# Usage of Silver Nanoparticles in Orthodontic Appliances

## TL;DR

This paper reviews the use of silver nanoparticles in orthodontic appliances to reduce bacterial growth, but highlights mixed results and the need for more clinical research.

## Contribution

A comprehensive review of the current evidence on silver nanoparticle applications in various orthodontic appliances.

## Key findings

- Silver nanoparticles show strong antibacterial activity on orthodontic appliance surfaces.
- Some appliances showed increased biofilm formation when silver nanoparticles were used.
- Cytotoxicity and increased surface roughness are potential adverse effects of silver nanoparticle incorporation.

## Abstract

Orthodontic treatment, offering significant benefits for oral function and facial aesthetics, is in high demand among both adolescent and adult populations. Orthodontic appliances pose challenges for maintaining oral hygiene and increase the risk of dental and periodontal diseases. With advances in dental materials and the use of nanoparticles, a significant amount of research has focused on modifying orthodontic appliances with nanoparticles to reduce bacterial adhesion and biofilm formation. Silver nanoparticles are one of the most popular antibacterial materials in medical research. This article presents current evidence on silver nanoparticle-incorporated orthodontic appliances, including brackets, molar bands, archwires, elastomeric ligatures, mini-implants, and acrylic retainers. Silver nanoparticles and modified silver nanoparticles exhibit robust antibacterial activity when applied to the surfaces of orthodontic appliances. However, there are exceptions in which, on a few orthodontic appliances, the silver nanoparticle incorporation actually increased biofilm formation. Moreover, a silver nanoparticle incorporation may introduce adverse effects, such as cytotoxicity, and increase surface roughness. It is also worth noting that most of the studies were conducted in vitro. Long-term clinical studies are necessary to evaluate the stability, safety, and clinical efficacy of silver nanoparticle-incorporated orthodontic appliances under real-world conditions.