Orthodontic brackets often leave white stains on teeth as a result of enamel demineralization caused by bacterial proliferation in the adhesive area, especially when accompanied by poor oral hygiene.
Researchers from Valencia (Spain), London (England) and Sul (Brazil) have performed research to develop adhesive materials that will prevent white stains from appearing on the teeth of individuals who use brackets.
Professors Salvatore Sauro and Santiago Arias at the Odontology Department of Valencia’s Universidad CEU Cardenal Herrera, in collaboration with the King’s College London Dental Institute and the Universidade Federaldo Rio Grande do Sul (Brazil), have compared the efficacy of three new types of experimental adhesives with bactericidal and enamel remineralisation properties which could prevent the appearance of these white stains around the brackets. This research has been published in the Journal of Dentistry scientific magazine, one of the most prestigious in the field on an international level.
Bactericidal and remineralisation properties
The study compares three experimental dental adhesives which contain a bioactive nano-mineral called halloysite and whose nanotubes have been loaded with triclosan, a strong antibacterial and fungicidal agent in different concentrations: 5, 10 and 20 per cent. The research compares the three new, experimental biomaterials’ polymerisation properties, their antibacterial strength and bioactive properties, which not only prevent demineralization of the teeth, but also promote remineralisation.
The three experimental materials tested in the laboratory have demonstrated an ability to stop bacterial proliferation in the 24 hours following their use, but only the one with the highest concentration of triclosan, at 20 per cent, has maintained this property after 72 hours. As far as the remineralising effect, all three tested materials have proven to be effective two weeks after their use in dental enamel samples submerged in experimental saliva.
One of the most undesirable side effects of comprehensive orthodontic treatment is white spot lesions (WSLs). Despite many attempts at prevention of WSLs, its prevalence remains very high on debonding. There are many agents like fluoride toothpastes, fluoride varnishes, and fluoride mouth rinses, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is frequently used for the remineralization of WSLs. However, there is no consensus in the literature with respect to the success rates of these agents (Singh et al, 2016).
Growth in orthodontics market
Last year, the orthodontics market saw $11 billion in revenue, according to market research company IBISWorld.
Dental ceramics has advanced in the past few years in terms of its mechanical properties and methods of fabrication of ceramic materials. Moreover, there has been development in terms of the bonding technique which has increased the range and scope for use of ceramics in dentistry. The porcelain-based materials are used as a major component in the market and market players are bringing in materials to replace the metal ceramics systems with all ceramic systems. The market for dental ceramics is driven by the increasing research to replace the metal ceramics with metal free ceramics. Moreover, the aesthetic appeal of offered by dental ceramics as compared to metal ceramics is also driving the market. Metal ceramics systems has both advantage of aesthetic appeal and extraordinary mechanical properties of metals. But some of the restorative materials used as constitute a problem for some patients. However, problems constitutes of gum staining and release of metallic ions into the gingival tissue and the gingival fluid. These drawbacks, as well as the search for more esthetic materials by patients and dentists, have stimulated research and development of metal-free ceramic systems.
Nanoparticles to develop next-generation invisible orthodontic braces
Researchers are using nanoparticles to develop next-generation invisible orthodontics. For instance, researchers in the Universidad Carlos III de Madrid, Spain, have developed nanoparticles for developing invisible orthodontic braces. These particles help to increase the mechanical and friction resistance and to maintain the transparency of the invisible orthodontic braces.
Similarly, in November 2012, Euro Ortodoncia, a Spain-based orthodontic materials manufacturer, collaborated with the researchers at the University to develop nanotechnology-based invisible orthodontic braces that can help to reduce the friction between the teeth and braces and provide additional comfort to the people using them.
These results of the most recent Spanish study are a promising step forward in the development of new adhesives that are capable of preventing the appearance of the bacteria that demineralise the enamel surrounding the brackets and, at the same time, remineralise the area and thus prevent the appearance of white stains on the teeth.
Singh S et al (2016) Effects of various remineralizing agents on the outcome of post-orthodontic white spot lesions (WSLs): a clinical trial.