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Evaluation of Nano TiO2 Modified Orthodontic Composite Effects on S. mutans Population and Enamel Demineralization in Fixed Orthodontic Patients; a Split Mouth Randomized Controlled Clinical Trial

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Abstract

The high incidence of demineralization around orthodontic brackets has led to the development of preventive measures. Incorporation of antibacterial or remineralizing agents into orthodontic adhesives is an attractive method. This single-center, split-mouth, randomized controlled clinical trial was conducted to assess the effect of a modified composite containing TiO2 nanoparticles on the Streptococcus mutans population and to prevent demineralization around orthodontic brackets. Each participant was assigned a random sequence (AB or BA). During the bonding session, the control lateral incisor was bonded with a conventional composite and the contralateral incisor was bonded with a composite containing nano TiO2 particles (1%weight). The eligibility criteria included the presence of S. mutans in the dental plaque and absence of active caries, fractures or cracks. The S. mutans count in the dental plaque immediately around the brackets was evaluated at baseline and 1, 3, and 6 months after bonding. The specificity of the colonies was determined by PCR. The DIAGNOdent score was assessed at baseline and re-assessed every month up to the sixth month. Salivary samples were collected at T0, T1, and T3 to assess the amount of Ti released from the composite. The cytotoxicity of the modified composites was evaluated using an MTT assay. Participants, examiners, and data analyzers were blinded to the test and intervention groups. Forty-two patients ranging from 12 to 25 years were enrolled in this study. The amount of Ti released into saliva was insignificant and far below the toxic level. There was no significant difference between the S. mutans counts of the studied tooth S. mutans counts at any time point evaluated. DIAGNOdent scores on both sides increased significantly after the first month. However, this increase was higher on the test side (p < 0.001), and a significant difference of 2.6 scores remained throughout the study period. No severe adverse events were observed. Orthodontic composites containing TiO2 nanoparticles may prevent demineralization induced around brackets during orthodontic treatment. However, the antibacterial effects were not statistically significant.

Registration: The protocol was registered with the IRCT.ir (IRCT20140215016582N6).

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Data availability

Data supporting the findings of this study are available upon reasonable request from the authors.

References

  1. Soltani MK, Jafari F, Taheri M, Soltanian AR, Khoshhal M, Torkaman S (2019) Effect of 5 oral hygiene teaching methods on orthodontic patients: a single-blind randomized controlled clinical trial. Hamadan Univ Med Sci 11(2):41–47. https://doi.org/10.34172/ajdr.2019.08

    Article  Google Scholar 

  2. Sundararaj D, Venkatachalapathy S, Tandon A, Pereira A (2015) Critical evaluation of incidence and prevalence of white spot lesions during fixed orthodontic appliance treatment: a meta-analysis. J Int Soc Prev Community Dent 5(6):433. https://doi.org/10.4103/2231-0762.167719

    Article  PubMed  PubMed Central  Google Scholar 

  3. Tasios T, Papageorgiou SN, Papadopoulos MA, Tsapas A, Haidich AB (2019) Prevention of orthodontic enamel demineralization: a systematic review with meta-analyses. Orthod Craniofac Res 22(4):225–235. https://doi.org/10.1111/OCR.12322

    Article  PubMed  Google Scholar 

  4. Kamber R, Meyer-Lueckel H, Kloukos D, Tennert C, Wierichs RJ (2021) Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a systematic review and meta-analysis. Sci Rep 11(1):1–10. https://doi.org/10.1038/s41598-021-95888-6

    Article  CAS  Google Scholar 

  5. Sardana D, Zhang J, Ekambaram M, Yang Y, McGrath CP, Yiu CKY (2018) Effectiveness of professional fluorides against enamel white spot lesions during fixed orthodontic treatment: a systematic review and meta-analysis. J Dent 2019(82):1–10. https://doi.org/10.1016/j.jdent.2018.12.006

    Article  CAS  Google Scholar 

  6. Bencze MA, Albu CC, Teodorescu E et al (2022) Clinical use of nanoparticles in orthodontics as possible aid to reduce the incidence of white spot lesions. Mater Plast 59(1):156–176. https://doi.org/10.37358/MP.22.1.5569

    Article  Google Scholar 

  7. Sodagar A, Akhoundi MSA, Bahador A et al (2017) Effect of TiO2 nanoparticles incorporation on antibacterial properties and shear bond strength of dental composite used in orthodontics. Dental Press J Orthod 22(5):67–74. https://doi.org/10.1590/2177-6709.22.5.067-074.oar

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kotta M, Gorantla S, Muddada V et al (2020) Antibacterial activity and debonding force of different lingual retainers bonded with conventional composite and nanoparticle containing composite: an in vitro study. J World Fed Orthod 9(2):80–85. https://doi.org/10.1016/j.ejwf.2020.03.001

