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Journal of Pharmacy & Bioallied Sciences Apr 2024In this, study's objective is to assess the shear bond strength (SBS) of metal and ceramic orthodontic brackets that have been adhered to enamel using a conventional...
AIM
In this, study's objective is to assess the shear bond strength (SBS) of metal and ceramic orthodontic brackets that have been adhered to enamel using a conventional acid etch/primer and self-etching primer (SEP) adhesive method.
MATERIALS AND METHODS
One hundred excised human premolars were bonded on brackets and were divided into group 1 -Metal brackets were bonded on teeth and group 2 -Ceramic brackets were bonded on teeth. These two groups were further subdivided: subgroup 1a - 25 metal brackets bonded using conventional acid etch/primer adhesive system, subgroup 1b - 25 metal brackets bonded using SEP, subgroup 2a - 25 ceramic brackets bonded using conventional acid etch/primer adhesive system, and subgroup 2b - 25 ceramic brackets bonded using SEP; brackets were debonded using a computerized Instron universal testing machine.
RESULTS
The mean value of SBS of metal and ceramic brackets bonded using conventional acid etch/primer adhesive systems had higher SBS than those bonded using SEP. SBS ranged from 7.95 to 12.24 MPa which was in the acceptable clinical range.
CONCLUSION
SBS values of all four subgroups exceeded the range of 6-8 MPa observed to be acceptable for routine clinical use.
PubMed: 38882726
DOI: 10.4103/jpbs.jpbs_386_23 -
Progress in Orthodontics Jun 2024Metallic and elastomeric ligatures are widely used in orthodontics to secure the archwire within the bracket slots, but elastomeric ligatures have traditionally been... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Metallic and elastomeric ligatures are widely used in orthodontics to secure the archwire within the bracket slots, but elastomeric ligatures have traditionally been associated with increased microbial colonization, which could adversely affect periodontal health.
AIM
This systematic review compares the periodontal effects of elastomeric and steel ligatures used for orthodontic fixed appliances.
METHODS
Unrestricted literature search of 7 databases (MEDLINE, Scopus, Web of Science, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Virtual Health Library) up to July 2023 were performed for randomized / non-randomized clinical studies on humans comparing the two ligation methods during fixed-appliance therapy. After duplicate study selection, data extraction, and risk-of-bias assessment with the Risk of Bias (RoB) 2 or the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool, random-effects meta-analyses of Mean Differences (MD) or Standardized Mean Differences (SMD) and their 95% confidence intervals (CIs) were carried out, followed by assessment of certainty of existing evidence with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.
RESULTS
A total of 11 studies (3 randomized / 8 non-randomized) with 354 patients (mean age 14.7 years and 42% male) were included. No statistically significant differences were seen for plaque index (5 studies; SMD = 0.48; 95% CI = -0.03 to 1.00; P = 0.07), gingival index (2 studies; MD = 0.01; 95% CI = -0.14 to 0.16; P = 0.89), probing pocket depth (2 studies; MD = 0; 95% CI = -0.17 to 0.16; P = 0.97), or Streptococcus mutans counts (4 studies; SMD = 0.40; 95% CI=-0.41 to 1.20; P = 0.21). Elastomeric ligatures were associated with moderately increased total bacterial load (3 studies; SMD = 0.43; 95% CI = 0.10 to 0.76; P = 0.03). Confidence in these estimates was low in all instances due to the inclusion of non-randomized studies with high risk of bias.
CONCLUSIONS
Existing low quality evidence indicates that ligature method does not seem to influence the periodontal health during fixed treatment, even if elastomeric ligatures are associated with a moderate increase of bacterial load.
REGISTRATION
PROSPERO (CRD42023444383).
Topics: Humans; Elastomers; Orthodontic Appliances, Fixed; Steel; Periodontal Index; Orthodontic Brackets; Ligation
PubMed: 38880839
DOI: 10.1186/s40510-024-00520-8 -
Biomaterial Investigations in Dentistry 2024The purpose of this study was to evaluate the effect of orthodontic bracket base shape on shear bond strength (SBS) to human enamel and assess the nature of debonding...
