Investigating the effect of incorporating nanosilver/nanohydroxyapatite particles on the shear bond strength of orthodontic adhesives

Dental Applications of Ion-Substituted Hydroxyapatite: A Review of the Literature

Hydroxyapatite (HA) forms an essential constituent of human teeth and bone. Its distinctive characteristic features, such as bioactivity and osteoconductivity, make it an ideal candidate to be used as an implant coating in restorative dentistry and maxillofacial surgery for bone regeneration. However, low fracture toughness and brittleness are a few of the inherent features of HA, which limit its application in load-bearing areas. The potential of HA to engage its lattice structure with either partial or complete substitution with external ions has become an increasing area of research as this phenomenon has the potential to enhance the biological and functional properties of the material. Consequently, this review aimed to highlight the role of various substituted ions in dental applications. Data indicate that the newly formed HA-substituted biomaterials demonstrate enhanced remineralization and antimicrobial activity along with improved hardness. Ion-substituted HA offers a promising strategy for future clinical research as these materials may be incorporated into various dental products for therapeutic treatments.

Study of ZnO nanoparticle-doped dental adhesives on enamels with fluorosis: Electron microscopy, elemental composition and shear bond strength analysis

This study aimed to evaluate dental adhesives containing different concentrations of zinc oxide nanoparticles (ZnO-NPs) for their use in the treatment of dental fluorosis, observe the interaction of the adhesive on healthy enamel surfaces and with mild and moderate fluorosis, measure the adhesive strength and fluorosis, and determine the phosphorus (P) and calcium (Ca) content on these surfaces, as a reference for the potential use of this adhesive with ZnO-NPs for dental fluorosis treatment. Transmission electron microscopy (TEM) and field emission scanning electron microscopy (FESEM) were used to characterise the ZnO-NPs and analyse the weight percentages of P and Ca in the enamel using X-ray energy dispersive spectroscopy (EDS) and the adhesive strength using a universal mechanical testing machine. FESEM characterisation revealed that the ZnO-NPs were less than 100 nm in size, with quasi-spherical and hexagonal prism shapes. The synthesis of the ZnO-NPs was confirmed by TEM, revealing their hexagonal crystalline structure. The adhesive strength by the universal mechanical testing machine showed that the adhesive with a 3% wt. concentration of ZnO-NPs was better in the three groups of teeth, showing higher adhesive strength in teeth with mild (15.15 MPa) and moderate (12.76 MPa) fluorosis surfaces, and was even higher than that in healthy teeth (9.65 MPa). EDS analysis showed that teeth with mild and moderate fluorosis had the highest weight percentages of P and Ca, but there were no statistically significant differences compared to healthy teeth and teeth treated with adhesives. Lay description: This study focused on testing a new dental adhesive containing small particles called ZnO nanoparticles (ZnO-NPs). This study aimed to demonstrate whether this adhesive with ZnO-NPs could be useful for treating dental fluorosis by improving its adhesion to teeth. One of the first objectives was to determine whether the dental adhesive could adhere better to teeth affected by mild or moderate fluorosis than to healthy teeth by measuring whether the levels of two important elements for healthy teeth, calcium (Ca) and phosphorus (P), were affected by the adhesive. The size and shape of the small particles and teeth with mild or moderate fluorosis were observed using scanning electron microscopy. The nanoparticles were small (< 100 nm) and had specific quasi-spherical and hexagonal prismatic shapes. More damage to the enamel was observed in teeth with mild or moderate fluorosis than in healthy teeth. The adhesive strength test demonstrated that the dental adhesive with 3% ZnO-NPs had the best adhesion on all healthy conditions of teeth. It was particularly effective in teeth with mild or moderate fluorosis. Finally, the evaluation of the levels of P and Ca on the enamel showed that teeth with fluorosis had higher levels of these elements, but using the dental adhesive with ZnO-NPs did not change the levels of these elements significantly because the adhesive avoided greater detachment because of greater adhesion to these surfaces. In conclusion, adding these small particles to dental adhesives could be an option for treating teeth affected by fluorosis. It stuck well and did not affect the levels of the important elements in the teeth.

Aluminum zirconate nanoparticles in etch and rinse adhesive to caries affected dentine: An in-vitro scanning electron microscopy, elemental distribution, antibacterial, degree of conversion and micro-tensile bond strength assessment

To incorporate different concentrations of Al2O9Zr3 (1%, 5%, and 10%) nanoparticles (NP) into the ER adhesive and subsequently assess the impact of this addition on the degree of conversion, μTBS, and antimicrobial efficacy. The current research involved a wide-ranging examination that merged various investigative techniques, including the application of scanning electron microscopy (SEM) for surface characterization of NP coupled with energy-dispersive x-ray spectroscopy (EDX), Fourier-transform infrared (FTIR) spectroscopy, μTBS testing, and microbial analysis. Teeth were divided into four groups based on the application of modified and unmodified three-step ER adhesive primer. Group 1 (0% Al2O9Zr3 NPs) Control, Group 2 (1% Al2O9Zr3 NPs), Group 3 (5% Al2O9Zr3 NPs), and Group 4 (10% Al2O9Zr3 NPs). EDX analysis of Al2O9Zr3 NPs was performed showing elemental distribution in synthesized NPs. Zirconium (Zr), Aluminum (Al), and Oxides (O2). After primer application, an assessment of the survival rate of Streptococcus mutans was completed. The FTIR spectra were analyzed to observe the characteristic peaks indicating the conversion of double bonds, both before and after the curing process, for the adhesive Etch and rinse containing 1,5,10 wt% Al2O9Zr3 NPs. μTBS and failure mode assessment were performed using a Universal Testing Machine (UTM) and stereomicroscope respectively. The μTBS and S.mutans survival rates comparison among different groups was performed using one-way ANOVA and Tukey post hoc (p = .05). Group 4 (10 wt% Al2O9Zr3 NPs + ER adhesive) specimens exhibited the minimum survival of S.mutans (0.11 ± 0.02 CFU/mL). Nonetheless, Group 1 (0 wt% Al2O9Zr3 NPs + ER adhesive) displayed the maximum surviving S.mutans (0.52 ± 0.08 CFU/mL). Moreover, Group 2 (1 wt% Al2O9Zr3 NPs + ER adhesive) (21.22 ± 0.73 MPa) samples displayed highest μTBS. However, the bond strength was weakest in Group 1 (0 wt% Al2O9Zr3 NPs + ER adhesive) (14.13 ± 0.32 MPa) study samples. The etch-and-rinse adhesive exhibited enhanced antibacterial activity and micro-tensile bond strength (μTBS) when 1% Al2O9Zr3 NPs was incorporated, as opposed to the control group. Nevertheless, the incorporation of Al2O9Zr3 NPs led to a decrease in DC. RESEARCH HIGHLIGHTS: 10 wt% Al2O9Zr3 NPs + ER adhesive specimens exhibited the minimum survival of S.mutans. 1 wt% Al2O9Zr3 NPs + ER adhesive samples displayed the most strong composite/CAD bond. The highest DC was observed in Group 1: 0 wt% Al2O9Zr3 NPs + ER adhesive.

Visible light-activated curcumin-doped zinc oxide nanoparticles integrated into orthodontic adhesive on Micro-tensile bond strength, degree of conversion, and antibacterial effectiveness against Staphylococcus Aureus. An investigation using scanning electron microscopy and energy-dispersive X-ray spectroscopy

AIM

To acquire a thorough comprehension of the photoactivated Cur-doped ZnONPs at different concentrations 0%, 2.5%, and 5% on the physical qualities, antibacterial efficacy, degree of conversion, and μshear bond strength between orthodontic brackets and the enamel surface.

MATERIAL AND METHODS

An extensive investigation was carried out utilizing a range of analytical methods, scanning electron microscopy (SEM) combined with energy-dispersive X-ray spectroscopy (EDX), Fourier-transform infrared (FTIR) spectroscopy, micro tensile bond strength (μTBS) testing, and evaluation of antibacterial effectiveness. Cur-doped ZnONPs at concentrations of 2.5% and 5% were blended with Transbond XT, a light-curable orthodontic adhesive. A control group without the addition of Cur-doped ZnONPs was also prepared. The tooth samples were categorized into three groups based on the weight percentage of NPs: Group 1 (control) with 0% Cur-doped ZnONPs, Group 2 with 2.5 wt% Cur-doped ZnONPs, and Group 3 with 5 wt% Cur-doped ZnONPs. The SEM technique was employed to analyze the morphological characteristics of Cur-doped ZnONPs and ZnONPs. The composition and elemental distribution of the modified Cur-doped ZnONPs were assessed using energy-dispersive X-ray spectroscopy. The effectiveness of NPs at various concentrations against S.Mutans was gauged through the pour plate method. DC of Cur-doped ZnONPs at a region of 1608 cm-1 to 1636 cm-1 for the cured area, whereas the uncured area spanned the same range of 1608 cm-1 to 1636 cm-1 was assessed. The Adhesive Remnant Index (ARI) approach was utilized to investigate the bond failure of orthodontic brackets, while a Universal Testing Machine (UTM) was utilized to test μTBS. The Kruskal-Wallis test was employed to investigate variations in S.mutans survival rates. To determine the μTBS values, analysis of variance (ANOVA) and the post hoc Tukey multiple comparisons test were used.