    Article  PubMed  Google Scholar 

  9. Ahrari F, Eslami N, Rajabi O, Ghazvini K, Barati S (2015) The antimicrobial sensitivity of Streptococcus mutans and Streptococcus sangius to colloidal solutions of different nanoparticles applied as mouthwashes. Dent Res J (Isfahan) 12(1):44–49. https://doi.org/10.4103/1735-3327.150330

    Article  PubMed  Google Scholar 

  10. Mollabashi V, Farmany A, Alikhani MY et al (2020) Effects of TiO2-coated stainless steel orthodontic wires on streptococcus mutans bacteria: a clinical study. Int J Nanomedicine 15:8759–8766. https://doi.org/10.2147/IJN.S258440

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Monica A, Padmanabhan S (2022) The effect of nitrogen-doped titanium dioxide-modified stainless steel brackets on Streptococcus mutans: a randomized clinical trial. Angle Orthod 93(2):396–401. https://doi.org/10.2319/062521-510.1

    Article  Google Scholar 

  12. Sardana D, Li KY, Ekambaram M, Yang Y, McGrath CP, Yiu CK (2022) Validation of clinical photography and a laser fluorescence device for assessment of enamel demineralization during multi-bracketed fixed orthodontic treatment. Photodiagnosis Photodyn Ther 38:102828. https://doi.org/10.1016/J.PDPDT.2022.102828

    Article  CAS  PubMed  Google Scholar 

  13. Yassaei S, Nasr A, Zandi H, Motallaei MN (2020) Comparison of antibacterial effects of orthodontic composites containing different nanoparticles on streptococcus mutans at different times. Dental Press J Orthod 25(2):52–60. https://doi.org/10.1590/2177-6709.25.2.052-060.oar

    Article  PubMed  PubMed Central  Google Scholar 

  14. Heravi F, Ramezani M, Poosti M, Hosseini M, Shajiei A, Ahrari F (2013) In vitro cytotoxicity assessment of an orthodontic composite containing titanium-dioxide nano-particles. J dent res, dent clin, dent prospects 7(4):192. https://doi.org/10.5681/joddd.2013.031

    Article  PubMed  Google Scholar 

  15. Pellegrini P, Sauerwein R, Finlayson T et al (2009) Plaque retention by self-ligating vs elastomeric orthodontic brackets: quantitative comparison of oral bacteria and detection with adenosine triphosphate-driven bioluminescence. Am J Orthod Dentofac Orthop 135(4):426.e1-426.e9. https://doi.org/10.1016/j.ajodo.2008.08.018

    Article  Google Scholar 

  16. Franco e Franco TCC, Amoroso P, Marin JM, de Ávila FA (2007) Detection of Streptococcus mutans and Streptococcus sobrinus in dental plaque samples from Brazilian preschool children by polymerase chain reaction. Braz Dent J 18(4):329–333. https://doi.org/10.1590/S0103-64402007000400011

    Article  PubMed  Google Scholar 

  17. Jahanbin A, Farzanegan F, Atai M, Jamehdar SA, Golfakhrabadi P, Shafaee H (2017) A comparative assessment of enamel mineral content and Streptococcus mutans population between conventional composites and composites containing nano amorphous calcium phosphate in fixed orthodontic patients: a split-mouth randomized clinical trial. Eur J Orthod 39(1):43–51. https://doi.org/10.1093/ejo/cjw009

    Article  PubMed  Google Scholar 

  18. Kamber R, Meyer-Lueckel H, Kloukos D, Tennert C, Wierichs RJ (2021) Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a systematic review and meta-analysis. Sci Rep 11(1):1–10. https://doi.org/10.1038/s41598-021-95888-6

    Article  CAS  Google Scholar 

  19. Restrepo M, Bussaneli DG, Jeremias F et al (2016) Control of white spot lesions with use of fluoride varnish or chlorhexidine gel during orthodontic treatment a randomized clinical trial. J Clin Pediatr Dent 40(4):274–280. https://doi.org/10.17796/1053-4628-40.4.274

    Article  CAS  PubMed  Google Scholar 

  20. Dong H, Zeng G, Tang L et al (2015) An overview on limitations of TiO2-based particles for photocatalytic degradation of organic pollutants and the corresponding countermeasures. Water Res 79:128–146. https://doi.org/10.1016/j.watres.2015.04.038

    Article  CAS  PubMed  Google Scholar 

  21. Jovanović B (2015) Critical review of public health regulations of titanium dioxide, a human food additive. Integr Environ Assess Manag 11(1):10–20. https://doi.org/10.1002/ieam.1571

    Article  CAS  PubMed  Google Scholar 

  22. Bischoff NS, de Kok TM, Sijm DTHM et al (2021) Review possible adverse effects of food additive e171 (Titanium dioxide) related to particle specific human toxicity, including the immune system. Int J Mol Sci 22(1):1–35. https://doi.org/10.3390/ijms22010207

    Article  CAS  Google Scholar 

  23. Poosti M, Ramazanzadeh B, Zebarjad M, Javadzadeh P, Naderinasab M, Shakeri MT (2013) Shear bond strength and antibacterial effects of orthodontic composite containing TiO2 nanoparticles. Eur J Orthod 35(5):676–679. https://doi.org/10.1093/ejo/cjs073

