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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 -
Progress in Orthodontics Jul 2018Bisphenol A (BPA) is released from orthodontic composites used for bracket bonding. Genetic variations could modify the metabolism of this chemical within the organism....
Association between polymorphisms in genes encoding estrogen receptors (ESR1 and ESR2) and excreted bisphenol A levels after orthodontic bracket bonding: a preliminary study.
BACKGROUND
Bisphenol A (BPA) is released from orthodontic composites used for bracket bonding. Genetic variations could modify the metabolism of this chemical within the organism. Considering that free BPA binds to estrogen receptors causing harmful effects to health, the present in vivo study aimed to evaluate the association between genetic polymorphisms in genes encoding estrogen receptors (ESR1 and ESR2) and excreted BPA levels in orthodontic patients.
METHODS
Quantification of BPA levels in the urine of 16 patients was performed in a gas chromatograph mass spectrometer before (T0), at 24 h (T1), and 1 week (T2) after bracket bonding. DNA was extracted from saliva, and one genetic polymorphism in ESR1 (rs2234693) and two in ESR2 (rs4986938 and rs1256049) were analyzed by real-time PCR. Increases in BPA levels in the urine at T1 and T2 were grouped according to the genotype, and mean differences were compared by unpaired T test or Mann-Whitney test according to the normality of the data. The established alpha was 5%.
RESULTS
BPA levels increased significantly at T1 and T2. There were no statistically significant differences in the increases in BPA levels according to the genotype for any genetic polymorphism (P > 0.05), at neither 24 h nor 1 week after bracket bonding.
CONCLUSIONS
The results suggested that there are no association between excreted BPA levels after bracket bonding and the evaluated genetic polymorphisms in ESR1 and ESR2. Further research should be performed in order to confirm these results.
Topics: Adolescent; Benzhydryl Compounds; Child; Estrogen Receptor alpha; Estrogen Receptor beta; Female; Gas Chromatography-Mass Spectrometry; Genotype; Humans; Male; Orthodontic Brackets; Phenols; Polymorphism, Single Nucleotide; Real-Time Polymerase Chain Reaction; Resin Cements; Young Adult
PubMed: 29961922
DOI: 10.1186/s40510-018-0219-z -
BMC Oral Health Oct 2020Conventional brackets are often used during orthodontic therapy of patients with malocclusion. The complex construction of such brackets greatly inhibits oral hygiene,...
BACKGROUND
Conventional brackets are often used during orthodontic therapy of patients with malocclusion. The complex construction of such brackets greatly inhibits oral hygiene, which predisposes to increased carriage of microbiota. Orthodontic brackets could act as reservoir of yeast and predispose to oral candidosis. The aim of this study was to assess Candida prevalence and the role of oral hygiene during fixed appliance therapy. A further aim was to characterize the isolated yeasts according to their ability to form biofilms.
METHODS
Seventeen participants (average age 17 ± 7 years) were monitored by taking oral rinses and elastomeric ligature samples, and by evaluating the approximal plaque index (API) and gingival bleeding index (GBI) before and after placement of the orthodontic conventional brackets for 12 weeks. Isolated yeasts were counted and biofilm formation was evaluated.
RESULTS
One hundred and sixteen samples (67 oral rinses and 49 orthodontic elastomers) were collected. Ten patients (58.8% subjects) were Candida-carriers (two were colonized after bracket placement) and C. albicans was the most common species. The average number of yeasts in the oral cavity showed some fluctuation during the study, but in general had an upward trend (adj. R2 = 0.7967, p = 0.07025). A correlation was found between median number of yeasts and the periodontal indices (API, GBI). The average API values decreased in the Candida-carriers (adj. R = 0.95; p = 0.01709), while average GBI values increased in the noncarriers (adj. R = 0.92; p = 0.0256).
CONCLUSIONS
Treatment with orthodontic appliances promotes Candida yeast colonization, which is variable over time in terms of strain and species, with dominance of C. albicans, and without increased biofilm-forming activity. The API value decreases over time in carriers, and the GBI value increases in uncolonized patients, which may have predictive significance for the development of oral candidiasis during orthodontic treatment.
Topics: Adolescent; Adult; Candida; Child; Dental Plaque Index; Humans; Oral Hygiene; Orthodontic Brackets; Periodontal Index; Prevalence; Young Adult
PubMed: 33036600
DOI: 10.1186/s12903-020-01267-4 -
The Angle Orthodontist May 2020To evaluate the effects of adhesive precoated (APC) flash-free brackets on enamel demineralization and periodontal status in patients during fixed orthodontic treatment. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To evaluate the effects of adhesive precoated (APC) flash-free brackets on enamel demineralization and periodontal status in patients during fixed orthodontic treatment.
