

2-Methacryloyloxyethyl phosphorylcholine (MPC), dimethylaminohexadecyl methacrylate (DMAHDM), and nanoparticles of amorphous calcium phosphate (NACP) were incorporated into a resin-modified glass ionomer (RMGI). Extracted human premolars had brackets bonded via four groups: (1) Transbond XT (TB), (2) RMGI (GC Ortho LC), (3) RMGI+MPC+DMAHDM, (4) RMGI+MPC+DMAHDM+NACP. Demineralization was induced via a dental plaque microcosm biofilm model. Samples were tested using polarized light microscopy (PLM) for lesion depth. Enamel hardness was tested for different groups.

RESULTS

Incorporating MPC, DMAHDM and NACP did not affect enamel bond strength. "RMGI+MPC+DMAHDM+NACP" group had the least lesion depth in enamel (p<0.05). Groups with NACP had the highest enamel hardness (p<0.05). Mineral loss (ΔS) in enamel for NACP group was about one third that for RMGI control. "RMGI+MPC+DMAHDM" had greater effect on demineralization-inhibition, compared to RMGI and TB controls. "RMGI+MPC+DMAHDM+NACP" was more effective in protecting enamel prisms from dissolution by biofilm acids, compared to RMGI and TB control groups.

CONCLUSION

The Novel "RMGI+MPC+DMAHDM+NACP" cement substantially reduced enamel demineralization adjacent to orthodontic brackets, yielding much less lesion depth and greater enamel hardness under biofilm acid attacks than commercial controls. The clinical significance is that the novel multi-agent (RMGI+MPC+DMAHDM+NACP) method is promising for a wide range of preventive and restorative applications to combat caries.

Streptococcus mutans forms xylitol-resistant biofilm on excess adhesive flash in novel ex-vivo orthodontic bracket model

INTRODUCTION

During orthodontic bonding procedures, excess adhesive is invariably left on the tooth surface at the interface between the bracket and the enamel junction; it is called excess adhesive flash (EAF). We comparatively evaluated the biofilm formation of Streptococcus mutans on EAF produced by 2 adhesives and examined the therapeutic efficacy of xylitol on S mutans formed on EAF.

METHODS

First, we investigated the biofilm formation of S mutans on 3 orthodontic bracket types: stainless steel preadjusted edgewise, ceramic preadjusted edgewise, and stainless steel self-ligating. Subsequently, tooth-colored Transbond XT (3M Unitek, Monrovia, Calif) and green Grengloo (Ormco, Glendora, Calif) adhesives were used for bonding ceramic brackets to extracted teeth. S mutans biofilms on EAF produced by the adhesives were studied using the crystal violet assay and scanning electron microscopy. Surface roughness and surface energy of the EAF were examined. The therapeutic efficacies of different concentrations of xylitol were tested on S mutans biofilms.

RESULTS

Significantly higher biofilms were formed on the ceramic preadjusted edgewise brackets (P = 0.003). Transbond XT had significantly higher S mutans biofilms compared with Grengloo surfaces (P = 0.007). There was no significant difference in surface roughness between Transbond XT and Grengloo surfaces (P >0.05). Surface energy of Transbond XT had a considerably smaller contact angle than did Grengloo, suggesting that Transbond XT is a more hydrophilic material. Xylitol at low concentrations had no significant effect on the reduction of S mutans biofilms on orthodontic adhesives (P = 0.016).

CONCLUSIONS

Transbond XT orthodontic adhesive resulted in more S mutans biofilm compared with Grengloo adhesive on ceramic brackets. Surface energy seemed to play a more important role than surface roughness for the formation of S mutans biofilm on EAF. Xylitol does not appear to have a therapeutic effect on mature S mutans biofilm.

Effect of silver nanoparticles on the physicochemical and antimicrobial properties of an orthodontic adhesive

OBJECTIVE

This study aimed to incorporate silver nanoparticle solutions (AgNP) in an orthodontic adhesive and evaluate its physicochemical and antimicrobial properties.

