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European Journal of Medical Research Nov 2023The objective of this systematic review and meta-analysis was to evaluate the effect of chewing gum on orthodontic pain and to determine the rate of bracket breakage... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The objective of this systematic review and meta-analysis was to evaluate the effect of chewing gum on orthodontic pain and to determine the rate of bracket breakage associated with fixed orthodontic appliances.
METHODS
This review and its reporting were performed according to the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. Six electronic databases were searched up to March 16, 2023, to identify relevant studies that met the inclusion and exclusion criteria. Furthermore, grey literature resources were searched. The Cochrane Collaboration Risk of Bias tool 2 was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan, and sensitivity analysis and publication bias analysis were performed using STATA software. GRADE tool was used to evaluate the certainty of evidence.
RESULTS
Fifteen studies with 2116 participants were ultimately included in this review, and 14 studies were included in the meta-analysis. Compared with the blank group, chewing gum had a significant pain relieving effect at all times after fixation of the initial archwire (P ≤ 0.05). No significant difference was found between the chewing gum group and the analgesics group at any timepoints (P > 0.05). Only four studies evaluated the rate of bracket breakage and revealed that chewing gum did not increase the rate of bracket breakage. The sensitivity analysis showed that there was no significant difference in the pooled outcomes after the included studies were removed one at times, and Egger analysis revealed no significant publication bias in included studies (P > 0.05).
CONCLUSIONS
Chewing gum is a non-invasive, low-cost and convenient method that has a significant effect on relieving orthodontic pain and has no effect on the rate of bracket breakage. Therefore, chewing gum can be recommended as a suitable substitute for analgesics to reduce orthodontic pain.
Topics: Humans; Chewing Gum; Pain; Analgesics; Orthodontic Brackets; Pain Measurement
PubMed: 37936237
DOI: 10.1186/s40001-023-01467-y -
International Journal of Computerized... Sep 2022To present an image-processing measurement algorithm to evaluate the transfer accuracy of indirect bonding (IDB) trays, exemplified by a CAD/CAM-based IDB tray...
AIM
To present an image-processing measurement algorithm to evaluate the transfer accuracy of indirect bonding (IDB) trays, exemplified by a CAD/CAM-based IDB tray integrated into a digital orthodontic workflow.
MATERIALS AND METHODS
Plaster casts of 24 patients with full dentition and different malocclusions were scanned with an intraoral scanner (Trios; 3Shape, Copenhagen, Denmark) to obtain digital models, which served for the virtual placement of orthodontic brackets in simulation software (OnyxCeph; Image Instruments, Chemnitz, Germany). The resulting STL files were sent to a dental laboratory (CA Digital; Hilden, Germany) for the production of INDIVIDUA IDB trays. These trays were used to transfer the brackets to the respective plaster casts. Finally, a second scan was performed to record the actual bracket positions. The transfer accuracy was then analyzed by a measurement algorithm scripted to automation, which calculated the deviations of the planned and real bracket positions with a local best-fit alignment, resulting in three linear and three angular measurements for each bracket.
RESULTS
In total, 622 brackets and tubes were transferred successfully. The presented algorithm analyzed the transfer accuracy and demonstrated that the linear measurements were 98.3% within the range of the American Board of Orthodontics standard. The angular measurements were 86.7% within this range when the INDIVIDUA IDB tray was used.
CONCLUSION
Scripted measurement algorithms facilitated the evaluation of present and future materials and designs for IDB trays to obtain an efficient solution for orthodontic practice. The INDIVIDUA IDB tray is a digital alternative to conventional IDB trays (Int J Comput Dent 2022;25(3):295-302; doi: 10.3290/j.ijcd.b2599775).
Topics: Algorithms; Computer-Aided Design; Dental Bonding; Humans; Malocclusion; Models, Dental; Orthodontic Brackets; Printing, Three-Dimensional
PubMed: 35072417
DOI: 10.3290/j.ijcd.b2599775 -
The Angle Orthodontist Jan 2018To assess, by means of a systematic review, the scientific evidence of the influence of 0.018-inch or 0.022-inch bracket slots on treatment time, efficiency of space... (Review)
Review
OBJECTIVES
To assess, by means of a systematic review, the scientific evidence of the influence of 0.018-inch or 0.022-inch bracket slots on treatment time, efficiency of space closure, efficiency of alignment, quality of orthodontic finishing, level of discomfort, and level of root resorption.
MATERIALS AND METHODS
The PubMed, Bireme, Medline, Scopus, Web of Science, Open Grey, and Google Scholar databases were searched, with no date and language restrictions, for randomized clinical trials and controlled clinical trials, using controlled terms related to bracket slots. After the selection and removal of duplicate articles, the risk of bias was assessed, and the data from the included studies were extracted by two independent researchers.
