Nanoparticles in orthodontics, a review of antimicrobial and anti-caries applications

Investigation of mechanical properties, remineralization, antibacterial effect, and cellular toxicity of composite orthodontic adhesive combined with silver-containing nanostructured bioactive glass

BACKGROUND

The formation of white spots, which represent early carious lesions, is a major issue with fixed orthodontics. The addition of remineralizing agents to orthodontic adhesives may prevent the formation of white spots. The aim of this study was to produce a composite orthodontic adhesive combined with nano-bioactive glass-silver (nBG@Ag) for bracket bonding to enamel and to investigate its cytotoxicity, antimicrobial activity, remineralization capability, and bond strength.

METHODS

nBG@Ag was synthesized using the sol-gel method, and characterized using transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy with an attenuated total reflectance attachment (ATR-FTIR). The cytotoxicity test (MTT) and antimicrobial activity of adhesives containing 1%, 3%, and 5% (wt/wt) nBG@Ag were evaluated, and the shear bond strength of the adhesives was measured using a universal testing machine. Remineralization was assessed through microhardness testing with a Vickers microhardness tester and scanning electron microscopy (SEM). Statistical analyses were conducted using the Shapiro-Wilk test, Levene test, one-way ANOVA, Robust-Welch test, Tukey HSD method, and two-way ANOVA.

RESULTS

The biocompatibility of the adhesives was found to be high, as confirmed by the lack of significant differences in the cytotoxicity between the sample and control groups. Discs made from composites containing nBG@Ag exhibited a significant reduction in the growth of Streptococcus mutans (p < 0.05), and the antibacterial activity increased with higher percentages of nBG@Ag. The shear bond strength of the adhesives decreased significantly (p < 0.001) after the addition of nanoparticles, but it remained above the recommended value. The addition of nBG@Ag showed improvement in the microhardness of the teeth, although the differences in microhardness between the study groups were not statistically significant. The formation of hydroxyapatite deposits on the tooth surface was confirmed through SEM and energy-dispersive X-ray spectroscopy (EDX).

CONCLUSION

Adding nBG@Ag to orthodontic adhesives can be an effective approach to enhance antimicrobial activity and reduce enamel demineralization around the orthodontic brackets, without compromising biocompatibility and bond strength.

New generation of orthodontic devices and materials with bioactive capacities to improve enamel demineralization

OBJECTIVE

The article reviewed novel orthodontic devices and materials with bioactive capacities in recent years and elaborated on their properties, aiming to provide guidance and reference for future scientific research and clinical applications.

DATA, SOURCES AND STUDY SELECTION

Researches on remineralization, protein repellent, antimicrobial activity and multifunctional novel bioactive orthodontic devices and materials were included. The search of articles was carried out in Web of Science, PubMed, Medline and Scopus.

CONCLUSIONS

The new generation of orthodontic devices and materials with bioactive capacities has broad application prospects. However, most of the current studies are limited to in vitro studies and cannot explore the true effects of various bioactive devices and materials applied in oral environments. More research, especially in vivo researches, is needed to assist in clinical application.

CLINICAL SIGNIFICANCE

Enamel demineralization (ED) is a common complication in orthodontic treatments. Prolonged ED can lead to dental caries, impacting both the aesthetics and health of teeth. It is of great significance to develop antibacterial orthodontic devices and materials that can inhibit bacterial accumulation and prevent ED. However, materials with only preventive effect may fall short of addressing actual needs. Hence, the development of novel bioactive orthodontic materials with remineralizing abilities is imperative. The article reviewed the recent advancements in bioactive orthodontic devices and materials, offering guidance and serving as a reference for future scientific research and clinical applications.

Influence of the orthodontic bonding procedure on biofilm formation

INTRODUCTION

In orthodontics, white spot lesions are a persistent and widespread problem caused by the demineralization of buccal tooth surfaces around bonded brackets. The remaining adhesive around the brackets leads to surface roughness, which might contribute to demineralization. The present in vitro study aimed to compare a conventional and a modern adhesive system (APC Flash-Free technology) for orthodontic brackets with regard to the adhesion of Streptococcus sobrinus, a leading caries pathogen.

METHODS

This in vitro study included 20 premolar teeth and compared 10 APC Flash-Free adhesive-coated ceramic brackets (FF)with 10 conventionally bonded (CB) ceramic clarity brackets. Specimens were incubated in an S. sobrinus suspension for 3 h. To evaluate the bacterial formation, samples were analysed with a scanning electron microscope (SEM). Imaging software was used to quantify and statistically compare percentage values of colonization (PVC) in both groups' adhesion and transition areas.

RESULTS

We found a significant difference in biofilm formation between the groups for the adhesive and transition areas. PVC in the adhesive area was approximately 10.3-fold greater for the CB group compared with the FF group (median: 3.2 vs 0.31; P < 0.0001). For the transition area, median PVC was approximately 2.4-fold greater for the CB group compared with the FF group (median: 53.17 vs 22.11; P < 0.01).

CONCLUSIONS

There was a significantly lower level of S. sobrinus formation around the FF bracket system than there was surrounding the conventionally bonded group. This study suggests that the FF adhesive bracket system can help reduce the occurrence of bacterial growth around orthodontic brackets.

Long term remineralizing effect of casein phosphopeptide amorphous calcium phosphate in white spot lesions: A systematic review and meta-analysis

BACKGROUND

White spot lesions (WSLs) appear as white, opaque areas on the teeth and are caused by a demineralization of the enamel.

OBJECTIVE

The purpose of this systematic review and meta-analysis was to determine whether casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has beneficial effects on WSLs and provides remineralizing benefits that are superior to those of placebo or no treatment.

METHODS

Following a thorough analysis of the literature across major online sources, 103 papers - 54 of which underwent in-depth evaluation - were found. We used inclusion and exclusion criteria to choose research articles that were appropriate for our review.

RESULTS

10 papers met this review's requirements and were subsequently included. As compared to the controls, CPP-ACP demonstrated increased efficacy in treatment of WSLs in terms of remineralisation and other parameters which included microhardness tests and enamel surface roughness. The forest plots present the results of meta-analyses comparing the effect of CPP-ACP versus control/other agents on white spot lesions (WSLs). In terms of odds ratios (OR), CPP-ACP showed a small increase in the odds of WSLs compared to control/other agents. In-vitro studies showed no significant difference in relative risk (RR) between CPP-ACP and control/other agents. Randomized control trials indicated a small increase in the risk of WSLs with CPP-ACP treatment, but the overall effect was not statistically significant.

CONCLUSION

There was evidence to support the use of CPP-ACP over other agents for WSL prevention or treatment, but further research is needed to confirm these findings.