MATERIAL AND METHODS

Silver nanoparticle solutions were added to a commercial adhesive in different concentrations (w/w): 0%, 0.11%, 0.18%, and 0.33%. Shear bond strength (SBS) test was performed after bonding metal brackets to enamel. Raman spectroscopy was used to analyze in situ the degree of conversion (DC) of the adhesive layer. The surface free energy (SFE) was evaluated after the measurement of contact angles. Growth inhibition of Streptococcus mutans in liquid and solid media was determined by colony-forming unit count and inhibition halo, respectively. One-way ANOVA was performed for SBS, DC, SFE, and growth inhibition.

RESULTS

The incorporation of AgNP solution decreased the SBS (p<0.001) and DC in situ (p<0.001) values. SFE decreased after addition of 0.18% and 0.33% AgNP. Growth inhibition of S. mutans in liquid media was obtained after silver addition (p<0.05).

CONCLUSIONS

The addition of AgNP solutions to Transbond™ XT adhesive primer inhibited S. mutans growth. SBS, DC, and SFE values decreased after incorporation up to 0.33% AgNP solution without compromising the chemical and physical properties of the adhesive.

Novel Dental Cement to Combat Biofilms and Reduce Acids for Orthodontic Applications to Avoid Enamel Demineralization

Orthodontic treatments often lead to biofilm buildup and white spot lesions due to enamel demineralization. The objectives of this study were to develop a novel bioactive orthodontic cement to prevent white spot lesions, and to determine the effects of cement compositions on biofilm growth and acid production. 2-methacryloyloxyethyl phosphorylcholine (MPC), nanoparticles of silver (NAg), and dimethylaminohexadecyl methacrylate (DMAHDM) were incorporated into a resin-modified glass ionomer cement (RMGI). Enamel shear bond strength (SBS) was determined. Protein adsorption was determined using a micro bicinchoninic acid method. A dental plaque microcosm biofilm model with human saliva as inoculum was used to investigate metabolic activity, colony-forming units (CFU) and lactic acid production. Incorporating 3% of MPC, 1.5% of DMAHDM, and 0.1% of NAg into RMGI, and immersing in distilled water at 37 °C for 30 days, did not decrease the SBS, compared to control (p > 0.1). RMGI with 3% MPC + 1.5% DMAHDM + 0.1% NAg had protein amount that was 1/10 that of control. RMGI with triple agents (MPC + DMAHDM + NAg) had much stronger antibacterial property than using a single agent or double agents (p < 0.05). Biofilm CFU on RMGI with triple agents was reduced by more than 3 orders of magnitude, compared to commercial control. Biofilm metabolic activity and acid production were also greatly reduced. In conclusion, adding MPC + DMAHDM + NAg in RMGI substantially inhibited biofilm viability and acid production, without compromising the orthodontic bracket bond strength to enamel. The novel bioactive cement is promising for orthodontic applications to hinder biofilms and plaque buildup and enamel demineralization.

Antibacterial orthodontic cement to combat biofilm and white spot lesions

INTRODUCTION

White spot lesions are an undesired side effect of fixed orthodontic treatment. The objective of this research was to develop an antibacterial resin-modified glass ionomer cement (RMGIC) containing nanoparticles of silver (NAg) for prevention of white spot lesions.

METHODS

NAg was incorporated into a commercial RMGIC. The NAg-enhanced cement was compared with the unaltered RMGIC and with a commercially available composite that does not release fluoride. The experimental and control products were used to bond brackets to 80 extracted maxillary first premolars. Enamel shear bond strength and the adhesive remnant index scores were determined. A dental plaque microcosm biofilm model with human saliva as the inoculum was used to investigate biofilm viability. Bacteria on the sample surface and bacteria in the culture medium away from the sample surface were tested for metabolic activity, colony-forming units, and lactic acid production.