MATERIALS AND METHODS
Thirty patients, age 12 to 18 years, who had Angle Class I or Class II malocclusion with mild to moderate crowding in the permanent dentition were selected for this study. APC flash-free and conventional ceramic brackets were bonded for a split-mouth study design. The quadrant allocation was randomized. Demineralization records were obtained immediately after bonding (T0), 1 month after bonding (T1), and 6 months after bonding (T2). Clinical periodontal measurements, including gingival index, plaque index, and bleeding upon probing, were obtained before bonding (T0) and at the same time points (T1 and T2). Data were analyzed using Mann-Whitney U and Friedman tests to compare parameters between groups and times.
RESULTS
Demineralization values decreased on most sides of the brackets for both groups between T0 and T1. In the conventional group, there was significantly higher demineralization on more sides compared with flash-free brackets between T1 and T2. With one exception, the decreased values were found in the incisal/occlusal sides of all brackets at T2. All periodontal parameters showed significant increases after 6 months of treatment in both groups. Intergroup comparison showed no significant differences in demineralization or periodontal measurements at any of the time points.
CONCLUSIONS
The effects of APC flash-free and conventional brackets on enamel demineralization and periodontal health did not differ from each other.
Topics: Adolescent; Child; Dental Bonding; Dental Cements; Dental Enamel; Dental Plaque Index; Humans; Orthodontic Brackets; Tooth Demineralization
PubMed: 33378441
DOI: 10.2319/80819-518.1 -
Journal of Applied Oral Science :... 2021Pain is a problem during bracket removal, and more comfortable treatment is needed. This study examined the association of pain with the removal force required for...
OBJECTIVE
Pain is a problem during bracket removal, and more comfortable treatment is needed. This study examined the association of pain with the removal force required for ceramic brackets, compared with metal and plastic brackets, to determine which removal method resulted in less pain and discomfort.
METHODOLOGY
81 subjects (mean age, 25.1 years; 25 males and 56 females) were enrolled, from whom 1,235 brackets (407 ceramic, 432 plastic, and 396 metal) were removed. Measured teeth were distinguished at six segments. Pain was measured with a visual analogue scale (VAS) during the removal of each bracket. An additional grip was placed on the grips of debonding pliers with right-angled beaks; a mini loading cell sensor pinched by the grips was used to measure removal force during debonding. VAS and force values were statistically analyzed. The Kruskal-Wallis test followed by the Mann-Whitney U test with Bonferroni correction were performed for multiple comparisons; multiple regression analysis was also performed.
RESULTS
Forces in the upper and lower anterior segments were significantly smaller (p<0.05) than those in the other segments. Pain tended to be greater in the upper and lower anterior segments than in the posterior segments. In all segments, the removal force was greater for metal brackets than for plastic or ceramic brackets. Ceramic brackets caused significantly greater pain than plastic brackets for the upper and lower anterior segments. Debonding force was involved in the brackets, following adjustments for pain, upper left segment, age, and sex.
CONCLUSIONS
Pain and discomfort are likely to occur during bracket debonding.
Topics: Adult; Animals; Ceramics; Dental Debonding; Humans; Orthodontic Brackets; Pain
PubMed: 34320118
DOI: 10.1590/1678-7757-2020-0879 -
The Angle Orthodontist Jul 2015To measure the slot dimensions of an entire series of metal orthodontic brackets.
OBJECTIVE
To measure the slot dimensions of an entire series of metal orthodontic brackets.
MATERIALS AND METHODS
Ten bracket series approximating five complete sets of brackets each were imaged and measured. Descriptive statistics were generated.
RESULTS
Slot dimension varied significantly from series to series as well as within the series themselves. About one-third of the brackets would not accommodate a full-size wire, and 15% to 20% are 0.001 inches or larger than the nominal advertised size.
CONCLUSION
The clinician is unlikely to have on hand complete sets (upper and lower 5-5) of ideal brackets and should both expect and be able to be accommodate tooth movement through wire bending in three planes of space to overcome any bracket deficiencies.
