Background: The aim of this study is to determine the prevalence of nocturnal enuresis (NE) in children with obstructive sleep apnea (OSA), the effect of adenotonsillectomy (AT) and the width of the arches, and to compare them with control children without respiratory problems. Methods: Children from 2 to 12 years old were divided into three groups: children with OSA and NE (n = 51), children with OSA without NE (n = 79), and the control group (n = 168). NE was defined as at least one bedwetting incident per month. Arch widths were measured at the baseline and one year after. OSA was diagnosed by means of polysomnography, and the apnea-hypopnea index (AHI) was obtained. Parents completed the Pediatric Sleep Questionnaire (PSQ) to classify their children into those with and without NE. Results: NE was present in 39.2% of children with OSA compared to 28% in the control group (p = 0.04). After AT, 49% of the children with OSA and NE significantly improved. Both OSA groups had narrower arch widths than the control group (p = 0.012), with the NE group having the narrowest widths. NE is more prevalent in children with OSA and should be considered one of the first signs of breathing disorders. Adenotonsillectomy reduces NE in about half of the affected children. Both arch widths are narrower in children with OSA, particularly in those with NE.

Biofilm accumulation on orthodontic appliances is a recognized risk factor for white spot lesion formation and caries during treatment. Antibacterial surface modifications and coating strategies have been proposed as appliance-level preventive approaches. Studied interventions in the literature span true thin-film surface coatings, plasma-based and ion-implantation surface modifications, and bulk-incorporated antibacterial agents in appliance matrix materials. Yet the extent to which in vitro efficacy translates to clinically meaningful protection remains unresolved. This PRISMA-ScR-compliant scoping review searched PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Google Scholar, identifying 109 eligible studies: 96 in vitro, 8 in vivo animal studies and 5 clinical trials, covering brackets, archwires, clear aligners, bands, miniscrews, elastomeric ligatures, and removable appliances, some articles studied multiple types of appliances. In vitro studies consistently demonstrated significant reductions in bacterial adhesion and biofilm formation across all appliance types, with silver-based coatings and nitrogen-doped TiO₂ showing the broadest evidence base; combination systems (Ag/ZnO, CuO-ZnO) outperformed individual agents. The 13 in vivo and clinical studies provided limited but directionally supportive evidence: silver nanoparticle-incorporated acrylic retainers reduced S. mutans counts in a double-blind RCT, and silver-infiltrated tungsten material-maintained biofilm reduction after simulated two-year abrasion. Coating durability emerged as an important determinant of potential clinical translation. Surface-deposited thin-film coatings degraded substantially within one month of intraoral use, whereas substrate-integrated approaches showed greater longevity. This scoping review maps the current evidence landscape, identifies coating durability and clinical endpoint validation as critical gaps, and prioritizes silver-based and nitrogen-doped TiO₂ coatings for future randomized clinical trials.

Fixed orthodontic appliances create retention sites for bacterial biofilm, increasing the risk of white spot lesions and periodontal complications. Silver ion (Ag) implantation offers a potential solution by conferring antimicrobial properties while preserving mechanical integrity. This study evaluated the physicochemical properties, Ag release, biocompatibility, and antibacterial efficacy of AISI 301 stainless-steel orthodontic brackets (Ormco Bios) modified by silver ion implantation using a Pulsed Filtered Cathodic Arc Vacuum System. Physical and micro-structural surface characterizations—including SEM/EDS, interferometric roughness analysis, contact angle measurements, nanoindentation hardness testing, and friction coefficient determination (under dry and saliva-lubricated conditions)—were conducted directly on the modified brackets. In compliance with international testing standards requiring defined geometric areas, AISI 301 flat samples of same chemical composition and microstructure were used to quantify Ag release in artificial saliva (cumulative silver ion release in artificial saliva was quantified via ICP-MS over time, with measured concentrations corrected for the volume extracted at each sampling interval), as well as to perform in vitro biological (human fibroblast cytocompatibility) and microbiological assays against seven bacterial strains (Streptococcus mutans, Streptococcus gordonii, Lactobacillus salivarius, Lactobacillus acidophilus, Porphyromonas gingivalis, Enterococcus faecalis, and Staphylococcus aureus). SEM/EDS confirmed successful Ag incorporation (0.93 wt.%) on the brackets. Surface roughness remained unchanged (0.16–0.17 mm), whereas hydrophilicity, surface energy, and nano-hardness increased significantly. Friction coefficients decreased under both dry and saliva-lubricated conditions. ICP-MS analysis revealed Ag release stabilizing at 119 ± 5.0 ppb after one week. Biocompatibility testing demonstrated no cytotoxic effects on fibroblasts. Furthermore, modified surfaces exhibited marked antibacterial activity against Lactobacillus spp., P. gingivalis, E. faecalis, and S. aureus, though no significant inhibition was observed against S. mutans or S. gordonii. Ag ion implantation directly improves the mechanical and tribological properties of stainless-steel orthodontic brackets. The use of standardized specimens confirmed steady Ag release, cytocompatibility, and selective antibacterial efficacy, supporting Ag implantation as a viable surface modification strategy for clinical orthodontic applications.