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Materials (Basel, Switzerland) Oct 2022During the last decade, there has been an increased demand for non-metallic materials in orthodontics due to allergies, compatibility with medical imaging devices such... (Review)
Review
During the last decade, there has been an increased demand for non-metallic materials in orthodontics due to allergies, compatibility with medical imaging devices such as MRI, and aesthetic reasons. Monolithic poly-ether-ether-ketone material could address medical issues such as allergies and MRI compatibility. Moreover, nickel-titanium (NiTi) archwires covered in PEEK, either by a tube or electrophoretic deposition, could address esthetic concerns. This scoping review aims to summarize the available evidence in the literature to provide an overview of the applications and material properties of PEEK in orthodontics. This scoping review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis for scoping reviews and the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols extension for Scoping Reviews (PRISMA-ScR). We searched for relevant publications in MEDLINE (via PubMed), Embase, Web of Science, Cochrane Library, CENTRAL, ProQuest, and SCOPUS. A gray literature search was conducted on Google Scholar. Six studies were included. In three studies, the authors investigated the feasibility of developing a composite PEEK-NiTi wire, while in two other studies, the authors investigated the feasibility of monolithic PEEK wires. In the final study, the authors investigated the feasibility of PEEK as a bonded retainer. The included studies show promising results in developing monolithic and composite (PEEK-NiTi) materials. Further research on the robustness of PEEK composites in the oral cavity, the status of cytotoxicity and roughness values, and the (bio)-mechanical behavior of the composites is needed. A homogenously set up comparative study of clinically relevant, evenly sized, monolithic PEEK wires versus conventional orthodontic wires for their biomechanical, mechanical, and material properties would clarify the possibilities of developing monolithic PEEK wires. Missing data in the retainer study suggest more research on the mechanical properties and points of failure of PEEK-bonded retainers, and a comparative study comparing the failure and mechanical properties of PEEK-bonded retainers to flat braided metallic bonded retainers is needed.
PubMed: 36363004
DOI: 10.3390/ma15217414 -
Medicina (Kaunas, Lithuania) Mar 2023: Orthodontic tooth movement (OTM) requires bone remodeling resulting from complex processes of aseptic inflammation. Recent studies have confirmed close interaction...
: Orthodontic tooth movement (OTM) requires bone remodeling resulting from complex processes of aseptic inflammation. Recent studies have confirmed close interaction between the immune and skeletal systems. In addition, various orthodontic appliances including fixed systems affect the sublingual microbial composition, and the likelihood of developing inflammatory reactions of the gums is high, especially early in the treatment period. It is known that these systems have both positive and negative effects on the humoral and cellular immune responses. The main aim of the study was to evaluate the influence of self-ligating and conventional brackets on the salivary concentrations of cytokines (IL-6, osteoprotegerin (OPG), TNF-alpha, and IFN-gamma) and cortisol as a marker of stress. : Forty patients were analyzed at baseline (T0) and 2 months (T2) after fixing self-ligating (Ormco Damond Q) and conventional brackets (Ormco Mini Diamond). Salivary cytokine and cortisol concentrations were evaluated by commercial ELISA kits. : Outcomes of our study showed that after two months of treatment with either of these brackets, IFN-gamma and IL-6 levels did not change. However, TNF-alpha decreased with self-ligating brackets (13.36 to 8.32, = 0.002). The self-ligating bracket system also affects OPG concentration and cortisol levels 2 months after orthodontic activation. The level of OPG in the group of self-ligating brackets decreased significantly (8.55 to 2.72, = 0.003). Cortisol concentration was significantly higher in the self-ligation group (25.72 to 48.45, = 0.001) due to the effect of sustained strength movements. : Thus, the use of self-ligating and conventional brackets has a different effect on the concentration of cortisol and cytokines (OPG and TNF-alpha) in saliva 2 months after their fixation. Further longitudinal studies are necessary to explore why OPG levels are decreased in case of self-ligating cases and how OPG levels are related to clinical improvement.
Topics: Humans; Hydrocortisone; Orthodontic Wires; Orthodontic Brackets; Cytokines; Tumor Necrosis Factor-alpha; Interleukin-6
PubMed: 36984567
DOI: 10.3390/medicina59030566 -
Frontiers in Dentistry 2022This study compared the effects of fluoride mouthwashes on surface topography of orthodontic wires, and static and kinetic frictional forces between the stainless steel...