Topics: Humans; Image Processing, Computer-Assisted; Materials Testing; Microscopy; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Surface Properties
PubMed: 25264581
DOI: 10.2319/042814-307.1 -
Brazilian Oral Research 2015This study aims at comparing conventional and nickel-free metal bracket surface characteristics with elemental composition by scanning electron microscopy (SEM), using... (Comparative Study)
Comparative Study
This study aims at comparing conventional and nickel-free metal bracket surface characteristics with elemental composition by scanning electron microscopy (SEM), using energy dispersive spectroscopy (EDS). The sample consisted of 40 lower incisor brackets divided into four groups: ABZ = conventional brackets, Kirium Abzil 3M® (n = 10); RL = conventional brackets, Roth Light Morelli® (n = 10); NF = nickel-free brackets, Nickel-Free Morelli® (n = 10); and RM = nickel-free brackets, Roth Max Morelli® (n = 10). Qualitative evaluation of the bracket surface was performed using SEM, whereby surface features were described and compared. The elemental composition was analyzed by EDS. According to surface analysis, groups ABZ and RL showed a homogeneous surface, with better finishing, whereas the surfaces in groups NF and RM were rougher. The chemical components with the highest percentage were Fe, Cr and C. Groups NF and MR showed no nickel in their composition. In conclusion, the bracket surface of the ABZ and RL groups was more homogeneous, with grooves and pores, whereas the surfaces in groups NF and RM showed numerous flaws, cracks, pores and grooves. The chemical composition analysis confirmed that the nickel-free brackets had no Ni in their composition, as confirmed by the manufacturer's specifications, and were therefore safe to use in patients with a medical history of allergy to this metal.
Topics: Alloys; Analysis of Variance; Corrosion; Materials Testing; Metals; Microscopy, Electron, Scanning; Nickel; Orthodontic Brackets; Reference Values; Spectrometry, X-Ray Emission; Statistics, Nonparametric; Surface Properties
PubMed: 25590508
DOI: 10.1590/1807-3107BOR-2015.vol29.0022 -
The Cochrane Database of Systematic... 2004White spots can appear on teeth during fixed brace treatment because of early decay around the brace attachments. Fluoride is effective at reducing decay in susceptible... (Review)
Review
BACKGROUND
White spots can appear on teeth during fixed brace treatment because of early decay around the brace attachments. Fluoride is effective at reducing decay in susceptible individuals and is routinely prescribed in various different forms to patients during orthodontic treatment.
OBJECTIVES
To evaluate the effectiveness of fluoride in preventing white spots during orthodontic treatment and to compare the different modes of delivery of fluoride.
SEARCH STRATEGY
We searched the Cochrane Oral Health Group's Trials Register (to 22 August 2002); CENTRAL (The Cochrane Library Issue 3, 2002); MEDLINE (January 1966 to July 2003); EMBASE (January 1980 to week July 2003). Authors of trials were contacted for further data.
SELECTION CRITERIA
Trials were selected if they met the following criteria: a randomised or quasi-randomised clinical trial, involving the use of a fluoride-containing product compared with no use or use of a non-fluoride control and enamel demineralisation was assessed during or after orthodontic treatment.
DATA COLLECTION AND ANALYSIS
Six reviewers independently, in duplicate, extracted data. The primary outcome was the difference in the presence or absence of white spots between experimental and control patients for parallel design studies, and between experimental and control quadrants, for split-mouth design studies. Potential sources of heterogeneity were examined. Sensitivity analyses were undertaken for the items assessed for quality and publication bias.
MAIN RESULTS
The primary outcome of the review was the presence or absence of white spots by patient at the end of treatment. Secondary outcomes included any quantitative assessment of enamel mineral loss or lesion depth. Other outcomes such as differences in size and severity of white spots, any patient based outcomes, such as perception of white spots could not be included because there were insufficient data. Fifteen trials, with 723 participants, provided data for this review. None of the studies fulfilled all of the methodological quality assessment criteria. There is some evidence that a daily sodium fluoride mouthrinse reduces the severity of enamel decay surrounding a fixed brace (weighted mean difference for lesion depth -70.0; 95% CI -118.2 to -21.8) and that use of a glass ionomer cement for bracket bonding reduces the prevalence (Peto OR 0.35; 95% CI 0.15 to 0.84) and severity of white spots (weighted mean difference for mineral loss -645 vol%.microm; 95% CI -915 to -375) compared with composite resins.
REVIEWERS' CONCLUSIONS
There is some evidence that the use of topical fluoride or fluoride-containing bonding materials during orthodontic treatment reduces the occurrence and severity of white spot lesions, however there is little evidence as to which method or combination of methods to deliver the fluoride is the most effective. Based on current best practice in other areas of dentistry, for which there is evidence, we recommend that patients with fixed braces rinse daily with a 0.05% sodium fluoride mouthrinse. More high quality, clinical research is required into the different modes of delivering fluoride to the orthodontic patient.
