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Lasers in Medical Science Jun 2024The risk of enamel deterioration that frequently coexists with debonding of orthodontic teeth brackets elevates the mandate for finding an optimum approach for debonding... (Comparative Study)
Comparative Study
The risk of enamel deterioration that frequently coexists with debonding of orthodontic teeth brackets elevates the mandate for finding an optimum approach for debonding them without harmful effects. This in-vitro study is intended to compare the effects of two different laser modes (scanning and circular) and a conventional method on the enamel surface after debonding orthodontic brackets. 66 extracted premolars were assigned into 3 groups. After that, light-cure composite resin was used to attach the ceramic brackets to the teeth. Amongst the test groups, Group I: specimens that were debonded using conventional debonding using pliers; Group 2: specimens that were debonded using Er, Cr: YSGG laser applications using the circular motion method; and Group 3: specimens that were debonded using Er, Cr: YSGG laser applications using the scanning motion method. Adhesive Remnant Index (ARI) assessment, intra-pulpal temperature increase, enamel surface roughness after polishing, and assessment of the microstructure of enamel were carried out with scanning electron microscopy. The gathered information was examined statistically. The conventional debonding method had a significantly higher proportion of adhesive remnant index (ARI) scores of 2 and 3 in comparison to the circular (p < .004) and scanning laser groups (p < .001). There was no significant difference in ARI scores between the circular and scanning laser groups (p > .05). Moreover, the circular and scanning laser debonding methods resulted in a significantly higher proportion of Enamel Surface Roughness (ESR) scores of 0 and a lower proportion of ESR scores of 3 compared to the conventional technique group (p < .001). However, there was no significant difference in ESR scores between the circular and scanning laser methods (p = .945). Lastly, the average intra-pulpal temperature was significantly higher in the circular laser group (1.9 ± 0.5 ) compared to the scanning laser group (0.9 ± 0.2) with p < .001. Er, Cr: YSGG laser irradiation is a tool that shows promise for debonding ceramic brackets with minimal harm to the enamel surface. The scanning laser technique is more desirable due to the lower intra-pulpal temperature increase.
Topics: Humans; Orthodontic Brackets; Dental Enamel; Dental Debonding; Ceramics; Lasers, Solid-State; Surface Properties; In Vitro Techniques; Microscopy, Electron, Scanning; Bicuspid
PubMed: 38869676
DOI: 10.1007/s10103-024-04097-w -
Heliyon Jun 2024Traditional working procedures requires a lot of clinical processes and processing time.
BACKGROUND
Traditional working procedures requires a lot of clinical processes and processing time.
METHODS
The orthodontic metal appliances were made by applying oral scanners, digital images, computer-aided design and computer-aided manufacturing (CAD-CAM) printers.
RESULTS
The computer digital technology simplified the manufacturing process for dental appliances and shorten the duration for clinical operation and technical processing.
CONCLUSIONS
The technique described in this paper can guarantee the accuracy of orthodontic appliances and bring revolution the field.
CLINICAL SIGNIFICANCE
The CAD-CAM technology provides a fully digital workflow for manufacturing metal orthodontic appliances, which saves a considerable amount of labor and material costs, and significantly reduces heavy metal pollution in the working environment of dental technicians.
PubMed: 38867998
DOI: 10.1016/j.heliyon.2024.e32064 -
Heliyon Jun 2024With the advancement of 3-dimensionally (3D) printing technology, orthodontists can design and fabricate 3D-printed indirect bonding trays and transfer jigs for lingual...
With the advancement of 3-dimensionally (3D) printing technology, orthodontists can design and fabricate 3D-printed indirect bonding trays and transfer jigs for lingual brackets independently from the laboratory. The present article describes, in detail, the digital workflows for designing and fabricating 3D-printed lingual bracket indirect bonding trays and transfer jigs. Additionally, it aims to demonstrate the effectiveness of this approach in managing common orthodontic issues in adult patients. The first case report exemplifies the successful management of moderate crowding in a Class I adult patient using a non-extraction approach with lingual brackets and flexible 3D-printed indirect bonding trays. The second case illustrates the application of lingual brackets and rigid 3D-printed indirect bonding trays in managing a skeletal Class II adult patient with mouth protrusion requiring four-bicuspid extractions. The achieved good treatment results might demonstrate the high transfer accuracy of 3D-printed lingual bracket indirect bonding trays. Additional studies with large sample sizes should be conducted to compare the effectiveness and efficiency of 3D-printed trays with other tray types.
