Orthodontic Appliances Research Articles

Can Velopharyngeal MRI be Used in Individuals with Orthodontic Devices?

To evaluate the influence of common pediatric orthodontic appliances on velopharyngeal (VP) MRI and to compare MR image sequences to determine if sequence parameters impact the visibility of key VP structures commonly assessed in clinical VP MRI. Participants undergoing orthodontic treatment completed a VP MRI study. Level of distortion caused by orthodontic devices on 8 anatomical sites of interest and using variable MRI sequences was evaluated. Single institution. Nineteen participants undergoing orthodontic treatment. Level of distortion caused by metal artifacts and MR sequence used. The results of this study demonstrate that appliances such as hyrax palatal expanders and braces with stainless steel brackets are acceptable for a VP MRI, while class II corrector springs are not recommended. The HASTE MRI sequence with 2D imaging techniques should be utilized if the child has orthodontic devices, while FSE and 3D imaging techniques are not recommended. The presence of wire spring coils and molar bands are likely to not to interfere with the MRI evaluation. Findings from this study suggest that the presence of orthodontic appliances does not hinder visualization of all velopharyngeal structures during an MRI. Therefore, careful consideration must be made prior to disqualifying or recommending patients for VP MRI.

Effects of probiotics on the oral health of patients undergoing orthodontic treatment: a systematic review and meta-analysis.

The effect of probiotics on oral health maintenance in orthodontic patients remains controversial. The aim of the study is to systematically review and assess the effects of probiotics on the oral health and microbiome of patients undergoing orthodontic treatment. Databases including PubMed, Web of Science, Cochrane Library, ClinicalTrials.gov, and ProQuest Dissertations & Theses Global databases were searched from their inception until June 2022. Randomised controlled trials that assessed the effects of probiotics on clinical and microbial outcomes in patients undergoing orthodontic treatment were included. Data screening and collection were performed, and the risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. The meta-analysis evaluated the effects of probiotics on Streptococcus mutans (S. mutans) and Lactobacillus counts. The quality of the evidence from the meta-analyses was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of 405 records were identified, of which 15 studies were included in the qualitative synthesis and 4 in the meta-analysis. The patients in all the included studies were treated with fixed orthodontic appliances. Results regarding clinical outcomes were controversial; four out of five studies reported no significant changes in plaque in the probiotic group (P > .05), and two out of three studies reported no significant changes in the gingival index (P > .05). Regarding microbial outcomes, the meta-analysis results revealed that probiotics significantly increased the likelihood of reducing the abundance of S. mutans to below 105 CFU/ml (risk ratio: 2.05 [1.54, 2.72], P < .001) and reduced the likelihood of increasing the abundance of S. mutans to beyond 106 CFU/ml (risk ratio: 0.48 [0.28, 0.83], P = .009). However, the quality of evidence according to the GRADE was moderate. There is insufficient evidence to determine the clinical benefits of probiotics as a supplement for the oral health of patients undergoing orthodontic treatment. However, probiotics may have benefits in reducing the salivary S. mutans counts in orthodontic patients. PROSPERO (CRD42022366650).

Effect of nanoparticle addition on antimicrobial properties for acrylic removable orthodontic appliance

Removable orthodontic appliances have acrylic resin-based plate components that often result in plaque retention and bacterial build-up, leading to dental and periodontal problems. Several studies have tried adding nanoparticles to acrylic resins to over-come these problems. This review discusses the effect of nanoparticle addition on the antimicrobial properties of orthodontic removable acrylic resin. A literature review was conducted on 10 articles obtained from PubMed, ScienceDirect, and Google Scholar by determining inclusion, exclusion and keyword criteria. Literature search using boolean search based on inclusion criteria obtained data that the addition of various nanoparticle materials such as zinc oxide, titanium dioxide, magnesium oxide produces good antimicrobial properties, especially in the process of inhibiting microbial adhesion. It is concluded that the addi-tion of nanoparticles to acrylic resin orthodontic appliances provides effective antimicrobial properties so that it can be applied clinically to prevent diseases in the oral cavity such as gingivitis and dental caries.