RESULTS

The maximum μTBS was given and documented in group 3: 5 wt% Cur-doped ZnONPs (21.21 ± 1.53 MPa). The lowest μTBS was given in group 2: 2.5 wt% Cur-doped ZnONPs (19.58 ± 1.27 MPa). The highest efficacy against S.mutans was documented in group 3 in which 5 wt% Cur-doped ZnONPs (0.39 ± 0.15). The lowest efficacy was seen in group 1 in which no Cur-doped ZnONPs were used (6.47 ± 1.23). The ARI analysis indicated that the predominant failure was between scores 0 and 1 among all experimental groups. Control group 1 which was not modified showed the highest DC (73.11 ± 4.19).

CONCLUSION

Orthodontic adhesive, containing 5% Cur-doped ZnONPs photoactivated with visible light exhibited a favorable impact on μTBS and indicated enhanced antibacterial efficacy against S.mutans. Nevertheless, it was observed that the addition of Cur-doped ZnONPs at different concentrations (2.5%,5%) resulted in a decrease in the monomer-to-polymer ratio compromising DC.

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.

Antibacterial Effect of the Nanoparticle-Incorporated Primers Commonly Used for Orthodontic Bonding

Background

Nanosized antibacterial agents can be used to prevent biofilm buildup on orthodontic appliances and auxiliaries, limiting microbial adherence and preventing caries. Nanoparticles (NPs) can enhance the antibacterial properties of orthodontic materials due to their smaller particle size and larger surface area.

Materials and Methods

The study's material analysis was divided into four groups, numbered I through IV, using Transbond XT Primer as a control and modifying group I by adding various antibacterial agents. 98.1 g of mutans-sanguis agar was dissolved in 1,000 ml of warm distilled water and autoclaved for 15 minutes at 121°C and 15 lb pressure. 176 disk specimens of 6 mm in diameter were created, sterilized in an autoclave, and heated to 60°C in a hot air oven for 1 hour. Ten milliliters of primer containing different antimicrobial agents was applied to the sterilized disks. Four petri plates were used for each concentration, with 16 disks in each group. 44 petri plates in all were utilized.

Results

The orthodontic primer modified by the addition of antibacterial agents showed a significantly increased antimicrobial activity, and nanobenzalkonium chloride (BAC) at 5% concentration showed the highest antimicrobial efficacy among all groups. Nanohydroxyapatite showed the least.

Conclusion

Within the confines of the current investigation, it was determined that the addition of antibacterial agents had significantly higher antimicrobial activity and BAC at 5% concentration had the highest antimicrobial efficacy of all the groups.

Cytotoxicity evaluation, antibacterial effect, and degree of conversion of QAM-containing adhesives

The aim of this study was to evaluate the influence of adding quaternary ammonium methacrylates (QAMs) to experimental adhesives by assessing the degree of conversion (DC), cytotoxicity against keratinocytes and fibroblasts, and antibacterial activity against biofilm formation. Two QAMs were added to an experimental adhesive: dimethylaminododecyl methacrylate bromododecane (DMADDM) or dimethylaminododecyl methacrylate bromohexadecane (DMAHDM) at three concentrations each: 1, 2.5, and 5 wt.%. Experimental adhesive without QAMs (control group) and commercially available Transbond XT Primer (3M Unitek, Monrovia, California, USA) were used for comparisons. The adhesives were tested for DC, cytotoxicity against keratinocytes and fibroblasts, and antibacterial activity against biofilm formation. DC, cytotoxicity against fibroblasts, and antibacterial activity were analyzed using one-way ANOVA and Tukey's multiple comparisons. Cytotoxicity against keratinocytes was evaluated using the Kruskal Wallis and Dunn's post-hoc (α = 5%) tests. Transbond showed lower DC as compared to 5% DMAHDM, 1% DMADDM, and 5% DMADDM (p < 0.05). However, all groups presented proper DC when compared to commercial adhesives in the literature. In the evaluation of cytotoxicity against keratinocytes, Transbond induced higher viability than 2.5 wt.% groups (p < 0.05). Against fibroblasts, Transbond induced higher viability as compared to 5 wt.% groups (p < 0.05). DMAHDM at 5 wt.% reduced biofilm formation when compared to all the other groups (p < 0.05). Despite their cytotoxic effect against keratinocytes, gingival fibroblasts showed higher viability. DMAHDM at 5 wt.% decreased Streptococcus mutans viability. The incorporation of DMAHDM at 5 wt.% may be a strategy for reducing the development of white spot lesions.

Effect of re-mineralizing surface treatment on the shear bond strength of orthodontic bracket: A systematic review and meta-analysis of in-vitro studies

INTRODUCTION

Re-mineralizing surface pretreatment is essential for both controlling and preventing white spot lesion (WSL) throughout the time of fixed orthodontic treatment. It is also important that the re-mineralizing have no negative impact on the bonding between the bracket, adhesive, and enamel. Therefore, this review is aimed to investigate the orthodontic brackets' shear bond strength after re-mineralizing surface treatment of enamel.

MATERIAL AND METHODOLOGY

The review was conducted following the PRISMA 2020 guidelines. In-vitro experimental studies measuring shear bond strength (SBS) of orthodontic brackets on both demineralized and intact enamel following re-mineralizing surface treatment were included. Database search was done in PubMed, Scopus, and Science Direct during July 2023. Methodological quality of the studies was assessed according to the guidelines for the reporting of pre-clinical in-vitro studies. Both qualitative and quantitative analyses of the included studies were done.

RESULTS

Matching the inclusion criteria, 46 and 37 studies were selected for qualitative and quantitative analysis respectively. On intact enamel re-mineralizing agents had no negative impact on the brackets' SBS. On the contrary, they seemed to enhance the bond strength remarkably on the demineralized enamel.

DISCUSSION

Re-mineralizing surface pretreatment is crucial prior to fixed orthodontic treatment as it did not reduce the bond strength. Although, it cannot be judged depending solely on the in-vitro results with high heterogeneity. Clinical evidence is required to support the statement.

Evaluation of Antimicrobial Properties and Shear Bond Strength of Conventional Orthodontic Adhesive Modified With Calotropis gigantea Nanoparticles: An In Vitro Study

INTRODUCTION

Bonding of brackets with adhesives during orthodontic fixed appliance therapy is associated with white spot lesions (WSLs). An adhesive developed with an antimicrobial property is advantageous to prevent decalcification of the enamel surface. The current study assesses the antimicrobial and shear bond strength (SBS) characteristics of an experimental conventional orthodontic adhesive incorporated with different concentrations of nanoparticles (NPs) prepared from the leaves of Calotropis gigantea and compares them with non-admixed conventional adhesive.

MATERIALS AND METHODS

A total of 40 premolar teeth therapeutically extracted for orthodontic purposes were randomly assigned to four equal groups of n = 10 each. In control Group I, unmodified conventional adhesive was used to bond the brackets. In the three experimental groups, Group II, Group III, and Group IV, the brackets were bonded with modified conventional adhesive admixed with the C. gigantea NPs in concentrations of 1%, 5%, and 10%, respectively. The agar well diffusion test and the disc agar diffusion (DAD) test were utilized for assessing the anti-microbial activity of the composite discs. The SBS of the groups was determined by a universal testing machine.

STATISTICAL ANALYSIS

A one-way ANOVA and Tukey's honestly significant difference (HSD) post-hoc test was used to analyze the difference in shear bond strength and microbial inhibition zone diameter between the groups with a probability (p) value of equal to or less than 0.05 as statistical significance.

RESULTS

The mean SBS for Group I without nanoparticles is 6.99±0.75 MPa. The SBS value decreased inversely in proportion to the concentration of NPs: Group II (1% NP) 6.29±0.67 MPa; Group III (5% NP) 4.40±0.47 MPa; and Group IV (10% NP) 1.98±0.21 MPa, which is statistically significant (p < 0.001). The incorporation of C. gigantea NPs resulted in a decrease in the actual microbial potency of the conventional adhesive.

CONCLUSION

Isolated C. gigantea NPs, when used alone, proved to have antimicrobial efficacy, but orthodontic adhesives admixed with C. gigantea NPs showed no additive effect, and SBS values decreased with increased concentrations of NPs.