Topics: Dental Caries; Fluorides; Humans; Mouthwashes; Orthodontic Brackets; Randomized Controlled Trials as Topic
PubMed: 15266503
DOI: 10.1002/14651858.CD003809.pub2 -
The Angle Orthodontist Nov 2016To compare microleakage under 3M Unitek's APC Flash-Free Adhesive Coated System bracket and the APC PLUS Adhesive Coated System bracket after thermal cycling.
OBJECTIVE
To compare microleakage under 3M Unitek's APC Flash-Free Adhesive Coated System bracket and the APC PLUS Adhesive Coated System bracket after thermal cycling.
MATERIALS AND METHODS
Forty freshly extracted human maxillary premolars were randomly divided into two groups and bonded with either a Flash-Free bracket or a PLUS bracket. After bonding, the samples were incubated in a water bath at 37°C for 24 hours and thermocycled for 5000 cycles between 5°C and 50°C. All teeth were immersed in a 2% methylene blue solution for 24 hours, embedded in acrylic and sectioned in a buccolingual direction at approximately the center of the bracket. Microleakage was observed at the enamel-adhesive interface from the occlusal and gingival margins of the bracket base. Statistical analysis was conducted using the Mann-Whitney U-test.
RESULTS
The median microleakage was higher in the Flash-Free group, but the difference between the two groups was not statistically significant (P > .05).
CONCLUSION
In a laboratory setting, there is no significant difference between the extent of microleakage under the APC Flash-Free Adhesive Coated System bracket and the APC PLUS Adhesive Coated System bracket after thermal cycling.
Topics: Ceramics; Composite Resins; Dental Bonding; Dental Leakage; Humans; Materials Testing; Orthodontic Brackets; Random Allocation; Resin Cements
PubMed: 27182779
DOI: 10.2319/021016-115.1 -
European Journal of Orthodontics Oct 2016Using lingual enamel surfaces for bracket placement not only has esthetic advantages, but may also be suitable in terms of reducing frequencies of enamel... (Comparative Study)
Comparative Study
BACKGROUND
Using lingual enamel surfaces for bracket placement not only has esthetic advantages, but may also be suitable in terms of reducing frequencies of enamel decalcifications.
OBJECTIVE
To test the null-hypothesis that there is no significant difference in enamel decalcification or cavitation incidence adjacent to and beneath bracket bases between two lingual multi-bracket (MB) appliances that are different in terms of design, material composition, and manufacturing technology (group A: WIN, DW-LingualSystems; group B: Incognito, 3M-Unitek), taking into account patient- and treatment-related variables on white spot lesion (WSL) formation.
METHODS
Standardized, digital, top-view photographs of 630 consecutive subjects (16214 teeth; n Incognito = 237/6076 teeth; n WIN = 393/10138 teeth; mean age: 17.47±7.8; m/f 43.2/56.8%) with completed lingual MB treatment of the upper and lower permanent teeth 1-7 were screened for decalcification or cavitation adjacent to and beneath the bracket bases before and after treatment, scored from 0 to 7. Non-parametric ANOVA was used for main effects 'appliance type', 'gender', 'treatment complexity', 'grouped age' (≤16/>16 years), and 'treatment duration' as covariable, at an α-level of 5%.
RESULTS
About 2.57% [5.94%] of all teeth in group A [B] developed decalcifications. Subject-related incidence was 9.59% [16.17%] for upper incisors in group A [B], and 12.98% [25.74%] for all teeth 16-46. There were significant effects by gender, age, and treatment duration.
CONCLUSION
The null-hypothesis was rejected: sub-bracket lesions were significantly less frequent in group A, while frequencies of WSL adjacent to brackets were not significantly affected by appliance type. In view of the overall low incidences of lingual post-orthodontic white-spot lesions, the use of lingual appliances is advocated as a valid strategy for a reduction of enamel decalcifications during orthodontic treatment.
Topics: Adolescent; Adult; Child; Dental Bonding; Dental Enamel; Esthetics, Dental; Female; Humans; Incisor; Orthodontic Appliance Design; Orthodontic Brackets; Tongue; Tooth Demineralization; Tooth Movement Techniques; Young Adult
PubMed: 26420772
DOI: 10.1093/ejo/cjv069