The purpose of this study was to evaluate the effect of orthodontic bracket base shape on shear bond strength (SBS) to human enamel and assess the nature of debonding fractures using the Adhesive Remnant Index (ARI). Orthodontic brackets with different-shaped bases (flower, heart, rectangle) were bonded to 120 extracted human third molars. Shear bond strength was measured using a Servohydraulic Test System at 24 h and 2 months after bonding. Adhesive Remnant Index scores were evaluated under 10x magnification to assess the amount of resin left on the tooth. The control bracket (rectangular base shape) had the highest mean SBS (26.8 ± 8.2 megapascals [MPa]), and significantly differed from the flower (17.2 ± 4.4 MPa) and heart (18.9 ± 3.5 MPa) base shapes ( < 0.001). The mean SBS between debonding times at 24 h (21.5 ± 7.4 MPa) and 2 months (20.4 ± 6.7 MPa) were not statistically significant > 0.05). Analysis of ARI scores showed a significant difference between flower-24 h versus heart-2 months ( = 0.039), flower-24 h versus heart-24 h ( = 0.004), and control-2 months versus heart-24 h ( = 0.015). Bracket base shape influenced SBS, with the rectangular base shape having a higher mean SBS compared to flower and heart base shapes. Variations in ARI scores occurred based on bracket shape and were of a mixed adhesive-cohesive nature. All bracket shapes had bond strengths above the clinically acceptable range of 6-8 MPa, and may thus provide adequate SBS in a clinical situation.
PubMed: 38873367
DOI: 10.2340/biid.v11.40585 -
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 -
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 -
Medical Science Monitor : International... Jun 2024Orthodontic treatments, while essential for achieving optimal oral health, present challenges in infection control due to the propensity for bacterial adhesion and...
Orthodontic treatments, while essential for achieving optimal oral health, present challenges in infection control due to the propensity for bacterial adhesion and biofilm formation on orthodontic appliances. Silver-coated orthodontic materials have emerged as a promising solution, leveraging the potent antimicrobial properties of silver nanoparticles (AgNPs). Antibacterial coatings are used in orthodontics to prevent the formation of bacterial biofilms. This systematic review evaluated the literature on antimicrobial silver coatings on fixed orthodontic appliances, including archwires, brackets, and microimplants. Two evaluators, working independently, rigorously conducted a comprehensive search of various databases, including PubMed, PubMed Central, Embase, Scopus and Web of Science. This systematic review comprehensively examined in vitro studies investigating the antimicrobial efficacy of silver-coated orthodontic archwires, brackets, and microimplants. The review registered in PROSPERO CRD42024509189 synthesized findings from 18 diverse studies, revealing consistent and significant reductions in bacterial adhesion, biofilm formation, and colony counts with the incorporation of AgNPs. Key studies demonstrated the effectiveness of silver-coated archwires and brackets against common oral bacteria, such as Streptococcus mutans and Staphylococcus aureus. Microimplants coated with AgNPs also exhibited notable antimicrobial activity against a range of microorganisms. The systematic review revealed potential mechanisms underlying these antimicrobial effects, highlighted implications for infection prevention in orthodontic practice, and suggested future research avenues. Despite some study heterogeneity and limitations, the collective evidence supports the potential of silver-coated orthodontic materials in mitigating bacterial complications, emphasizing their relevance in advancing infection control measures in orthodontics.
Topics: Silver; Humans; Biofilms; Orthodontic Brackets; Metal Nanoparticles; Orthodontic Wires; Orthodontic Appliances, Fixed; Anti-Infective Agents; Coated Materials, Biocompatible; Anti-Bacterial Agents; Streptococcus mutans; Bacterial Adhesion; Staphylococcus aureus
PubMed: 38843112
DOI: 10.12659/MSM.944255 -
Journal of Oral Biology and... 2024Fluoridated mouth rinses improve anti-cariogenic environment but decrease oral pH below critical value, affecting orthodontic bracket surface topography and causing...
BACKGROUND
Fluoridated mouth rinses improve anti-cariogenic environment but decrease oral pH below critical value, affecting orthodontic bracket surface topography and causing corrosive changes over prolonged use. This invitro study aimed to quantitatively and qualitatively assess the surface topography and metallic ion release of the stainless steel (SS) brackets at varying acidic and alkaline pH.
MATERIALS AND METHODS
Forty unused SS brackets were divided into four groups (Group A, B, C, D) and immersed for 48- hours in solutions of artificial saliva and sodium fluoride (0.2 %) mouth rinse at varying pH of 5.5,6.7,7 and 8. The surface morphologic changes were analyzed under scanning electron microscope (SEM) at 50×, 150×, and 500× magnification. The changes in slot area were scored using the customized scale. The Energy Dispersive Xray Spectroscopy Analysis (EDAX) was used to estimate the probed elements' atomic and weight percentage.
RESULTS
The mean score of the scale was 3.4 for the brackets immersed in the acidic solution which was statistically significant (p = 0.00)and for alkaline and neutral solutions (p = 0.00). Chromium was found to be significantly higher in the alkaline solution (p = 0.016) followed by the neutral solution. Carbon was found excess in acidic solution than the neutral and alkaline solution.
CONCLUSION
Quantitative and qualitative analysis of the ion release in stainless steel brackets using SEM and EDAX revealed the corrosive effect of fluoride ion causing maximum surface changes in acidic medium and chromium release in alkaline pH.
