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Six-month bracket failure rate with a flowable composite: A split-mouth randomized controlled trial.Dental Press Journal of Orthodontics 2017The use of flowable composites as an orthodontic bonding adhesive merits great attention because of their adequate bond strength, ease of clinical handling and reduced... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION:
The use of flowable composites as an orthodontic bonding adhesive merits great attention because of their adequate bond strength, ease of clinical handling and reduced number of steps in bonding.
OBJECTIVE:
The aim of this Randomized Controlled Trial was to comparatively evaluate over a 6-month period the bond failure rate of a flowable composite (Heliosit Orthodontic, Ivoclar Vivadent AG, Schaan) and a conventional orthodontic bonding adhesive (Transbond XT, 3M Unitek).
METHODS:
53 consecutive patients (23 males and 30 females) who fulfilled the inclusion and exclusion criteria were included in the study. A total of 891 brackets were analyzed, where 444 brackets were bonded using Heliosit Orthodontic and 447 brackets were bonded using Transbond XT. The survival rates of brackets were estimated with the Kaplan-Meier analysis. Bracket survival distributions for bonding adhesives, tooth location and dental arch were compared with the log-rank test.
RESULTS:
The failure rates of the Transbond XT and the Heliosit Orthodontic groups were 8.1% and 6% respectively. No significant differences in the survival rates were observed between them (p= 0.242). There was no statistically significant difference in the bond failure rates when the clinical performance of the maxillary versus the mandibular arches and the anterior versus the posterior segments were compared.
CONCLUSIONS:
Both systems had clinically acceptable bond failure rates and are adequate for orthodontic bonding needs.
Topics: Adolescent; Adult; Composite Resins; Dental Arch; Dental Bonding; Dental Cements; Dental Restoration Failure; Equipment Failure; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Male; Materials Testing; Orthodontic Brackets; Resin Cements; Time Factors; Tooth; Young Adult
PubMed: 28658358
DOI: 10.1590/2177-6709.22.2.069-076.oar -
Asian Journal of Surgery Jul 2022
Topics: Artifacts; Hernia; Humans; Magnetic Phenomena; Magnetic Resonance Imaging; Orthodontic Brackets
PubMed: 35346588
DOI: 10.1016/j.asjsur.2022.02.043 -
The Bulletin of Tokyo Dental College Jun 2019Various types of bracket are currently available, and different prescriptions are provided for the same type of tooth. There are no definite criteria, however, on which...
Various types of bracket are currently available, and different prescriptions are provided for the same type of tooth. There are no definite criteria, however, on which to base bracket selection. The purpose of this study was to investigate differences in the angulation and inclination of orthodontically aligned teeth when using different prescription brackets. Thirty patients undergoing orthodontic treatment for maxillary protrusion and crowding were enrolled. After orthodontic treatment with a pre-adjusted appliance, angulation and inclination were measured on dental casts obtained from these patients (10 each with 0.022 MBT, 0.022 Roth, or 0.018 Roth brackets). The dental casts were scanned and digitized using a 3-dimensional (3-D) scanner and measured with 3-D model measurement software. A significant difference was observed in the mean angulation of the mandibular canine between the 0.022 MBT (5.81°) and 0.018 Roth groups (9.07°). Greater mesial inclination was observed in the 0.018 Roth group. No significant difference was observed in any of the other regions measured. Differences in bracket prescription showed no clinical influence on treatment outcomes. A significant difference was observed in the mandibular canine (p<0.05), suggesting that consideration is required when selecting brackets.
Topics: Cuspid; Humans; Malocclusion; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Treatment Outcome
PubMed: 30971675
DOI: 10.2209/tdcpublication.2018-0030 -
European Journal of Orthodontics Aug 2014To investigate the composition and the microstructural and mechanical characterization of three different types of lingual brackets.
OBJECTIVES
To investigate the composition and the microstructural and mechanical characterization of three different types of lingual brackets.
MATERIALS AND METHODS
Incognito™ (3M Unitek), In-Ovation L (DENTSPLY GAC) and STb™ (Light Lingual System, ORMCO) lingual brackets were studied under the scanning electron microscope employing backscattered electron imaging and their elemental composition was analysed by energy-dispersive X-ray microanalysis. Additionally, Vickers hardness was assessed using a universal hardness-testing machine, and the indentation modulus was measured according to instrumented indentation test. Two-way analysis of variance was conducted employing bracket type and location (base and wing) as discriminating variable. Significant differences among groups were allocated by post hoc Student-Newman-Keuls multiple comparison analysis at 95% level of significance.