This study compared the effects of fluoride mouthwashes on surface topography of orthodontic wires, and static and kinetic frictional forces between the stainless steel (SS) orthodontic brackets and SS and nickel-titanium (NiTi) archwires. This in vitro, study evaluated 240 standard SS maxillary central incisor brackets and 0.018, and 0.025×0.019 inch NiTi and SS archwires. The wire-bracket sets (different combinations of wire diameters and types) were exposed to artificial saliva (control), 0.05% sodium fluoride (NaF) for 1 minute daily, or 0.2% NaF for 1 minute, weekly (37°C) for 3 months. The wires were pulled in bracket slots by 5 mm in a universal testing machine (10 mm/minute). The static and kinetic forces were measured. The surface topography of wires was inspected under a scanning electron microscope (SEM; x500). Data were analyzed by SPSS 25. The mean static and kinetic frictional forces of 0.025×0.019 inch NiTi wire in 0.05% NaF group were significantly greater than SS wire (P=0.000). The mean kinetic frictional force in 0.05% NaF was significantly greater than 0.2% NaF and artificial saliva for all wires (P=0.001). The mean static and kinetic forces in 0.2% NaF were significantly greater than in artificial saliva (P=0.025). In all groups, larger wires showed higher mean frictional forces (P=0.000). SEM results revealed higher wire surface roughness in 0.05% NaF followed by 0.2% NaF group. Weekly use of 0.2% NaF mouthwash is recommended during sliding mechanics to minimize frictional forces between the SS and NiTi wires and SS brackets.
PubMed: 36458274
DOI: 10.18502/fid.v19i21.9968 -
BioMed Research International 2021Gummetal is a novel multifunctional alloy which possesses distinctive properties with the potential to refine and amend the efficacy of orthodontic treatment. The... (Review)
Review
OBJECTIVE
Gummetal is a novel multifunctional alloy which possesses distinctive properties with the potential to refine and amend the efficacy of orthodontic treatment. The objective of this critical literature review was to investigate scientific evidence concerning the mechanical and clinical features of this recently manufactured beta-titanium orthodontic wire.
MATERIALS AND METHODS
Electronic databases: PubMed, PMC, Google Scholar, Ovid, and Cochrane Library were searched. Studies investigating the properties of Gummetal orthodontic wire including in vitro and clinical studies were selected, validity was assessed, and data was extracted. The risk of bias was assessed by the Cochrane risk of bias Tool 2.0 in a randomized clinical trial. . Among 322 papers, 13 papers were selected and divided into two groups: prospective double-blinded randomized clinical trial and in vitro studies.
CONCLUSIONS
The results of this review should be interpreted with caution because of the heterogeneity of the studies. Only single clinical trial paper was found in the literature. The studies reported different characteristics obtained by various methods; thus, it was difficult to objectively compare the results. Low bending strength, low fatigue limit, and high resilience have been confirmed. Gummetal provides lower force than Nitinol and TMA but higher than Supercable wire. Plastic deformation of Gummetal questions its superelasticity. Friction of Gummetal wire is comparable to SS and CoCr wires. Because of its nontoxic chemical composition, Gummetal might be useful in the initial phase of orthodontic treatment for patients suffering from nickel allergy. Further studies are necessary to assess the usefulness of Gummetal in the clinical practice.
Topics: Alloys; Elastic Modulus; Humans; Orthodontic Brackets; Orthodontic Wires; Tensile Strength; Titanium
PubMed: 33575329
DOI: 10.1155/2021/6611979 -
International Journal of Biomaterials 2021Orthodontic wires are made of alloys containing different metals, including nickel. It is important to evaluate their biocompatibility prior to use, owing to their...
Orthodontic wires are made of alloys containing different metals, including nickel. It is important to evaluate their biocompatibility prior to use, owing to their long-term use in patients. This study compared the cytotoxicity and chemical composition of six latest orthodontic wires: Fantasia®, Tanzo®, FLI®, NT3®, DuoForce®, and Gummetal®. The before-use group consisted of wires that were not used in the mouth, and the after-use group consisted of wires that were used in the mouth for two months. The wires were placed in contact with human gingival fibroblasts (HGF) for 72 h, and cytotoxicity was determined using the resazurin test. The chemical composition and surface characterisation were evaluated by spectrometry and scanning electron microscopy. The groups were compared using ANOVA and Kruskal-Wallis test. Only the FLI® wires produced a 36% reduction in HGF viability ( < 0.05) and presented greater irregularities and loss of polymer structure. After-use wires showed a significant reduction in the percentage of nickel and the appearance of new elements (oxygen and carbon). Therefore, it can be concluded that no toxic ion release was noticed in this study. Rhodium-coated wires were more stable than PTFE-coated wires, and only the FLI® wires showed a slight cytotoxic effect.
