The PMMA incorporated with nanoparticles of silver (NanoAg-I-PMMA) and NanoAg in situ in PMMA (NanoAg-IS-PMMA) have been shown to control the growth of cariogenic bacteria, but clinical trial of anti-

The gap

Consensus across the literature

Supporting evidence — 3 representative gaps

• Effects of chlorhexidine use on periodontal health during fixed appliance orthodontic treatment: a systematic review and meta-analysis (2022) · doi

  CONCLUSIONS: Adjunct use of CHX mouthwash during fixed-appliance treatment is associated with improved gingival inflammation, plaque control, and pocket depths, but caution is warranted and recommendations about CHX use during orthodontic treatment of children/adults should consider the heterogeneous patient response, cost-effectiveness, and potential adverse effects.

  Keywords: treatment conclusions adjunct mouthwash fixed appliance associated improved gingival inflammation plaque control pocket depths caution
• Effects of Baseplates of Orthodontic Appliances with in situ generated Silver Nanoparticles on Cariogenic Bacteria: A Randomized, Doubleblind Cross-over Clinical Trial (2015) · doi

  The PMMA incorporated with nanoparticles of silver (NanoAg-I-PMMA) and NanoAg in situ in PMMA (NanoAg-IS-PMMA) have been shown to control the growth of cariogenic bacteria, but clinical trial of anti-cariogenic application of these novel materials in orthodontics has not been evaluated.

  Keywords: pmma nanoag cariogenic incorporated nanoparticles silver situ control growth bacteria clinical trial anti application novel
• Caries Direction Antimicrobial Activity of Zinc Oxide Nanoparticles Containing Cement for the Management of Orthodontic Teeth against <i>Streptococcus mutans</i> and <i>Lactobacillus casei</i> (2026) · doi

  Future research should focus on in vivo validation, long-term antimicrobial efficacy, and comparative studies with other nanoparticles or antibacterial agents to optimize clinical application in orthodontics. However, the findings are limited to in vitro conditions and do not account for factors such as salivary flow, dietary variations, and long-term ion release in the oral cavi- ty.

  Keywords: long term future focus vivo validation antimicrobial efficacy comparative nanoparticles antibacterial agents optimize clinical application