PubMed: 38867963
DOI: 10.1016/j.heliyon.2024.e32035 -
BMC Oral Health Jun 2024To investigate the effect of a 50% ascorbic acid with 50% citric acid solution on the immediate shear bond strength (SBS) of metallic brackets after tooth bleaching. The...
Reduction of surface treatment time by combination of citric acid and ascorbic acid while restoring shear bond strength of metal brackets bonded to bleached enamel: a pilot study.
BACKGROUND
To investigate the effect of a 50% ascorbic acid with 50% citric acid solution on the immediate shear bond strength (SBS) of metallic brackets after tooth bleaching. The enamel etching pattern and the required quantity of these combined acids as antioxidants following 35% hydrogen peroxide (HP) bleaching were also determined.
METHODS
The stability of the solution at room temperature was assessed at various time intervals. Fifty teeth were randomly divided into five groups: non-bleached (G1), bleached then acid etched (G2), bleached followed by a 10-minute treatment with 10% sodium ascorbate and acid etched (G3), 5-minute treatment with 50% ascorbic acid (G4), and 5-minute treatment with a combination of 50% ascorbic acid and 50% citric acid (G5). Groups G2, G3, G4 and G5 were bleached by 35% HP gel for a total of 32 min. Acid etching in groups G1, G2, and G3 was performed using 37% phosphoric acid (Ormco®, Orange, CA, USA) for 15 s. In all groups, metal brackets were immediately bonded using Transbond™ XT primer and Transbond™ PLUS adhesive, with light curing for 40 s. The SBS was tested with a universal testing machine, and statistical analysis was conducted using one-way ANOVA followed by Tukey's HSD test. The level of significance was set at p < 0.05 for all statistical tests.
RESULTS
Stability tests demonstrated that the combined acids remained effective for up to 21 days. Group G5 significantly increased the SBS of bleached teeth to the level of G1 (p < 0.05), while G3 did not achieve the same increase in SBS (p > 0.05). SEM analysis revealed enamel etching patterns similar to those of both control groups (G1 and G2). Kinetic studies at 6 min indicated that the antioxidation in G5 reacted 0.2 mmole lower than in G3 and G4.
CONCLUSION
5-minute application of the combined acids enhanced the SBS of bleached teeth comparable to unbleached teeth. The combined acids remain stable over two weeks, presenting a time-efficient, single-step solution for antioxidant application and enamel etching in orthodontic bracket bonding.
Topics: Ascorbic Acid; Citric Acid; Tooth Bleaching; Shear Strength; Orthodontic Brackets; Humans; Pilot Projects; Dental Enamel; Dental Bonding; Acid Etching, Dental; Antioxidants; Surface Properties; Time Factors; Hydrogen Peroxide; Tooth Bleaching Agents; Phosphoric Acids; Dental Stress Analysis
PubMed: 38867181
DOI: 10.1186/s12903-024-04424-1 -
International Orthodontics Jun 2024To synthesise the dentoalveolar, periodontal and skeletal changes that occur when using maxillary expansion techniques assisted by temporary anchorage devices compared...
Dentoalveolar, periodontal and skeletal effects of maxillary expansion techniques assisted by temporary anchorage devices compared with conventional protocols in growing patients with transverse maxillary deficiency: A systematic review and meta-analysis.
OBJECTIVES
To synthesise the dentoalveolar, periodontal and skeletal changes that occur when using maxillary expansion techniques assisted by temporary anchorage devices compared to conventional protocols.