Sodium Selenite Ameliorates Silver Nanoparticles Induced Vascular Endothelial Cytotoxic Injury by Antioxidative Properties and Suppressing Inflammation Through Activating the Nrf2 Signaling Pathway

Silver nanoparticles (AgNP) are the dominant nanomaterials in commercial products and the medical field, but the widespread occurrence of AgNP has become a global threat to human health. Growing studies indicate that AgNP exposure can induce vascular endothelial toxicity by excessive oxidative stress and inflammation, which is closely related to cardiovascular disease (CVD), but the potential intrinsic mechanism remains poorly elucidated. Thus, it has been crucial to control the toxicological effects of AgNP in order to improve their safety and increase the outcome of their applications.Multiple researches have demonstrated that sodium selenite (Se) possesses the capability to counteract the toxicity of AgNP, but the functional role of Se in AgNP-induced CVD is largely unexplored. The aim of this study was to explore the potential protective effect of Se on AgNP-induced vascular endothelial lesion and elucidate the underlying mechanisms. An in vivo model of toxicity in animals was established by the instillation of 200 µL of AgNP into the trachea of rats both with (0.2 mg/kg/day) and without Se treated. In vitro experiments, human umbilical vein endothelial cells (HUVECs) were incubated with AgNP (0.3 µg/mL ) and Se for a duration of 24 h. Utilizing transmission electron microscopy, we observed that the internalization of AgNP-induced endothelial cells was desquamated from the internal elastic lamina, the endoplasmic reticulum was dilated, and the medullary vesicle formed. Se treatment reduced the levels of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1), inhibited the release of pro-inflammatory cytokines (specifically tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6), improved endothelial cell permeability, integrity, and dysfunction, and prevented damage to the aortic endothelium caused by AgNP. Importantly, we found that Se showed the capacity against AgNP with biological functions in guiding the intracellular reactive oxygen species (ROS) scavenging and meanwhile exhibiting anti-inflammation effects. Se supplementation decreased the intracellular ROS release and suppressed NOD-like receptor protein 3 (NLRP3) and nuclear factor kappa-B (NF-κB) mediated inflammation within AgNP-intoxicated rats and HUVECs. The anti-oxidant stress and anti-inflammatory effects of Se were at least partly dependent on nuclear factor erythroid 2-related factor 2 (Nrf2). Overall, our results indicated that the protectiveness of Se against AgNP-induced vascular endothelial toxicity injury was at least attributed to the inhibition of oxidative ROS and pro-inflammatory NF-κB/NLRP3 inflammasome by activating the Nrf2 and antioxidant enzyme (HO-1) signal pathway.

Influence of inorganic nanoparticles on dental materials' mechanical properties. A narrative review

Inorganic nanoparticles have been widely incorporated in conventional dental materials to help in improving their properties. The literature has shown that incorporating nanoparticles in dental materials in different specialties could have a positive effect on reinforcing the mechanical properties of those materials; however, there was no consensus on the effectiveness of using nanoparticles in enhancing the mechanical properties of dental materials, due to the variety of the properties of nanoparticles itself and their effect on the mechanical properties. This article attempted to analytically review all the studies that assessed the effect of different types of inorganic nanoparticles on the most commonly used dental materials in dental specialties such as polymethyl methacrylate, glass ionomer cement, resin composite, resin adhesive, orthodontic adhesive, and endodontic sealer. The results had shown that those inorganic nanoparticles demonstrated positive potential in improving those mechanical properties in most of the dental materials studied. That potential was attributed to the ultra-small sizes and unique physical and chemical qualities that those inorganic nanoparticles possess, together with the significant surface area to volume ratio. It was concluded from this comprehensive analysis that while a definitive recommendation cannot be provided due to the variety of nanoparticle types, shapes, and incorporated dental material, the consensus suggests using nanoparticles in low concentrations less than 1% by weight along with a silane coupling agent to minimize agglomeration issues and benefit from their properties.

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.

In vitro evaluation of a novel fluoride-coated clear aligner with antibacterial and enamel remineralization abilities

OBJECTIVE

To investigate the antibacterial and enamel remineralization performances as well as physicochemical properties and biocompatibility of a fluoride-coated clear aligner plastic (FCAP).

MATERIALS AND METHODS

FCAP and normal clear aligner plastic (CAP) was bought from the manufacturer (Angelalign Technology Inc, China). The FCAP was observed under scanning electron microscopy. Its element composition, resistance to separation, contact angle, and protein adhesion performance were characterized. Colony-forming unit (CFU) count and 3-(4,5)-dimethylthiazol(-z-y1)-3,5-diphenyltetrazolium bromide (MTT) assay were used to evaluate the antibacterial ability of Streptococcus mutans. Fluoride release-recharge patterns were obtained. Apatite formation was evaluated after immersing FCAP in artificial saliva. Enamel remineralization capability was evaluated in the demineralization model (immersing samples in demineralization solution for 36 h) and pH cycling model (immersing samples in demineralization solution and remineralization solution in turns for 14 days). Cell Counting Kit-8 (CCK-8) and live/dead cell staining kits were used for cytotoxicity assay.

RESULTS

The FCAP showed uniformly distributed fluoride and did not compromise protein adhesion performance. CFU count (5.47 ± 0.55 for CAP, 3.63 ± 0.38 for FCAP) and MTT assay (0.41 ± 0.025 for CAP, 0.28 ± 0.038) indicated that the FCAP had stronger antibacterial activity compared with normal CAP (P < 0.05 for both evaluations). The FCAP could release fluoride continuously for 14 days and could be recharged after immersing in NaF solution. The FCAP could induce the formation of hydroxyapatite in artificial saliva and could reduce the microhardness decrease, color change, and mineral loss of enamels in both two models (P < 0.05 for all evaluations). CCK-8 and live/dead cell staining analyses showed that the coating did not compromise the biocompatibility of the clear aligner (P > 0.05 for CCK-8 evaluation).

CONCLUSIONS

The FCAP had antibacterial, fluoride recharge, and enamel remineralization abilities while it did not compromise physicochemical properties and biocompatibility.

CLINICAL RELEVANCE

The FCAP has the potential to prevent enamel demineralization during clear aligner treatment.

Quantifying the Release of Titanium From the Titanium Dioxide-Impregnated Composites Used in Orthodontic Bonding

BACKGROUND

Previous literature data has extensively assessed the biocompatibility of various orthodontic adhesives and their components, where the results of most of the studies showed cytotoxic effects of different degrees owing to the unbound molecules released structurally from the cured components.

AIM

The present in-vitro study was aimed to assess the release of titanium dioxide nanoparticles in the artificial saliva from the orthodontic composites impregnated with titanium dioxide nanoparticles of 5% w/w (weight/weight) and 1% w/w used for metal brackets bonding.

METHODS

The study assessed 160 teeth extracted freshly during orthodontic treatment and divided into two groups of 80 samples, each that bonded to orthodontic brackets having 5% w/w and 1% w/w composites with titanium dioxide nanoparticles kept in the artificial saliva. Quantification was done for 5% w/w and 1% w/w composites having titanium nanoparticles with inductively coupled plasma mass spectroscopy at 24 hours, two, four, and six months.

RESULTS

It was seen that in teeth with 1% titanium dioxide, the greatest titanium release was seen at two months, with non-significant release after two months. In teeth with 5% w/w titanium dioxide nanoparticles showed significant titanium release all the time. A significantly greater titanium dioxide release on increasing concentration from 1% to 5% was seen for the 5% w/w group at all the assessment times.

CONCLUSION

The present study concludes that a higher release of titanium is seen in 5% w/w composite containing titanium dioxide nanoparticles, and the concentrations of 1% and 5% can be safely used and are considered to be within permissible limits.

A Novel Coating of Orthodontic Archwires with Chlorhexidine Hexametaphosphate Nanoparticles

Statement of the Problem. The use of orthodontic fixed appliances may adversely affect oral health leading to demineralizing lesions and the development of gingival problems. Aims of the Study. The study aimed to coat orthodontic archwires with chlorhexidine hexametaphosphate nanoparticles (CHX-HMP NPs) and to evaluate the elusion of CHX from CHX-HMP NPs. Materials and Methods. A solution of CHX-HMP nanoparticles with an overall concentration of 5 mM for both CHX and HMP was prepared, characterized (using atomic force microscope and Fourier transformation infrared spectroscopy), and used to coat orthodontic stainless steel (SSW) and NiTi archwires (NiTiW). The coated segments were characterized (using scanning electron microscopy SEM with energy dispersive X-ray spectrometry and field emission SEM) and subjected to the elusion assessment. Results. After having their composition validated, the average size of the CHX-HMP NPs was assessed to be 51.21 nm, and the analysis revealed that the particles had both chlorine and phosphorus. After 30 minutes in the coating solution, NPs deposited on the surface of the SSW and NiTiW. A continuous release of soluble CHX in artificial saliva was detected from both SSW and NiTiW as long as the experiment lasted for 28 days without reaching a plateau. However, the release from coated NiTiW was significantly more than coated SSW at 7, 14, and 28 days. While at day 21, the release from coated SSW was slightly greater than that from the coated NiTiW. Conclusion. Orthodontic stainless steel and NiTi archwires can be successfully coated with CHX-HMP NPs and give sustained release of CHX along the examined period.

