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(2025-03-12) Alqarni, Heba; Ba-Armah, Ibrahim; Almutairi, Nader; Alenizy, Mohammad; Sun, Jirun; Weir, Michael D.; Xu, Hockin H. K.
Introduction: Clear aligner orthodontic treatment provides a more
hygienic and esthetic alternative to fixed appliances. Attachments play a
crucial role in clear aligner therapy, but prolonged use is associated with
plaque accommodation and white spot lesions.
Objectives: (1)Develop a novel resin-based antibacterial and
remineralizing clear aligner attachment material to reduce white spot
lesions during treatment (2) Investigate the material mechanical and
physical properties, and antimicrobial capabilities on Streptococcus
mutans (S). mutans. Materials and Methods: The resin-based clear
aligner attachment material was formulated by adding triethylene
glycoldivinylbenzyl ether (TEG-DVBE) and urethane dimethacrylate
(UDMA), denoted as (UV), along with 3% of the antibacterial monomer
dimethylaminododecyl methacrylate (DMADDM), nano-amorphous
calcium phosphate (NACP) and glass fillers at different mass fractions
(45%,50%,55%). Transbond LV and Vitremer were selected as commercial
controls. Flexural strength, elastic modulus, degree of conversion (DC%)
and microhardness, Enamel shear bond CFU, MTT and Lactic acid were
evaluated. Results: The experimental groups with glass fillers at 45%,50%
and 55% exhibited flexural strength from (109.2±8.6)MPa to
(96.4±8.2)MPa, exceeding the ISO standard for resin-based materials.
Degree of conversion for all experimental groups ranged from
(53.4±2.3)% to (68.3±0.9)% significantly higher than the commercial
control (37.1±4.1)% (p<0.05). Enamel shear bond shows no statistical
significance difference between all the experimental and the commercial
control I. The antibacterial effectiveness for experimental groups with 3%
DMADDM showed 6-log CFU reduction and 95% reduction of metabolic
activity and 92% lactic acid production. Conclusion: The modified resin
based clear aligner attachment material demonstrated excellent
antimicrobial activity and remineralizing potential while maintaining
good physical and mechanical properties. These qualities may offer
enhanced protection against white spots lesions during clear aligner
therapy.