METHODS
Five databases and grey literature were consulted, up to December 2023, focusing on intervention designs and excluding other type of studies. The quality assessment was conducted by using the adaptation for orthodontics of the CONSORT statement, the guidelines for reporting non-randomised studies, the RoB-2 tool, and the ROBINS-I tool. A descriptive summary and meta-analysis using RevMan 5.4 were performed.
RESULTS
Nine clinical trials were included (n=377 patients, mean age 13.2±0.6) with a diagnosis of transverse maxillary deficiency. The analysed studies showed qualitative dentoalveolar and periodontal changes after expansion, which were greater on the maxillary first premolars in tooth-borne appliances. Meta-analyses for some effects were included from two studies (n=64); patients who used tooth-borne appliances had greater effects of buccal intercoronal width between the premolars with statistically significant differences (Std Mean difference 2.34; 95% CI: 0.04-4.65 p=0.05). Conversely, those patients who used bone-borne or hybrid appliances had greater effects of buccal intercoronal width between molars with statistically significant differences (Std Mean difference -0.64; 95% CI: -1.38-0.10; p=0.09).
CONCLUSIONS
According to the studies analysed, all measurements increased in the intervention groups after expansion. Quantitative analyses show different findings at dentoalveolar level when tooth-borne, bone-borne or hybrid appliances are considered. Nevertheless, the results should be taken with caution due to the heterogeneity of the studies. The protocol was registered at PROSPERO (CRD42021283170), with no funding to report.
PubMed: 38865748
DOI: 10.1016/j.ortho.2024.100891 -
Dental Press Journal of Orthodontics 2024To assess the effectiveness of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization.
OBJECTIVE
To assess the effectiveness of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization.
METHODS
Seventeen patients aged between 12.5 and 24 years underwent distalization with a customized distalizer. Lateral cephalogram and cast analysis were performed before and after distalization. Linear and angular parameters of the upper first molar, first premolar, and central incisor were assessed.
RESULTS
Distalization with the force passing near the center of resistance (CRes) of the upper first molars resulted in distal movement, with minimal distal tipping (2.8 ± 0.45°, p< 0.05). However, distalization passing occlusal to the CRes led to greater distal tipping (13.6 ± 1.63°, p< 0.05). Statistically significant spontaneous distal tipping and distal movement of the upper first premolars occurred, with a mean of 6.2 ± 1.24° (p< 0.05) and 0.68 ± 0.34 mm (p< 0.05), respectively. The positional change of the upper central incisors presented a mean of -0.23 ± 0.1 mm (p> 0.05) and 2.65 ± 1.1° (p< 0.05). Upper first molar intrusion was statistically significant, with a mean of 0.88 ± 0.2 mm (p< 0.05). Upper right and left first molars rotation towards palatal midline presented mean of 4.1 ± 0.19° (p< 0.05) and 3.4 ± 0.1° (p< 0.05), respectively. Additionally, the distance between upper right and left first molars increased significantly, with a mean of 2.54 ± 0.01 mm (p< 0.05).
CONCLUSION
The study successfully demonstrated the efficiency of molar distalization without anchorage loss using a customized distalizer anchored on palatal miniscrews.
Topics: Humans; Molar; Bone Screws; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Adolescent; Child; Young Adult; Female; Male; Cephalometry; Orthodontic Appliance Design; Maxilla; Bicuspid; Incisor; Models, Dental
PubMed: 38865515
DOI: 10.1590/2177-6709.29.2.e2423253.oar -
Dental Press Journal of Orthodontics 2024The purpose of this retrospective study was to compare accuracy of arch expansion using two different thermoplastic materials in Invisalign aligners: EX30®... (Comparative Study)
Comparative Study
OBJECTIVE
The purpose of this retrospective study was to compare accuracy of arch expansion using two different thermoplastic materials in Invisalign aligners: EX30® (Polyethylene Terephthalate Glycol, or PETG) and SmartTrack® (polyurethane).