Studying the Corrosion Effect of Fixed Orthodontic Appliances on Thyroid Hormones

This study aimed to determine the nickel (Ni), and chromium (Cr) ions amounts and investigate their potential effects on thyroid hormones in patients' saliva who were receiving treatment with fixed orthodontic appliances (FOA). In this study, 42 FOA volunteers participated, and all samples were obtained from a specialized center for manufacturing and orthodontics in Bab Al-Moadham, Baghdad, Iraq. According to the findings, individuals with fixed orthodontics have significantly higher levels of the thyroid hormones (P&lt;0.05) FT3 and FT4 than those who did not have orthodontic treatment, whereas there were no significant changes in TSH (P=0.599). Additionally, the amounts of Ni+2 and Cr+3 were considerably higher in the individuals receiving metallic orthodontic treatment (P &lt;0.0001). The findings of this investigation support the hypothesis that corrosion metals from the FOA have a meaningful impact on the concentration of Ni and Cr ions and, consequently, on the thyroid and salivary functioning of the patient group.

WEARING ORTHODONTIC APPLIANCES MAY NOT IMPACT THE ORAL HEALTH-RELATED QUALITY OF LIFE (OHRQOL) OF CHILDREN AND ADOLESCENTS

Impacts of using orthodontic appliances on the quality of life of children and adolescents: systematic review and meta-analysis. Vidigal MTC, Mesquita CM, de Oliveira MN, de Andrade Vieira W, Blumenberg C, Nascimento GG, Pithon MM, Paranhos LR. Eur J Orthod. 2022 Aug 16; 44(4):359-368. Government. Systematic review with meta-analysis of data.

The success rate of mini-screws for incisors intrusion and patient age, gender, and insertion angle in the maxilla using CBCT and implant-guided surgery. A split-mouth, randomized control trail.

The intrusion of anterior teeth is a routine procedure in orthodontics, which has been performed efficiently with the help of mini-screws in the anterior region, especially the upper maxilla. This study aimed to investigate the effect of insertion angle and sociodemographic features on the success rate of mini-screws at the anterior maxillary region. Twenty-nine patients (18 Females and 11 Males) aged 18-40 years old were involved in the current study. A split-mouth design was carried out in which recruited patients needed bilateral anterior screws at the labial bone in the region of the incisor for the intrusion of upper anterior incisor teeth as part of their orthodontic treatment with a fixed appliance (upper right side received 90-degree insertion angle mini-screw and 45° for left side) using a surgical guide fabricated from patients CBCT and intraoral scans. The mini-screws were inserted at the attached gingiva bilaterally to achieve intrusion of upper anterior teeth with a power chain ligated from the main archwire to the anterior min-implants. The patient was recalled monthly for orthodontic appliance activation and screw assessment for 6 months. The intrusion force was 15 g on each side. The results of the study showed that screw stability was higher in the male group than the female group at the 6th monthly follow-up visit with a statistically significant difference between both genders (P = .044). Concerning insertion angle, results showed a statistically significant difference between 45° and 90° as an insertion angle with a P-value <.01 in most of the follow-up months. This study found that male patients with mini-screws inserted at 90° showed greater screw stability over time.

Temporal dynamics of adhesion of oral bacteria to orthodontic appliances.

Adhesion of the most common dental biofilm bacteria to alloys used in orthodontics in relation to surface characteristics was analyzed. Streptococcus mutans (S. mutans), Streptococcus oralis (S. oralis), Veillonella parvula (V. parvula), and Aggregatibacter actinomycetemcomitans (A. actynomicetemcomitans) were incubated for 4 h with nickel-titanium (NiTi) and stainless-steel (SS) wires. The surface roughness and free energy of the alloys, as well as the hydrophobicity of the alloys and bacteria, were assessed. NiTi had higher surface free energy and rougher (p<0.001) and more hydrophilic surfaces than SS (p<0.001). The hydrophobic properties of the bacteria decreased in the following order: V. parvula>S. oralis>S. mutans>A. actynomicetemcomitans. Bacterial adhesion generally increased over time, though this pattern was influenced by the type of alloy and the bacteria present (p<0.001). In a multiple linear regression, the principal predictor of adhesion was bacterial hydrophobicity (p<0.001), followed by time (p<0.001); alloy surface characteristics had a low influence.

Biocompatibility Stainless Steel Brackets with Nickel and Chromium Ions: A Scoping Review

Background: The use of stainless steel brackets in the oral cavity for a long time will definitely experience a corrosion reaction. The corrosion process is always followed by the release of ions from metal elements. The release of nickel and chromium ions is the most common and studied because of its negative effects on the human body. Objective: to review the biocompatibility and release effect of nickel and chromium ions from stainless steel brackets on the human body. Methods: The data source of this study was obtained through literature search through a database with descriptions related to the biocompatibility of the use of stainless steel brackets with the release of nickel and chromium ions. Results: The results of research and literature studies show that the corrosion results obtained from orthodontic appliances do not cause DNA damage and low genotoxicity, toxicity and cytotoxicity. Conclusion: Biocompatibility of dental materials is the basic point of the success of these materials to be used in the oral cavity. The biocompatibility of stainless steel brackets is good due to the low level of toxicity, cytotoxicity and genotoxicity in the body.