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.

An ex vivo evaluation of physico-mechanical and anti-biofilm properties of resin-modified glass ionomer containing ultrasound waves-activated nanoparticles against Streptococcus mutans biofilm around orthodontic bands

BACKGROUND

The present study evaluated the physico-mechanical and antimicrobial properties of ultrasound waves-activated modified-resin glass ionomer containing nanosonosensitizers such as nano-curcumin (n-Cur), nano-emodin (n-Emo), and nano-quercetin (n-Qct) against Streptococcus mutans biofilm on the surface of modified-resin glass ionomer bonded orthodontic bands.

MATERIALS AND METHODS

A total of 50 human molar teeth were used in this study. The shear bond strength (SBS), adhesive remnant index (ARI), setting time, and fluoride release of modified orthodontics cement containing different concentrations of n-Cur, n-Emo, and n-Qct (0, 2, 5, and 10%) were measured. The antimicrobial effectiveness was assessed against S. mutans by the biofilm inhibition test, and the Log₁₀ colony-forming unit (CFU)/mL was evaluated.

RESULTS

SBS and setting time of modified glass ionomer decreased compared with the control group. 5% n-Emo, 2% n-Qct, and 5% n-Cur were the highest concentrations that had an insignificant difference in comparison with Transbond XT (P = 0.647, 0.819, and 0.292, respectively). The groups were not significantly different in terms of ARI score (P > 0.05). The highest and lowest setting time belonged to the control and 5% n-Emo groups, respectively; this difference in setting time was significant (P < 0.05). Ultrasound waves and 0.2% CHX significantly reduced S. mutans biofilms compared with the control group (P < 0.001), and minimum S. mutans colony count was shown in 0.2% CHX and 5% n-Emo groups. The addition of nanosonosensitizers to the glass ionomer did not compromise the fluoride release of the glass ionomer.

CONCLUSION

It could be concluded that resin-modified glass ionomer containing ultrasound waves-activated 5% n-Emo reduces S. mutans biofilm around orthodontic bands with no adverse effect on SBS, ARI, and its application in the clinic.

Application of antibacterial nanoparticles in orthodontic materials

During the orthodontic process, increased microbial colonization and dental plaque formation on the orthodontic appliances and auxiliaries are major complications, causing oral infectious diseases, such as dental caries and periodontal diseases. To reduce plaque accumulation, antimicrobial materials are increasingly being investigated and applied to orthodontic appliances and auxiliaries by various methods. Through the development of nanotechnology, nanoparticles (NPs) have been reported to exhibit excellent antibacterial properties and have been applied in orthodontic materials to decrease dental plaque accumulation. In this review, we present the current development, antibacterial mechanisms, biocompatibility, and application of antibacterial NPs in orthodontic materials.

Influence of β-AgVO3 nanomaterial incorporation on mechanical and microbiological properties of dental porcelain

OBJECTIVE

To explore the effect of adding different percentages of nanostructured silver vanadate decorated with silver nanoparticles (β-AgVO₃) to dental porcelains, evaluating the antimicrobial activity and the influence on the mechanical properties.

METHODS

Thirty-six specimens were made, for each concentration, control group, 0.5%, 1%, 2.5% and 5%, using two commercial brands: IPS InLine and Noritake Cerabien ZR. For the analysis of mechanical properties, the Vickers microhardness test and the roughness test were performed. For the antimicrobial analysis, the XTT and CFU assays were performed.

RESULTS

There was a statistically significant difference between groups for mechanical and microbiological analyses.

SIGNIFICANCE

The modification of dental porcelains, with the incorporation of β-AgVO₃, influenced the mechanical properties of the material and demonstrated antimicrobial activity at certain concentrations.

Comparative Evaluation of Influence of Nd:YAG Laser (1064 nm) and 980 nm Diode Laser on Enamel around Orthodontic Brackets: An In Vitro Study

(1) Background: The prevention of demineralizing lesions at the enamel structure level continues to represent a challenge in daily dental practice. When bacteria influence the pH level, this will decrease below the threshold for remineralization and the dissociation of hydroxyapatite will occur with a high percentage of phosphate and calcium loss. These elements continue to be studied by many authors in order to obtain a working protocol that will lead to their stabilization at the level of the enamel structure, thus preventing the demineralization process. The aim of this study is to evaluate and compare the influence of two types of laser wavelengths on the surface morphology and mineral components of the enamel through an examination with scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDX). (2) Methods: Thirty permanent human incisors extracted for periodontal reasons from patients aged 25−40 years old were selected for this study. Metallic brackets (SS Standard 022 Slot, OC Orthodontics, McMinnville, OR, 97128, USA) were bonded onto each tooth. The buccal surface was randomly assigned three sections: Section A—negative control (no treatment), section B—treated with 980 nm Gallium−Aluminum−Arsenide diode laser (a 300 µm optic fiber was used with 0.8 W output power, energy density of 5.33 J/mm2, in continuous mode, for 30 s, oriented perpendicularly to the enamel surface in contact mode) (KaVo GENTLEray 980 Diode Laser, Kaltenbach & Voigt GmbH, Biberach, Germany), and section C—treated with Nd:YAG laser (a 300 µm fiber was carried out at a 1 mm distance from the enamel surface with 0.75 W power, 75 mJ pulse energy, pulse repetition rate of 10 Hz, 5 J/mm2 fluency, average exposure time of 30 s, and water cooling assisted) (LIGHTWALKER AT S, M021-5AF/1 S, Fotona d.o.o, Ljubljana, Slovenia). The elements evaluated in this study were calcium (Ca), phosphate (P), oxygen (O), and carbon (C). A one-way analysis of variance, paired t-tests, and independent t-tests were carried out to evaluate the results using the SPSS 19 IBM Statistical package software for Microsoft. (3) Results: The evaluation of the data indicated that both wavelengths produced an increase in Ca wt% (for diode laser the mean of Ca wt% before irradiation was 21.06, while that after treatment reached 28.24; and for Nd:YAG laser, the mean of Ca wt% before irradiation was 21.31, while that after treatment reached 33.88); as well, the 980 nm diode laser decreased P wt% (from 17.20 before irradiation to 16.92 after irradiation) and the Nd:YAG laser increased P wt% (from 17.46 before irradiation to 18.28 after irradiation). These results showed a statistically significant difference at the p < 0.05 level. (4) Conclusions: It can be concluded that the best improvement of enamel chemical composition was obtained with Nd:YAG irradiation.

Physico-mechanical properties, antimicrobial activities, and anti-biofilm potencies of orthodontic adhesive containing cerium oxide nanoparticles against Streptococcus mutans

Introduction: White spot lesions around orthodontic brackets may lead to the formation of dental caries during and following fixed orthodontic treatment.

Aim: This study aimed to evaluate the physico-mechanical properties and antimicrobial potencies of orthodontic adhesive doped with cerium oxide nanoparticles (CeO2-NPs) against Streptococcus mutans.