RESULTS

Adding NAg to RMGIC and aging in water for 30 days did not adversely affect the shear bond strength compared with the commercial RMGIC control (P >0.1). The RMGIC with 0.1% NAg achieved the greatest reductions in colony-forming units, metabolic activity, and lactic acid production. The RMGIC with 0.1% NAg inhibited not only the bacteria on the surface, but also the bacteria away from the surface in the culture medium. Incorporation of NAg into RMGIC greatly reduced biofilm activity.

CONCLUSIONS

This novel RMGIC reduced biofilm formation and plaque buildup and could inhibit white spot lesions around brackets. The method of using NAg may apply in a wide range of dental adhesives, cements, sealants, and composites to inhibit biofilm and caries.

Acid Neutralizing Ability and Shear Bond Strength Using Orthodontic Adhesives Containing Three Different Types of Bioactive Glass

The objective of the study was to compare the acid neutralizing ability and shear bond strength (SBS) of three different types of orthodontic adhesives containing bioactive glasses (BAGs). 45S5, 45S5F and S53P4 BAGs were prepared using the melting technique and ground to fine particles. Orthodontic adhesives containing three types of BAGs were prepared as follows: 52.5% 45S5 BAG + 17.5% glass (45S5_A); 61.25% 45S5 BAG + 8.75% glass (45S5_B); 52.5% 45S5F BAG + 17.5% glass (45S5F_A); 61.25% 45S5F BAG + 8.75% glass (45S5F_B); 52.5% S53P4 BAG + 17.5% glass (S53P4_A); 61.25% S53P4 BAG + 8.75% glass (S53P4_B); and 70.0% glass (BAG_0). To evaluate the acid neutralizing properties, specimens were immersed in lactic acid solution, and pH changes were measured. SBS was measured with a universal testing machine. For all of the BAG-containing adhesives, the one with 61.25% of BAG showed a significantly greater increase of pH than the one with 52.5% of BAG (p < 0.05). Groups with 61.25% of BAG showed lower SBS than samples with 52.5% of BAG. 45S5F_A showed no significant difference of SBS compared to BAG_0 (p > 0.05). The adhesive containing 61.25% of 45S5F BAG exhibited clinically acceptable SBS and acid neutralizing properties. Therefore, this composition is a suitable candidate to prevent white spot lesions during orthodontic treatment.

Antibacterial and protein-repellent orthodontic cement to combat biofilms and white spot lesions

OBJECTIVES

White spot lesions are the most undesired side-effect of fixed orthodontic treatments. The objectives of this study were to combine nanoparticles of silver (NAg) with 2-methacryloyloxyethyl phosphorylcholine (MPC) to develop a modified resin-modified glass ionomer cement (RMGI) as orthodontic cement with double benefits of antibacterial and protein-repellent capabilities for the first time.

METHODS

NAg and MPC were incorporated into a commercial RMGI. Another commercial orthodontic adhesive also served as control. Enamel shear bond strengths (SBS) were determined. Protein adsorption was measured via a micro bicinchoninic acid method. A dental plaque microcosm biofilm model with human saliva as inoculum was tested. Biofilms adherent on the cement samples and planktonic bacteria in the culture medium away from the cement surfaces were both evaluated for bacterial metabolic activity, colony-forming units (CFU), and lactic acid production.

RESULTS

Adding 0.1% NAg and 3% MPC to RMGI, and water-aging for 30 days, did not adversely affect the SBS, compared to the unmodified RMGI control (p>0.1). The modified RMGI containing 0.1% NAg and 3% MPC achieved the greatest reduction in protein adsorption, bacterial adhesion, CFU, metabolic activity and lactic acid production. The RMGI containing 0.1% NAg and 3% MPC inhibited not only the bacteria on its surface, but also the bacteria away from the surface in the culture medium.

CONCLUSIONS

The incorporation of double agents (antibacterial NAg+protein-repellent MPC) into RMGI achieved much stronger inhibition of biofilms than using each agent alone. The novel antibacterial and protein-repellent RMGI with substantially-reduced biofilm acids is promising as an orthodontic cement to combat white spot lesions in enamel.