RESULTS
Three different phases were identified for Incognito and In-Ovation L bracket based on mean atomic number contrast. On the contrary, STb did not show mean atomic contrast areas and thus it is recognized as a single phase. Incognito is a one-piece bracket with the same structure in wing and base regions. Incognito consists mainly of noble metals while In-Ovation L and STb show similar formulations of ferrous alloys in wing and base regions. No significant differences were found between ferrous brackets in hardness and modulus values, but there were significant differences between wing and base regions. Incognito illustrated intermediate values with significant differences from base and wing values of ferrous brackets.
CONCLUSIONS/IMPLICATIONS
Significant differences exist in microstructure, elemental composition, and mechanical properties among the brackets tested; these might have a series of clinical implications during mechanotherapy.
Topics: Algorithms; Chromium; Chromium Alloys; Copper; Dental Alloys; Dental Stress Analysis; Elastic Modulus; Electron Probe Microanalysis; Gold Alloys; Hardness; Humans; Iron; Materials Testing; Microscopy, Electron, Scanning; Nickel; Orthodontic Appliance Design; Orthodontic Brackets; Surface Properties
PubMed: 24232131
DOI: 10.1093/ejo/cjt086 -
Clinical Oral Investigations May 2023White spot lesions are one of the most common side effects of orthodontic therapy with a multibracket appliance and may indicate a preliminary stage of caries, also...
OBJECTIVES
White spot lesions are one of the most common side effects of orthodontic therapy with a multibracket appliance and may indicate a preliminary stage of caries, also known as initial caries. Several approaches may be utilized to prevent these lesions, such as reducing bacterial adhesion in the area surrounding the bracket. This bacterial colonization can be adversely affected by a number of local characteristics. In this context, the effects of excess dental adhesive in the bracket periphery were investigated by comparing a conventional bracket system with the APC flash-free bracket system.
MATERIALS AND METHODS
Both bracket systems were applied to 24 extracted human premolars, and bacterial adhesion with Streptoccocus sobrinus (S. sobrinus) was performed for 24 h, 48 h, 7 d, and 14 d. After incubation, bacterial colonization was examined in specific areas by electron microscopy.
RESULTS
Overall, significantly fewer bacterial colonies were found in the adhesive area around the APC flash-free brackets (n = 507 ± 13 bacteria) than the conventionally bonded bracket systems (n = 850 ± 56 bacteria). This is a significant difference (**p = 0.004). However, APC flash-free brackets tend to create marginal gaps with more bacterial adhesion in this area than conventional bracket systems (n = 265 ± 31 bacteria). This bacterial accumulation in the marginal-gap area is also significant (*p = 0.029).
CONCLUSION
A smooth adhesive surface with minimal adhesive excess is beneficial for reducing bacterial adhesion but also poses a risk of marginal gap formation with subsequent bacterial colonization, which can potentially trigger carious lesions.
CLINICAL RELEVANCE
To reduce bacterial adhesion, the APC flash-free bracket adhesive system with low adhesive excess might be beneficial. APC flash-free brackets reduce the bacterial colonization in the bracket environment. A lower number of bacteria can minimize white spot lesions in the bracket environment. APC flash-free brackets tend to form marginal gaps between the bracket adhesive and the tooth.
Topics: Humans; Dental Cements; Orthodontic Brackets; Bacterial Adhesion; Dental Bonding; Materials Testing; Dental Caries
PubMed: 36809356
DOI: 10.1007/s00784-023-04924-4 -
BioMed Research International 2020Dietary habits with high consumption of acidic food can induce in orthodontic patients an increased risk of demineralization lesions around orthodontic brackets and...
Biomimetic Effect of Nano-Hydroxyapatite in Demineralized Enamel before Orthodontic Bonding of Brackets and Attachments: Visual, Adhesion Strength, and Hardness in In Vitro Tests.