Materials and methods: After synthesis and conformation of CeO2-NPs by transmission electron microscope (TEM), shear bond strength (SBS) and adhesive remnant index (ARI) of modified orthodontic adhesive containing different concentrations of CeO2-NPs (0, 1, 2, 5, and 10 wt%) were measured. The antimicrobial effects of modified orthodontic adhesive were evaluated by disk agar diffusion method and biofilm formation inhibition assay.

Results: The pseudo-spherical shapes of CeO2-NPs were observed in TEM micrographs. The physico-mechanical finding showed that 5 wt% CeO2-NPs showed the highest concentration of CeO2-NPs and SBS value (18.21±9.06 MPa, p&lt;0.05) simultaneously with no significant differences in ARI compared with the control group (p&gt;0.05). There was a significant reduction in cell viability of S. mutans with increasing CeO2-NPs concentration. The 3.1 Log10 and 4.6 Log10 reductions were observed in the count of treated S. mutans with 5 and 10 wt% CeO2-NPs, respectively (p&lt;0.05).

Conclusions: Overall, an orthodontic adhesive containing 5 wt% CeO2-NPs had antimicrobial properties against S. mutans without adverse effects on SBS and ARI.

A Bioactive Enamel Sealer Can Protect Enamel during Orthodontic Treatment: An In Vitro Study

Background: This study aimed to evaluate the effectiveness of an experimental bioactive enamel resin sealer in protecting the enamel adjacent to orthodontic brackets against erosion. Methods: Orthodontic brackets (n = 50) were bonded to freshly extracted, sound maxillary premolars using Transbond™ XT Primer (3M Unitek, Monrovia, CA, USA) and Transbond Plus Color Change adhesive (3M Unitek, USA). Five experimental groups (n = 10) had the following treatments applied: a resin bioactive sealer with 45S5 bioglass, 35% by weight; a resin sealer without bioactive glass; fluoride; the orthodontic sealer, Opal Seal (Opal-Orthodontics, South Jordan, UT, USA); and, in the control group, an untreated surface. All the specimens were stored for 18 min in 1% citric acid. All the specimens were examined by SEM and electron dispersive spectroscopy (EDS). The Wilcoxon signed-rank test was used to compare the enamel surfaces covered by the sealers before and after the acid challenge. Attenuated total reflectance Fourier transform infrared spectroscopy detected the degree of the experimental resins’ conversion to verify their suitability for clinical use. Results: The percentage of the bioactive resin sealer and Opal Seal groups’ protection against enamel erosion was 100%, which was significantly more than the other groups, p < 0.05. The degree of conversion for the bioactive and unfilled resins was 42.4% ± 3.6% and 48.57% ± 5%, respectively. Conclusion: The bioactive resin sealer and the Opal Seal both protected the enamel from erosion.

Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: an in-vitro study

Background

White spot lesion (WSL) is the most common consequence during and after orthodontic treatment. This study was conducted to investigate the ability of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) coupled with universal adhesive resin to treat white spot lesions.

Material and methods

Forty-five extracted premolars were sectioned to create 90 specimens. Seventy-five specimens were demineralized to generate artificially created WSLs. Different strategies have been applied for the management of the artificially created WSLs. Six experimental groups were employed: Group I: sound enamel (control), Group II: demineralized enamel (artificially-created WSLs), Group III: ICON resin-treated WSLs, Group IV: CPP-ACP-treated WSLs, Group V: universal adhesive resin-treated WSLs, and Group VI: CPP-ACP followed by universal adhesive resin-treated WSLs. Assessment of color stability using a spectrophotometer, surface microhardness using a Vickers tester, and surface roughness using a profilometer was done. The surface topography of representative specimens from each experimental group was inspected using a scanning electron microscope. Collected data were analyzed using one-way ANOVA followed by Tukey’s post hoc test at p ≤ 0.05.

Results

White spot lesions treated with CPP-ACP and subsequently coated with universal adhesive resin (Group VI) exhibited a significantly lower ΔE than both CPP-ACP (Group IV) and universal adhesive resin-treated (Group V) groups (p ≤ 0.05), but it was not significantly different from the ICON resin-treated group (Group III). For surface microhardness, WSLs treated with CPP-ACP and consequently coated with universal adhesive resin (Group VI) recorded the highest mean that was significantly different from both ICON resin (Group III) and universal adhesive resin-treated (Group V) groups (p ≤ 0.05). All the tested strategies (ICON resin, CPP-ACP, universal adhesive resin, and CPP-ACP followed by universal adhesive resin) significantly lowered the surface roughness of the WSLs (p ≤ 0.05), while no significant difference was detected among them.

Conclusions

Combining a considerable caries remineralizing program using CPP-ACP with subsequent universal adhesive resin infiltration could be a promising approach to manage WSLs efficiently through increasing surface microhardness and restoring esthetic while developing a smoother surface.

Study on the role of nano antibacterial materials in orthodontics (a review)

Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial adherence or enamel demineralization. Certain NPs are included in orthodontic adhesives or acrylic resins (fluorohydroxyapatite, fluorapatite, hydroxyapatite, SiO2, TiO2, silver, nanofillers), and NPs (i.e., a thin layer of nitrogen-doped TiO2 on the bracket surfaces) are coated on the surfaces of orthodontic equipment. Although using NPs in orthodontics may open up modern facilities, prior research looked at antibacterial or physical characteristics for a limited period of time, ranging from one day to several weeks, and the limits of in vitro studies must be understood. The long-term effectiveness of nanotechnology-based orthodontic materials has not yet been conclusively confirmed and needs further study, as well as potential safety concerns (toxic effects) associated with NP size.

Quantification of Titanium Release From Titanium Dioxide Impregnated Composites in Orthodontic Bonding—An In Vitro Study

Objective

To evaluate the quantity of titanium dioxide nanoparticles released into the artificial salivary medium from orthodontic composite impregnated with 1% weight/weight (w/w) and 5% w/w titanium dioxide nanoparticles (TiO2 NPs) used for bonding metal brackets, thereby eventually comprehending the permissible levels.

Materials and Method

Eighty freshly extracted teeth for orthodontic treatment were divided into 2 groups of 40 teeth each and were bonded with brackets containing 1% w/w and 5% w/w composite containing titanium dioxide nanoparticles and placed in an artificial salivary medium. Quantification of 1% w/w and 5% w/w composite containing titanium nanoparticles was done using inductively coupled plasma mass spectroscopy for 4 timely periods 24 h, 2 months, 4 months, and 6 months.

Results

In the teeth that received 1% TiO2, the amount of titanium released was greatest in 2 months with no significant release at later intervals. In the second group that received 5%, there was a significant release of titanium at all intervals, with highest release at second month. On comparing the 2 concentrations at 4 different time intervals, the quantities were significantly greater in the 5% group at all time frames, thus implying a significant increase in titanium released with an increase in concentration from 1% to 5%.

Conclusion

Titanium release was higher in 5% w/w composite containing nanoparticles than 1% w/w composite containing nanoparticles, and 1% and 5% concentrations can be used safely and are within the permissible limits.

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.

Anti-Bacterial effect, fluoride release, and compressive strength of a glass ionomer containing silver and titanium nanoparticles

Background

Many attempts have been made to enhance the anti-cariogenic properties of the conventional glass ionomer through incorporation of variable materials. However, most importantly, the incorporation of such materials should not jeopardise the physical or mechanical properties of the final restoration.

Aims

To investigate the effect of adding silver nanoparticles (Ag-NPs) and titanium dioxide nanoparticles (TiO₂-NPs) to conventional glass ionomer cement (GIC) on its anti-bacterial effect against Streptococcus mutans (S. mutans), fluoride ion release, and compressive strength (CS).

Settings and Design

This study was an in vitro investigation where 30-disc specimens were prepared in each of the three studied groups.

