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Head & Face Medicine Jul 2021Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual features, thus retention should be adjusted in the most optimal way. Bonding a retainer makes retention less dependent on patient's compliance.
QUESTIONS ARISE
What wire or fiber splint type provides the best treatment stability? What materials should be used to bond the wire or fiber splint? Should be the bonding procedure be direct or indirect? The aim of the study is to assess and synthesize available controlled trials investigating failures of fixed retainers.
METHODS
Literature searches of free text and MeSH terms were performed in Scopus, Web of Science, Embase and PubMed Central in order to find studies, referring to failures of fixed retention (12th February 2021). The keywords were: ("orthodontic retainers AND failure AND wire"). The framework of this systematic review according to PICO was: Population: orthodontic patients; Intervention: fixed orthodontic retainer bonding; Comparison: Different protocols of fixed orthodontic retention applied; Outcomes: failure rate, survival rate. Three different specific scales from the Cochrane Collaboration Handbook were used, according to each study type. Additionally, a meta-analysis was conducted to compare the effectiveness of retention using fiber reinforced composite and multistranded steel wire.
RESULTS
The search identified 177 potential articles: 114 from PubMed, 41 from Scopus, 20 from Web of Science and 2 from Embase. After excluding studies inconsistent with selection criteria, 21 studies were included and subjected to qualitative analysis. The main outcome investigated was failure rate. This systematic review has some potential limitations due to the heterogeneity of design between included studies.
CONCLUSIONS
No retainer is proved to guarantee a perfect stability of dental alignment. The retainer should be bonded to all adherent teeth, preferably with additional use of bonding resin. No wire or fiber splint present superior characteristics concerning failure rate. Fiber reinforced composite retention is more sensitive to operator skills, and with imperfect bonding technique, failure rate is much higher. During the first 6 months after bonding retainer the patient should be under frequent control. The study protocol was registered in PROSPERO database with the number CRD42021233406.
Topics: Dental Bonding; Humans; Orthodontic Appliance Design; Orthodontic Retainers; Orthodontic Wires
PubMed: 34301280
DOI: 10.1186/s13005-021-00281-3 -
BMC Oral Health Jul 2022Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also...
BACKGROUND
Before the magnetic resonance imaging (MRI) examination fixed orthodontic devices, such as brackets and wires, cause challenges not only for the orthodontist but also for the radiologist. Essentially, the MRI-safe scan of the fixed orthodontic tools requires a proper guideline in clinical practice. Therefore, this systematic review aimed to examine all aspects of MRI-safe scan, including artifact, thermal, and debonding effects, to identify any existing gaps in knowledge in this regard and develop an evidence-based protocol.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in "PIO" format was: "Does MRI examination influence the temperature of the orthodontic devices, the size of artifacts, and the debonding force in patients who have fixed orthodontic bracket and/or wire?" The search process was carried out in PubMed, PubMed Central, Scopus, and Google Scholar databases. The search resulted in 1310 articles. After selection according to the eligibility criteria, 18 studies were analyzed by two reviewers. The risk of bias was determined using the Quality In Prognosis Studies tool.
RESULTS
Out of the eligible 18 studies, 10 articles examined the heating effect, 6 were about the debonding effect, and 11 measured the size of artifact regarding brackets and wires. Considering the quality assessment, the overall levels of evidence were high and medium. The published studies showed that heating and debonding effects during MRI exposure were not hazardous for patients. As some wires revealed higher temperature changes, it is suggested to remove the wire or insert a spacer between the appliances and the oral mucosa. Based on the material, ceramic and plastic brackets caused no relevant artifact and were MRI-safe. Stainless steel brackets and wires resulted in susceptibility artifacts in the orofacial region and could cause distortion in the frontal lobe, orbits, and pituitary gland. The retainer wires showed no relevant artifact.
CONCLUSIONS
In conclusion, the thermal and debonding effects of the fixed orthodontic brackets and wires were irrelevant or resoluble; however, the size of the artifacts was clinically relevant and determined most significantly the feasibility of fixed brackets and wires in MRI examination.
Topics: Artifacts; Humans; Magnetic Resonance Imaging; Orthodontic Brackets; Orthodontic Wires; Stainless Steel
PubMed: 35854295
DOI: 10.1186/s12903-022-02317-9 -
The Angle Orthodontist Oct 1987Etiologies and various treatment modalities regarding anterior openbite are discussed to elucidate the pros and cons of different approaches, with emphasis on...
Etiologies and various treatment modalities regarding anterior openbite are discussed to elucidate the pros and cons of different approaches, with emphasis on understanding of the true nature of anterior openbite. Subjective interpretation in a diagnosis invariably leads into an erroneous description of a malocclusion, which can lead to a disastrous result. Cognizance of the anatomy, histology, physiology, and dynamics of orthodontic mechanotherapy can bring most openbite malocclusions into the realm of treatability, with a high degree of success and stability without surgical intervention. A Multiloop Edgewise Archwire (MEAW) technic developed over the past nineteen years is introduced, and three illustrative cases are presented.
Topics: Adolescent; Adult; Cephalometry; Child; Equipment Design; Female; Humans; Male; Malocclusion; Orthodontic Appliances; Orthodontic Wires; Tooth Movement Techniques
PubMed: 3479033
DOI: 10.1043/0003-3219(1987)057<0290:AOAITW>2.0.CO;2 -
The Angle Orthodontist Jan 2021The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time.