The scientific evidence for pre-adjusted edgewise attachments and mechanics.

Introduction Fixed orthodontic appliance systems continue to evolve with a wealth of evidence emerging to underpin these refinements.Aims To present the evidence from comparative prospective research informing the selection of fixed appliance design and mechanics.Design Detailed literature review.Materials and methods An electronic search to identify randomised controlled trials and clinical controlled trials was undertaken using pre-defined search terms.Results Based on high-level evidence, no one bracket system has been proven superior in terms of efficiency or outcome. Similarly, a clear advantage associated with one wire type or dimension has not been shown. The effect of lacebacks in terms of anchorage management appears to be limited, while elastomeric chain and nickel titanium closing coils are associated with similar rates of space closure.Discussion A wealth of high-quality recent evidence to support the selection of fixed appliance attachments, archwires and auxiliaries, including lacebacks and space closing mechanics, was identified.Conclusions There has been a considerable increase in the amount of high-quality evidence informing the choice of pre-adjusted edgewise mechanics in recent years. This information can be used to make evidence-based decisions in the selection and manipulation of fixed appliances during daily practice.

Reflection on patients’ experience with orthodontic appliances wear and its impact on oral health related quality of life: observational comparative study

BackgroundThe objective of this study was to explore and compare patient’s experience with the use of a removable functional appliance or fixed orthodontic appliance and its influence on oral health-related quality of life.Material and methodsThis clinical trial included 81 participants having Class II Division 1 and age ranging between 10 and 16 years. The participants were included in any of a three equal groups according to the set inclusion and exclusion criteria; Group 1: patients treated with a Twin-Block functional appliance; Group 2: patients treated with a fixed orthodontic appliance only; and Group 3 (control group): patients not in orthodontic treatment yet. The COHIP SF-19 was used. Patients were given the questionnaire as follows: Group 1: (1) after at least 8 months from starting treatment; (2) after completing phase 1 by 2–3 months without wearing the appliance; Group 2: (1) just before debonding; (2) after finishing the treatment by 2–3 months without any appliances; and Group 3: (1) at the patient’s first visit to the orthodontic clinic; (2) after 2–3 months from the first visit to the orthodontic clinic and before starting any treatment.ResultsThe 81 participants were 31 males and 50 females with median age of 13 years. The total COHIP SF-19 scores at baseline were 57 (49–64), 67 (63–72), and 47 (42–53) for the Twin-Block, the fixed appliance, and the malocclusion groups, respectively. Two-month mean scores adjusted to the baseline scores were 64.82 ± 1.15, 65.65 ± 1.47, and 54.45 ± 1.44 for the Twin-Block, the fixed appliance, and the malocclusion groups, respectively.ConclusionsBoth at baseline and two-months (adjusted to the baseline scores), participants in the malocclusion group showed compromised socio-emotional quality of life and reported the poorest total OHRQoL. At the baseline, better socio-emotional and total OHRQoL was reported by the fixed appliance group compared to the Twin-Block group but, after two months both groups gave similar sores. Therefore; patients’ perceptions about their experience with the orthodontic appliance might change.

Randomized multicenter study on the plaque removal efficacy of 2 interdental brushes around the base of orthodontic brackets