    Article  PubMed  Google Scholar 

  24. Venkatesan K, Kailasam V, Padmanabhan S (2020) Evaluation of titanium dioxide coating on surface roughness of nickel-titanium archwires and its influence on Streptococcus mutans adhesion and enamel mineralization: a prospective clinical study. Am J Orthod Dentofac Orthop 158(2):199–208. https://doi.org/10.1016/j.ajodo.2019.07.019

    Article  Google Scholar 

  25. Oscarson P, Lif Holgerson P, Sjöström I, Twetman S, Stecksén-Blicks C (2006) Influence of a low xylitol-dose on mutans streptococci colonisation and caries development in preschool children. Eur Arch Paediatr Dent 7(3):142–147. https://doi.org/10.1007/BF03262555

    Article  CAS  PubMed  Google Scholar 

  26. Jose JE, Padmanabhan S, Chitharanjan AB (2013) Systemic consumption of probiotic curd and use of probiotic toothpaste to reduce Streptococcus mutans in plaque around orthodontic brackets. Am J Orthod Dentofac Orthop 144(1):67–72. https://doi.org/10.1016/j.ajodo.2013.02.023

    Article  Google Scholar 

  27. Farzanegan F, Shahabi M, Niazi AE, Soleimanpour S, Shafaee H, Rangrazi A (2021) Effect of the addition of chitosan and TiO2 nanoparticles on antibacterial properties of an orthodontic composite in fixed orthodontic treatment: a randomized clinical trial study. Biomedical Physics & Engineering Express 7(4):045017. https://doi.org/10.1088/2057-1976/ac0609

  28. Zarif Najafi H, Shavakhi M, Pakshir HR (2022) Evaluation of the preventive effect of two concentrations of xylitol varnish versus fluoride varnish on enamel demineralization around orthodontic brackets: a randomized controlled trial. Eur J Orthod 44(3):243–251. https://doi.org/10.1093/ejo/cjab049

    Article  PubMed  Google Scholar 

  29. Onwubu SC, Mdluli PS, Singh S, Nyembe S, Thakur R (2019) Corrigendum to “an in situ evaluation of the protective effect of nano eggshell/titanium dioxide against erosive acids”. Int J Dent. https://doi.org/10.1155/2018/4216415

  30. Muhriz M, Niazy M, Elsharkawy D (2020) Remineralizing effect of nanofilled glass ionomer combined with titanium dioxide nanoparticle and nanohydroxyapatite in root caries-like lesions. Al-Azhar Dent J Girls 7(2):179–187. https://doi.org/10.21608/adjg.2020.10808.1133

    Article  Google Scholar 

  31. Okada M, Kawamura M, Oda Y, Yasuda R, Kojima T, Kurihara H (2012) Caries prevalence associated with Streptococcus mutans and Streptococcus sobrinus in Japanese schoolchildren. Int J Paediatr Dent 22(5):342–348. https://doi.org/10.1111/J.1365-263X.2011.01203.X

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to acknowledge the postgraduate orthodontics students Mahsa Asadimanesh, Anahita Morrovat, and Behrooz Khodabandehloo for their kind assistance during the study course.

Funding

This study was supported by the Vice Chancellor of Research and Technology at the Hamadan University of Medical Sciences, Hamadan, Iran. (Grant No: 140010218555).

Author information

Authors and Affiliations

  1. Orthodontic Department, Dental School and Dental Research Center, Hamadan University of Medical Sciences, Hamadan, 6517838695, Iran

    Vahid Mollabashi, Maryam Soleymani & Maryam Salehzadeh

  2. Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

    Mohammad Reza Arabestani

  3. Department of Biostatistics, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran

    Maryam Farhadian

  4. Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

    Roghayeh Abbasalipourkabir

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  1. Vahid Mollabashi
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  4. Maryam Farhadian
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  5. Roghayeh Abbasalipourkabir
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Contributions

V. M. conceptualization, methodology, writing (review and editing), M.So: resources, data curation, writing, MR.A. methodology, writing, M.F. validation, formal analysis, writing, and editing, R.A. resources, data curation, software, writing and M.Sa. conceptualization, resources, data curation, writing. All authors reviewed the manuscript.

Corresponding author

Correspondence to Maryam Salehzadeh.

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The authors declare no competing interests.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Hamadan University of Medical Sciences. (IR.UMSHA. REC.1400.445).

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The authors declare no competing interests.

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Mollabashi, V., Soleymani, M., Arabestani, M.R. et al. Evaluation of Nano TiO2 Modified Orthodontic Composite Effects on S. mutans Population and Enamel Demineralization in Fixed Orthodontic Patients; a Split Mouth Randomized Controlled Clinical Trial. Biol Trace Elem Res 201, 4657–4666 (2023). https://doi.org/10.1007/s12011-023-03559-6

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