It is suggested that nanosilver coated orthodontic brackets, as an antibacterial agent without patient compliance, could be helpful for the prevention of white spot lesions during fixed orthodontic treatment.

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BackgroundNanosilver particles of which antibacterial and antifungal properties have been shown in various in vitro and in vivo studies are used in many medical and dental fields for the prevention of infection. In this study, it is intended to evaluate the biocompatibility of nanosilver-coated brackets.MethodsNanosilver coating process was applied to the standard orthodontic brackets by a physical vapor deposition system. Brackets were coated with nanosilver particles of 1 μ thickness. A total of 12 Wistar Albino rats were included in the study (six) and control (six) groups. For the study and control groups, four nanosilver-coated and four standard brackets were aseptically implanted subcutaneously in the dorsal region of each rat. The brackets were removed with the surrounding tissues on days 7, 14, 30, and 60. The specimens were evaluated for inflammatory response.ResultsNo significant difference was found in terms of tissue reaction between the study and control groups. On day 7, randomly distributed brown-black granules were seen in the granulation tissue adjacent to the bracket in the study group. These foreign particles continued along the bracket cavity in a few samples, but the inflammatory response was insignificant between the groups. Mast cell count was found to be significantly smaller only on day 7 in the study group than in the control group.ConclusionsNanosilver-coated orthodontic brackets were found to be similar with the standard type concerning inflammation. Further researches are needed with regard to the assessment of the brown-black granules, especially on the deposition of the vessel walls.

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Orthodontic treatment is the main treatment procedure to achieve a well-aligned dental arch and an esthetic smile. For this purpose, various types of removable or fixed orthodontic appliances are designed. However, each has their specific disadvantages. The most important one is that orthodontic appliances especially the brackets and the ligation mode create new retention areas in addition to blocking plaque-removing shear forces arising from fluid flow and masticatory loads with a resultant undesired effect of accumulation of dental plaque. Increased amount of dental plaque containing cariogenic bacteria is the main etiologic factor in decalcification of enamel during orthodontic treatment. This demineralization of the tooth surfaces results in appearance of white spots or even caries. However, in the literature, there are conflicting results in the relationship between orthodontic treatment and development of dental caries. Many preventive methods such as topical fluoride application, using bonding materials releasing fluoride, using mouth rinse with sodium fluoride, applying chlorhexidine, and so on were defined. The general comment of the authors is that supplying an adequate oral hygiene has the main role in prevention of demineralization-caries during orthodontic treatment. In the light of the previous studies' results, it can be concluded that professional application like a varnish can be provided for patients who have high caries incidence.