The objective of this multicenter study was to analyze the efficacy of cleaning 2 interdental brushes (IDBs) around brackets in patients with fixed orthodontic appliances. The study design was a multicenter, randomized, examiner-blinded crossover study with 3 interventions, the first of which was a baseline intervention. This study included 20 patients (12 females, 8 males) aged 12-18 years with fixed orthodontic devices examined at the Department of Orthodontics, University Medical Center of the Johannes Gutenberg University Mainz, and the Children's Dental Clinic St. Gallen. The outcome was a conventional, cylindrically shaped IDB (IDBG-S [IB]; Top Caredent GmbH, Schönau, Germany) was examined in comparison with an innovative waist-shaped IDB (Circum, CDB-8 [CB]; Top Caredent GmbH). The participants did not use the IDB themselves. The brushing procedure was performed professionally by 1 operator (C.E.). Each buccal tooth surface with a bracket was split into 8 areas, the main areas being 1 and 8. These main areas, which were difficult for toothbrushes to reach, were mesial (area 1) and distal (area 8) of the bracket edges in the gingival direction. Plaque index (PI) scores were assessed at 2 examinations before and after the cleaning procedure on 8 tooth surfaces in the area with orthodontic brackets. A computer-generated program randomly allocated the IDB sequence to the participants. Examiners (L.Z.-G. and Y.W.) assessing the outcomes were blinded to the intervention and the randomized allocation of participants to the different IDBs. Both IDBs showed a plaque removal effect (CB, 0.68 [interquartile range, 0.63-0.77]; IB, 0.43 [interquartile range, 0.33-0.55]). The difference between the 2 IDB was statistically significant (P= 0.002). In particular, the CB yielded a higher plaque removal efficacy (CB effect, 0.68; IB effect, 0.21) at the main areas 1 and 8, which were difficult to reach. Ten participants were randomized to each sequence, and all 20 completed the study. No side effects or adverse events were reported or observed. The waist-shaped brush head of the CB significantly enhanced plaque reduction in total and particularly in problem areas. This trial was registered at the German Clinical Trials Registry (no. DRKS00014088; https://www.drks.de/drks_web/navigate.xxdo?navigationId=trial.HTML&TRIAL_ID=DRKS00014088) PROTOCOL: The protocol was not published before trial commencement. This study was supported by the manufacturer Top Caredent GmbH, Schönau, Germany, which provided all interdental brushes used in this study.

Comparison of self-rated pain and salivary alpha-amylase and cortisol levels during early stages of fixed orthodontic and clear aligner therapy

Objectives To compare self-rated orthodontic pain (OP) and whole salivary alpha-amylase (αA) and cortisol levels (CL) during early stages of fixed orthodontic and clear aligner therapy (CAT). Methods In groups 1 and 2, malocclusions were treated using fixed orthodontic appliances and CAT, respectively. In Group-3, individuals had normal occlusion and had never undergone orthodontic therapy. Self-rated OP was assessed using the visual-analogue-scale at baseline (T0); after 24-hours (T1) of appliance activation; and after 30 days (T2). Unstimulated whole saliva was collected and αA and CL were measured using enzyme-linked immunosorbent assay. p < .01 was considered statistically significant. Results Twenty-four (Group-1), 24(Group-2) and 25 (Group-3) patients were included. In groups 1 and 2, participants had Class-I malocclusion with anterior-crowding in both arches. At baseline (T0) none of the participants reported pain on mastication. In groups 1 (p < .01) and 2 (p < .01), OP was higher at T1 than T2. In groups 1 and 2, αA and CL were higher at T1 (p < .01) than T0 and T2. At T1 and T2, salivary αA and CL were higher in groups 1 (p < .01) and 2 (p < .01) than Group-3. In groups 1 and 2, a significant correlation was recorded between OP and αA (p < .01) and CL (p < .01) at T1 interval. Conclusion Self-rated OP and salivary αA and CL during the early stages of fixed OT and CAT are similar. Whole salivary αA and CL and OP and are high during the first 24 hours of fixed OT and CAT activation.

EFFECTS OF 2x4 APPLIANCE AND NiTi OPEN SPRING ON MIXED DENTITION

Background/Objectives: The mixed dentition period is the best time to guide the occlusion and intercept a malocclusion. Among the preventive orthodontic procedures, space recovery is considered extremely important for the biogenesis of the occlusion to follow its normal course. Several orthodontic appliances indicated for space recovery in mixed dentition are mentioned in the literature and among them, mechanics with a fixed 2x4 partial appliance.This study aimed to evaluate changes in the dimensions of the upper arch after using a 2x4 fixed partial appliance with expanded CuNiTi wires and open NiTi springs. Material and Methods: Twenty-four children (±9 years) were assessed who had no space for the eruption of permanent teeth in the upper arch, treated with a 2x4 fixed partial appliance. Lateral teleradiography imaging, panoramic radiography and cast models were used before and after the treatment. The results were compared to a control group of 24 children who did not receive treatment and had their documents assessed for growth-related changes. The following changes were evaluated: dimension of arch perimeter, arch depth, intermolar distance, and inclination and displacement of permanent upper molars and incisors. Student’s t-test was used to assess the differences between pre- and post-treatment times, with significance level of 5%. Results: Increases were observed in arch perimeter (p=0) and arch depth (p=0) due to a distal movement of the crown (p=0) and the root of molars (p=0.004), and maintenance of the spatial position of the incisors, without protrusion (p=0.37) or vestibular movement (p=0.13). Limitations: the limitation of the present study was not to randomize the sample and not to use a control group identical to the group that received treatment. Conclusion: 2x4 fixed partial appliance was effective for the recovery of mixed dentition space, increasing the arch perimeter and depth through a distal movement of the upper molar and maintenance of incisor position.