Materials and Methods

The specimens were categorized into the control group (Group C), in which conventional GIC was used, and Group Ag and Group Ti, in which 5 wt% of Ag-NP and TiO₂-NP were added, respectively, to GIC powder. In each group, the anti-bacterial effect against S. mutans, fluoride ion release at 24 hours and 14 and 28 days, and CS were assessed. Data were analysed using one-way analysis of variance, followed by Tukey honest significant difference post-hoc test.

Results

Both Ag and Ti groups showed a significantly higher anti-bacterial effect than the control group. Ag-NP increased fluoride ion release, whereas TiO₂-NP decreased fluoride release; however, cumulative ion release of both experimental groups did not differ significantly compared to the control group. Adding Ag-NP and TiO₂-NP increased CS, yet only the Ti group showed the highest CS mean value that was statistically significant compared to other groups.

Conclusions

Adding 5 wt% TiO₂-NP or Ag-NP to conventional GIC significantly increased its anti-bacterial effect and its CS without affecting fluoride release.

Bionic effects of nano hydroxyapatite dentifrice on demineralised surface of enamel post orthodontic debonding: in-vivo split mouth study

BACKGROUND

Orthodontic debonding procedure produces inevitable enamel surface alterations, sequelae to which are enamel demineralization, sensitivity and retention of pigments. Several agents have been employed to counterbalance the same. The purpose of this study was (1) To evaluate the hypothesis that no significant difference exists in the remineralising potential of nano hydroxyapatite (NanoHAP) dentifrice and fluoridated dentifrice after orthodontic debonding, (2) To estimate the enamel topographic parameters following use of nano HAP dentifrice, post orthodontic debonding.

METHODS

Sixty upper first bi-cuspids (30 subjects) planned for therapeutic extraction for the orthodontic treatment were bonded with a light cured adhesive. Envelope method of randomisation was followed in this prospective in-vivo study. In each subject, one of the first premolar brackets was debonded using a debonding plier and polished following standard protocols. Envelope method of randomisation was used to determine the side of the premolar to be debonded first. Patient was advised to use fluoridated (Group I) dentifrice for the first 15 days, then the first premolar was covered with a heavy-bodied putty cap, extracted and subjected to atomic force microscopy (AFM). Contralateral first premolar was then debonded and polished using similar protocol, and patient was advised to use nano hydroxyapatite dentifrice (Group II) for next 15 days. The premolar was then extracted and analyzed for surface roughness using AFM. The remineralizing potential of dentifrices was assessed by evaluating surface roughness parameters of the two groups and were compared using a two-sample t test.

RESULTS

A significant difference was found amongst Group I (Fluoridated dentifrice) and Group II (NanoHAP dentifrice) (p > 0.001***) for enamel surface roughness variables which reflect remineralising potential of dentifrices. Group II showed significantly lesser value of surface roughness characteristics.

CONCLUSIONS

NanoHAP dentifrice was shown, after 15 days, to be superior to fluoridated dentifrice in remineralising enamel post orthodontic debonding.

A Novel Developed Bioactive Composite Resin Containing Silver/Zinc Oxide (Ag/ZnO) Nanoparticles as an Antimicrobial Material against Streptococcus mutans, Lactobacillus, and Candida albicans

Aim

The objectives of this study were to develop a new bioactive composite resin containing silver/zinc oxide (Ag/ZnO) nanoparticles and investigate the effects on mechanical, cytotoxic, biocompatibility, and antimicrobial properties.

Materials and Methods

Disc-shaped specimens were prepared from composite with and without nanoparticles in separate culture media containing Streptococcus mutans, Lactobacillus, and Candida albicans. Bracket bonding evaluation was performed on composite without nanoparticles (O), composite containing ZnO (Z) nanoparticles, composite containing ZnO nanoparticles and silver ions (A&Z), and composite containing Ag/ZnO nanoparticles (AZ) synthesized using optical precipitation.

Results

Composite resin with nanoparticles (AZ, A&Z, and Z) showed significant antimicrobial properties (P < 0.05). The mean shear bond strength of A&Z composite resin (13.61 ± 0.73 MPa) was significantly less than that of conventional composite resin (19.03 ± 4.12 MPa) (P < 0.05). In addition, the mean shear bond strength of AZ composite resin (20.49 ± 1.03 MPa) was significantly higher than that of Z (16.35 ± 1.03 MPa) and A&Z composite resins.

Conclusions

Incorporation of ZnO nanoparticles and their compounds into orthodontic composite resins induced antibacterial properties against oral pathogens, and of all these nanoparticles, the AZ group exhibited the best antimicrobial activity and highest shear bond strength.

Effect of Nanostructures on the Properties of Glass Ionomer Dental Restoratives/Cements: A Comprehensive Narrative Review

Overall perspective of nanotechnology and reinforcement of dental biomaterials by nanoparticles has been reported in the literature. However, the literature regarding the reinforcement of dental biomaterials after incorporating various nanostructures is sparse. The present review addresses current developments of glass ionomer cements (GICs) after incorporating various metallic, polymeric, inorganic and carbon-based nanostructures. In addition, types, applications, and implications of various nanostructures incorporated in GICs are discussed. Most of the attempts by researchers are based on the laboratory-based studies; hence, it warrants long-term clinical trials to aid the development of suitable materials for the load bearing posterior dentition. Nevertheless, a few meaningful conclusions are drawn from this substantial piece of work; they are as follows: (1) most of the nanostructures are likely to enhance the mechanical strength of GICs; (2) certain nanostructures improve the antibacterial activity of GICs against the cariogenic bacteria; (3) clinical translation of these promising outcomes are completely missing, and (4) the nanostructured modified GICs could perform better than their conventional counterparts in the load bearing posterior dentition.

Effect of Bioactive Glass-Containing Light-Curing Varnish on Enamel Remineralization

This study aimed to evaluate the effect of novel experimental light-curing bioactive glass (BAG)-containing varnish on enamel remineralization. An experimental light-curing, BAG-containing varnish and two commercial varnishes (Nupro White Varnish; Dentsply International, York, PA, USA and Tooth Mousse; GC Corporation, Tokyo, Japan) were used. Microhardness tests (n = 3), field emission scanning electron microscopy (FE-SEM) coupled with energy dispersive X-ray spectroscopy (EDS) (n = 5), and X-ray diffraction (XRD) analysis (n = 5) were performed to compare the remineralization effect of three varnishes with and without ultrasonication. The data of microhardness test were analyzed using one-way ANOVA and Tukey's post hoc comparison (P < 0.05). Microhardness of demineralized enamel increased after the application of three varnishes (P < 0.05). The experimental BAG-containing varnish showed the highest microhardness among the three varnishes (P < 0.05). Ultrasonication decreased microhardness of Tooth Mousse and BAG-containing varnish groups (P < 0.05). FE-SEM and XRD revealed precipitates of hydroxyapatite (HAP) or fluorapatite (FAP) crystals of three varnishes. The novel experimental BAG-containing varnish may be a promising clinical strategy for the remineralization of early carious lesions or demineralized enamel surfaces.

Bacterial adhesion to biomaterials: What regulates this attachment? A review

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Bacterial adhesion to the surface of dental materials play a significant role in infections.

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The factors that govern microbial attachment involves different types of physical-chemical interactions and biological processes.

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Studying bacterial adhesion makes it possible to understand the mechanisms involved in attachment and helps in the search for technologies that promote antibacterial surfaces.

