The Efficacy of Nanosilver Coated Stainless Steel Brackets in Prevention of Enamel Demineralization in Orthodontic Patients

Objective: the aim of this study was to evaluate the effect of nanosilver coated stainless steel brackets in prevention of enamel demineralization during orthodontic treatment. Subjects and Methods: A randomized clinical trial was conducted on 32 patients aged 13-16 years. All participants were scheduled to have maxillary and mandibular first premolars extraction as a part of orthodontic treatment. The patients were randomly divided into two equal groups: Group I in which 64 nanosilver coated stainless steel brackets were bonded in the upper and lower first premolars, and Group II in which conventional uncoated stainless steel brackets were bonded in the upper and lower first premolars. In both groups, 32 brackets of one side from upper and lower arches were deboned after one month, and the other side after 2 months. After debonding, the teeth were extracted, cleaned, and prepared for evaluation under scanning electron microscope to investigate enamel surface topography, and energy dispersive x-ray analysis that evaluate the mineral content of the teeth. Results: Calcium & phosphorus contents in the extracted premolars were stable in group I after one and two months, while group II showed significant decrease in calcium & phosphorus contents at the same periods. Scanning electron microscope examination revealed almost normal topographic feature of enamel surface in group I, while enamel surface in group II showed typical features of enamel demineralization. Conclusion: Silver nanoparticles coated stainless steel brackets can preserve the mineral content of the enamel surface, thus decreasing the likelihood of demineralization during treatment than uncoated brackets.