Evaluation of Antimicrobial and Mechanical Properties of a Novel Propolis-Modified Orthodontic Primer: An In-Vitro Study

Introduction Accumulation of cariogenic biofilm around the bracket surface and the enamel adhesive interface leads to the formation of white spot lesions which poses an arduous challenge in orthodontics today. The aim of this study was to do a comparative evaluation of the antimicrobial, cytotoxic and mechanical properties of a novel propolis-modified orthodontic primer with a control primer. Materials and methods This in-vitro study involved two groups (group A: propolis-modified primer and group B: control primer). Antibacterial properties against Streptococcus mutans were evaluated using the agar well diffusion technique to measure the zone of inhibition and mic was evaluated using the two-fold diffusion technique. 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) fibroblast assay was done to evaluate the cytotoxicity. After bonding brackets on extracted natural teeth (premolars) the shear bond strength (SBS), contact angle (CA) and adhesive remnant index (ARI) were evaluated for both groups. Statistical analysis was done using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 23.0, Armonk, NY), and an independent t-test was performed. Results The propolis-modified primer when compared to the control primer had higher zone of inhibition values and lower minimum inhibitory concentration (MIC) values. The MTT fibroblast assay showed that the cell viability % shown by the propolis primer was more than the control primer. There was no statistically significant difference between the two primers for SBS (p>0.05), CA (p>0.05) and ARI (p>0.05) (p=0.05). Conclusion The propolis-modified primer showed higher antibacterial activity against S. mutans at a lower inhibitory concentration, with less cytotoxicity and no effect on the SBS, CA and ARI scores.

The effect of vanillin nanoparticles on antimicrobial and mechanical properties of an orthodontic adhesive

AIMS

To evaluate the effect of adding vanillin nanoparticles on the antimicrobial and mechanical properties of the orthodontic adhesive.

MATERIALS AND METHODS

Transbond XT orthodontic adhesive (3M Unitek, Monrovia, California, USA) was modified with 1% and 2% vanillin nanoparticles. The chemical composition and degree of chemical conversion in orthodontic adhesive before and after adding vanillin nanoparticles to orthodontic adhesive were measured using Fourier transformation infrared spectroscopy (FTIR). Mechanical properties of unmodified orthodontic adhesive (UMOA) and 1% and 2% vanillin-modified orthodontic adhesive (VMOA) were assessed in shear bond strength (SBS) and tensile bond strength (TBS). The antimicrobial properties were evaluated using a Mueller-Hinton plate swapped with streptococcus mutans. The zone of bacterial inhibition for UMOA, 1% VMOA, and 2% VMOA was measured. Descriptive statistics, multiple comparisons, one-way ANOVA, and post hoc Duncan's test were used to compare among the results.

RESULTS

FTIR showed no chemical conversion of 1% VMOA and 2% VMOA. There was significant streptococcus mutans growth inhibition in 1% VMOA and 2% VMOA compared to UMOA. No significant difference in streptococcus mutans growth inhibition in 1% VMOA and 2% VMOA. The SBS decreased significantly in 1% VMOA compared to UMOA. In addition, SBS decreased insignificantly when comparing 1% VMOA and 2% VMOA. TBS significantly reduced in 2% VMOA compared with UMOA. In addition, there was no significant difference in TBS between UMOA and 1% VMOA, and 1% VMOA and 2% VMOA, respectively.

CONCLUSIONS

The 1% VMOA has improved antimicrobial properties and kept mechanical properties of orthodontic adhesive within the acceptable level.

Effect of incorporating silica-hydroxyapatite-silver hybrid nanoparticles into the resin-modified glass ionomer on the adhesive remnant index score and shear bond strength of orthodontic metal brackets: An in vitro study

OBJECTIVES

This study aimed to assess the effect of addition of silica-hydroxyapatite-silver (Si-HA-Ag) hybrid nanoparticles to light-cure glass ionomer (GI) on shear bond strength (SBS) of metal brackets bonded with this adhesive and the adhesive remnant index (ARI) score.

MATERIAL AND METHODS

In this in vitro experimental study, 50 sound extracted premolars were assigned to 5 groups (n=10) for orthodontic metal bracket bonding with BracePaste® composite, Fuji ORTHO™ pure resin modified GI (RMGI), and RMGI reinforced with 2wt%, 5wt% and 10wt% Si-HA-Ag nanoparticles. The SBS of brackets was measured by a universal testing machine. Debonded specimens were inspected under a stereomicroscope at×10 magnification to determine the ARI score. Data were analyzed by one-way ANOVA, Scheffe test, Chi-square test, and Fisher's exact test (alpha=0.05).

RESULTS

The maximum mean SBS was recorded in BracePaste® composite followed by 2% RMGI, 0% RMGI, 5% RMGI and 10% RMGI. Only the difference between the BracePaste® composite and 10% RMGI was significant in this regard (P=0.006). The groups were not significantly different regarding the ARI scores (P=0.665). All the SBS values were within the clinically acceptable range.

CONCLUSION

Addition of 2wt% and 5wt% Si-HA-Ag hybrid nanoparticles to RMGI as orthodontic adhesive caused no significant change in SBS of orthodontic metal brackets while addition of 10wt% hybrid nanoparticles significantly decreased the SBS. Nonetheless, all the SBS values were within the clinically acceptable range. Addition of hybrid nanoparticles had no significant effect on the ARI score.

Evaluation of the Shear Bond Strength of Chitosan Nanoparticles-Containing Orthodontic Primer: An In Vitro Study

Objectives

The present study was intended to investigate the effect of different concentrations of chitosan nanoparticles mixed with an orthodontic primer on the shear bond strength and bond failure of stainless steel brackets bonded to dental enamel.

Methods

Four concentrations of chitosan nanoparticles (0%, 1%, 5%, and 10%) were prepared and mixed with Transbond™ XT primer. Forty-eight extracted maxillary first premolars were bonded under a standardized procedure with stainless steel orthodontic brackets utilizing those different concentrations (12 teeth per each group). After the bonding procedure, the specimens were stored in deionized water (37°C for 24 hr) and then thermocycling 5,000 times before shear bond testing, which was performed using a universal testing device. Bond failure sites were examined under a stereomicroscope. Scanning electron microscopy and X-ray diffraction were also performed to verify and evaluate the phase of the nanopowder.

Results

The data were statistically analyzed using one-way analysis of variance) and Kruskal-Wallis H tests, and the findings revealed statistically nonsignificant group differences regarding the shear bond strength and adhesive remnant index (p > 0.05).

Conclusions

Primers containing varying concentrations of chitosan nanoparticles demonstrated acceptable shear bonding strength and adhesive remnant index.

White Spots: Prevention in Orthodontics-Systematic Review of the Literature

Early-stage dental demineralization, called white spots (WS), get their name from the characteristic colour that enamel takes on due to the acid attack of salivary cariogenic bacteria. They are often associated with fixed orthodontic therapy (FOT) and, if left untreated, evolve into caries with repercussions on oral health and dental aesthetics. This review aims to identify the most effective prophylaxis strategies to prevent WS during FOT. The search for the reviewed studies was conducted on the Pubmed, Scopus, and Web of Science databases, selecting English-only articles published in the 5 years from January 2018 to January 2023. The keywords used were "WS" and "fixed orthodontic*", using "AND" as the Boolean operator. A total of 16 studies were included for qualitative analysis. Prevention begins with maintaining proper oral hygiene; fluoride in toothpaste, mouthwashes, gels, varnishes, and sealants can be added to prophylaxis and used regularly. Using a laser in combination with fluoride helps prevent the occurrence of WS and assists in the repair processes of initial lesions. Further studies are needed to establish international guidelines for preventing WS in orthodontically treated patients.

Toxicological Aspects, Safety Assessment, and Green Toxicology of Silver Nanoparticles (AgNPs)—Critical Review: State of the Art

In recent years, research on silver nanoparticles (AgNPs) has attracted considerable interest among scientists because of, among other things, their alternative application to well-known medical agents with antibacterial properties. The size of the silver nanoparticles ranges from 1 to 100 nm. In this paper, we review the progress of research on AgNPs with respect to the synthesis, applications, and toxicological safety of AgNPs, and the issue of in vivo and in vitro research on silver nanoparticles. AgNPs’ synthesis methods include physical, chemical, and biological routes, as well as “green synthesis”. The content of this article covers issues related to the disadvantages of physical and chemical methods, which are expensive and can also have toxicity. This review pays special attention to AgNP biosafety concerns, such as potential toxicity to cells, tissues, and organs.

Evaluation of shear bond strength and enamel remineralizing effect of experimental orthodontic composite containing nano-hydroxyapatite: An in vitro study

OBJECTIVE

The purpose of this study was to prepare an orthodontic composite containing hydroxyapatite nanoparticles to prevent demineralization and create a suitable environment for mineral deposition around orthodontic brackets, and to investigate the mechanical and remineralizing properties of the experimental adhesive composite.