Bacterial attachment to biomaterials is of great interest to the medical and dental field due to its impact on dental implants, dental prostheses, and others, leading to the need to introduce methods for biofilm control and mitigation of infections. Biofilm adhesion is a multifactorial process and involves characteristics relevant to the bacterial cell as well as biological, chemical, and physical properties relative to the surface of biomaterials. Bacteria encountered different environmental conditions during their growth and developed interspecies communication strategies, as well as various mechanisms to detect the environment and facilitate survival, such as chemical sensors or physical detection mechanisms. However, the factors that govern microbial attachment to surfaces are not yet fully understood. In order to understand how bacteria interact with surfaces, as well as to characterize the physical-chemical properties of bacteria adhesins, and to determine their interrelation with the adhesion to the substrate, in recent years new techniques of atomic force microscopy (AFM) have been developed and helped by providing quantitative results. Thus, the purpose of this review is to gather current studies about the factors that regulate microbial adhesion to surfaces in order to offer a guide to studies to obtain technologies that provide an antimicrobial surface.

Microshear Bond Strength of Nanoparticle-Incorporated Conventional and Resin-Modified Glass Ionomer to Caries-Affected Dentin

The purpose of this study was to assess the influence of three different types of nanoparticles (silver (SNPs), titanium dioxide (TNPs), and zinc oxide (ZNPs)) on the microshear bond strength of conventional glass ionomer cement (CGIC) and resin-modified glass ionomer cement based on whether CGIC or RMGIC is used with four subgroups (based on the incorporation of SNPs, ZNPs, and TNPs in addition to a control subgroup) (n = 12) as follows: CGIC, CGIC + TNP, CGIC + ZNP, CGIC + SNP, RMGIC, RMGIC + TNP, RMGIC + ZNP, and RMGIC + SNP. After 24 hours, the μSBS of specimens was tested and the obtained data were analyzed using two-way ANOVA and Tukey's HSD test. The obtained results showed that the incorporation of TNPs in two glass ionomers was not statistically significant compared with the control subgroups (p > 0.05). In the first group, the highest and lowest mean μSBS were, respectively, observed in the CGIC + SNP subgroup and CGIC + ZNP subgroup. In the second group, RMGIC + ZNP and RMGIC + SNP, respectively, showed the highest and lowest mean μSBS compared to the other subgroups. According to the results, it can be concluded that TNPs can be incorporated into both CGIC and RMGIC without compromising the bond strength of glass ionomers. SNPs and ZNPs can be, respectively, added to CGICs and RMGICs to improve the bond strength of the restoration.

The Efficiency of Fluoride Bioactive Glasses in Protecting Enamel Surrounding Orthodontic Bracket

Objectives

The aim of this study was to evaluate the protective effect of using four different fluoride bioactive enamel sealers against an acidic erosion challenge.

Materials and Methods

A sample of 50 freshly extracted sound upper premolars had their buccal surface bonded to 50 orthodontic brackets using Transbond PLUS color change adhesive; the first four groups had four compositions of fluoride bioactive glasses based on 37 mol% SiO₂, 43.9-53.9 mol% CaO, 6.1 mol% P₂O₅ and CaF₂, and 0-10 mol% of Na₂O applied to their surfaces and the fifth group served as control (which was not treated by any bioactive sealer). All specimens were challenged by 1% citric acid for 18 minutes which was stirred by a magnetic stirrer. The enamel surfaces next to the orthodontic brackets were examined by SEM. The Wilcoxon signed-rank test was used to compare the area covered by the fluoride bioactive pastes before/after erosion (p < 0.05). Samples from the layer formed on top of the examined teeth were tested before/after erosion to be examined by the attenuated total reflectance Fourier-transform infrared spectroscopy (FTIR/ATR).

Results

The FTIR/ATR test showed that fluoride bioactive pastes' applications resulted in the formation of a hydroxyapatite-rich layer; the SEM analysis showed that the aforementioned layer significantly resisted erosion challenge when compared to the control group (p < 0.05).

Conclusions

Fluoride bioactive pastes can efficiently protect the enamel surfaces next to orthodontic brackets from acidic erosion challenges.

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.

Study on the Performance of Titanium Materials Based on Nano Silver Particles in Orthodontic Healing

Nanomaterials are used as a new type of antibacterial agent in clinical medical research projects due to their unique physical and chemical properties. In this study, silane coupling method was used to coat nano-silver particles on titanium sheets to make the smooth titanium surface have antibacterial properties. Scanning electron microscope to observe the surface morphology of silane coupling modified titanium plate, the shape and size of nano-silver particles, and the adhesion on titanium plate; X-ray energy spectroscopy and line scan analysis of each element on the titanium wafer; X-ray photoelectron spectroscopy quantitative analysis of surface elements on the titanium wafer. The experimental group was nano-silver modified titanium sheet, and the control group was smooth titanium sheet. The experimental results show that the titanium material loaded with nano-silver particles has better antibacterial performance in the orthodontic process than ordinary materials. This material is highly safe and can be promoted for use.

Nanomaterials Application in Orthodontics

Nanotechnology has gained importance in recent years due to its ability to enhance material properties, including antimicrobial characteristics. Nanotechnology is applicable in various aspects of orthodontics. This scientific work focuses on the concept of nanotechnology and its applications in the field of orthodontics, including, among others, enhancement of antimicrobial characteristics of orthodontic resins, leading to reduction of enamel demineralization or control of friction force during orthodontic movement. The latter one enables effective orthodontic treatment while using less force. Emphasis is put on antimicrobial and mechanical characteristics of nanomaterials during orthodontic treatment. The manuscript sums up the current knowledge about nanomaterials' influence on orthodontic appliances.

Application of Nanotechnology in Orthodontic Materials: A State-of-the-Art Review

Nanotechnology refers to the science that manipulates matter at molecular and atomic levels, and studies matter at the nanoscale level to detect and exploit the useful properties that derive from these dimensions; materials with components less than 100 nm in at least one dimension are called nanomaterials. Nanotechnology is applied in many fields, such as medicine (nanomedicine) and dentistry (nano-dentistry). The purpose of these innovations and research in this field is to improve human life and health. This article aims to summarize and describe what the most recent and known innovations of nanotechnology in dentistry are, focusing on and paying particular attention to the branch that is orthodontics, and on the application of new nanomaterials in the realization, for example, of orthodontic elastomeric ligatures, orthodontic power chains, and orthodontic miniscrews. We also address a very important topic in orthodontics, which is how to reduce the friction force.

Application and development of aptamer in cancer: from clinical diagnosis to cancer therapy

Traditional anticancer therapies can cause serious side effects in clinical treatment due to their nonspecific of tumor cells. Aptamers, also termed as 'chemical antibodies', are short DNA or RNA oligonucleotides selected from the synthetic large random single-strand oligonucleotide library by systematic evolution of ligands by exponential enrichment (SELEX) to bind to lots of different targets, such as proteins or nucleic acid structures. Aptamers have good affinities and high specificity with target molecules, thus may be able to act as drugs themselves to directly inhibit the proliferation of tumor cells, or own great potentialities in the targeted drug delivery systems which can be used in tumor diagnosis and target specific tumor cells, thereby minimizing the toxicity to normal cells. Here we review the unique properties of aptamer represents a great opportunity when applied to the rapidly developing fields of biotechnology and discuss the recent developments in the use of aptamers as powerful tools for analytic, diagnostic and therapeutic applications for cancer.

Silver nanoparticles in orthodontics, a new alternative in bacterial inhibition: in vitro study

BACKGROUND

The purpose of the study is to assess the antiadherent and antibacterial properties of surface-modified different orthodontic brackets with silver nanoparticles against Streptococcus mutans and Streptococcus sobrinus, using radiomarker.