Reduction of bacterial adhesion on dental composite resins by silicon-oxygen thin film coatings

Adhesion of bacteria on dental materials can be reduced by modifying the physical and chemical characteristics of their surfaces, either through the application of specific surface treatments or by the deposition of thin film coatings. Since this approach does not rely on the use of drugs or antimicrobial agents embedded in the materials, its duration is not limited by their possible depletion. Moreover it avoids the risks related to possible cytotoxic effects elicited by antibacterial substances released from the surface and diffused in the surrounding tissues. In this work, the adhesion of Streptococcus mutans and Streptococcus mitis was studied on four composite resins, commonly used for manufacturing dental prostheses. The surfaces of dental materials were modified through the deposition of a-SiO(x) thin films by plasma enhanced chemical vapor deposition. The chemical bonding structure of the coatings was analyzed by Fourier-transform infrared spectroscopy. The morphology of the dental materials before and after the coating deposition was assessed by means of optical microscopy and high-resolution mechanical profilometry, while their wettability was investigated by contact angle measurements. The sample roughness was not altered after coating deposition, while a noticeable increase of wettability was detected for all the samples. Also, the adhesion of S. mitis decreased in a statistically significant way on the coated samples, when compared to the uncoated ones, which did not occur for S. mutans. Within the limitations of this study, a-SiO(x) coatings may affect the adhesion of bacteria such as S. mitis, possibly by changing the wettability of the composite resins investigated.

Novel antibacterial orthodontic cement containing quaternary ammonium monomer dimethylaminododecyl methacrylate

OBJECTIVES

Demineralized lesions in tooth enamel around orthodontic brackets are caused by acids from cariogenic biofilm. This study aimed to develop a novel antibacterial orthodontic cement by incorporating a quaternary ammonium monomer dimethylaminododecyl methacrylate (DMADDM) into a commercial orthodontic cement, and to investigate the effects on microcosm biofilm response and enamel bond strength.

METHODS

DMADDM, a recently-synthetized antibacterial monomer, was incorporated into orthodontic cement at 0%, 1.5%, 3% and 5% mass fractions. Bond strength of brackets to enamel was measured. A microcosm biofilm model was used to measure metabolic activity, lactic acid production, and colony-forming units (CFU) on orthodontic cements.

RESULTS

Shear bond strength was not reduced at 3% DAMDDM (p > 0.1), but was slightly reduced at 5% DMADDM, compared to 0% DMADDM. Biofilm viability was substantially inhibited when in contact with orthodontic cement containing 3% DMADDM. Biofilm metabolic activity, lactic acid production, and CFU were much lower on orthodontic cement containing DMADDM than control cement (p < 0.05).

CONCLUSIONS

Therefore, the novel antibacterial orthodontic cement containing 3% DMADDM inhibited oral biofilms without compromising the enamel bond strength, and is promising to reduce or eliminate demineralization in enamel around orthodontic brackets.

Quantitative analysis of S. mutans and S. sobrinus cultivated independently and adhered to polished orthodontic composite resins

In orthodontics, fixed appliances placed in the oral cavity are colonized by microorganisms.

OBJECTIVE

The purpose of this study was to quantitatively determine the independent bacterial colonization of S. mutans and S. sobrinus in orthodontic composite resins.

MATERIAL AND METHODS

Seven orthodontic composite adhesives for bonding brackets were selected and classified into 14 groups; (GIm, GIs) Enlight, (GIIm, GIIs) Grengloo, (GIIIm, GIIIs) Kurasper F, (GIVm, GIVs) BeautyOrtho Bond, (GVm, GVs) Transbond CC, (GVIm, GVIs) Turbo Bond II, (GVIIm, GVIIs) Blugloo. 60 blocks of 4x4x1 mm of each orthodontic composite resin were made (total 420 blocks), and gently polished with sand-paper and ultrasonically cleaned. S. mutans and S. sobrinus were independently cultivated. For the quantitative analysis, a radioactive marker was used to codify the bacteria (³H) adhered to the surface of the materials. The blocks were submerged in a solution with microorganisms previously radiolabeled and separated (210 blocks for S. mutans and 210 blocks for S. sobrinus) for 2 hours at 37 ºC. Next, the blocks were placed in a combustion system, to capture the residues and measure the radiation. The statistical analysis was calculated with the ANOVA test (Sheffè post-hoc).