PubMed: 33574848
DOI: 10.1155/2021/8885290 -
Cureus Apr 2024Robotics has various applications in dentistry, particularly in orthodontics, although the potential use of these technologies is not yet clear. This review aims to... (Review)
Review
Robotics has various applications in dentistry, particularly in orthodontics, although the potential use of these technologies is not yet clear. This review aims to summarize the application of robotics in orthodontics and clarify its function and scope in clinical practice. Original articles addressing the application of robotics in any area of orthodontic practice were included, and review articles were excluded. PubMed, Google Scholar, Scopus, and DOAJ were searched from June to August 2023. The risk of bias was established using the risk of bias in non-randomized studies (ROBINS) and certainty assessment tools following the grading of recommendations, assessment, development, and evaluation (GRADE) guidelines. A narrative synthesis of the data was generated and presented according to its application in surgical and non-surgical orthodontics. The search retrieved 2,106 articles, of which 16 articles were selected for final data synthesis of research conducted between 2011 and 2023 in Asia, Europe, and North America. The application of robotics in surgical orthodontics helps guide orthognathic surgeries by reducing the margin of error, but it does not replace the work of a clinician. In non-surgical orthodontics, robotics assists in performing customized bending of orthodontic wires and simulating orthodontic movements, but its application is expensive. The articles collected for this synthesis exhibited a low risk of bias and high certainty, and the results indicated that the advantages of the application of robotics in orthodontics outweigh the disadvantages. This project was self-financed, and a previous protocol was registered at the PROSPERO site (registration number: CRD42023463531).
PubMed: 38765377
DOI: 10.7759/cureus.58555 -
Materials (Basel, Switzerland) Jun 2022Fluoride-based mouthwashes and gels are preventive measures in countering demineralization and caries but, modifying environmental acidity, can reduce the wet corrosion...
Fluoride-based mouthwashes and gels are preventive measures in countering demineralization and caries but, modifying environmental acidity, can reduce the wet corrosion resistance of orthodontic alloys. To evaluate chemical stability, in vitro experiments were conducted on stainless steel and nickel-titanium wires, weighed before and after immersion in household fluorinated mouthwashes and gels, measuring weight variations and elution of metal ions from acid corrosion phenomena. Elution samples were analyzed by inductively coupled plasma mass spectrometry, detecting residual ion concentration, while surface changes were analyzed under scanning electron microscopy. Results showed stainless steel wires do not undergo significant erosion when exposed to most fluorinated mouthwashes but, at prolonged exposure, alloys elute gradually greater amounts of metals and Ni-Ti wires become more sensitive to some mouthwashes. Ions' elution varies considerably, especially for Ni-Ti wires, if exposed to household fluorinated gels, for which significant negative values were obtained. Changes, affecting wires' outer layer, negatively act on shiny appearance and luster, reducing corrosion resistance. Although examined orthodontic wires showed good chemical stability and low toxicity, surface corrosion from exposure to fluorinated agents was observed. Home use must be accompanied by clinician prescription and, for household dental gels, must follow manufacturers' recommendations, ensuring prophylactic action without damaging alloys surfaces.
PubMed: 35806740
DOI: 10.3390/ma15134612 -
Frontiers in Dentistry 2024The reduction of resistance to sliding between the archwire and bracket promotes more seamless tooth movement, leading to a faster and improved orthodontic treatment...
The reduction of resistance to sliding between the archwire and bracket promotes more seamless tooth movement, leading to a faster and improved orthodontic treatment experience. This research aimed to examine how the degradation of elastomeric modules, different ligation methods, bracket-wire angle, and wire type (nickel titanium, NiTi or stainless-steel, SS) impact the kinetic friction resulting from the interaction between NiTi or SS archwires and SS brackets. The current in vitro study was conducted on nine groups, including NiTi and SS archwires with three types of ligations (O-ring, figure of 8, and SS wire ligature) and two bracket-wire angles (0˚ and 10˚). The kinetic friction in each group was measured using a Universal Testing Machine at four time intervals: baseline, day one, week one, and week four. Repeated measures ANOVA, Mauchly test of sphericity followed by the Greenhouse-Geisser test, and relevant post hoc tests were used for statistical analysis (P<0.05). The authors found a decrease in kinetic friction in all types of ligations, which confirmed the effect of time on the degradation of ligation modules. The kinetic friction of figure of 8 ligations was higher than both O-ring and SS wire ligations. No difference was observed between O-ring and SS wire ligations. Furthermore, the bracket-wire angle did not affect friction. The authors suggest that the use of figure of 8 ligations in NiTi and SS wires should be limited due to their high friction and replaced with other types of ligations, if possible.
