Synthesis and Characterization of a Sustained Nitric Oxide-Releasing Orthodontic Elastomeric Chain for Antimicrobial Action

The acidic byproducts of bacteria in plaque around orthodontic brackets contribute to white spot lesion (WSL) formation. Nitric oxide (NO) has antibacterial properties, hindering biofilm formation and inhibiting the growth of oral microbes. Materials that mimic NO release could prevent oral bacteria-related pathologies. This study aims to integrate S-nitroso-acetylpenicillamine (SNAP), a promising NO donor, into orthodontic elastomeric ligatures, apply an additional polymer coating, and evaluate the NO-release kinetics and antimicrobial activity against Streptococus mutans. SNAP was added to clear elastomeric chains (8 loops, 23 mm long) at three concentrations (50, 75, 100 mg/mL, and a control). Chains were then coated, via electrospinning, with additional polymer (Elastollan®) to aid in extending the NO release. NO flux was measured daily for 30 days. Samples with 75 mg/mL SNAP + Elastollan® were tested against S. mutans for inhibition of biofilm formation on and around the chain. SNAP was successfully integrated into ligatures at each concentration. Only the 75 mg/mL SNAP chains maintained their elasticity. After polymer coating, samples exhibited a significant burst of NO on the first day, exceeding the machine’s reading capacity, which gradually decreased over 29 days. Ligatures also inhibited S. mutans growth and biofilm formation. Future research will assess their mechanical properties and cytotoxicity. This study presents a novel strategy to address white spot lesion (WSL) formation and bacterial-related pathologies by utilizing nitric oxide-releasing materials. Manufactured chains with antimicrobial properties provide a promising solution for orthodontic challenges, showing significant potential for academic-industrial collaboration and commercial viability.

正畸托槽周围牙菌斑中细菌产生的酸性副产物会导致白斑病变（WSL）的形成。一氧化氮（NO）具有抗菌特性，可阻碍生物膜形成并抑制口腔微生物的生长。模拟一氧化氮释放的材料可以预防与口腔细菌相关的疾病。本研究旨在将一种有前景的一氧化氮供体S - 亚硝基 - 乙酰青霉胺（SNAP）整合到正畸弹性结扎丝中，施加额外的聚合物涂层，并评估其对变形链球菌的一氧化氮释放动力学和抗菌活性。将SNAP以三种浓度（50、75、100 mg/mL，以及一个对照组）添加到透明弹性链（8个环，长23 mm）中。然后通过静电纺丝用额外的聚合物（Elastollan®）对链条进行涂层，以帮助延长一氧化氮的释放。在30天内每天测量一氧化氮通量。对含有75 mg/mL SNAP + Elastollan®的样本针对变形链球菌进行测试，以检测其对链条上及其周围生物膜形成的抑制作用。SNAP在每种浓度下都成功地整合到结扎丝中。只有75 mg/mL的SNAP链条保持了其弹性。经过聚合物涂层后，样本在第一天出现一氧化氮的显著释放峰值，超过了仪器的读数范围，并在29天内逐渐下降。结扎丝还抑制了变形链球菌的生长和生物膜的形成。未来的研究将评估其机械性能和细胞毒性。本研究提出了一种利用一氧化氮释放材料解决白斑病变（WSL）形成和细菌相关疾病的新策略。具有抗菌特性的制造链条为正畸挑战提供了一种有前景的解决方案，显示出学术 - 工业合作和商业可行性的巨大潜力。