Dietary habits with high consumption of acidic food can induce in orthodontic patients an increased risk of demineralization lesions around orthodontic brackets and bands. The purpose of the present laboratory study is to assess the visual efficacy of a biomimetic nano-hydroxyapatite remineralizing solution in a hypomineralized enamel surface and its effect on adhesion of fixed orthodontic appliances and on enamel microhardness. Intact teeth were demineralized, and subsequently the areas of demineralization were visually recorded using a 0-100 scale. Subsequently, a remineralizing solution (Biorepair® Repair Shock Treatment) was applied for ten minutes once a day/for one week per month for a total remineralizing treatment of 3 months. Visual effects were recorded. Moreover, bond strength was recorded and adhesive remnant index scores were measured for both orthodontic brackets and composite attachments both before demineralization and after demineralization and application of remineralizing solution. Also, Vickers microhardness was measured. All data were submitted to statistical analysis. The application of remineralizing solution induced a significant reduction of demineralized areas after the first week of application. No significant differences between untreated enamel surfaces and remineralized surfaces were detected after 2 months of remineralizing treatment. Bond strength values were significantly reduced for both brackets and attachments after remineralizing treatment. However, attachments showed higher adhesion values than brackets in both conditions tested. Remineralized enamel showed significantly higher microhardness values than demineralized enamel and lower values than intact enamel.
Topics: Adhesiveness; Animals; Biomimetic Materials; Cattle; Dental Bonding; Dental Enamel; Durapatite; Hardness; Nanoparticles; Orthodontic Brackets; Tooth Demineralization
PubMed: 32090106
DOI: 10.1155/2020/6747498 -
British Dental Journal Dec 2020
Topics: Dental Alloys; Dental Bonding; Orthodontic Brackets; Resin Cements; Surface Properties
PubMed: 33339907
DOI: 10.1038/s41415-020-2514-6 -
Clinical and Experimental Dental... Apr 2020This study aimed to investigate salivary concentrations of Streptococcus mutans (S. mutans) and some Lactobacilli, and plaque index (PI) in patients wearing fixed versus... (Comparative Study)
Comparative Study Observational Study
Salivary concentrations of Streptococcus mutans and Lactobacilli during an orthodontic treatment. An observational study comparing fixed and removable orthodontic appliances.
AIM
This study aimed to investigate salivary concentrations of Streptococcus mutans (S. mutans) and some Lactobacilli, and plaque index (PI) in patients wearing fixed versus removable orthodontic appliances.
METHODS
A sample of 90 orthodontic patients (56 males and 34 females) was included in the study: 30 subjects (aged 21.5±1.5 years) were treated with removable clear aligners (CA), while for other 30 cases (aged 23.3±1.6 years) a fixed multibrackets appliance (MB) were utilized, and 30 patients (aged 18.2 ±1.5 years) wearied a removable positioner (RP). Salivary concentrations of S. mutans and Lactobacilli and PI were evaluated prior to start of the orthodontic treatment, after 3 months and 6 months.
RESULTS
After 6 months, 40% of MB patients (12 subjects over 30) showed a concentration of S. mutans associated to high risk of developing tooth decay (CFU/ml>10 ), differently from participants wearing removable appliances (odds ratio = 5.05; 95% C.I. = 1.72-14.78; chi-square = 9.64; p = 0.0019). The same trens was observed for the concentration of Lactobacilli (odds ratio = 4.33; 95% C.I. = 1.53-12.3; chi-square = 8.229; p = 0.004). In addition, over the duration of the study, CA patients maintained PI at 0 level, while MB patients experienced a statistically significant increasing trend of PI over time, and their PI became clinically/statistically relevant after 6 months, respect to CA and RP patients.
CONCLUSIONS
Comparing all the data, while, after 6 months, only about 10% of CA patients and 13.3% of RP patients achieved a microbial colonization which may lead to high risk of caries development, about 40% of MB patients - and 20% after 3 months - showed a high level of vulnerability to developing caries, which require additional strategies for plaque control and microbial colonization to be employed.
Topics: Adolescent; Bacterial Load; Dental Caries; Female; Humans; Lactobacillus; Male; Orthodontic Appliances, Removable; Orthodontic Brackets; Risk Assessment; Saliva; Streptococcus mutans; Young Adult
PubMed: 32250562
DOI: 10.1002/cre2.261 -
Advances in Clinical and Experimental... May 2020In orthodontics, erbium (Er:YAG) lasers can be used for bracket debonding.
