White spot lesions (WSLs), a side effect of orthodontic treatment, can result in reversible and unaesthetic results. Graphene oxide (GO) with a bioactive glass (BAG) mixture (BAG@GO) was added to Low-Viscosity Transbond XT (LV) in a ratio of 1, 3, and 5%. The composite’s characterization and its physical and biological properties were verified with scanning electron microscopy (SEM) and X-ray diffraction (XRD); its microhardness, shear bond strength (SBS), cell viability, and adhesive remnant index (ARI) were also assessed. Efficiency in reducing WSL was evaluated using antibacterial activity of S. mutans. Anti-demineralization was analyzed using a cycle of the acid-base solution. Adhesives with 3 wt.% or 5 wt.% of BAG@GO showed significant increase in microhardness compared with LV. The sample and LV groups showed no significant differences in SBS or ARI. The cell viability test confirmed that none of the sample groups showed higher toxicity compared to the LV group. Antibacterial activity was higher in the 48-h group than in the 24 h group; the 48 h test showed that BAG@GO had a high antibacterial effect, which was more pronounced in 5 wt.% of BAG@GO. Anti-demineralization effect was higher in the BAG@GO-group than in the LV-group; the higher the BAG@GO concentration, the higher the anti-demineralization effect.

White spot lesions (WSL) that occur on teeth after orthodontic appliances have been attached are caused by bacterial demineralization of the enamel surface. This study investigated the anti-demineralization effect of orthodontic resins containing mesoporous bioactive glass nanoparticles (MBN) doped with gallium, which has antibacterial activity, as well as MBN with increased calcium and phosphate contents as these ions can remineralize enamel. Resins (CF, CharmFill Flow, Dentkist, Seoul, South Korea) containing 1%, 3%, and 5% Ga-doped MBN (GaMBN) were characterized using scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX), X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and isothermal tests, and their physical properties were measured in terms of Vickers microhardness, bracket retention force, and adhesive remnant index (ARI). Cell viability in the resins was confirmed by testing human dental pulp stem cells (hDPSCs), and ion release tests were performed after 1, 7, and 14 days to determine whether the resins released Ga3+, Ca2+, and PO43–. After 14 days, antibacterial activity was determined using Streptococcus mutans (S. mutans)—the bacteria that causes tooth decay—and the chemical remineralization effect was investigated using a cycle of acid–base solutions. The microhardness of the resins increased with GaMBN concentration whereas their bracket retention force, ARI, and cell viability remained unchanged. The bacterial activity of the 5%-GaMBN resin decreased after 24 and 48 h; however, the change in activity was not statistically significant. Anti-demineralization testing demonstrated that the degree of enamel demineralization decreased as the GaMBN concentration increased, which indicates that resins containing 5%-GaMBN may be viable orthodontic adhesives for preventing WSLs.

Orthodontic treatment involving the bonding of fixed appliances to tooth surfaces can cause white spot lesions (WSLs). WSLs increase the likelihood of cavity formation and hence require preservation and prosthetic restoration. Therefore, the prevention of WSLs is of greater importance than treatment. Application of fluoride or the use of fluoride-containing mouthwash can prevent WSLs, but this requires patient cooperation and additional time and cost. Bioactive glass containing 2.5% fluoride was synthesized and mixed with the orthodontic bonding adhesive Transbond XT Low Flow (LV) at ratios of 1, 3, and 5% to prepare orthodontic adhesive samples. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) were used to characterize the samples. The Vickers hardness test, bracket retention test, and adhesive remnant index (ARI) of the samples were analysed to determine their mechanical properties. To determine the biological cytotoxicity, the cell activity of the samples was evaluated using cell viability tests and the antibacterial activity was analysed using Streptococcus mutans. To evaluate the anti-demineralization effect, the sample was bonded to extracted teeth and a pH cycle test was performed. Micro computed tomography data were obtained from the bonded teeth and sample, and the anti-demineralization effect was evaluated using the ImageJ software program. The Vickers hardness of the sample was higher than that of LV and was dependent on the concentration of fluoride-containing bioactive glass (FBAG). The bracket retention test and ARI of the sample showed no significant differences from those of LV. The cell viability test showed no significant changes at 24 and 48 h after application of the sample. The fluoride ion release test indicated an ion release rate of 9.5–17.4 μg/cm2. The antibacterial activity of the experimental group containing FBAG was significantly higher than that of the LV group. The anti-demineralization test showed a concentration-dependent increase. However, the resin containing 5 mass% FBAG (FBAG5) showed a statistically-significant increase compared with LV. The orthodontic adhesive containing FBAG showed antibacterial and anti-demineralization effects, thus indicating possible WSL prevention activity.

All orthodontic appliances are potentially cariogenic. The plaque around the orthodontic appliance can make demineralization on tooth surface causing white spot lesion (WSL). The most effective method to prevent WSL is Fluoride appliance and gargling, but this requires patient cooperation, which consumes additional treatment time and cost. As suggested in this study, biomaterials like bioactive glass and fluorinated graphite (FGt) having antibacterial and anti-demineralization ability effective and easy to use in the clinic. To clinically use orthodontic bonding resins containing Graphite Fluoride BAG (FGtBAG), its properties, biological stability, antimicrobial activity, and remineralization effect must be verified. BAG was mixed with 2.5% FGt containing 51 to 61% fluorine. This mixture was mixed with the CharmFill Flow (CF) in the ratios of 1, 3, and 5 wt%. Microhardness and shear bond strength tests were performed to evaluate its mechanical properties. MTT (3-(4, 5-dimethyl thiazol-2-yl)-2, 5-diphenyl tetra) assay was performed for evaluating its safety. Streptococcus mutans, which is major cariogen by producing lactic acid, was evaluated for antibacterial ability of reducing WSL. In addition, x-ray images were obtained by CBCT (Cone beam computed tomography) after a pH cycle. The remineralization effect was verified in vivo and by Image J. FGtBAG did not differ significantly from CF in mechanical tests. The MTT assay found no significant differences between the groups. The antibacterial activity of FGtBAG at 24 h and 48 h was significantly higher than that of CF. The fluoride release rate tended to increase with the FGtBAG content. The pH cycle results showed that FGtBAG had higher concentration-dependent remineralization effect than CF. The results of this study suggests that orthodontic resins containing FGtBAG can prevent WSL owing to their antibacterial activity and remineralization effect.

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