METHODS

Experimental orthodontic composite were formulated using varying percentages of nano-hydroxyapatite particles. Assessments were based on four groups: a control group (3M™ Transbond™ XT) and experimental composites containing 2% (HA2), 5% (HA5) and 10% (HA10) hydroxyapatite. Vickers Microhardness test was performed to investigate the remineralizing effect in 3 stages: initial stage, after demineralization and after 4 weeks of exposure to artificial saliva. Scanning electron microscopy with energy dispersive X-ray spectroscopy analyser (SEM/EDAX) was used to evaluate hydroxyapatite precipitation and elemental composition of enamel surface. Shear Bond Strength tests were carried out using a universal testing machine and the debonding pattern was assessed using Adhesive Remnant Index (ARI).

RESULTS

All groups showed clinically acceptable SBS values. The highest SBS was achieved in the HA2 group, followed by Transbond™ XT, HA5 and HA10. There was no significant difference in the ARI scores. In terms of microhardness properties, HA5 and HA10 demonstrated a significant increase after 4 weeks. The results of SEM analysis showed the precipitation of hydroxyapatite crystals and EDAX analysis indicated the increase of calcium and phosphate ion peaks compared to the demineralized sample. The data were analysed using one-way ANOVA and Tukey's Post-hoc test.

CONCLUSIONS

Addition of hydroxyapatite nanoparticles to orthodontic composite can increase the mineral content and microhardness of the adjacent enamel. However, increasing the amount of nanoparticles reduces shear bond strength in a decreasing trend. The above-mentioned findings showed that incremental increase of nanoparticles of HA can be incorporated in composite to a certain extent and limitations are determined by mechanical properties (SBS) required for bracket bonding.

New Materials and Techniques for Orthodontics

Orthodontics is a specialty of dentistry dealing with the prevention, diagnosis, and treatment of mispositioned jaws and teeth [...].

Evaluation and comparison of the effect of incorporating zinc oxide and titanium dioxide nanoparticles on the bond strength and microleakage of two orthodontic fixed retainer adhesives

BACKGROUND

An adhesive with both proper mechanical and antimicrobial properties seems to be beneficial. We aimed to investigate the effect of zinc oxide (ZnO) and titanium dioxide (TiO₂) nanoparticles (NPs) on bond strength and microleakage of two different fixed retainer adhesives.

METHODS

In this in vitro experimental study, 168 extracted human incisors were randomly divided into six groups of 28 (eight double-tooth specimens for the bond strength test and 12 specimens for the microleakage test). In three groups: Transbond XT (3M Unitek, Monrovia, CA) without NPs, with 1% ZnO NPs and with 1% TiO2 NPs were applied. The other three groups included Ortho Connect Flow (GC orthodontics, Tokyo, Japan) composite with the same order to bond a 0.175-inch multistrand wire to the lingual surfaces of the teeth. The bond strength was measured using the Universal Testing Machine, and the adhesive remnant index was reported using a stereomicroscope (Nikon, SMZ800, Tokyo, Japan). The dye-penetration method was used to determine the microleakage.

RESULTS

For bond strength, there was no significant difference among groups. For microleakage, there was no significant difference between GC and Transbond XT groups. However, in subgroups of Transbond XT, the addition of TiO₂ NPs increased the microleakage significantly in comparison with ZnO and control groups (P = 0.011). There was no significant statistical difference between the groups in terms of residual adhesives (P = 0.166).

CONCLUSIONS

Through the incorporation of 1% TiO₂ and ZnO NPs into the fixed retainer adhesive, the bond strength was maintained within the clinically acceptable range. The addition of TiO2 NPs to Transbond XT significantly increased the percentage of microleakage.

Bond Strength Survival of a Novel Calcium Phosphate-Enriched Orthodontic Self-Etching System after Various Ageing Protocols: An In Vitro Study

Objective

This study aimed to evaluate the orthodontic bond strength and enamel-preserving ability of a hydroxyapatite nanoparticles-containingself-etch system following exposure to various ageing methods.

Materials and Methods

Hydroxyapatite nanoparticles (nHAp) were incorporated into an orthodontic self-etch primer (SEP, Transbond™ plus) in three different concentrations (5%, 7%, and 9% wt) and tested versus the plain SEP (control) for shear bond strength (SBS), adhesive remnant index (ARI) scores, and enamel damage in range-finding experiments using premolar teeth. The best-performing formulation was further exposed to the following four artificial ageing methods: initial debonding, 24 h water storage, one-month water storage, and one-month acid challenge. A field-emission scanning electron microscope (FE-SEM) was used to examine the integrity of debonded enamel surfaces and calcium-phosphates (CaPs) reprecipitation.

Results

The best-performing formulation (7% nHAp-SEP) resulted in significantly lower SBS (p < 0.001) than the control SEP following the four artificial ageing methods. Nevertheless, it survived the ageing protocols and yielded clinically acceptable SBS with the advantages of leaving minimal adhesive residue, preserving enamel integrity and smoothness, and inducing CaP reprecipitation as confirmed by FE-SEM images.

Conclusions

A newly developed SEP produced adequate orthodontic bond strengths and left unblemished debonded enamel surfaces with minimal remnant adhesive and remineralisation potential, thereby suggesting simpler and safer bonding/debonding procedures.

Development of a remineralizing calcium phosphate nanoparticle-containing self-etching system for orthodontic bonding

Objectives

This study aimed to incorporate hydroxyapatite nanoparticles (nHA) or amorphous calcium phosphate nanoparticles (nACP) into a self-etch primer (SEP) to develop a simplified orthodontic bonding system with remineralizing and enamel preserving properties.

Materials and Methods

nHA and nACP were incorporated into a commercial SEP (Transbond™ plus) in 7% weight ratio and compared with the plain SEP as a control. Shear bond strengths (SBS), enamel damage, and adhesive remnant index (ARI) scores were evaluated at 24 h and post 5000 thermocycling. Field-emission scanning electron microscope (FESEM) was used to inspect the distribution of the nanoparticles in the experimental SEPs and evaluate the enamel surface integrity both before bracket bonding and post bracket debonding. Phase determination and remineralizing capability of the modified SEP were characterized by X-ray diffraction and Raman spectroscopy, respectively.

Results

The addition of nHA or nACP to the SEP significantly reduced the SBS, ARI, and enamel damage (p < 0.05) as compared to the control SEP; however, only nHA-SEP survived the thermocycling protocol and yielded acceptable SBS (13.38 MPa). Enamel remineralizing ability of the developed nHA-SEP was confirmed by both FESEM images and Raman phosphate map.

Conclusions

Incorporating nHA into SEP resulted in clinically acceptable bond strengths with remineralizing ability.

Clinical relevance

The newly developed nHA-SEP has unprecedented ability to simultaneously etch, prime, and remineralize the enamel in a single step leaving immaculate enamel surface with the potential of saving cost and time at the post-debonding step.

Green synthesis of silver nanoparticles and their antibacterial effects

Antibacterial resistance is by far one of the greatest challenges to global health. Many pharmaceutical or material strategies have been explored to overcome this dilemma. Of these, silver nanoparticles (AgNPs) are known to have a non-specific antibacterial mechanism that renders it difficult to engender silver-resistant bacteria, enabling them to be more powerful antibacterial agents than conventional antibiotics. AgNPs have shown promising antibacterial effects in both Gram-positive and Gram-negative bacteria. The aim of this review is to summarize the green synthesis of AgNPs as antibacterial agents, while other AgNPs-related insights (e.g., antibacterial mechanisms, potential toxicity, and medical applications) are also reviewed.

Dual-functional adhesive containing amorphous calcium phosphate nanoparticles and dimethylaminohexadecyl methacrylate promoted enamel remineralization in a biofilm-challenged environment

OBJECTIVE

The cariogenic biofilm on enamel, restoration, and bonding interface is closely related to dental caries and composite restoration failure. Enamel remineralization at adhesive interface is conducive to protecting bonding interface and inhibiting secondary caries. This study intended to assess the remineralization efficiency of adhesive with dimethylaminohexadecyl methacrylate (DMAHDM) and nanoparticles of amorphous calcium phosphate (NACP) on initial caries lesion of biofilm-coated enamel.

METHODS

Artificial initial carious lesion was created via 72-hour immersion in demineralization solution and cariogenic biofilm was formed after 24-hour culture of Streptococcus mutans (S. mutans). Specimens were then divided into 4 groups: enamel control, enamel treated with NACP, DMAHDM and NACP+DMAHDM respectively. Samples next underwent 7-day cycling, 4 h in BHIS (brain heart infusion broth containing 1 % sucrose) and 20 h in AS (artificial saliva) per day. The pH of BHIS was tested daily. So did the concentration of calcium and phosphate in BHIS and AS. Live/dead staining, colony-forming unit (CFU) count, and lactic acid production of biofilms were measured 7 days later. The enamel remineralization efficiency was evaluated by microhardness testing and transverse microradiography (TMR) quantitatively.