BACKGROUND
In orthodontics, erbium (Er:YAG) lasers can be used for bracket debonding.
OBJECTIVES
To assess the changes in temperature of pulp and enamel during laser debonding of brackets.
MATERIAL AND METHODS
A total of 13 brackets (n = 13; 2 metal and 11 ceramic brackets) were bonded to 13 caries-free premolars extracted for orthodontic reasons. Brackets were irradiated with 2 lasers. Laser No. 1 was an erbium-chromium (Er,Cr:YSGG) laser (Waterlase Express; Biolase, Irvine, USA) with a wavelength of 2,780 nm at a power of 2.78-2.85 W, energy of 185-190 mJ, fluence of 10 ns, frequency of 25 Hz, pulse duration of 300 μs, tip diameter of 0.6 mm, air/fluid cooling of 3.5 mL/s, and time of irradiation of 5-25 s. Laser No. 2 was an Er:YAG laser (LiteTouch; Light Instruments Ltd., Yokneam, Israel) with a wavelength of 2,940 nm at a power of 4 W, energy of 200 mJ, fluence of 10 ns, frequency of 20 Hz, pulse duration of 300 μs, tip diameter of 0.8 mm, air/fluid cooling of 3.5 mL/s, and time of irradiation of 5-15 s. Two thermographic cameras (FLIR Zenmuse XT and FLIR P65; FLIR Systems, Wilsonville, USA) and type K thermocouple (Zhangzhou Weihua Electronic Co., Fujian, China) were used for precise temperature measurement on the surface of the teeth and inside them.
RESULTS
When laser No. 1 was in use, the mean difference between the inner and outer temperature of the examined teeth (1.4°C) was higher than when the laser No. 2 was in use (0.6°C) (p = 0.0974). The study found that the temperature inside the tooth did not increase, and it even decreased during treatment with Er:YAG laser using water cooling, provided that appropriate proportion of water and air was used. For laser No. 1, confidence interval (CI) was between 0.7 and 2.2 and for laser No. 2 it was between 0.500 and 1.23. Only experiment for ceramic brackets was described.
CONCLUSIONS
These findings confirm that the use of Er:YAG family lasers for orthodontic bracket debonding in an in vitro study is safe and effective.
Topics: Ceramics; China; Dental Debonding; Humans; Lasers, Solid-State; Metals; Orthodontic Brackets; Temperature
PubMed: 32396714
DOI: 10.17219/acem/118844 -
Acta Medica Academica Dec 2019The purpose of this in vitro investigation was to evaluate qualitatively the surface topography at the bracket-adhesive-enamel junction, bonded to the buccal and lingual...
OBJECTIVES
The purpose of this in vitro investigation was to evaluate qualitatively the surface topography at the bracket-adhesive-enamel junction, bonded to the buccal and lingual surfaces of premolars with composite resin and resin-modified glass-ionomer orthodontic adhesives, using two methods of adhesive removal: a dental explorer and a micro brush.
METHODS
Forty premolar surfaces were allocated to four groups of 10/ each, 20/buccal and 20/lingual surfaces. The brackets were bonded to the surface of the enamel and any extra adhesive was removed with a dental explorer or a micro brush. Specimens were evaluated and scored by two calibrated independent raters, at the bracketadhesive-enamel junction, for adhesive overlap on the bracket, the smoothness of the surface, as well as the presence of projections and depressions, using a digital microscope. The Fisher-exact statistical test was conducted to compare the different groups.
RESULTS
Regardless of the method used to remove the adhe sives, all groups showed partial or complete overlap of the adhesive on the bracket. No statistical difference was found between the groups for adhesive overlap (P=1.0). However, resin-modified glass-ionomer was found to be statistically significantly (P<0.05) better than composite resin in both smoothness and the lack of projections or depressions, regardless of the instrument of removal.
CONCLUSION
Removing excess adhesive with a dental explorer or a micro brush is not an ideal method for adhesive removal, as partial or complete overlap of the adhesive on the bracket existed in all groups. On the other hand, resin-modified glassionomer was a superior material to composite resin for better smoothness and surface topography at the bracket-adhesive-enamel junction.
Topics: Composite Resins; Dental Bonding; Dental Cements; Dental Enamel; Humans; In Vitro Techniques; Orthodontic Brackets
PubMed: 32124624
DOI: 10.5644/ama2006-124.266