Gold-oxoborate nanocomposite-coated orthodontic brackets gain antibacterial properties while remaining safe for eukaryotic cells.

The study's main objective is to limit bacterial biofilm formation on fixed orthodontic appliances. Bacterial biofilm formation on such devices (e.g., brackets) causes enamel demineralization, referred to as white spot lesions (WSL). WSL is significant health, social and economic problem. We provide a nanotechnology-based solution utilizing a nanocomposite of gold nanoparticles embedded in a polyoxoborate matrix (BOA: B-boron, O-oxygen, A-gold, Latin aurum). The nanocomposite is fully inorganic, and the coating protocol is straightforward, effective, and ecologically friendly (low waste and water-based). Prepared coatings are mechanically stable against brushing with a toothbrush (up to 100 min of brushing). Bacteria adhesion and antibacterial properties are tested against Streptococcus mutans-common bacteria in the oral cavity. BOA reduces the adhesion of bacteria by around 78%, that is, from around 7.99 × 105  ± 1.33 × 105  CFU per bracket to 1.69 × 105  ± 3.07 × 104  CFU per bracket of S. mutans detached from unmodified and modified brackets, respectively. Modified fixed orthodontic brackets remain safe for eukaryotic cells and meet ISO 10993-5:2009 requirements for medical devices. The gathered data show that BOA deposited on orthodontic appliances provides a viable preventive measure against bacteria colonization, which presents frequent and significant complications of orthodontic treatment.

Influence of antibiotic prophylaxis on the stability of orthodontic microimplants: A pilot randomized controlled trial.

INTRODUCTION: The aims of this 2-arm parallel pilot randomized controlled trial were to investigate the influence of antibiotic prophylaxis on the stability of orthodontic microimplants and to evaluate the efficacy of systemic inflammatory marker measurements in detecting infections in tissues surrounding microscrews. METHODS: Orthodontic patients requiring en-masse distalization in the maxilla received antibiotics or a placebo before microimplant placement. Eligibility criteria included 13 years of age, and good general and oral health. Exclusion criteria comprised allergy to antibiotics, severe systemic allergy, heart and kidney diseases, and recent antibiotic treatment. Stability of the microimplants was the primary outcome; inflammation of the tissues surrounding the microscrews, pain related to the microimplantation, and serum levels of inflammatory markers were the secondary outcomes. Randomization in a 1:1 ratio was performed by auxilliary staff via a flip of a coin between 2 participants of the same sex and developmental stage, and the "winner" was allocated to the intervention group. Pharmaceutically prepared identical capsules with either amoxicillin (intervention) or glucose (control) given 1 hour before microimplant placement according to the allocation provided blinding of the participants. Subsequently, 1 clinician unaware of the allocation inserted the microimplants and assessed the outcomes, which simultaneously blinded the operator-assessor. Blood samples for laboratory analysis of inflammatory markers were collected a day before and 1, 3, and 7 days postoperatively. RESULTS: Out of 80 participants initially assessed for eligibility, 41 received the randomized allocation. Three patients were lost to follow-up. Eventually, data of 18 and 20 participants (mean age, 20.4 ± 5.9 years) were available for analysis in the intervention and control groups, in which 1 and 2 patients lost a microimplant, respectively, resulting in odds ratio of 0.53 (95% confidence interval [CI], 0.0084-11.23; P = 1.0). The odds ratio for inflammation development was 1.22 (95% CI, 0.34-4.38), and the odds ratio for feeling milder pain was 1.174 (95% CI, 0.350-3.941) in the intervention compared with the control group, but the result was not statistically significant (P = 0.758; P = 0.795, respectively). The inflammatory marker levels did not increase due to either microimplantation (procalcitonin, P = 0.445; C-reactive protein, P = 0.4) or peri-implantitis. Antibiotic prophylaxis slightly decreased the levels of the biomarkers in the intervention group; however, the results were not statistically significant (P = 0.68; P = 0.908, respectively). No harms caused by the microimplantation procedure or drug intake were noted. CONCLUSIONS: Antibiotics provided no benefit in terms of microimplant stability, inflammation of soft tissues, or postoperative pain in our pilot sample. Measurements of serum levels of inflammatory markers were inefficient in detecting soft tissue inflammations. These initial results should be interpreted with caution until validated by a large multicenter definitive trial. REGISTRATION: This trial was not registered. PROTOCOL: The protocol was not published before trial commencement. FUNDING: The trial was funded by Wroclaw Medical University; grant number pbmn91 and supported by Diagnostyka.

Objectively measured compliance during early orthodontic treatment: Do treatment needs have an impact?

BACKGROUND: Objective assessment of daily wear time of removable appliances is possible, so the next step is to ascertain whether the severity of malocclusion influences patients' compliance. This could help resolve the controversy over the question of whether removable appliance therapy truly works. OBJECTIVES: The aim of the study was to investigate whether the patient's orthodontic treatment needs affect the cooperation between the patient and the doctor, and to find a correlation that could affect recommendations for orthodontic treatment. MATERIAL AND METHODS: The study involved 58 patients (29 boys, 29 girls) aged 9-12 years, who qualified for treatment with removable appliances equipped with a sensor system. The patients were divided into four groups according to their Index of Orthodontic Treatment Need dental health component scores. Over a 9-month period, data stored in the sensors were compared with the recommended daily wear time (DWT) of the appliances, and a statistical analysis was conducted. RESULTS: DWT differed considerably in all the groups. Statistically significant differences in the mean DWT values occurred only when extreme values of the IOTN DHC were compared. CONCLUSIONS: The degree of patient compliance depends to a small extent on the severity of malocclusion. Patients with mild malocclusion will probably be less likely to cooperate. Among patients with severe malocclusion, compliance may be unpredictable. Patient compliance is an important background factor that can explain a lot of the controversy over the effectiveness of treatment with removable appliances.

Effectiveness of orthodontic miniscrew implants in anchorage reinforcement during en-masse retraction: A systematic review and meta-analysis.

INTRODUCTION: The aim of this systematic review was to compare the effectiveness of orthodontic miniscrew implants-temporary intraoral skeletal anchorage devices (TISADs)-in anchorage reinforcement during en-masse retraction in relation to conventional methods of anchorage. METHODS: A search of PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science was performed. The keywords were orthodontic, mini-implants, miniscrews, miniplates, and temporary anchorage device. Relevant articles were assessed for quality according to Cochrane guidelines and the data extracted for statistical analysis. A meta-analysis of raw mean differences concerning anchorage loss, tipping of molars, retraction of incisors, tipping of incisors, and treatment duration was carried out. RESULTS: Initially, we retrieved 10,038 articles. The selection process finally resulted in 14 articles including 616 patients (451 female, 165 male) for detailed analysis. Quality of the included studies was assessed as moderate. Meta-analysis showed that use of TISADs facilitates better anchorage reinforcement compared with conventional methods. On average, TISADs enabled 1.86 mm more anchorage preservation than did conventional methods (P <0.001). CONCLUSIONS: The results of the meta-analysis showed that TISADs are more effective than conventional methods of anchorage reinforcement. The average difference of 2 mm seems not only statistically but also clinically significant. However, the results should be interpreted with caution because of the moderate quality of the included studies. More high-quality studies on this issue are necessary to enable drawing more reliable conclusions.