Nanoparticle-based oral rinse in prevention of white spot lesions in orthodontic treatment: A systematic review.

Abstract

Background and aim: White spot lesions (WSLs) are the most common lesions in orthodontic treatment. Preventing WSLs during and after orthodontic treatment is a major challenge in modern dentistry. Introducing nanotechnology-based materials with antimicrobial, anticariogenic, and remineralizing potential is the emerging trend to prevent WSL. This systematic review was conducted to find the effectiveness of nanoparticle-based oral rinses in preventing WSL in orthodontic treatments.

Materials and methods: The systematic review included human trials published in English between January 2010 and September 2024. The search strategy involved exploring electronic databases such as PubMed Central, SCOPUS, Web of Science, and Cochrane. The reviewers individually assessed the risk of bias in the included studies using the recommended assessment of the risk of bias approach in the included studies.

Results: One study that met the inclusion criteria was included in this systematic review. The overall incidence of WSLs per tooth after six months was 9.52% for the nanosilver (NS) mouthwash, compared to 24.4% for both the fluoride and chlorhexidine (CHX) mouthwashes. The right maxillary lateral incisor had the highest incidence (38.09%). Gingival margins of maxillary teeth had a higher incidence of WSLs compared to mandibular teeth, as the formation of biofilm is high in maxillary teeth.

Conclusion: Nanosilver mouthwash reduces the incidence of WSLs by over 80% compared to chlorhexidine and fluoride mouthwash in fixed orthodontic treatment. Furthermore, better-conducted trials with various nanoparticle-based mouthwashes are necessary for their clinical use in orthodontic patients.