RESULTS
The search yielded 2640 studies. After applying the eligibility criteria, eight articles were fully read and four studies were selected for the qualitative systematic review. No randomized clinical trials assessed the duration of treatment in patients treated with 0.018-inch and 0.022-inch bracket slots. Due to heterogeneity of the data available, a meta-analysis could not be conducted.
CONCLUSIONS
While most studies indicated a shorter duration of treatment in patients with 0.018-inch bracket slots, no available data confirmed the higher efficiency of one system over the other. The biases in the studies did not allow for a reliable conclusion; therefore, new studies with a better methodologic design are needed.
Topics: Humans; Malocclusion; Orthodontic Appliance Design; Orthodontic Brackets; Outcome Assessment, Health Care; Time Factors; Tooth Movement Techniques
PubMed: 28949767
DOI: 10.2319/031217-185.1 -
International Orthodontics Jun 2020To evaluate the effects of one-step orthodontic composite combined with primer on microleakage and shear bond strength (SBS) of metal and ceramic brackets. (Comparative Study)
Comparative Study
OBJECTIVE
To evaluate the effects of one-step orthodontic composite combined with primer on microleakage and shear bond strength (SBS) of metal and ceramic brackets.
MATERIALS AND METHODS
This in vitro study included 144 extracted premolar teeth. Teeth were divided into two main groups according to the bracket type (metal and ceramic). In each group, brackets were bonded with three different bonding systems: two-step total-etch (37% phosphoric acid+Transbond XT primer+Transbond XT light cure adhesive), one-step self-etch (Transbond Plus self-etch primer+Transbond XT light cure adhesive), and one-step orthodontic adhesive (37% phosphoric acid+GC Ortho Connect light cure adhesive). A total of 6 groups (n=12) were performed for each evaluation. All samples were subjected to thermal cycling. After dye penetration, sections were prepared and assessed under stereomicroscope. After SBS test, adhesive remnant index (ARI) scores were determined. Data were analyzed statistically.
RESULTS
There were no significant differences between total-etch and one-step orthodontic adhesive for microleakage. Self-etch adhesive showed more microleakage at occlusal interfaces (P<0.05). The highest and lowest mean SBS values were found in ceramic brackets bonded with total- and self-etch adhesives, respectively. No significant differences were found among the SBS values of the groups. However, the differences between ARI scores were found statistically significant (P<0.05).
CONCLUSIONS
Orthodontic composite integrated with primer can be used safely instead of two-step total-etch adhesives during the bonding of metal and ceramic brackets due to less microleakage and adequate SBS values.
Topics: Acid Etching, Dental; Bicuspid; Ceramics; Composite Resins; Dental Bonding; Dental Cements; Dental Stress Analysis; Humans; In Vitro Techniques; Materials Testing; Orthodontic Brackets; Phosphoric Acids; Shear Strength
PubMed: 32111576
DOI: 10.1016/j.ortho.2020.01.010 -
Journal of Orthodontics Sep 2021To evaluate the colour stability of polymeric resins that could be used to 3D-print orthodontic brackets.
OBJECTIVE
To evaluate the colour stability of polymeric resins that could be used to 3D-print orthodontic brackets.
DESIGN
In vitro, laboratory study.
MATERIALS AND METHODS
Disc-shaped specimens were fabricated via 3D printing using three resins: Dental LT; Dental SG; and Clear. Five conditions were evaluated for each resin (n = 10 per treatment per resin) to assess its corresponding effect on colour and translucency: immersion in (1) red wine, (2) coffee, (3) tea and (4) distilled water (control), and (5) exposure to accelerated aging. Colour and translucency measurements were made before and after exposure using a spectrophotometer. Mean colour differences (ΔE) and changes in translucency parameter (ΔTP) were calculated for each sample using the CIEDE2000 colour difference formula.
RESULTS
Statistically significant effects of the resin material, the treatment condition and interactions effects of material and condition were observed for ΔE and ΔTP ( < 0.001). The most pronounced changes in colour (ΔE) were a result of the staining effects of wine on all three resins, ranging from 14.5 ± 0.6 to 20.8 ± 1.2. Dental LT, Dental SG and Clear resins all showed changes in colour when exposed to certain staining agents. Dental SG and Clear resins exhibited changes in colour with aging, while the colour of Dental LT resin remained stable with aging.
CONCLUSIONS
The colour changes of the resins investigated does not support their use in 3D-printed aesthetic bracket applications.
Topics: Coffee; Color; Composite Resins; Dental Materials; Humans; Materials Testing; Orthodontic Brackets; Printing, Three-Dimensional; Surface Properties
PubMed: 33719707
DOI: 10.1177/14653125211001079 -
Brazilian Dental Journal 2023This study aimed to assess and correlate initial surface roughness and frictional resistance of rectangular CuNiTi wires inserted in different self-ligating brackets....