PubMed: 38742224
DOI: 10.18502/fid.v21i10.15222 -
Journal of Orofacial Orthopedics =... Nov 2017The present study evaluated the temporal release of Co Cr, Mn, and Ni from the components of a typical orthodontic appliance during simulated orthodontic treatment.
AIM
The present study evaluated the temporal release of Co Cr, Mn, and Ni from the components of a typical orthodontic appliance during simulated orthodontic treatment.
MATERIALS AND METHODS
Several commercially available types of bands, brackets, and wires were exposed to an artificial saliva solution for at least 44 days and the metals released were quantified in regular intervals using inductively coupled plasma quadrupole mass spectrometry (ICP-MS, Elan DRC+, Perkin Elmer, USA). Corrosion products encountered on some products were investigated by a scanning electron microscope equipped with an energy dispersive X-ray microanalyzer (EDX).
RESULTS
Bands released the largest quantities of Co, Cr, Mn, and Ni, followed by brackets and wires. Three different temporal metal release profiles were observed: (1) constant, though not necessarily linear release, (2) saturation (metal release stopped after a certain time), and (3) an intermediate release profile that showed signs of saturation without reaching saturation. These temporal metal liberation profiles were found to be strongly dependent on the individual test pieces. The corrosion products which developed on some of the bands after a 6-month immersion in artificial saliva and the different metal release profiles of the investigated bands were traced back to different attachments welded onto the bands.
CONCLUSION
The use of constant release rates will clearly underestimate metal intake by the patient during the first couple of days and overestimate exposure during the remainder of the treatment which is usually several months long. While our data are consistent with heavy metal release by orthodontic materials at levels well below typical dietary intake, we nevertheless recommend the use of titanium brackets and replacement of the band with a tube in cases of severe Ni or Cr allergy.
Topics: Corrosion; Humans; In Vitro Techniques; Metals; Orthodontic Appliances, Removable; Orthodontic Brackets; Orthodontic Wires; Saliva; Saliva, Artificial
PubMed: 28913542
DOI: 10.1007/s00056-017-0107-z -
Journal of Orthodontic Science 2022MH cortical screws were designed to combine the advantages of thick mini-implants with the versatility of micro-screws while avoiding the disadvantages of both.
OBJECTIVE
MH cortical screws were designed to combine the advantages of thick mini-implants with the versatility of micro-screws while avoiding the disadvantages of both.
MATERIALS AND METHODS
An MH cortical screw (MH is an abbreviation for the author's name) was made from titanium material. The screw has a 3 mm-long amphora-shaped shank of 2 mm thickness at its thinnest and 3 mm at its thickest part. Uniform 4 mm diameter threads blend into a 1 mm cutting tip. An external hexagonal head with side retentive ligature holes and a central hole for attachments was fabricated on a saucer-shaped gingival collar. Multiple attachments have been prepared for amending to the central hole.
RESULTS
The shank design allowed cortical plate retention. The uniform threads and the amphora design provided maximum primary and secondary stability, respectively. The self-drilling tip allowed for a flapless technique, while the hexagonal head with side holes facilitated screwdriver control and allows for ligature wire anchorage. Cleats and buttons facilitated the use of elastics and springs, together with bracket-heads and eyelets for titanium molybdenum alloy and nickel-titanium wires inclusion. Adjustable hooks and chains provided versatility of line of action. Cover screws to retain extra-tissue mini-plates applied skeletal anchorage and long-term retention with flapless manipulations.
CONCLUSION
MH cortical screws are a novel and important introduction to orthodontic anchorage. They combine primary and secondary stability with avoidance of root damage together with insertions into attached gingiva only. Multiple and versatile attachments allow for the application of biomechanical techniques according to the clinician's preferences. Extra-tissue mini-plates facilitate maximum anchorage for skeletal control and long-term retention without surgery.
PubMed: 36411811
DOI: 10.4103/jos.jos_49_22