This study aimed to evaluate the antimicrobial effect of coated orthodontic molar tubes (COMT) with zinc oxide nanoparticles (ZnO NPs) using an electrophoretic deposition method (EPD) and to evaluate the orthodontic molar tubes (OMT) bond failure rate. Seventy-two orthodontic molar tubes (OMTs) for second molars were divided into two groups 36 each; one group coated with ZnO NPs and the other control negative uncoated. The OMT was coated using the EPD method with ZnO NPs in a concentration of 10 g/l. The OMTs were randomly allocated using a split-mouth, cross-quadrant design. After 2 weeks of appliance placement, swabs were taken from the surface of the OMTs for microbial assessment against Streptococcus mutans, Lactobacillus acidophilus, and total bacterial counts; additionally, plaque and gingival indices were assessed. The patient was followed for 3 months to evaluate the bond failure rate. The COMT showed a statistically significant reduction in total bacterial accounts, S. mutans, and L. acidophilus compared to UOMT (P < 0.001). Furthermore, the plaque and gingival indices near COMT were significantly less than that of UOMT. The bond failure rate was not significant between the COMT and UOMT. The COMT with ZnO NPs has potent antibacterial activity against the tested pathogens with a reduction in the amount of plaque accumulation. The use of the EPD method was feasible without adverse effects on the orthodontic molar tubes bond failure rate.
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