RESULTS

Significant differences of bacterial adhesion were found amongst the groups. In the GIm and GIs the significant lowest scores for both microorganisms were shown; in contrast, the values of GVII for both bacteria were significantly the highest.

CONCLUSIONS

This study showed that the orthodontic composite resin evaluated in the GIm and GIs, obtained the lowest adherence of S. mutans and S. sobrinus, which may reduce the enamel demineralization and the risk of white spot lesion formation.

Adhesion of Streptococci to various orthodontic composite resins

BACKGROUND

This investigation aimed to determine quantitatively the adhesion of Streptococcus mutans and Streptococcus sobrinus to orthodontic composite resins that were tested simultaneously using radio-markers.

METHODS

Seven orthodontic composite resins were classified into seven groups: BeautyOrtho Bond (GI), Blugloo (GII), Enlight (GIII), Grengloo (GIV), Kurasper F (GV), Transbond CC (GVI) and Turbo Bond II (GVII). Thirty 4 x 4 x 1 mm blocks of each orthodontic composite resin were made (a total of 210 blocks). Both Streptococcus species were cultivated independently. For the quantitative analysis, radioactive markers were used to codify the bacteria ((3) H for Streptococcus mutans and (14) C for Streptococcus sobrinus). The blocks were submerged in a solution with microorganisms previously radiolabelled for 2 hours at 37 °C in constant movement. The blocks were placed in a combustion system to quantify the Streptococcus adhering to the surface of the materials by capturing the residues and measuring the radiation.

RESULTS

Significant differences in bacterial adhesion were found among the groups. The lowest significant scores for both microorganisms were observed in GIII.

CONCLUSIONS

The orthodontic composite resin evaluated in GIII exhibited the lowest adhesion of Streptococcus mutans and Streptococcus sobrinus, which may reduce enamel demineralization and the risk of white spot lesion formation.

Influence of S. mutans on Base-metal Dental Casting Alloy Toxicity

We have highlighted that exposure of base-metal dental casting alloys to the acidogenic bacterium Streptococcus mutans significantly increases cellular toxicity following exposure to immortalized human TR146 oral keratinocytes. With Inductively Coupled Plasma-Mass Spectrometry (ICP-MS), S. mutans-treated nickel-based (Ni-based) and cobalt-chromium-based (Co-Cr-based) dental casting alloys were shown to leach elevated levels of metal ions compared with untreated dental casting alloys. We targeted several biological parameters: cell morphology, viable cell counts, cell metabolic activity, cell toxicity, and inflammatory cytokine expression. S. mutans-treated dental casting alloys disrupted cell morphology, elicited significantly decreased viable cell counts (p < 0.0001) and cell metabolic activity (p < 0.0001), and significantly increased cell toxicity (p < 0.0001) and inflammatory cytokine expression (p < 0.0001). S. mutans-treated Ni-based dental casting alloys induced elevated levels of cellular toxicity compared with S. mutans-treated Co-Cr-based dental casting alloys. While our findings indicated that the exacerbated release of metal ions from S. mutans-treated base-metal dental casting alloys was the likely result of the pH reduction during S. mutans growth, the exact nature of mechanisms leading to accelerated dissolution of alloy-discs is not yet fully understood. Given the predominance of S. mutans oral carriage and the exacerbated cytotoxicity observed in TR146 cells following exposure to S. mutans-treated base-metal dental casting alloys, the implications for the long-term stability of base-metal dental restorations in the oral cavity are a cause for concern.