METHODS

In this study evaluated quantitatively the adherence of Streptococci to orthodontic brackets, 300 samples of orthodontic brackets were selected and classified in to 10 groups as follow: GIn (InVu-Roth), GIIn (System-AlexanderLTS), GIIIn (Gemini-Roth), GIVn (NuEdge-Roth), GVn (Radiance plus-Roth), GVI (InVu-Roth), GVII (System-AlexanderLTS), GVIII (Gemini-Roth), GIX (NuEdge-Roth), GX (Radiance plus-Roth). All the samples were sonicated and Streptococci were cultivated by gender. A radioactive marker (³H) was used to codify the bacteria and measure them. After that, the brackets were submerged in a radiolabelled solution, and the radiation was measured. The statistical analysis was calculated with ANOVA test (Sheffè post hoc).

RESULTS

The results showed significant differences were found among the groups. GIIIn shown the lowest scores for both bacteria; in contrast, GIX for Streptococcus mutans and GVI for Streptococcus sobrinus were the highest values.

CONCLUSIONS

Surface modification of orthodontic brackets with silver nanoparticles can be used to prevent the accumulation of dental plaque and the development of dental caries during orthodontic treatment.

The Effects of Silver, Zinc Oxide, and Titanium Dioxide Nanoparticles Used as Dentin Pretreatments on the Microshear Bond Strength of a Conventional Glass Ionomer Cement to Dentin

Aim

This study was conducted to evaluate the effects of three nanoparticle solutions used as dentin pretreatments on the microshear bond strength (µSBS) of a conventional glass ionomer cement (GIC) to dentin.

Materials and Methods

Ninety intact human molars were used after sectioning their occlusal surfaces to expose flat dentin surfaces. The specimens were randomly assigned to nine groups (n = 10). Group A was the control group (without using the cavity disinfectant). In groups B, C, D, and E, the prepared dentin surfaces were treated with 1 cc 2% chlorhexidine (CHX), 0.1% silver nanoparticle (SNP), 0.1% titanium dioxide nanoparticle (TNP), and 0.1% zinc oxide nanoparticle (ZNP) solutions for 1 minute, respectively, before applying the conditioner. CHX, SNPs, TNPs, and ZNPs were applied for 1 minute after applying the conditioner in groups F, G, H, and I, respectively. The specimens were restored with a conventional GIC and underwent µSBS testing after 24 hours. The data were analyzed using the one-way analysis of variance and Tukey’s test (p=0.05).

Results

The applications of the nanoparticles (SNP, TNP, and ZNP) after the conditioner were associated with significantly greater µSBS values compared to that of the control group (p values < 0.05). Significantly higher µSBS values were observed when TNP or ZNP was applied after the conditioner compared to their applications before the conditioner (p values < 0.05). The highest µSBS values were observed when TNP was applied after the conditioner.

Conclusion

Dentin pretreatment with the nanoparticles after applying the conditioner enhanced the bond strength of the GIC to dentin compared with the control group. The best results were obtained for the TNPs applied after the conditioner.

Evaluation of the Shear Bond Strength and Antibacterial Activity of Orthodontic Adhesive Containing Silver Nanoparticle, an In-Vitro Study

This study evaluated the effect of incorporating silver nanoparticles (AgNPs) into conventional orthodontic adhesive on its antibacterial activity and the shear bond strength (SBS) to stainless steel orthodontic brackets. Thirty-four extracted premolars were randomly allocated into two groups (n = 17). Orthodontic adhesive (Transbond XT, 3M Unitek) was blended with AgNPs (50 nm, 0.3% w/w) to form a nano-adhesive. In order to bond stainless steel twin brackets (0.022-inch, American Orthodontics), Transbond XT (n = 17) and nano-adhesive (n = 17) were used in each group, respectively, after acid etching (37% phosphoric acid, 30 s) and rinsing with water (15 s). SBS and the adhesive remnant index (ARI) scores were recorded. Antibacterial activity against Streptococcus mutans in both groups after 24 h and 30 days was assessed (Disc agar diffusion test) and the inhibition zone diameter around each specimen was measured and recorded. Adding AgNPs significantly (p = 0.009) reduced the mean (SD) SBS in the nano-adhesive group [10.51(7.15) MPa] compared to Transbond XT [17.72(10.55) MPa]. The ARI scores on the Transbond XT and nano-adhesive showed no statistically significant difference (p = 0.322). Nano-adhesive with AgNPs showed significant antibacterial activity against Streptococcus mutans at 24 h and 30 days (p < 0.001). In both groups, no significant decline in the zones of inhibition was detected after 30 days (p = 0.907). The findings suggest that SBS decreased after incorporation of AgNPs [0.3% (w/w)], but was still above the recommended SBS of 5.9–7.8 MPa. The nano-adhesive showed significant antibacterial activity which did not change much after 30 days.

Functional Coatings for Orthodontic Archwires-A Review

In this literature review, the current state-of-art of coatings for orthodontic archwires’ increasing antimicrobial and relevant mechanical properties, such as surface topography, friction or corrosion resistance, has been presented. There is a growing request for orthodontic appliances, therefore, most researchers focus on innovative functional coatings to cover orthodontic archwires and brackets. Orthodontic appliances are exposed to the unfavorable oral cavity environment, consisting of saliva flow, food, temperature and appliance force. As a consequence, friction or biocorrosion processes may occur. This can affect the functionality of the orthodontic elements, causing changes in their microstructure, surface topography and mechanical properties. Furthermore, the material which the orthodontic archwire is made from is of particular importance in terms of the possible corrosion resistance. This is especially important for patients who are hypersensitive to metals, for example, nickel, which causes allergic reactions. In the literature, there are some studies, carried out in vitro and in vivo, mostly examining the antibacterial, antiadherent, mechanical and roughness properties of functional coatings. They are clinically acceptable but still some properties have to be studied and be developed for better results. In this paper the influence of additives such as nanoparticles of silver and nitrogen-doped TiO₂ applied on orthodontic brackets by different methods on the antimicrobial properties was analyzed. Future improvement of coating techniques as well as modification of the archwire composition can reduce the release of nickel ions and eliminate friction and bacterial adhesion problems, thus accelerating treatment time.

Antibacterial activity and debonding force of different lingual retainers bonded with conventional composite and nanoparticle containing composite: An in vitro study

BACKGROUND

To evaluate the antibacterial activity and debonding force of retainers bonded with conventional and nanoparticle (TiO₂) containing composite.

METHODOLOGY

Antibacterial activity was tested against Streptococcus mutans and Lactobacillus acidophilus using disk agar diffusion, biofilm inhibition, and eluted components tests. For the eluted components test, colony counts of bacteria were tested on 0, 3, and 30 days. Three different retainers were bonded to the lingual surface of extracted lower incisors using conventional and 1% TiO₂ composite. Samples were divided as follows: Group 1: 1a, stainless steel retainer (Bond-a-Braid) with conventional composite, and 1b, stainless steel retainer with nanoparticle composite; Group 2: 2a, titanium retainer with conventional composite, and 2b, titanium retainer with nanoparticle composite; Group 3: 3a, fiber-reinforced retainer (Interlig) with conventional composite, and 3b, fiber-reinforced retainer with nanoparticle composite. The Instron stereomicroscope was used to test debonding force and failure sites respectively.

RESULTS

In the disk agar diffusion test, TiO₂ composite has shown more inhibition zones. Biofilm inhibition test showed a significant decrease in colony counts of both organisms in the TiO₂ group. The eluted component test showed a significant decrease in colony counts from day 0 to day 30 in the TiO₂ group compared with the control group. The highest debonding force was observed in stainless steel retainers with conventional composite, and lowest in fiber-reinforced composite retainers with TiO2 composite, with no significant difference in Adhesive Remnant Index scores.

CONCLUSION

The TiO₂ composite group showed greater antibacterial activity without compromising the bond strength, which was statistically significant. Compared with other groups, stainless steel wires bonded with conventional composite showed the highest debonding force.