This study aimed to assess and correlate initial surface roughness and frictional resistance of rectangular CuNiTi wires inserted in different self-ligating brackets. The sample consisted of 40 bracket-wire sets (rectangular CuNiTi wires of 0.017" x 0.025" and passive self-ligating brackets) divided into four groups (n=10): metallic self-ligating bracket and metallic CuNiTi wire (G1); metallic self-ligating bracket and rhodium-coated CuNiTi wire (G2); esthetic self-ligating bracket and metallic wire (G3); esthetic self-ligating bracket and rhodium-coated CuNiTi wire (G4). The initial surface roughness of the wires was examined with a Surfcorder roughness meter, model SE1700. Later, frictional resistance was assessed in an Instron 4411 universal testing machine at a speed of 5 mm/min, in an aqueous medium at 35°C. Microscopic analyses of surface morphology were performed with scanning electron microscopy, using an LEO 1430, with magnifications of 1000X. Generalized linear models were applied, considering the 2 x 2 factorial (bracket type x wire type), at a 5% significance level. Regardless of bracket type, the groups with esthetic wires presented higher initial surface roughness than the groups with metallic wires (p<0.05). There was no significant difference between the different bracket-wire sets for frictional resistance and no significant correlation between frictional resistance and initial surface roughness in the environment studied. It is concluded that esthetic wires presented higher initial surface roughness but did not interfere with the frictional resistance between brackets and wires.
Topics: Rhodium; Orthodontic Wires; Orthodontic Appliance Design; Orthodontic Brackets; Dental Stress Analysis; Materials Testing; Stainless Steel; Surface Properties; Dental Alloys; Titanium
PubMed: 37194851
DOI: 10.1590/0103-6440202304912 -
Microscopy Research and Technique Mar 2022This study aims to evaluate the feasibility of chlorhexidine (CHX)-loaded poly-L-glycolic acid (PLGA) nanoparticles as a modifier of a commercial orthodontic adhesive...
This study aims to evaluate the feasibility of chlorhexidine (CHX)-loaded poly-L-glycolic acid (PLGA) nanoparticles as a modifier of a commercial orthodontic adhesive via the assessment of physicochemical, biological, and mechanical properties at tooth-bracket interface. CHX-loaded PLGA nanoparticles were synthesized using double emulsion-solvent evaporation method and characterized using transmission electron microscopy and Raman analysis. CHX-loaded PLGA nanoparticles in Transbond XT orthodontic adhesive were prepared using two different concentrations of the CHX (25 and 50%) and characterized for degree of conversion (DC), antimicrobial, and cytotoxicity testing. Bonded specimens were tested for shear bond strength (SBS) and adhesive remnant index (ARI) at tooth-bracket interface. The synthesized PLGA nanoparticles averaged between 60 and 80 nm in size. After loading CHX inside PLGA nanoparticles, the morphology of the PLGA nanoparticles was considerably changed. Orthodontic bracket bonded with 25% CHX-loaded PLGA-modified adhesive demonstrated DC scores similar to control group. Both 25 and 50% CHX-loaded PLGA-modified adhesive specimens showed higher antibacterial activity against S. mutans compared to control group. The least mean SBS values were exhibited by 50% CHX-loaded PLGA-modified adhesive samples, while a statistically significant difference was observed in the mean ARI values among all study groups at all-time points (p = .018). This study indicates that the addition of CHX-loaded PLGA nanoparticles in Transbond XT achieved stable bonds with enhanced antimicrobial and mechanical properties.
Topics: Chlorhexidine; Dental Bonding; Dental Stress Analysis; Glycolates; Hydrogen-Ion Concentration; Materials Testing; Orthodontic Brackets; Resin Cements
PubMed: 34716725
DOI: 10.1002/jemt.23968 -
Journal of Biomedical Optics Jun 2016Lasers have the potential for reducing the required debonding force and can prevent the mechanical damage given to the enamel surface as a result of conventional...
Lasers have the potential for reducing the required debonding force and can prevent the mechanical damage given to the enamel surface as a result of conventional debonding procedure. However, excessive thermal effects limit the use of lasers for debonding purposes. The aim of this study was to investigate the optimal parameters of 1940-nm Tm:fiber laser for debonding ceramic brackets. Pulling force and intrapulpal temperature measurements were done during laser irradiation simultaneously. A laser beam was delivered in two different modes: scanning the fiber tip on the bracket surface with a Z shape movement or direct application of the fiber tip at one point in the center of the bracket. Results showed that debonding force could be decreased significantly compared to the control samples, in which brackets were debonded by only mechanical force. Intrapulpal temperature was kept equal or under the 5.5°C threshold value of probable thermal damage to pulp. Scanning was found to have no extra contribution to the process. It was concluded that using 1940-nm Tm:fiber laser would facilitate the debonding of ceramic brackets and can be proposed as a promising debonding tool with all the advantageous aspects of fiber lasers.
