Drug delivery and antibiofilm efficacy of nano silver fluoride sustained release orthodontic elastomerics against Streptococcus mutans.

We aimed to investigate the chemical and physical properties of nano silver fluoride sustained release orthodontic elastomerics (NSF-RE) and determine their antimicrobial and antibiofilm formation activities against Streptococcus mutans. Orthodontic elastomerics were dip-coated with NSF solution in ethyl cellulose (EC) and polyethylene glycol 6000 (PEG). The studied groups included NSF (no EC/PEG), NSF-E (EC), NSF-EP1 (EC:PEG, 4:1), and NSF-EP2 (EC:PEG, 2:1). The cumulative release of silver nanoparticles (AgNPs) and fluoride, along with the compatibility of the tensile force with orthodontic brackets, was evaluated. The antimicrobial activity was evaluated using an agar diffusion test. The inhibition of biofilm formation was evaluated using colony-forming units (CFUs), biofilm thickness, and the live/dead cell ratio. NSF-RE containing EC sustained the release of AgNPs and fluoride for > 7 days. Tensile forces were not significantly different among the groups. The inhibition zone was 2.64- and 1.31-fold larger with NSF-EP2 than that with NSF and NSF-E, respectively. NSF-EP2 was the most effective in inhibiting biofilm formation with significant reductions in CFUs, biofilm thickness, and live/dead cell ratio by 57, 86, and 96%, respectively, as compared to those in the control group. Overall, sustained release of AgNPs and fluoride by NSF-RE provides antimicrobial and antibiofilm effects against S. mutans.