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In vitro evaluation of a novel fluoride-coated clear aligner with antibacterial and enamel remineralization abilities

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Abstract

Objective

To investigate the antibacterial and enamel remineralization performances as well as physicochemical properties and biocompatibility of a fluoride-coated clear aligner plastic (FCAP).

Materials and methods

FCAP and normal clear aligner plastic (CAP) was bought from the manufacturer (Angelalign Technology Inc, China). The FCAP was observed under scanning electron microscopy. Its element composition, resistance to separation, contact angle, and protein adhesion performance were characterized. Colony-forming unit (CFU) count and 3-(4,5)-dimethylthiazol(-z-y1)-3,5-diphenyltetrazolium bromide (MTT) assay were used to evaluate the antibacterial ability of Streptococcus mutans. Fluoride release-recharge patterns were obtained. Apatite formation was evaluated after immersing FCAP in artificial saliva. Enamel remineralization capability was evaluated in the demineralization model (immersing samples in demineralization solution for 36 h) and pH cycling model (immersing samples in demineralization solution and remineralization solution in turns for 14 days). Cell Counting Kit-8 (CCK-8) and live/dead cell staining kits were used for cytotoxicity assay.

Results

The FCAP showed uniformly distributed fluoride and did not compromise protein adhesion performance. CFU count (5.47 ± 0.55 for CAP, 3.63 ± 0.38 for FCAP) and MTT assay (0.41 ± 0.025 for CAP, 0.28 ± 0.038) indicated that the FCAP had stronger antibacterial activity compared with normal CAP (P < 0.05 for both evaluations). The FCAP could release fluoride continuously for 14 days and could be recharged after immersing in NaF solution. The FCAP could induce the formation of hydroxyapatite in artificial saliva and could reduce the microhardness decrease, color change, and mineral loss of enamels in both two models (P < 0.05 for all evaluations). CCK-8 and live/dead cell staining analyses showed that the coating did not compromise the biocompatibility of the clear aligner (P > 0.05 for CCK-8 evaluation).

Conclusions

The FCAP had antibacterial, fluoride recharge, and enamel remineralization abilities while it did not compromise physicochemical properties and biocompatibility.

Clinical relevance

The FCAP has the potential to prevent enamel demineralization during clear aligner treatment.

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Data Availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Funding

This work was supported by the National Natural Science Foundation of China (No. 81901044), and the Chinese Stomatological Association COS Basic Research Fund (No. COS-B2021-08).

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Authors and Affiliations

  1. State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China

    Jiarong Yan, Lingyun Cao, Ting Luo, Danchen Qin, Fang Hua & Hong He

  2. Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China

    Jiarong Yan, Lingyun Cao, Ting Luo, Danchen Qin & Hong He

  3. Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology , Wuhan University, Wuhan, China

    Fang Hua

  4. Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

    Fang Hua

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  1. Jiarong Yan
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  2. Lingyun Cao
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  3. Ting Luo
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  5. Fang Hua
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Contributions

Yan Jiarong: conceptualization, methodology, formal analysis and writing — original draft; Cao Lingyun: visualization, resources; Luo Ting: visualization, investigation; Qin Danchen: visualization, investigation; Hua Fang: supervision, conceptualization, writing — review and editing; He Hong: supervision, conceptualization, writing — review and editing.

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Correspondence to Fang Hua or Hong He.

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Yan, J., Cao, L., Luo, T. et al. In vitro evaluation of a novel fluoride-coated clear aligner with antibacterial and enamel remineralization abilities. Clin Oral Invest 27, 6027–6042 (2023). https://doi.org/10.1007/s00784-023-05216-7

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