RESULTS

Enamel of NACP+DMAHDM group demonstrated excellent remineralization effectiveness. And the NACP+DMAHDM adhesive released a great number of Ca²⁺ and PO₄^3- ions, increased pH to 5.81 via acid neutralization, decreased production of lactic acid, and reduced CFU count of S. mutans (P < 0.05).

SIGNIFICANCE

The NACP+DMAHDM adhesive would be applicable to preventing secondary caries, strengthening enamel-adhesive interface, and extending the lifespan of composite restoration.

The Potential Application of Green-Synthesized Metal Nanoparticles in Dentistry: A Comprehensive Review

Orodental problems have long been managed using herbal medicine. The development of nanoparticle formulations with herbal medicine has now become a breakthrough in dentistry because the synthesis of biogenic metal nanoparticles (MNPs) using plant extracts can address the drawbacks of herbal treatments. Green production of MNPs such as Ag, Au, and Fe nanoparticles enhanced by plant extracts has been proven to be beneficial in managing numerous orodental disorders, even outperforming traditional materials. Nanostructures are utilized in dental advances and diagnostics. Oral disease prevention medicines, prostheses, and tooth implantation all employ nanoparticles. Nanomaterials can also deliver oral fluid or pharmaceuticals, treating oral cancers and providing a high level of oral healthcare. These are also found in toothpaste, mouthwash, and other dental care products. However, there is a lack of understanding about the safety of nanomaterials, necessitating additional study. Many problems, including medication resistance, might be addressed using nanoparticles produced by green synthesis. This study reviews the green synthesis of MNPs applied in dentistry in recent studies (2010–2021).

Evaluation of antibacterial properties and shear bond strength of orthodontic composites containing silver nanoparticles, titanium dioxide nanoparticles and fluoride: An in vitro study

ABSTRACT Objective: The study aimed at determining the antibacterial properties of composites containing silver nanoparticles (Ag NPs) or titanium dioxide nanoparticles (TiO2 NPs), and a fluoride-releasing composite against Streptococcus mutans and Lactobacillus acidophilus, and to evaluate the effect on shear bond strength (SBS) of nanoparticles-modified composites. Materials and Methods: An orthodontic composite was modified by adding 1% w/w Ag NPs or 1% w/w TiO2 NPs. Composite discs were prepared to evaluate the antibacterial properties of these modified composites against Streptococcus mutans and Lactobacillus acidophilus, using three different antibacterial tests, namely: Disk agar diffusion test, Biofilm inhibition test and eluted component test. For evaluating the shear bond strength, 80 extracted premolars were collected and divided into four groups (n=20 each), which were bonded with stainless steel preadjusted Edgewise brackets, by using these modified composites. Their SBS was then compared with that of the control group, using a universal testing machine. Results: Composite discs containing nanoparticles and fluoride were capable of producing growth inhibition zones for all bacterial types. Results of the biofilm inhibition test showed that all the study groups inhibited the bacterial count, in comparison to the control group. A significant difference of SBS was observed between all groups. Conclusion: The antibacterial activity of orthodontic composites modified with Ag and TiO2 nanoparticles was significant, compared with conventional and fluoride-containing composites. The control group showed the highest SBS, followed by fluoride, titanium, and silver groups, with statistically significant difference in mean SBS values among all groups.

Evaluation the properties of orthodontic adhesive incorporated with nano-hydroxyapatite particles

Objective

This research was designed to study the effects of calcium hydroxyapatite nanoparticle incorporation on polymerization as well as the shear bond strength for Heliosit adhesive.

Materials and methods

Calcium hydroxyapatite nanoparticles were prepared from natural products using the sol-gel method, and were inspected using a transmission electron microscope. The nanoparticles were added to the conventional orthodontic adhesive at 2% wt and 4% wt concentrations. The degree of conversion for each test group was measured using a Fourier transform infrared spectroscopy device. Each adhesive group was used for bonding metal brackets to the premolar buccal enamel surface. The shear bond strength of all samples was measured.

Results

A significant difference was found among all the study groups (p ≤ 0.05) in terms of the degree of conversion and shear bond strength. The 2% wt nanoparticle group showed the highest values for both variables. The lowest value was recorded within the 4% wt nanoparticle group in comparison to the control group.

Conclusions

Calcium hydroxyapatite nanoparticle incorporation with a conventional Heliosit adhesive resin to a limited concentration has improved the mechanical properties of orthodontic adhesive.

The effects of bimodal action of photodynamic and photothermal therapy on antimicrobial and shear bond strength properties of orthodontic composite containing nano-graphene oxide

BACKGROUND

White spot lesions are a common adverse effect of fixed orthodontic treatment and represent the main challenge to achieving esthetic appearance. The purpose of the current study was to evaluate physico-mechanical and antimicrobial potency of orthodontic composite (OC; Transbond XT) containing nano-structured graphene oxide (nGO) (OC-nGO) as a novel composite following photodynamic therapy (PDT) and photothermal therapy (PTT) against Streptococcus mutans.

MATERIALS AND METHODS

Following preparation of OC-nGO, shear bond strength (SBS) and adhesive remnant index (ARI) of the test OC-nGO (containing 1, 2, 5, and 10% wt. nGO) were measured using a universal testing machine and stereomicroscope, respectively. The antimicrobial activities of test OC contained different concentrations of nGO were determined by disk agar diffusion (DAD), biofilm formation inhibition, and eluted components assays. After continuously rinsed in the aging process (up to 180 days), the antimicrobial activity of OC-nGO containing the highest concentration of nGO which had simultaneously the highest antimicrobial activity and SBS value were determined by DAD, biofilm formation, metabolic activity, and gtfB gene expression assays following photo-activation using diode laser irradiation against S. mutans. Data were analyzed using One-way Analysis of Variance (ANOVA). The Bonferroni post hoc test was used for comparison between the experimental groups. The significant difference was considered at P values < 0.05.

RESULTS

OC with 5% wt. nGO showed simultaneously the highest SBS value (10.64 ± 2.76 MPa, P < 0.05) an antimicrobial and anti-biofilm activities. The OC-nGO in all test concentrations of nGO had ARI scores as same as control group (Transbond XT without the nGO) (P < 0.05). In microbial biofilm formation and gene expression assays, the reduction of photothermal disinfection and anti-virulence activities of the 5% wt. OC-nGO against test bacterium was associated with the time of aging process, so they were reduced significantly up to day 150. Diode laser irradiated 5% wt. OC-nGO suppressed 15.6 and 8.1-fold gtfB mRNA expressions in the biofilm growth of the S. mutans at days 120 and 150 of rinsing (P < 0.05). Microbial biofilm formation and gtfB gene expression in S. mutans at day 180 following PAD had a high level of similarity with OOC as the control group. 5% wt. OC-nGO following photo-activation was not colonized by the S. mutans at day 90 and significant suppressed 91.98% and 76.37% of S. mutans biofilm formation at day 120 and 150, respectively (both P < 0.05). From day 120 onwards, metabolic activity was progressively increased on laser-irradiated 5% wt. OC-nGO discs compared to the control group (OC alone). Photo-activated OC-nGO containing 5% wt. nGO suppressed 86.94% and 46.82% metabolic activity of the S. mutans at days 120 and 150 of rinsing (both P < 0.05).

CONCLUSIONS

Our data support that the photo-activated 5% wt. OC-nGO can serve as an orthodontic composite/adhesive additive to control cariogenic bacterial biofilms.

Effect of nano-zinc oxide and nano-chitosan particles on the shear bond strength of dental composites used as orthodontic adhesive

BACKGROUND

This study aimed to evaluate the effect of the combination of zinc oxide nanoparticles (NPs) and chitosan NPs on the shear bond strength (SBS) of composites used for orthodontic bonding.

METHODS

Four groups of composites (n = 10), containing 0%, 1%, 5%, and 10% w/w NP fillers, respectively, were used to bond brackets to the surfaces of 40 intact bovine incisors. After 1000 rounds of thermal cycling at 5°C-55°C, all specimens were mounted in acrylic blocks. The SBS was tested using a universal testing machine, and the adhesive remnant index scores were registered using a stereomicroscope. Data were statistically analyzed using a 1-way ANOVA and the Kruskal-Wallis test.

RESULTS

The highest value of mean SBS was found in the control group, and the lowest value was found in the group with composite containing 10% NPs. The adhesive remnant index did not differ significantly among the groups (P = 0.823).

CONCLUSIONS

Incorporation of 1% and 5% zinc oxide and chitosan NPs had no effect on the SBS of composite, and the obtained SBS values were similar to that of the control group.