PubMed: 38832295
DOI: 10.1016/j.jobcr.2024.05.001 -
Journal of International Society of... 2024Single-component adhesives do not require the application of a primer on the enamel surface that has been etched and has been reported to have acceptable shear bond...
BACKGROUND
Single-component adhesives do not require the application of a primer on the enamel surface that has been etched and has been reported to have acceptable shear bond strengths on evaluation.
AIM
This split-mouth study aimed to examine and assess the rates of bracket bond failure of hydroxyethyl methacrylate (HEMA)-based (Aqualine LC) and bisphenol A-glycidyl methacrylate (BisGMA)-based (Orthofix SPA) single-component adhesives used to bond orthodontic brackets over 6 months.
MATERIALS AND METHODS
This study involved the participation of 50 adult subjects, with 1080 metallic brackets directly bonded to the labial/facial surface in a split-mouth design. After 6 months of treatment, 49 patients with 490 brackets bonded using a HEMA-based adhesive and 490 brackets bonded using a BisGMA-based adhesive were evaluated for bracket bond failures. Descriptive statistics and chi-square tests were done to compare the results.
RESULTS
The overall bracket bond failure rate (BFR) with single-component adhesives was 6.02%. Bracket BFRs of HEMA-based and BisGMA-based adhesives were 4.16% and 7.8%, respectively, and the difference was statistically significant ( < 0.05). Significant differences in BFRs between maxillary teeth (4.28%) and mandibular teeth (7.75%) were noted ( < 0.05). No significant differences in bond failures between either side or region were noted.
CONCLUSION
Bond failures were more in brackets bonded with BisGMA-based adhesive (Orthofix SPA) compared with HEMA-based adhesive (Aqualine LC). Bond failures were less in the maxillary arch.
PubMed: 38827357
DOI: 10.4103/jispcd.jispcd_44_23 -
BMC Oral Health Jun 2024The formation of white spots, which represent early carious lesions, is a major issue with fixed orthodontics. The addition of remineralizing agents to orthodontic...
Investigation of mechanical properties, remineralization, antibacterial effect, and cellular toxicity of composite orthodontic adhesive combined with silver-containing nanostructured bioactive glass.
BACKGROUND
The formation of white spots, which represent early carious lesions, is a major issue with fixed orthodontics. The addition of remineralizing agents to orthodontic adhesives may prevent the formation of white spots. The aim of this study was to produce a composite orthodontic adhesive combined with nano-bioactive glass-silver (nBG@Ag) for bracket bonding to enamel and to investigate its cytotoxicity, antimicrobial activity, remineralization capability, and bond strength.
METHODS
nBG@Ag was synthesized using the sol-gel method, and characterized using transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy with an attenuated total reflectance attachment (ATR-FTIR). The cytotoxicity test (MTT) and antimicrobial activity of adhesives containing 1%, 3%, and 5% (wt/wt) nBG@Ag were evaluated, and the shear bond strength of the adhesives was measured using a universal testing machine. Remineralization was assessed through microhardness testing with a Vickers microhardness tester and scanning electron microscopy (SEM). Statistical analyses were conducted using the Shapiro-Wilk test, Levene test, one-way ANOVA, Robust-Welch test, Tukey HSD method, and two-way ANOVA.
RESULTS
The biocompatibility of the adhesives was found to be high, as confirmed by the lack of significant differences in the cytotoxicity between the sample and control groups. Discs made from composites containing nBG@Ag exhibited a significant reduction in the growth of Streptococcus mutans (p < 0.05), and the antibacterial activity increased with higher percentages of nBG@Ag. The shear bond strength of the adhesives decreased significantly (p < 0.001) after the addition of nanoparticles, but it remained above the recommended value. The addition of nBG@Ag showed improvement in the microhardness of the teeth, although the differences in microhardness between the study groups were not statistically significant. The formation of hydroxyapatite deposits on the tooth surface was confirmed through SEM and energy-dispersive X-ray spectroscopy (EDX).
CONCLUSION
Adding nBG@Ag to orthodontic adhesives can be an effective approach to enhance antimicrobial activity and reduce enamel demineralization around the orthodontic brackets, without compromising biocompatibility and bond strength.
Topics: Anti-Bacterial Agents; Silver; Tooth Remineralization; Orthodontic Brackets; Dental Cements; Materials Testing; Nanostructures; Streptococcus mutans; Microscopy, Electron, Scanning; Spectroscopy, Fourier Transform Infrared; X-Ray Diffraction; Glass; Microscopy, Electron, Transmission; Ceramics; Humans; Composite Resins; Shear Strength; Hardness; Dental Bonding; Dental Enamel
PubMed: 38824555
DOI: 10.1186/s12903-024-04402-7