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.

[Parathyroid hypofunction after total thyroidectomy for differentiated thyroid carcinoma--perspectives after long term observation and treatment]

Hypoparathyroidism remains a serious complication of total thyroidectomy for differentiated thyroid carcinoma (DTC). In Brachytherapy Department 952 patients affected with DTC were followed up in the years 1996-2000. Radical total thyroidectomy was performed in 235 (24.6%) of cases, while the other 717 patients underwent complete rethyroidectomy. The incidence of hypoparathyroidism following radical operation and after complete rethyroidectomy was 15.74% and 23.43%, respectively. In patients operated in our institution, blood for calcium was analyzed daily for five days following the surgery. If calcium level was normal the next measurement was performed 4-5 weeks thereafter. Hypoparathyroidism was diagnosed later in postoperative period in many patients operated elsewhere. Asymptomatic hypocalcemia during the first week after the operation requires oral administration of calcium. If hypocalcemia requiring intravenous calcium supplementation does not resolve in a few days, vitamin 1(OH)D3 is introduced. Vitamin 1(OH)D3 and calcium carbonate play the main role in management of persistent hypocalcemia. In case of marked hypercalciuria thiazid diuretics are instituted. Low-phosphate diet is recommended. The aim of treatment of hypoparathyroidism is to restore normal serum calcium level with calciuria not exceeding 5 mg/kg/24 h, so to avoid hypocalcemic complications as well as vitamin D intoxication.