Evaluation of a newly developed calcium fluoride nanoparticles-containing orthodontic primer: An in-vitro study

OBJECTIVES

Fluoride and calcium ions have the ability to reduce the formation of white spot lesions (WSL) in enamel. This study aimed to develop a novel orthodontic primer that incorporates calcium fluoride nanoparticles (nCaF₂) and investigate its cytotoxic and physical properties as this primer could enhance the remineralization process when used with the conventional acid etching technique.

MATERIALS AND METHODS

Three groups of the newly introduced primers were prepared by adding and mixing nCaF2 (Nanoshell Company, USA at 5%, 10%, 20% in weight) to Transbond™ XT orthodontic primers (3M-Unitek, Monrovia, USA). X-Ray Diffraction (XRD) was performed to verify and evaluate the phase of the nanopowders. Field Emission Scanning Electron Microscope (FESEM) observation was used to assess the homogeneity of tested primers, and Energy Dispersive X-Ray Spectroscopy (EDS) was performed to analyze elements of the prepared samples. The three primer groups were compared to the control primer (without the addition of nCaF2) in terms of cytotoxic behavior, homogeneity, agglomeration, shear bond strength (SBS), and adhesive remnant index (ARI).

RESULTS

nCaF₂ primers with all the prepared concentrations revealed good homogeneity with no apparent agglomeration after four months of mixing. Cytotoxicity of the new primers was higher than that of the control primer, but it was within the accepted limits of the ISO standards (70% cell viability). While the SBS and ARI values were comparable with the control primer (p > 0.05).

CONCLUSIONS

The newly developed orthodontic primers with different concentrations of nCaF₂ (5%, 10%, and 20%) showed a homogenous distribution of nCaF₂ within the primers with no apparent agglomeration, acceptable cytotoxic level, adequate SBS, and ARI. Future clinical testing of nCaF₂-containing orthodontic primer as a preventive measure for WSLs during fixed orthodontic treatment is suggested.

Effect of the Incorporation of Chitosan and TiO2 Nanoparticles on the Shear Bond Strength of an Orthodontic Adhesive: An In Vitro Study

Aim:

This in vitro study was aimed to evaluate the effect of adding different concentrations of chitosan nanoparticles (NPs) and TiO2 NPs on the shear bond strength (SBS) of an orthodontic adhesive.

Materials and Methods:

In this in vitro study, 72 extracted human premolars were embedded in an acrylic resin and randomly allocated into four groups of 18 specimens. In group 1 (control), brackets were bonded to the tooth with the Transbond XT orthodontic adhesive. In groups 2, 3, and 4, 0.5% chitosan NPs and 0.5% TiO2 NPs, 1% chitosan NPs and 1% TiO2 NPs, and 1.5% chitosan NPs and 1.5% TiO2 NPs were added to Transbond XT, respectively. Then, the brackets were bonded by the modified adhesive. The SBS and adhesive remnant index (ARI) of each group were assessed with a universal testing machine. The SBS test results were analyzed using one-way analysis of variance followed by the posthoc Tukey’s honestly significant difference (HSD) test. The Kruskal–Wallis test was also applied to evaluate the ARI scores.

Results:

The results showed no statistically significant difference between groups 1, 2, and 3, but SBS decreased significantly in group 4. With increasing the concentration of NPs up to 1% chitosan NPs and 1% TiO2 NPs, SBS did not change significantly. However, in 1.5% chitosan NPs and 1.5% TiO2 NPs, SBS decreased compared to the other three groups. No significant differences were found between the groups in terms of ARI scores.

Conclusion:

It is concluded that the orthodontic composite containing 1% chitosan NPs and 1% TiO2 NPs has adequate SBS for use in the clinical setting.

Evaluation of antimicrobial properties of nano-silver particles used in orthodontics fixed retainer composites: an experimental in-vitro study

Background. The present study evaluated the antimicrobial efficacy of composite resins containing nano-silver (NAg) particles used in fixed orthodontic retainers. Methods. Nano-composite resin samples with 1%, 2%, and 5% concentrations of NAg were prepared. The antimicrobial effectiveness of NAg was assessed against Streptococcus mutans, Streptococcus sanguis, and Lactobacillus acidophilus by the biofilm inhibition test (three-day-old biofilms), eluted components test (on days 3, 15, and 30), and disk-diffusion agar test after 48 hours. Measures of central tendency and index of dispersion were used to determine colony-forming units. Kruskal-Wallis test and Mann-Whitney U test were also used. Results. The biofilm inhibition test showed a significant decrease in the colonies of S. mutans (87.64%, 96.47%, and 99.76% decrease), S. sanguis (98.13%, 99.47%, and 99.93% decrease), and L. acidophilus (81.59%, 90.90%, and 99.61% decrease) at 1%, 2%, and 5% concentrations of Nag, respectively, compared to the control groups. The colony-forming unit (CFU)/mL of tested microorganisms continuously decreased with increased NAg concentration. In the eluted component test, no significant differences were noted in the 3rd, 15th, and 30th days between the different concentrations of Nag-containing composite resin disks and control samples. According to the disk-diffusion agar test, there was no growth inhibition zone for the composite resin disks containing 1% and 2% concentrations of Nag. However, the growth inhibition zone was seen with a 5% concentration, with a diameter of 9.5±0.71 mm for S. mutans, 8.5±0.71 mm for S. sanguis, and 8±1.41 for L. acidophilus. Conclusion. The incorporation of NAg into composite resins has antibacterial effects, possibly preventing dental caries around fixed orthodontic retainers.

Remineralization effectiveness of adhesive containing amorphous calcium phosphate nanoparticles on artificial initial enamel caries in a biofilm-challenged environment

OBJECTIVES

Dental caries is closely associated with acid-producing bacteria, and Streptococcus mutans is one of the primary etiological agents. Bacterial accumulation and dental demineralization lead to destruction of bonding interface, thus limiting the longevity of composite. The present study investigated remineralization effectiveness of adhesive containing nanoparticles of amorphous calcium phosphate (NACP) in a stimulated oral biofilm environment.

METHODS

The enamel blocks were immersed in demineralization solution for 72 h to imitate artificial initial carious lesion and then subjected to a Streptococcus mutans biofilm for 24 h. All the samples then underwent 4-h demineralization in brain heart infusion broth with sucrose (BHIS) and 20-h remineralization in artificial saliva (AS) for 7 days. The daily pH of BHIS after 4-h incubation, lactic acid production, colony-forming unit (CFU) count, and content of calcium (Ca) and phosphate (P) in biofilm were evaluated. Meanwhile, the remineralization effectiveness of enamel was analyzed by X-ray diffraction (XRD), surface microhardness testing, transverse microradiography (TMR) and scanning electron microscopy (SEM).

RESULTS

The NACP adhesive released abundant Ca and P, achieved acid neutralization, reduced lactic acid production, and lowered CFU count (P < 0.05). Enamel treated with NACP adhesive demonstrated the best remineralization effectiveness with remineralization value of 52.29 ± 4.79% according to TMR. Better microhardness recovery of cross sections and ample mineral deposits were also observed in NACP group.

CONCLUSIONS

The NACP adhesive exhibited good performance in remineralizing initial enamel lesion with cariogenic biofilm.

SIGNIFICANCE

The NACP adhesive is promising to be applied for the protection of bonding interface, prevention of secondary caries, and longevity prolonging of the restoration.

Shear bond strength of orthodontic brackets on intact and demineralized enamel after application of resin infiltrant, fluoride varnish and casein phosphopeptide-amorphous calcium phosphate remineralizing agents: in-vitro study

OBJECTIVE

To evaluate the effects of remineralizing agents on the shear bond strength (SBS) of orthodontic brackets bonded to intact and demineralized enamel.

MATERIAL AND METHODS

In this in-vitro study, 160 human premolars were divided into 8 groups, including group 1 with intact enamel as the positive control, group 2 with demineralized enamel as the negative control, groups 3-5 treated with fluoride varnish, Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) and resin infiltrant on intact enamel, and groups 6-8 treated with the same agents on demineralized enamel. Brackets were bonded using the conventional method, and the samples were thermocycled. SBS of the brackets was measured using a universal testing machine, and the adhesive remnant index (ARI) was assessed. Data were analysed with one-way ANOVA and post hoc statistical test at the significance level of 0.05.

RESULTS

SBS of the brackets in all groups with intact enamel was higher than that of their counterparts on demineralized enamel, which was only significantly different between groups 1 and 2 (P-value<0.001). SBS values of groups 7 and 8 were not significantly different from group 1 (P-value=1), yet the application of fluoride varnish on both intact (P-value=0.091) and demineralized enamel (P-value<0.001) created less SBS than in group 1.