METHODS
The study sample comprised 65 adult patients consecutively treated with Invisalign from two private practices: group 1 - treated with EX30® (358 teeth) and group 2 - treated with SmartTrack® (888 teeth). Six hundred and twenty-three measurements were assessed in three digital models throughout treatment: model 1 - initial, model 2 - predicted tooth position, and model 3 - achieved position. Sixteen reference points per arch were marked and, after best alignment, 2 points per tooth were copied from one digital model to another. Linear values of both arches were measured for canines, premolars, and first molars: on lingual gingival margins and cusp tips of every tooth. Comparisons were performed by Wilcoxon and Mann-Whitney test.
RESULTS
Both termoplastic materials presented significant differences between predicted and achieved values for all measurements, except for the lower molar cusp tip in the SmartTrack® group. There is no statistical difference in the accuracy of transverse expansion between these two materials. Overall accuracy for EX30® aligners in maxilla and mandible were found to be 37 and 38%, respectively; and Smarttrack® presented an overall accuracy of 56.62% in the maxilla and 68.72% in the mandible.
CONCLUSIONS
It is not possible to affirm one material expands better than the other. Further controlled clinical studies should be conducted comparing SmartTrack® and EX30® under similar conditions.
Topics: Humans; Retrospective Studies; Adult; Female; Tooth Movement Techniques; Male; Orthodontic Appliance Design; Polyurethanes; Polyethylene Terephthalates; Polyethylene Glycols; Dental Arch; Orthodontic Appliances, Removable; Young Adult
PubMed: 38865514
DOI: 10.1590/2177-6709.29.2.e2423212.oar -
IET Nanobiotechnology 2024The massive growth of various microorganisms on the orthodontic bracket can form plaques and cause diseases. A novel amine-terminated hyperbranched...
The massive growth of various microorganisms on the orthodontic bracket can form plaques and cause diseases. A novel amine-terminated hyperbranched zirconium-polysiloxane (HPZP) antimicrobial coating was developed for an orthodontic stainless steel tank (SST). After synthesizing HPZP and HPZP-Ag coatings, their structures were characterized by nuclear magnetic resonance spectroscopy, scanning electron microscopy, thickness measurement, contact angle detection, mechanical stability testing, and corrosion testing. The cell toxicity of the two coatings to human gingival fibroblasts (hGFs) and human oral keratinocytes (hOKs) was detected by cell counting kit eight assays, and SST, HPZP@SST, and HPZP-Ag@SST were cocultured with , , and for 24 hr to detect the antibacterial properties of the coatings, respectively. The results show that the coatings are about 10 m, and the water contact angle of HPZP coating is significantly higher than that of HPZP-Ag coating ( < 0.01). Both coatings can be uniformly and densely distributed on SST and have good mechanical stability and corrosion resistance. The cell counting test showed that HPZP coating and HPZP-Ag coating were less toxic to cells compared with SST, and the toxicity of HPZP-Ag coating was greater than that of HPZP coating, with the cell survival rate greater than 80% after 72 hr cocultured with hGFs and hOKs. The antibacterial test showed that the number of bacteria on the surface of different materials was ranked from small to large: HPZP@SST < HPZP-Ag@SST < SST and 800 g/mL HPZP@SST showed a better bactericidal ability than 400 g/mL after cocultured , , and , respectively (all < 0.05). The results showed that HPZP coating had a better effect than HPZP-Ag coating, with effective antibacterial and biocompatible properties, which had the potential to be applied in orthodontic process management.
Topics: Stainless Steel; Coated Materials, Biocompatible; Humans; Anti-Bacterial Agents; Orthodontic Brackets; Zirconium; Siloxanes; Fibroblasts; Materials Testing; Amines; Staphylococcus aureus; Surface Properties; Escherichia coli; Keratinocytes; Cell Survival; Gingiva
PubMed: 38863970
DOI: 10.1049/2024/4391833 -
Clinical Oral Investigations Jun 2024Fixed orthodontic appliances may increase the risk for caries and white spot lesions. The aim of this retrospective study was to determine the long-term associations...
OBJECTIVES
Fixed orthodontic appliances may increase the risk for caries and white spot lesions. The aim of this retrospective study was to determine the long-term associations between both in orthodontic patients.