Effect of vitamin D deficiency on postorthodontic relapse: An animal study.

This study aims to evaluate the effect of vitamin D deficiency (VDD) on orthodontic tooth movement (OTM), retention, and relapse and to assess the effect of systemic administration of vitamin D (VD) in a rat model. A total of 32 male Wistar rats were divided into two groups, a control group of 11 rats and an experimental group of 21 rats with VDD, after enhancement using a custom diet. Of the VDD group, 11 rats were supplemented with systemic vitamin D3 and categorized as vitamin (VD supplement [VDS]) groups. The VDS group received 40,000 IU/kg via intramuscular injection on Days 1 and 15 of the orthodontic treatment period. A modified orthodontic appliance was fitted to apply 0.5 N of force to move the maxillary right first molars mesially for 14 days, followed by retention and relapse periods for 7 days. Space created during OTM was measured and reassessed after the retention and relapse periods. The relapse ratio was estimated, and histomorphometric analysis was performed to assess the number of osteoblasts, osteoclast bone cells, and bone area. A significant increase in the relapse ratio and a reduction in osteoblast cells and bone area were observed in the VDD group. By contrast, the amount of tooth movement was significantly higher together with osteoblast cells and bone marrow in VDS with a significant reduction in relapse ratio. VDD was associated with a significant reduction in osteoblast cell count and total bone area in addition to a significant increase in relapse ratio. Routine screening of VD may be beneficial before commencing orthodontic treatment.

Effect of Mobile Phone with and without Earphones Usage on Nickel Ion Release from Fixed Orthodontic Appliance.

This study is an attempt to assess whether the usage of headphones could minimize the nickel ion release from fixed orthodontic appliance compared with hand-held mobile phones. The aim of the study is to validate the hypothesis whether there is a significant variation in nickel ion release from fixed orthodontic appliance among the patients using hand-held mobile phones and patients using mobile earphones. This is a cross-sectional study where a total of 60 healthy individuals who were undergoing fixed orthodontic treatment in the Department of Orthodontics and Dentofacial Orthopedics, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Chennai, India, and all these individuals were bonded and banded. All of them are class I malocclusion with bimaxillary protrusion. Salivary samples were collected in their regular checkup after two months and 7th, 14th, and 21st days salivary nickel level was evaluated based on their usage of mobile phones with earphones and without earphones. In this study, paired and independent t-tests were used. On basis of statistics results, the mean of nickel release in both male and female participants using mobile phones without earphones were significantly higher than the participants using mobile phone with earphones. By our study, we concluded that usage of mobile phones with earphones has a significant reduced effect on metal ion release from fixed orthodontic appliance when compared to usage of mobile phones without earphones.

Traumatic Ulcers in a Patient Using Fixed Orthodontic Appliances with Moderate Oral Hygiene

Traumatic Ulcers in a Patient Using Fixed Orthodontic Appliances with Moderate Oral Hygiene

Robust automated teeth identification from dental radiographs using deep learning

ObjectivesThis study developed and validated a deep learning-based method to automatically segment and number teeth in panoramic radiographs across primary, mixed, and permanent dentitions. MethodsA total of 6,046 panoramic radiographs were collected and annotated. The dataset encompassed primary, mixed and permanent dentitions and dental abnormalities such as tooth number anomalies, dental diseases, dental prostheses, and orthodontic appliances. A deep learning-based algorithm consisting of a U-Net-based region of interest extraction model, a Hybrid Task Cascade-based teeth segmentation and numbering model, and a post-processing procedure was trained on 4,232 images, validated on 605 images, and tested on 1,209 images. Precision, recall and Intersection-over-Union (IoU) were used to evaluate its performance. ResultsThe deep learning-based teeth identification algorithm achieved good performance on panoramic radiographs, with precision and recall for teeth segmentation and numbering exceeding 97%, and the IoU between predictions and ground truths reaching 92%. It generalized well across all three dentition stages and complex real-world cases. ConclusionsBy utilizing a two-stage training framework with a large-scale heterogeneous dataset, the automatic teeth identification algorithm achieved a performance level comparable to that of dental experts. Clinical SignificanceDeep learning can be leveraged to aid clinical interpretation of panoramic radiographs across primary, mixed, and permanent dentitions, even in the presence of real-world complexities. This robust teeth identification algorithm could contribute to the future development of more advanced, diagnosis- or treatment-oriented dental automation systems.