CONCLUSIONS

All pre-treatment methods increased SBS of the brackets bonded to demineralized enamel, yet only the resin infiltrant and CPP-ACP produced SBS similar to that of intact enamel. Also, the use of fluoride varnish on intact enamel significantly reduced SBS.

Comparative Evaluation of Antibacterial Effects of Nanoparticle-Incorporated Orthodontic Primer: An In Vitro Study

Aim and Objectives:

To compare and evaluate the antibacterial efficacy of various nanoparticles incorporated in orthodontic primer with that of conventional antimicrobial agents at different concentrations on Streptococcus mutans ( S. mutans) strain.

Materials and Methods:

Transbond XT Primer was mixed with 2.5% and 5% benzalkonium chloride (BAC), 0.2% and 2.5% chlorhexidine, 1% and 3% titanium dioxide (TiO2) nanoparticles, 0.2% and 0.5% nanohydroxyapatite, and 0.2% and 0.5% silica-doped nanohydroxyapatite powders. Antibacterial activity against S. mutans for all the materials was evaluated by the disk diffusion method for periods of 48 (T1) and 72 (T2) hours.

Results:

There was a significant increase in the antimicrobial activity of the orthodontic primer modified by the addition of antibacterial agents. The highest zone of inhibition against S. mutans was observed for silica-doped nanohydroxyapatite of 0.5% (11.03 mm) among all the nanoparticles, which was similar to the conventional antibacterial agents used in our study.

Conclusions:

• Among all the groups, BAC at 5% concentration showed the highest antimicrobial activity, and the least activity was exhibited by 1% TiO2 nanoparticles. • Silica-doped nanohydroxyapatite at 0.5% expressed the greatest antibacterial activity among all the nanoparticles. • All the materials showed sustained antibacterial activity even after 72 hours.

Silver Nanoparticles: Mechanism of Action and Probable Bio-Application

This review is devoted to the medical application of silver nanoparticles produced as a result of "green" synthesis using various living organisms (bacteria, fungi, plants). The proposed mechanisms of AgNPs synthesis and the action mechanisms on target cells are highlighted.

Chitosan capping of CuO nanoparticles: Facile chemical preparation, biological analysis, and applications in dentistry

This investigation is vital contribution to the healthcare system utilizing techniques of nanobiotechnology. It interestingly applies chitosan capped CuO nanoparticles in the field of medicine and restorative dentistry. The CuO nanoparticles and CuO-Chitosan nanoparticles are prepared by co-precipitation, and their characterization is performed using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and energy dispersive X-ray (EDX). The average crystallite size of these nanoparticles has been found to be in the dimensions of <40 nm and <35 nm, respectively. CuO-Chitosan nanoparticles show significant enhancement in in vitro antibacterial, antioxidant, cytotoxic, and antidiabetic activity as compared to CuO nanoparticles. In addition, the successful amalgamation of CuO nanoparticles and CuO-Chitosan nanoparticles into dentine bonding agents results in providing efficient remedy against secondary caries. CuO-Chitosan nanoparticles reinforced dental adhesive discs cause significant upsurge in reduction of Lactobacillus acidophillus and Streptococcus mutans. Also, the augmentation of mechanical properties, water sorption and solubility plus slow and sustained release profile and slight variation of shear bond strength is attained. Taken together, the chemically synthesized CuO nanoparticles and CuO-Chitosan nanoparticles have proven to be promising candidates having enormous potential to be utilized in drug delivery and nanotheranostics.

Casein phosphopeptide-amorphous calcium phosphate modified glass ionomer cement attenuates demineralization and modulates biofilm composition in dental caries

The study investigated the effects of the modified conventional glass ionomer cement (GIC) incorporated with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on biofilm composition of dental caries. Shear bond strength, durability tests, adhesive remnant index (ARI) and scanning electron microscope were used to measure the physical properties. Microhardness and ions release were determined to evaluate anti-demineralization effects; growth of the biofilm and its composition were assessed using MTT assay and Q-PCR assay. All experimental groups exhibited a significant stimulation of ions release, and reduced attenuation of microhardness. Nearly 39% reduction in the bacterial biofilm was observed with 5% CPP-ACP group. The regulation ability is mainly manifested in the inhibition of S. mutans and promotion of S. gordonii. The modified GICs by exhibiting anti-demineralization effects potentially lead to a reduction in the cariogenicity of plaque and can serve as a putative promising remineralization system with both enhanced antimicrobial and remineralization properties.

Sanches FS, Molina F, Henriques RP, Cruz EF, S. Freitas KM. Comparative Study of Adhesion of Brackets with Metal Injection Molding (MIM) Technology and Welded bases: In vitro Study

Introduction:

Brackets bonded to enamel surface depend on the adhesion material and the quality of the bracket base.

Objective:

The aim of this study was to compare the shear bond strength of metallic brackets with Metal Injection Molding (MIM) technology base or welded base.

Materials and Methods:

Forty mandibular extracted premolars mounted in acrylic resin blocks were divided randomly into two groups, both bonded with Transbond XT. In Group 1, brackets with MIM technology bases (Masel) were used, and in group 2, brackets with a welded base (Morelli) were used. After 24 hours, all brackets were tested for shear bond strength in a universal testing machine. Intergroup comparison was performed with an independent t test.

Results:

MIM base brackets showed a mean maximum load registered of 107.55 N, a mean shear bond strength of 9.58 MPa with a standard deviation of 5.80 MPa and the welded base brackets showed a mean maximum load of 167.37 N, a mean shear bond strength of 13.28 MPa with a standard deviation of 2.58 MPa. The difference between the two groups was statistically significant, indicating a higher shear bond strength of the welded base brackets.

Conclusion:

It was concluded that the brackets with welded bases presented a significantly higher shear bond strength than the brackets with MIM bases.

The effect of incorporation Nano Cinnamon powder on the shear bond of the orthodontic composite (an in vitro study)

Objectives

One of the causes of dental caries that occurs due to orthodontic treatment is the lack of antibacterial properties in orthodontic adhesive. This study was designated to investigate the effect of orthodontic resin modified by incorporating Nano Cinnamon powder on the shear bond strength of orthodontic brackets.

Materials and methods

Heliosit Orthodontic Resin, a photo-activated light cure resin was modified by the addition of Cinnamon in the form of Nano particle powder. Twenty uniform disks were made, 5 as a control and 5 for each concentration of the 1%, 3% and 5% wt/wt Cinnamon modified resin. Their antimicrobial activity against Streptococcus Mutans was tested using the disk diffusion method. Then, the most effective concentration of the modified resin was used to bond metal orthodontic brackets to human extracted premolars. The universal testing machine was used to record the shear bond strength of the control and the modified resin. Also, the adhesive remnant index was measured.

Results

Disc diffusion method showed that the 3% wt/wt Cinnamon powder modified resin was more effective than 1% with a larger bacterial inhibition zone. Shear bond strengths of the control were 8.50 MPa and 7.20 MPa for the 3% Cinnamon modified resin with no significant difference between them. Also, no significant difference was recorded in the adhesive remnant index scores between the control and the modified resin groups.

Conclusion

Findings of this study revealed that the incorporation of 3% Cinnamon Nano particles in orthodontic resin produced an antibacterial effect against Streptococcus mutans without compromising the shear bond strength.

Clinical relevance

Incorporation of Cinnamon Nano particles in orthodontic resin may reduce caries formation around brackets during treatment course.

Shear bond strength, adhesive remnant index, and anti-biofilm effects of a photoexcited modified orthodontic adhesive containing curcumin doped poly lactic-co-glycolic acid nanoparticles: An ex-vivo biofilm model of S. mutans on the enamel slab bonded brackets

BACKGROUND

Potential complications during fixed orthodontic procedures are white spot lesions (WSLs) and tooth decay. This study evaluated the anti-biofilm activity of an orthodontic adhesive (OA) incorporating curcumin (Cur) doped Poly lactic-co-glycolic acid nanoparticles (Cur-PLGA-NPs), which can have the highest concentration of Cur-PLGA-NPs and shear bond strength (SBS) value simultaneously, against cariogenic bacteria i.e., Streptococcus mutans.

MATERIALS AND METHODS

Following synthesis and confirmation of Cur-PLGA-NPs, SBS and adhesive remnant index (ARI) of the modified orthodontic adhesives (MOA) containing Cur-PLGA-NPs (3, 5, 7, and 10 % wt.) were measured using universal testing machine and stereomicroscope, respectively. After artificial aging (continuously rinsed up to 180 days), the residual anti-biofilm ability of MOA which can have the highest concentration of Cur-PLGA-NPs and SBS value simultaneously were determined by anti-biofilm assay following photoexcited enamel slab bonded brackets by MOA containing Cur-PLGA-NPs against S. mutans biofilms using crystal violet assay.

