Preparation and antimicrobial assay of ceramic brackets coated with TiO2 thin films

Comprehensive evaluation of the antibacterial and antibiofilm activities of NiTi orthodontic wires coated with silver nanoparticles and nanocomposites: an in vitro study

BACKGROUND

Fixed orthodontic appliances act as a niche for microbial growth and colonization. Coating orthodontic wires with antimicrobial silver nanoparticles (AgNPs) and nanocomposite was adopted in this study to augment the biological activity of these wires by increasing their antibacterial and antibiofilm properties and inhibiting bacterial infections that cause white spot lesions and lead to periodontal disease.

METHODS

Three concentrations of biologically synthesized AgNPs were used for coating NiTi wires. The shape, size, and charge of the AgNPs were determined. Six groups of 0.016 × 0.022-inch NiTi orthodontic wires, each with six wires, were used; and coated with AgNPs and nanocomposites. The antimicrobial and antibiofilm activities of these coated wires were tested against normal flora and multidrug-resistant bacteria (Gram-positive and Gram-negative bacterial isolates). The surface topography, roughness, elemental percentile, and ion release were characterized.

RESULTS

AgNPs and nanocomposite coated NiTi wires showed significant antimicrobial and antibiofilm activities. The chitosan-silver nanocomposite (CS-Ag) coated wires had the greatest bacterial growth inhibition against both Gram-positive and Gram-negative bacteria. The surface roughness of the coated wires was significantly reduced, impacting the surface topography and with recorded low Ni and Ag ion release rates.

CONCLUSIONS

NiTi orthodontic wires coated with AgNPs, and nanocomposites have shown increased antimicrobial and antibiofilm activities, with decreased surface roughness, friction resistance and limited- metal ion release.

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.

Effects of titanium oxide coating on the antimicrobial properties, surface characteristics, and cytotoxicity of orthodontic brackets - A systematic review and meta analysis of in-vitro studies

Objective

The objective of this review is to systematically analyze the available literature on the effects of titanium oxide (TiO₂) coating on the antimicrobial properties, surface characteristics, and cytotoxicity of orthodontic brackets.

Methods

In-vitro studies reporting on the effects of Titanium oxide (TiO₂) coatings on antimicrobial properties, surface roughness, cytotoxic activity and bacterial adhesion of orthodontic brackets were included in the review. Electronic databases such as PubMed, SCOPUS, Web of Science and Google Scholar, were searched till September 2022. Risk of Bias was analyzed by using RoBDEMAT tool. Meta-analysis using Random Effects Model was performed for assessing the antimicrobial activity against S. mutans, C. albicans and L. Acidophilus.

Results

A total of 11 studies were included the RoB analysis revealed sufficient reporting across all the domains and inconsistent reporting in only two of the domains. On qualitative analysis, a significant antimicrobial effect of TiO2 coating on orthodontic brackets against Streptococcus mutans, Candida albicans and Lactobacillus acidophilus was reported. The meta analysis revealed a significant overall antimicrobial effect with a high heterogeneity. (SMD: 3.5; p < 0.00001; i2 - 99.2%).

Conclusion

An overall significant antimicrobial effect of TiO₂ coated brackets against S. mutans, L. Acidophilus, C. Albicans was noted but with a high heterogeneity. The subgroup analysis revealed a significant antimicrobial effect on C albicans with a low heterogeneity but it was limited by a publication bias. The included studies reported reduced surface roughness, minimal bacterial adhesion and less cytotoxic activity with TiO₂ coated brackets than uncoated brackets.

Evaluation of antimicrobial potential and surface morphology in thin films of titanium nitride and calcium phosphate on orthodontic brackets

INTRODUCTION

The goal of this research was to experimentally evaluate the surface morphology and adhesion capacity of Streptococcus mutans (U159) on brackets with thin films of titanium nitride (TN) and of titanium nitride doped with calcium phosphate (TNCP).

METHODS

Twenty-four metallic brackets were equally allocated to 3 groups (n = 8), according to the type of covering (no covering, TNCP, and TN). The coatings were deposited by cathodic cage (TNCP and TN groups) and were evaluated by scanning electron microscopy and energy dispersive x-ray spectrometry. The biofilm formation of S. mutans on the surface of brackets was determined by crystal violet assay and subsequent optical density quantification.

RESULTS

There was homogeneity on the surface morphology of the tie wing area in all groups, whereas the TNCP group has presented particles in the slot. After 24 hours, a biofilm of S. mutans was formed in all the observed groups. The optical density obtained in all 3 groups was similar (no covering, 0.347 ± 0.042; TNCP, 0.238 ± 0.055; TN, 0.226 ± 0.057), with no statistically relevant difference (P = 0.06).

CONCLUSIONS

The thin film of TNCP has altered the surface of the bracket's slot, whereas the coatings of TN and TNCP have not altered the superficial morphology of the tie wings. The presence of coatings have not influenced the formation of the S. mutans biofilm on the surface of metallic brackets.