MATERIALS AND METHODS
103 patients aged 36.6 ± 6.5 years whose fixed appliance orthodontic treatment had finished at least 15 years ago were included. Current clinical data and photographs (T3), panoramic x-ray and photographs from before treatment (T0), after debonding (T1) and at 2-year follow-up (T2) were available. Parameters of interest were dentine caries, "Missing/Filled Teeth" (MFT), "White Spot Lesion" (WSL) index and "Periodontal Screening and Recording" index (PSR; T3 only).
RESULTS
At T0, 30.4% had no caries experience decreasing to 25.6%, 22.4% and 6.8% at T1, T2 and T3 resp. The median MFT (95% CI) at T0, T1, T2 and T3 was 2 (1;3), 3 (2;4), 3 (2;4) and 7 (6;9) resp. increasing significantly at each time point (p < 0.001 each); 30.1% had WSL at debonding. Patients with caries experience at T0 had a 2.4-fold increased risk of WSL at debonding. Dentine caries, caries experience and WSL at T1 were significantly associated with incident caries at T2, but not at T3. PSR at T3 had a significant association with previous caries incidence and WSL.
CONCLUSIONS
Caries experience prior to orthodontic treatment may constitute a risk indicator for WSL, and caries experience and WSL at its end for caries incidence in the near term.
CLINICAL RELEVANCE
Present caries and WSL may help identifying orthodontic patients with special need for prevention and counselling.
Topics: Humans; Dental Caries; Retrospective Studies; Male; Female; Adult; Radiography, Panoramic; Risk Factors; Orthodontic Appliances, Fixed; DMF Index
PubMed: 38861170
DOI: 10.1007/s00784-024-05752-w -
Journal of Orthodontics Jun 2024New technologies have paved the way for newer fabrication techniques, such as rapid prototyping, which has gained popularity in the fabrication of several orthodontic...
BACKGROUND
New technologies have paved the way for newer fabrication techniques, such as rapid prototyping, which has gained popularity in the fabrication of several orthodontic appliances including retainers.
AIM
To evaluate the stability, survival time and periodontal health associated with vacuum-formed retainers (VFRs), bonded retainers (BRs) and rapid prototype retainers (RPRs) over a period of 12 months in retention.
STUDY DESIGN
Prospective clinical study.
METHODS
A total of 72 participants completing fixed orthodontic treatment were allocated to the following three groups by the investigators based upon their initial malocclusion, compliant and preferences: VFR; BR; and RPR. The primary outcome was Little's Irregularity Index (LII). Other stability parameters, including arch length (AL), inter-canine width (ICW) and inter-molar width (IMW), were also assessed immediately after debonding (T0) and 12 months (T2) after debonding. In addition, survival time, and calculus index and gingival index (GI) were assessed.
RESULTS
LII showed a significant difference ( = 0.00) between the groups and was increased in the VFR group (0.18 ± 0.22 mm) compared to the BR (0.03 ± 0.05 mm) and RPR (0.01 ± 0.03 mm) groups but was not clinically significant. The mean survival time of maxillary retainers was longest for the RPR group (220.63 days; 95% confidence interval [CI] = 194.1-247.16) but there was no significant difference between the three groups ( = 0.43). The mean survival time of mandibular retainers was higher and the same for the VFR and RPR groups (240 days; 95% CI = 240-240) and there was no significant difference between the three groups ( = 0.38). The calculus index score ( = 0.00) was statistically significant between the groups, with an increased score for the BR group (0.33 ± 0.27) compared to the VFR (0.07 ± 0.16) and RPR (0.13 ± 0.22) groups. Similarly, the GI score ( = 0.02) was statistically significant between the groups and was increased in the BR group (0.01 ± 0.19) compared to the VFR (-0.15 ± 0.18) and RPR (-0.06 ± 0.15) groups. The increase in calculus index and GI scores for the BR group were not clinically significant.
CONCLUSION
There were no clinically significant differences between the three retainer groups in terms of stability, periodontal health and time to failure.
PubMed: 38859624
DOI: 10.1177/14653125241255702