RESULTS

Adhesive with 7 % wt. Cur-PLGA-NPs revealed the highest concentration of Cur-PLGA-NPs and SBS value (16.19 ± 2.69 MPa, P < 0.05) simultaneously. No statistically significant difference in ARI scores was observed between the MOA and control (Transbond XT without the Cur-PLGA-NPs). On days 15, 30, 60, 90 and 120 there was a considerable decrease in optical density (OD) of preformed S. mutans biofilms on photoexcited enamel slab bonded brackets using MOA containing 7 % wt. Cur-PLGA-NPs, to 94.1 %, 79.6 %, 69.6 %, 69.4 %, and, 55.1 % respectively in comparison to the control group (all, P < 0.05). From days 150 onwards, microbial biofilm formation was progressively increased on enamel slab bonded brackets using MOA containing 7 % wt. Cur-PLGA-NPs compared to the control group (OA). Although chlorhexidine (2 %; as positive control) showed significant activity against pre-formed S. mutans biofilms on enamel slab bonded brackets using OA (99.1 % biofilm reduction; P = 0.001), its activity was slightly higher but not significant than photoexcited enamel slab bonded brackets using MOA containing 7 % wt. Cur-PLGA-NPs on the days 15 and 30 (both, P > 0.05).

CONCLUSIONS

The 7 % wt. Cur-PLGA-NPs can serve as an orthodontic adhesive antimicrobial additive as exposure to blue laser provides an acceptable antimicrobial effect against cariogenic bacteria for a considerable time.

Formulation and characterization of antibacterial orthodontic adhesive

OBJECTIVE

The objective of this study was to formulate experimental orthodontic bracket adhesives and test their mechanical properties, fluoride release and antibacterial activity.

METHODS

Four experimental antibacterial orthodontic bracket adhesives were prepared with different compositions of synthesized antibacterial monomers replacing total 5% of dental monomers in the control Transbond XT (3M): 5%C11, 3.5%C11+1.5%C2, 5%C16, and 3.5%C16+1.5%C2. Transbond XT alone was used as control. These groups were used to bond premolar brackets to extracted premolars. Shear bond strength (SBS) was tested using an Instron machine. For antibacterial test, disk specimens (10mm diameter, 1mm thick, n=4) were fabricated and incubated with cultures of cariogenic Streptococcus mutans for 48h, and following gentle sonication, S. mutans biofilms in colony-forming-units (CFU) on the disks were enumerated by plating on agar medium. The data were analyzed using ANOVA and Tukey test (α=0.05).

RESULTS

All experimental groups had similar shear bond strength (no significant difference) to the control. All experimental groups showed significant inhibitory effect against S. mutans biofilm formation, when compared to the control, but there was no significant difference between experimental groups.

CONCLUSION

Antibacterial orthodontic adhesive can be fabricated to have similar mechanical properties but better caries-inhibitory effect than current adhesive.

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.

Novel rechargeable calcium phosphate nanoparticle-filled dental cement

The objectives were to develop a novel rechargeable cement containing amorphous calcium-phosphate nanoparticles (nanoACP) to suppress tooth decay. Five cements were made with: (1) 60% glass particles (experimental control); (2) 40% glass+20% nanoACP; (3) 30% glass+30% nanoACP; (4) 20% glass+40% nanoACP; (5) 10% glass+50% nanoACP. Groups 1-4 had enamel bond strengths similar to Transbond XT (3M) and Vitremer (3M) (p>0.1). The nanoACP cement had calcium and phosphate ion release which increased with increasing nanoACP fillers. The recharged cement had substantial ion re-release continuously for 14 days after a single recharge. Ion re-release did not decrease with increasing recharge/re-release cycles. Groups 3-5 maintained a safe pH of medium (>5.5); however, control cements had cariogenic pH of medium (<4.5) due to biofilm acid. Therefore, nanoACP cement (1) had good bond strength to enamel, (2) possessed calcium and phosphate ion recharge/re-release capability, and (3) raised biofilm pH to a safe level to inhibit caries.

A review of bioceramics-based dental restorative materials

Currently, much has been published related to conventional resin-based composites and adhesives; however, little information is available about bioceramics-based restorative materials. The aim was to structure this topic into its component parts and to highlight the translational research that has been conducted up to the present time. A literature search was done from indexed journals up to September 2017. The main search terms used were based on dental resin-based composites, dental adhesives along with bioactive glass and the calcium phosphate family. The results showed that in 123 articles, amorphous calcium phosphate (39.83%), hydroxyapatite (23.5%), bioactive glass (16.2%), dicalcium phosphate (5.69%), monocalcium phosphate monohydrate (3.25%), and tricalcium phosphate (2.43%) have been used in restorative materials. Moreover, seven studies were found related to a newly developed commercial bioactive composite. The utilization of bioactive materials for tooth restorations can promote remineralization and a durable seal of the tooth-material interface.

Effect of TiO2 nanoparticles incorporation on antibacterial properties and shear bond strength of dental composite used in Orthodontics

Introduction:

Plaque accumulation and bond failure are drawbacks of orthodontic treatment, which requires composite for bonding of brackets. As the antimicrobial properties of TiO₂ nanoparticles (NPs) have been proven, the aim of this study was to evaluate the antimicrobial and mechanical properties of composite resins modified by the addition of TiO₂ NPs.

Methods:

Orthodontics composite containing 0%, 1%, 5% and 10% NPs were prepared. 180 composite disks were prepared for elution test, disk agar diffusion test and biofilm inhibition test to collect the counts of microorganisms on three days, measure the inhibition diameter and quantify the viable counts of colonies consequently. For shear bond strength (SBS) test, 48 intact bovine incisors were divided into four groups. Composites containing 0%, 1%, 5% and 10% NPs were used for bonding of bracket. The bracket/tooth SBS was measured by using an universal testing machine.

Results:

All concentration of TiO₂ NPs had a significant effect on creation and extension of inhibition zone. For S. mutans and S. sanguinis, all concentration of TiO₂ NPs caused reduction of the colony counts. Composite containing 10% TiO₂ NPs had significant effect on reduction of colony counts for S. mutans and S. sanguinis in all three days. The highest mean shear bond strength belonged to the control group, while the lowest value was seen in 10% NPs composite.

Conclusions:

Incorporating TiO₂ nanoparticles into composite resins confer antibacterial properties to adhesives, while the mean shear bond of composite containing 1% and 5% NPs still in an acceptable range.

Shear bond strength and adhesive remnant index of orthodontic brackets bonded to enamel using adhesive systems mixed with TiO2 nanoparticles

INTRODUCTION

It is recently suggested that titanium dioxide (TiO2) nanoparticles can be added to bracket luting agents in order to reduce bacterial activity and protect the enamel. However, it is not known if this addition can affect the shear bond strength (SBS) below clinically acceptable levels. Therefore, this study examined this matter within a comprehensive setup.

METHODS

This in vitro experimental study was conducted on 120 extracted human premolars randomly divided into four groups (n=30): in groups 1 and 2, Transbond XT light-cured composite with or without TiO2 was applied on bracket base; in groups 3 and 4, Resilience light-cured composite with or without TiO2 was used. Brackets were bonded to teeth. Specimens in each group (n=30) were divided into three subgroups of 10 each; then incubated at 37°C for one day, one month, or three months. The SBS and adhesive remnant index (ARI) were calculated and compared statistically within groups.

RESULTS

The SBS was not significantly different at one day, one month or three months (p>0.05) but composites without TiO2 had a significantly higher mean SBS than composites containing TiO2 (p<0.001). The SBS of Transbond XT was significantly higher than that of Resilience (p<0.001). No significant differences were noted in ARI scores based on the type of composite or addition of TiO2 (p>0.05).

CONCLUSIONS

Addition of TiO2 nanoparticles to Transbond XT decreased its SBS to the level of SBS of Resilience without TiO2; thus, TiO2 nanoparticles may be added to Transbond XT composite for use in the clinical setting.

An overview of application of silver nanoparticles for biomaterials in dentistry

Oral cavity is a gateway to the entire body and protection of this gateway is a major goal in dentistry. Plaque biofilm is a major cause of majority of dental diseases and although various biomaterials have been applied for their cure, limitations pertaining to the material properties prevent achievement of desired outcomes. Nanoparticle applications have become useful tools for various dental applications in endodontics, periodontics, restorative dentistry, orthodontics and oral cancers. Off these, silver nanoparticles (AgNPs) have been used in medicine and dentistry due to its antimicrobial properties. AgNPs have been incorporated into biomaterials in order to prevent or reduce biofilm formation. Due to greater surface to volume ratio and small particle size, they possess excellent antimicrobial action without affecting the mechanical properties of the material. This unique property of AgNPs makes these materials as fillers of choice in different biomaterials whereby they play a vital role in improving the properties. This review aims to discuss the influence of addition of AgNPs to various biomaterials used in different dental applications.