Topics: Ceramics; Dental Debonding; Dental Enamel; Humans; Lasers; Orthodontic Brackets
PubMed: 27367251
DOI: 10.1117/1.JBO.21.6.065007 -
Journal of Orofacial Orthopedics =... Apr 2023The aim of this study was to compare classical friction (FR) in passive self-ligating brackets (P-SLBs), active self-ligating brackets (A-SLBs) and a traditional twin...
PURPOSE
The aim of this study was to compare classical friction (FR) in passive self-ligating brackets (P-SLBs), active self-ligating brackets (A-SLBs) and a traditional twin bracket, in vitro, and to identify the point of initiation of bracket-archwire engagement.
METHODS
Nine bracket systems of 0.022 in slot size were FR tested: 5 P‑SLB systems; 4 A‑SLB systems; and a control group of twin brackets with elastomeric ligatures. Single upper right central incisor brackets were mounted on a custom metal fixture for testing. Straight sections of various round and rectangular nickel-titanium (NiTi) archwires (0.016, 0.018, 0.018 × 0.018, 0.020 × 0.020, 0.016 × 0.022, 0.017 × 0.025, 0.019 × 0.025, and 0.021 × 0.025 in) were ligated to the bracket and peak static FR (cN) was measured with an Instron Universal Testing Machine. Ten unique tests each utilizing a new bracket and new archwire were conducted for each group in the dry state.
RESULTS
FR was significantly different between control, P‑SLB and A‑SLB systems (P < 0.001). P‑SLB groups displayed no significant differences in FR between each other, regardless of archwire size. A‑SLB groups did exhibit significant differences in FR between each other depending on both the bracket system and archwire size. Each A‑SLB system tested possessed a distinctly different pattern of initiation of bracket-archwire engagement.
CONCLUSIONS
FR between the archwire and bracket slot differs between P‑SLB and A‑SLB systems, with a distinct pattern of FR and bracket-archwire engagement for each A‑SLB system. Understanding the different bracket-wire interactions of SLB systems should help orthodontic clinicians to plan effective and efficient biomechanics with the bracket system of their choice.
Topics: Dental Alloys; Orthodontic Appliance Design; Friction; Orthodontic Brackets; Orthodontic Wires; Stainless Steel; Materials Testing; Dental Stress Analysis; Titanium
PubMed: 34779866
DOI: 10.1007/s00056-021-00361-8 -
BMC Oral Health Jul 2021Bond strength of orthodontic composite is strongly influenced by molecular and structural mechanisms. Aim of this in vitro study was to compare bond strength of...
BACKGROUND
Bond strength of orthodontic composite is strongly influenced by molecular and structural mechanisms. Aim of this in vitro study was to compare bond strength of light-cure orthodontic composites by measuring debonding forces and evaluating locations of bond failure. Investigations on chemical compositions clarified adhesive behaviors and abilities, exploring effects of ageing processes in this junction materials.
METHODS
Twelve enamel discs, from human premolars, were randomly coupled to one orthodontic adhesive system (Transbond XT™ 3 M UNITEK, USA, Light-Cure Orthodontic Paste, LEONE, Italy and Bisco Ortho Bracket Paste LC, BISCO, Illinois) and underwent to Shear Bond Strength test. Metallic brackets were bonded to twenty-seven human premolar, with one of the adhesive systems, to quantify, at FE-SEM magnifications, after debonding, the residual material on enamel and bracket base surfaces. Raman Spectroscopy analysis was performed on eight discs of each composites to investigate on chemical compositions, before and after accelerated aging procedures in human saliva and sugary drink.
RESULTS
Orthodontic adhesive systems showed similar strength of adhesion to enamel. The breakage of adhesive-adherent bond occurs in TXT at enamel-adhesive interface while in Bisco and Leone at adhesive-bracket interface. Accelerated in vitro aging demonstrated good physical-chemical stability for all composites, Bisco only, was weakly contaminated with respect to the other materials.
CONCLUSION
A similar, clinically adequate and acceptable bond strength to enamel for debonding maneuvers was recorded in all orthodontic adhesive systems under examination. No significant chemical alterations are recorded, even in highly critical situations, not altering the initial mechanical properties of materials.
Topics: Dental Bonding; Dental Cements; Dental Stress Analysis; Humans; Italy; Materials Testing; Orthodontic Brackets; Resin Cements; Shear Strength; Stress, Mechanical; Surface Properties
PubMed: 34271907
DOI: 10.1186/s12903-021-01715-9