Silver Nanoparticle-Coated Orthodontic Brackets for Preventing Enamel Demineralization

Enamel demineralization is a common complication of fixed orthodontic treatment because dental plaque can accumulate around orthodontic brackets. Silver nanoparticles have demonstrated antimicrobial properties and may help reduce bacterial growth around brackets, potentially decreasing the risk of enamel demineralization.

This randomized split-mouth clinical trial aims to evaluate the effectiveness of silver nanoparticle-coated stainless steel orthodontic brackets in preventing enamel demineralization compared with conventional stainless steel brackets in participants undergoing fixed orthodontic treatment requiring premolar extractions.

Participants will receive both silver nanoparticle-coated and conventional brackets on contralateral premolars according to a randomized allocation. The split-mouth design allows each participant to serve as their own control, reducing the influence of individual differences in oral hygiene, diet, and saliva composition.

After one month of orthodontic treatment, premolars that were already planned for extraction as part of the participants' orthodontic treatment will be removed. Enamel adjacent to the brackets will be evaluated using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) to assess surface characteristics and mineral content. The findings will be used to compare the effectiveness of silver nanoparticle-coated and conventional brackets in reducing enamel demineralization during fixed orthodontic treatment.

• Silver Nanoparticle-Coated Stainless Steel Orthodontic Brackets (Device): Stainless steel orthodontic brackets coated with silver nanoparticles were bonded to randomly assigned premolars during fixed orthodontic treatment and remained in place for one month before the planned extraction of the premolars for enamel evaluation.
• Conventional Stainless Steel Orthodontic Brackets (Device): Conventional stainless steel orthodontic brackets were bonded to the contralateral premolars during fixed orthodontic treatment and remained in place for one month before the planned extraction of the premolars for enamel evaluation.

Primary outcomes

• Calcium-to-Phosphorus Ratio of Enamel Adjacent to Orthodontic Brackets [One month after bracket placement]: The calcium-to-phosphorus (Ca/P) ratio of enamel adjacent to silver nanoparticle-coated and conventional stainless steel orthodontic brackets will be measured using energy-dispersive X-ray spectroscopy (EDS). The mean Ca/P ratio will be compared between the two bracket types.

Secondary outcomes

• Enamel Surface Morphological Characteristics Adjacent to Orthodontic Brackets [One month after bracket placement]: Enamel surface morphology adjacent to silver nanoparticle-coated and conventional stainless steel orthodontic brackets will be evaluated using scanning electron microscopy (SEM). Representative SEM images will be analyzed descriptively to assess differences in enamel surface appearance between the two bracket types.

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Patients scheduled for fixed orthodontic treatment requiring premolar extraction
* No history of previous orthodontic treatment done
* Intact enamel surface of the premolars to be extracted

Exclusion Criteria:

* Non-extraction cases
* Patients with previously done orthodontic treatment
* Enamel surface defects on the premolars to be extracted(caries, hypoplasia, cracks etc.)

• Jeny M George, MDS, Principal investigator, Ajman University