The effect of silver nanoparticles, zinc oxide nanoparticles, and titanium dioxide nanoparticles on the push-out bond strength of fiber posts

Background

This study was undertaken to investigate the effect of intraradicular dentin pretreatment with silver nanoparticles (SNPs), zinc oxide nanoparticles (ZNPs), and titanium oxide nanoparticles (TNPs) on the push-out bond strength (PBS) of fiber posts to root dentin using two types of resin cements.

Material and Methods

Eighty single-rooted human premolar roots were randomly divided into eight groups after endodontic treatment and post space preparation, according to the type of intraradicular dentin pretreatment with different nanoparticle solutions (n=20). The groups included no pretreatment (control) and pretreatments with SNPs, ZNPs, and TNPs. Each group was divided into 2 subgroups (n=10) according to cementation: Excite DSC/Variolink II and ED Primer II/Panavia F2.0. The PBS values were measured in different areas of the post space. The data were subjected to the three-way analysis of variance and Tukey tests (p=0.05).

Results

The SNP-pretreated groups showed significantly higher PBS values than the other groups. No significant differences in PBS were noted among the control, ZNP-pretreated, and TNP-pretreated groups. There was no significant difference in the PBS of the fiber posts with respect to cement type. The PBS was significantly lower in the apical region than in the other two regions. There was no statistically significant difference between the PBSs of the cervical and middle thirds.

Conclusions

Intraradicular dentin pretreatment with SNPs, TNPs, and ZNPs did not interfere with the PBS of the fiber posts. The best result was obtained for the SNP-pretreated groups for both types of cement. Also, the lowest PBS was found in the apical third of the root canal spaces.

Key words:Fiber post, nanoparticles, push-out bond strength.

The use of a new chemical device based on silver and cationic surfactants as a new approach for daily oral hygiene: A preliminary study on a group of periodontal patients

The aim of this study was to evaluate the abatement power of oral microbial loading of a new gel formulation based on the complex silver-2-mercaptobenzoate, chlorhexidine digluconate and didecyldimethylammonium chloride (named ADC) through polymerase chain reaction (PCR). The study sample consists of a group of 20 patients with chronic periodontal disease. Patients were over 25 years of age and did not undergo surgical or non-surgical periodontal treatment in the previous 6 months. The study sample was allotted into two groups of 10 patients each, homogeneous by age and sex. The test group received a bottle containing ADC gel, while the control group received an identical one containing placebo, similar to ADC in consistence, colour, taste and odour. Sub-gingival samples of four sites, one in each quadrant, of greatest probing depth in each patient were used. Microbiological analyses were performed at baseline and at day 15. Paired t test was performed to detect statistical significant reduction in total bacterial loading and oral pathogens in the study groups. The analysis showed a statistically significant reduction in the total bacterial loading evaluated pre- and post-treatment (P = 0.029) in the study groups. In the control group, the decrease in total bacterial loading was not significant (P = 0.279). Clinically, ADC gel does not have any side effects and discomfort such as pain, burning, tingling sensation or numbness and produces no adverse reactions in time. Our study aimed to evaluate the efficacy of a new chemical formulation with antibacterial properties to use for daily oral hygiene with a preliminary study. Our results showed a statistically significant reduction in total bacterial loading after treatment, but the limitations of our study do not allow us to demonstrate the clinical efficacy of the ADC gel.

Effect of nanomaterial incorporation on the mechanical and microbiological properties of dental porcelain

STATEMENT OF PROBLEM

Dental porcelain restorations are subject to biological failures related to secondary caries and periodontal disease leading to prosthesis replacement.

PURPOSE

The purpose of this in vitro study was to explore the microbiological and mechanical properties of dental porcelain incorporated with different percentages of silver vanadate (β-AgVO₃) through microbiological analysis, roughness tests, and the Vickers microhardness test.

MATERIAL AND METHODS

IPS InLine porcelain specimens were made by using a cylindrical Teflon matrix in the dimensions of 8×2 mm. For the control group, the porcelain was manipulated according to the manufacturer's instructions. The groups incorporating the nanomaterial were prepared with 2.5%, 5%, and 10% of β-AgVO_3, which was added proportionally by mass to the porcelain powder. In vitro microbiologic analysis, roughness tests, and the Vickers microhardness test were performed.

RESULTS

Against Streptococcus mutans, the control group showed no inhibition halo (0 mm). All groups with AgVO₃ showed a zone of inhibition, the highest for the group with 10% (30 mm) and then the groups with 2.5% (9 mm) and 5% (17 mm). For Vickers microhardness, no statistically significant difference (P<.05) was observed between the evaluated groups. The group with 10% of AgVO₃ had the highest mean roughness and was statistically different (P<.001) from the other groups.

CONCLUSIONS

Adding β-AgVO₃ to dental porcelain demonstrated antimicrobial effectiveness at all concentrations (2.5%, 5%, and 10%), with no effect on Vickers microhardness. The 10% group had higher roughness than the other groups.

Synthesis and Characterization of Silver Nanoparticles on Orthodontic Brackets: A New Alternative in the Prevention of White Spots

Silver nanoparticles (AgNPs) are used for their powerful antibacterial effect and their ability to adhere to surfaces due to their size; they are used in different areas of life, mainly in the area of health as medicine. More recently, in dentistry, the synthesis and characterization of AgNPs attracted significant attention due to their antibacterial properties. In this study, the AgNPs were synthesized using the most effective method on different orthodontic brackets (metallic and esthetic) and characterized by scanning electron microscopy/energy-dispersive spectroscopy (SEM/EDS) and transmission electron microscopy (TEM). Their antimicrobial effect was tested against the widely used standard human pathogens Staphylococcus aureus (Gram-negative) and Escherichia coli (Gram-positive). Our results showed that, via a simple chemical method, AgNPs can be synthesized on the surface of orthodontic brackets with good antimicrobial activity and the possibility of reducing dental decay, periodontal disease and white spots generated during orthodontic treatment.

Comparative evaluation of Icon® resin infiltration and Clinpro™ XT varnish on colour and fluorescence changes of white spot lesions: a randomized controlled trial

Background

The aim of this trial was to comparatively evaluate Icon® resin infiltration and Clinpro™ XT varnish in restoring aesthetics of white spot lesions (WSLs) present post-orthodontic treatment.

Materials and methods

Two hundred forty WSLs were detected in 193 teeth of 12 patients. The participants were analysed—before intervention (T₀), immediately after intervention (T₁), 3 months later (T₂) and 6 months later (T₃), with a 1:1 allocation ratio for the application of Icon® resin infiltration and Clinpro™ XT varnish. Using a computer-generated allocation sequence, block randomization was done. A spectrophotometer was used to assess the colour of WSLs and the adjacent enamel, while a DIAGNOdent® was used to assess the fluorescence loss.

Results

Immediately after the intervention, Icon® resin infiltration showed statistically significant better improvement than Clinpro™ XT varnish in restoring the colour (p = 0.000); however, at 3 (p = 0.001) and 6 months (p = 0.000), this was reversed. Except at 3 months, the fluorescence loss sequentially reduced more for Icon® resin infiltration (4.48 ± 1.42 at T₀ to 1.48 ± 0.81 at T₃) and was not statistically significant.

Conclusions

Clinpro™ XT varnish showed significantly better improvement than Icon® resin infiltration in restoring the colour and lightness of the WSLs at 3 and 6 months. The fluorescence loss significantly recovered with both intervention methods between immediate application and at 6 months. However, Clinpro™ XT varnish-treated WSLs showed a statistically significant difference compared to the adjacent sound enamel at 6 months.