In vitro effects of antimicrobial properties and shear bond strength of different concentrations of Emodin nanoparticles incorporated orthodontic composites.

OBJECTIVE: Fixed appliances used in orthodontic treatment are accompanied by some drawbacks, including the development of white spots or enamel demineralization in the vicinity of the brackets and bonding failures. This study aims to evaluate the effect of combining different wt.% of Emodin nanoparticles (ENPs) with orthodontic adhesives to attain adhesives with improved antimicrobial and mechanical properties.

METHODS: ENPs were synthesized and added to orthodontic composite at different concentrations (0.5%, 1%, and 2%). The distribution of ENPs within the composite was evaluated using a field emission scanning electron microscope (FESEM). A total of 216 disks were prepared, with 144 subjected to an eluted components test, 36 used for disk agar diffusion (DAD) test, and 36 for biofilm inhibition test. These tests aimed to assess the antimicrobial activity of the composites against Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans. Additionally, the bond strength between stainless-steel brackets and teeth was evaluated using the shear bond strength (SBS) test, and the adhesive remnant index (ARI) score was determined. One-way analysis of variance and Kruskal-Wallis test were used to analyse the SBS and ARI, respectively. For pairwise group comparison concerning the biofilm inhibition, DAD, and eluted components tests, the Tamhane and Games-Howell tests for data with unequal variances and the post-hoc Tukey's HSD and Scheffe tests for data with equal variances were used.

RESULTS: The FESEM results confirmed the synthesis and even distribution of ENPs in the composite. Only the 2% group showed significant biofilm inhibition against all microorganisms studied (P<0.05). The DAD test revealed that a 1% concentration of ENPs is sufficient to inhibit growth for all microorganisms. The eluted components test demonstrated that the 2% concentration of ENPs performed significantly better against S. mutans compared to the control group (P<0.05). The highest mean SBS was observed with the 0.5% ENP concentration, while no significant differences in SBS and ARI were found among the groups (P>0.05).

CONCLUSIONS: This in vitro study showed that the 2% concentration of ENP produced significantly improved antimicrobial activity without adversely affecting SBS and ARI score. This would support the addition of 2% ENP to orthodontic adhesives.