Rëndësia e higjienës së gojës tek pacientët me aparate ortodontike fikse

Orthodontic treatment is important in cases of aesthetic and functional problems and in the prevention of various complications related to malocclusion. In some cases, or- thodontic treatment is accompanied by side effects that the orthodontist must pay attention to prevent. The pur- pose of this research is to evaluate the condition of the gin- giva and periodontium in patients with fixed orthodontic appliances, before and after cleaning and sanitizing the mouth with ozone therapy for a period of 3 months. In a group of 45 patients with braces, aged 10-47 years, hy- giene and gingival problems were checked. The main cri- teria were the color of the marginal gingiva and the depth of the gingival pockets in the buccal sulcus. In a period of 3 months we treated them with cleanings and ozone ther- apy of the mouth, every three weeks and compared the results with those of the previous months. Tooth move- ment during orthodontic treatment promotes inflam- matory processes and gingivitis. Poor oral hygiene, foods and bacterial plaque easily adhere to braces. The bacteria present in this plaque cause gingival inflammation. Pa- tients in altered health conditions such as during pregnan- cy, diabetes, obesity are more prone to gum disease. Poor oral hygiene leads to food sticking and the creation of bacterial plaque around braces. Professional mouth cleanings and the use of ozone therapy help prevent these problems.

Antimicrobial activity of probiotic Streptococcus salivarius LAB813 on in vitro cariogenic biofilms

ObjectiveTo investigate the antimicrobial activity of a novel commensal strain of Streptococcus salivarius, LAB813, against Streptococcus mutans biofilms. MethodsThe inhibitory activity of LAB813 towards S. mutans was tested using mono-, dual-, and multi-species cariogenic biofilms formed on three types of orthodontic appliances (metal, ceramic, aligner). The activity of the commercially available probiotic, BLIS M18™ was used as control. ResultsLAB813 significantly inhibited S. mutans biofilms with cell killing approximating 99% for all materials. LAB813 showed effectiveness at inhibiting S. mutans in more complex multi-species biofilms with cell killing approximating 90% for all three materials. When comparing the killing kinetics of the probiotics, LAB813 had a faster rate of killing biofilms than M18. Experiments conducted with cell-free culture supernatant confirmed the presence of an inhibitory substance of proteinaceous nature. The addition of xylitol, a common sugar substitute used for human consumption, potentiated the inhibitory effects of LAB813 against S. mutans embedded in a more complex fungal-bacterial biofilm. ConclusionsLAB813 possesses strong antimicrobial activity, potent anti-biofilm properties, and enhanced antimicrobial activity in the presence of xylitol. The identification and characterization of strain LAB813 exhibiting antimicrobial activity towards S. mutans hold exciting promise for this novel strain to be developed as an oral probiotic for use in the prevention of dental caries.

Evaluation of the Remineralisation of the Demineralized Enamel Surrounding Orthodontic Brackets using the Nano Hydroxyapatite: An Original Study.

The orthodontic appliances have been known to accelerate enamel loss due to various reasons. Since there are few studies supporting the role of the nano-HAP in the mineralization of the demineralized tooth surfaces, the current study compared nano-HAP's capacity to remineralize the demineralized enamel layer surrounding braces at various concentration levels. This investigation involved 60 healthy permanent premolars that had just been excised. All specimens had 3M-Unitek brackets glued to their buccal surfaces. The samples were artificially demineralized and divided into three groups. The control group, Toothpaste ApaCare, and ApaCareTM varnish. Before and after remineralization, selected samples from each group were analyzed using a "Scanning Electron Microscope (SEM)" and evaluated using "Energy Dispersive X-Ray Analysis (EDAX)." Spectrometer and profilometer were used for the study of surface and the color. Statistics were used to analyze the outcomes. The threshold for significance was fixed at 0.05. After remineralization by nano-HAP, there was a significant rise (P < 0.001) in both calcium and phosphorus levels. This was picked up by EDAX, and SEM verified it. When compared to the control group, the nano-HAP application greatly improved the color measurements in the study groups (P < 0.001), and it also resulted in a significant decrease in surface roughness (P < 0.001). Our study's results showed that nano-HAP could be successful in restoring demineralized enamel around brackets, reducing the surface roughness and color of the enamel surface.