Advances of nanomaterial applications in oral and maxillofacial tissue regeneration and disease treatment

Using bioactive nanomaterials in clinical treatment has been widely aroused. Nanomaterials provide substantial improvements in the prevention and treatment of oral and maxillofacial diseases. This review aims to discuss new progresses in nanomaterials applied to oral and maxillofacial tissue regeneration and disease treatment, focusing on the use of nanomaterials in improving the quality of oral and maxillofacial healthcare, and discuss the perspectives of research in this arena. Details are provided on the tissue regeneration, wound healing, angiogenesis, remineralization, antitumor, and antibacterial regulation properties of nanomaterials including polymers, micelles, dendrimers, liposomes, nanocapsules, nanoparticles and nanostructured scaffolds, etc. Clinical applications of nanomaterials as nanocomposites, dental implants, mouthwashes, biomimetic dental materials, and factors that may interact with nanomaterials behaviors and bioactivities in oral cavity are addressed as well. In the last section, the clinical safety concerns of their usage as dental materials are updated, and the key knowledge gaps for future research with some recommendation are discussed. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement.

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.

Polymeric and inorganic nanoscopical antimicrobial fillers in dentistry

Failure of dental treatments is mainly due to the biofilm accumulated on the dental materials. Many investigations have been conducted on the advancements of antimicrobial dental materials. Polymeric and inorganic nanoscopical agents are capable of inhibiting microorganism proliferation. Applying them as fillers in dental materials can achieve enhanced microbicidal ability. The present review provides a broad overview on the state-of-the-art research in the field of antimicrobial fillers which have been adopted for incorporation into dental materials over the last 5 years. The antibacterial agents and applications are described, with the aim of providing information for future investigations. STATEMENT OF SIGNIFICANCE: Microbial infection is the primary cause of dental treatment failure. The present review provides an overview on the state-of-art in the field of antimicrobial nanoscopical or polymeric fillers that have been applied in dental materials. Trends in the biotechnological development of these antimicrobial fillers over the last 5 years are reviewed to provide a backdrop for further advancement in this field of research.

Mesoporous Titanium Dioxide: Synthesis and Applications in Photocatalysis, Energy and Biology

Mesoporous materials are materials with high surface area and intrinsic porosity, and therefore have attracted great research interest due to these unique structures. Mesoporous titanium dioxide (TiO₂) is one of the most widely studied mesoporous materials given its special characters and enormous applications. In this article, we highlight the significant work on mesoporous TiO₂ including syntheses and applications, particularly in the field of photocatalysis, energy and biology. Different synthesis methods of mesoporous TiO₂-including sol⁻gel, hydrothermal, solvothermal method, and other template methods-are covered and compared. The applications in photocatalysis, new energy batteries and in biological fields are demonstrated. New research directions and significant challenges of mesoporous TiO₂ are also discussed.

Long-term antimicrobial assessment of orthodontic brackets coated with nitrogen-doped titanium dioxide against Streptococcus mutans

Background

The antimicrobial properties of orthodontic wire and brackets with nitrogen-doped titanium dioxide (N-doped TiO2) coating have been studied in the past. However, the evaluation period had been short and limited to 30 days. The aim of the present study was to extend the evaluation period (up to 90 days) of assessing the long-term antimicrobial effects of stainless steel orthodontic brackets coated with nitrogen-doped titanium dioxide (N-doped TiO2).

Methods

A total of 40 stainless steel pre-adjusted premolar brackets were equally divided into two groups; namely the control group (n=20, uncoated brackets) and the experimental group (n=20, coated brackets). RF magnetron sputtering was used to apply a thin film of TiO2 on the bracket surface. The crystalline structure of the thin film was assessed using X-ray diffraction. The antimicrobial property of the brackets against Streptococcus mutans (S. mutans) was evaluated using the survival rate by colony-forming units (CFU) at four intervals: 24 hours (T0), 30 days (T1), 60 days (T2), and 90 days (T3). 2-way ANOVA Repeated Measures was used to compare the effects between the groups over the time.

Results

There was no significant interaction between group and time (p = 0.568). The orthodontic brackets coated with the N-doped TiO2 thin film showed a significant CFU reduction (37.71 ± 5.21, 37.81 ± 5.03, 37.98 ± 5.37, and 37.74 ± 5.21 at T0, T1, T2, and T3, respectively) compared to the uncoated brackets (400.91 ± 14.67, 401.58 ± 14.01, 400.31 ± 14.68, and 402.04 ± 13.98 at T0, T1, T2, and T3, respectively) through visible light (p < 0.001).

Conclusion

N-doped TiO2 coated orthodontic brackets showed strong antimicrobial property against S. mutans over a period of 90 days, which is effective in preventing enamel decalcification during orthodontic therapy.

Surface Hydrophilicity and Antifungal Properties of TiO2 Films Coated on a Co-Cr Substrate

The purpose of this study was to deposit a thin layer of TiO₂ on a Co-Cr substrate, serving as a deactivation film protecting the metallic fitting surface. The crystalline structure and surface morphology of the film were characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). A scratch tester was used to examine the adhesion strength between the TiO₂ film and the Co-Cr substrate. The water contact angles and antifungal efficacy against C. albicans of the TiO₂-deposited Co-Cr samples were investigated and further compared with those of uncoated Co-Cr substrates. The results indicated that a pure anatase microstructure and dense and smooth surface texture as well as strong binding to the underlying metallic surface were obtained. The originally hydrophobic Co-Cr alloy surface turned hydrophilic after TiO₂ film coating. Most importantly, the TiO₂-coated surface showed a superior antifungal capability under UV-irradiation compared to those without TiO₂ coating. This work contains meaningful results for the development of a new metallic framework coating with improved hydrophilicity and antifungal properties.