Antimicrobial Efficacy of Various Nanoparticles on Addition to Orthodontic Materials- A Systematic Review and Meta-Analysis

Aim: The purpose of this study is to examine the evidence for the efficiency of nanoparticles (NPs) incorporated into orthodontic materials (brackets, bonding agents, wires, acrylic resin, and elastics) in order to enhance their antimicrobial properties. Materials and Methods: A comprehensive search strategy was conducted in electronic databases like PubMed, Cochrane, and Google scholar, books, grey literature like unpublished literature, dissertations, conference reports, etc. Finally, out of all the literature reviewed, a total of 30 articles met the inclusion criteria and were included in the qualitative analysis. For the quantitative analysis, a total of 6 articles were used. Results: Antimicrobial agents such as silver nanoparticles, Titanium dioxide, Silver platinum alloy, zinc oxide and copper oxide, quaternary ammonium dimethacrylate (QADM), Hydroxyapatite crystals, and silver, quaternary ammonium polyethyleneimine (QPEI) particles, silica, and titanium have been incorporated in various orthodontic materials. The incorporation of these nanoparticles into orthodontic materials led to a significant increase in the antibacterial capacity when compared to controls used in the various studies. Conclusion: It can be concluded that the incorporation of nanoparticles into orthodontic materials improves their antibacterial properties. Due to the heterogeneity observed across the studies reviewed, further research with standardized study protocols in terms of the size, concentration, and techniques of incorporation of different NPs into various orthodontic materials is pertinent.