Comparitive evaluation of ion release from orthodontic brackets in two mouthwashes and two gels: an in vitro study

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Background of the study: The stainless steel bracket is widely used in orthodontics because of its mechanical properties, strength, and good biocompatibility. However, under certain conditions, it can be susceptible to corrosion. Moreover, metal ion release can cause adverse local or systemic biological effects on patient’s health. During orthodontic treatment, practitioners recommend that their patients use mouthwashes or gels to ensure a satisfactory oral hygiene regime to reduce the risk of dental caries. Hence, the purpose of this study was to observe metal ion release from 2 mouthwashes and 2 gels.Methodology: The sample size consisted of 75 brackets, divided into 5 groups of (15 brackets each) and were tested in 5 different medium.Group 1-Clohex® -ADS mouthwashGroup 2-Colgate Plax® mouthwashGroup 3- Hexigel® Group 4-Rexidin -M forte® gelGroup 5-Deionized distilled water (control group)As divided in the groups above, the brackets were immersed in the various media. Each bracket were incubated in an oven at a constant temperature of 37˚in individual plastic capped vials for 45 days. After the incubation period the solutions were tested with an inductively coupled Plasma (ICP)spectrometer to detect the ions released. Each solution was analysed for chromium, copper, iron, manganese and nickel ions. The measurement of pH of each medium was measured by a pH meter. The data obtained was noted and subjected to statistical analysis.Results: Group 1 -Clohex -ADS (Chlorhexidine mouthwash) showed highest release of chromium, nickel, iron and chromium ions when compared to the remaining groups.Conclusion: The study concluded that the Group 1 (Clohex -ADS) mouthwash showed highest release of chromium, nickel, iron, manganese ions when compared to Colgate plax (group 2), Hexigel (group3), Rexidin-M (group 4) and deionized distilled water (group 5). Hence chlorhexidine can cause increased surface roughness of the metal brackets with decreased efficiency of the appliance by creating friction. Also, the release of copper ion was found to be higher in group -3 hexigel and group -4 rexidin -M forte gel.