MATERIALS AND METHODS
This was a two-armed prospective study. Consecutively treated patients who were recruited from a private practice were enrolled and asked to choose between SB and conventional brackets (CB). If the patient did not have a preference, that patient was randomly allocated. An identical archwire sequence was used, and all patients were treated by a single orthodontist. Treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, whether or not to orthodontic mini-implants (OMI) were used, OMI failure, extraction, American Board of Orthodontics Discrepancy Index, and arch length discrepancy were measured and statistically analyzed using t-tests, correlation analysis, and analysis of covariance (ANCOVA). Stepwise regression analysis was conducted to generate an equation to predict treatment duration.
RESULTS
A total of 134 patients with an average age of 22.73 years were included. The average treatment duration was 28.63 months. ANCOVA showed no significant difference in treatment duration between CB and SB. Stepwise regression analysis could explain 64.6% of the variance in treatment duration using five variables.
CONCLUSIONS
SB did not exhibit a significant reduction in treatment time as compared with CB. Patient cooperation, extractions, and malocclusion severity had a significant impact on treatment duration.
Topics: Adult; Cohort Studies; Dental Implants; Humans; Orthodontic Anchorage Procedures; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Prospective Studies; Young Adult
PubMed: 33289803
DOI: 10.2319/050220-379.1 -
The Kaohsiung Journal of Medical... Apr 2018This literature review investigated a recently developed orthodontic wire composed of a β-titanium alloy known as "Gum Metal" and compared its properties with those of... (Review)
Review
This literature review investigated a recently developed orthodontic wire composed of a β-titanium alloy known as "Gum Metal" and compared its properties with those of conventional wires. The attractive properties of Gum Metal include an ultra-low Young's modulus, non-linear elastic behavior, ultra-high strength, high yield strain, high ductility, and superplastic deformability without work hardening at room temperature. The unique multifunctional characteristics of this new orthodontic wire make it almost ideal for orthodontic applications. The results of this literature review indicate the strong potential use of Gum Metal wire for improving and enhancing the effectiveness of orthodontic treatment.
Topics: Dental Stress Analysis; Elastic Modulus; Humans; Materials Testing; Orthodontic Wires; Orthodontics; Tensile Strength; Titanium
PubMed: 29655408
DOI: 10.1016/j.kjms.2018.01.010 -
Dental Press Journal of Orthodontics 2020The aim of this study was to evaluate the attractiveness of different types of esthetic orthodontic wires by laypeople and dentists.
OBJECTIVE
The aim of this study was to evaluate the attractiveness of different types of esthetic orthodontic wires by laypeople and dentists.
METHODS
Five different types of orthodontic wires were evaluated: three esthetic wires (Teflon-coated, epoxy resin-coated and rhodium-coated wires), and two metallic wires (stainless steel and NiTi), as control. Monocrystalline ceramic brackets were installed in the maxillary arch of a patient presenting good dental alignment. The five evaluated wires were attached to the orthodontic appliance with an esthetic silicone elastic and photographed. The photographs were evaluated by 163 individuals, 110 dentists and 53 laypeople. The data were statistically evaluated by two-way ANOVA and one-way ANOVA, followed by Tukey tests.
RESULTS
There was a statistically significant difference in the attractiveness among the wires evaluated; the most esthetic was the rhodium-coated wire, followed by the epoxy resin-coated wire and, finally, the Teflon-coated wire, with no significant difference from the stainless steel and NiTi control archwires. There was no significant difference between the groups of evaluators.
CONCLUSION
The most attractive was the rhodium-coated wire, followed by the epoxy resin-coated wire and, finally, the least attractive wire was the Teflon-coated wire, without statistically significant difference to the stainless steel and NiTi wires, used as control.
Topics: Dental Alloys; Esthetics, Dental; Humans; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Stainless Steel; Surface Properties; Titanium
PubMed: 33503122
DOI: 10.1590/2177-6709.25.6.027-032.oar -
Brazilian Oral Research 2014This study examined the effect of cariogenic and erosive challenges (CCs and ECs, respectively) on the degradation of copper-nickel-titanium (CuNiTi) orthodontic wires....
This study examined the effect of cariogenic and erosive challenges (CCs and ECs, respectively) on the degradation of copper-nickel-titanium (CuNiTi) orthodontic wires. Sixty wire segments were divided into four treatment groups and exposed to CCs, ECs, artificial saliva, or dry storage (no-treatment control). CC and EC were simulated using a demineralizing solution (pH 4.3) and a citric acid solution (pH 2.3), respectively. Following treatment, the average surface roughness (Ra) of the wires was assessed, and friction between the wires and a passive self-ligating bracket was measured. CuNiTi wires subjected to ECs exhibited significantly higher Ra values than did those that were stored in artificial saliva. In contrast, surface roughness was not affected by CCs. Finally, friction between the treated wires and brackets was not affected by ECs or CCs. Our results indicate that CuNiTi orthodontic wires may suffer degradation within the oral cavity, as ECs increased the surface roughness of these wires. However, rougher surfaces did not increase friction between the wire and the passive self-ligating bracket.
Topics: Cariogenic Agents; Copper; Corrosion; Friction; Humans; Materials Testing; Microscopy, Atomic Force; Nickel; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Saliva, Artificial; Statistics, Nonparametric; Surface Properties; Titanium
PubMed: 25098823
DOI: 10.1590/1807-3107bor-2014.vol28.0024 -
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 Orofacial Orthopedics =... Jan 2022Gummetal® (Maruemu Works, Osaka, Japan), a new orthodontic wire material successfully used in clinical applications since 2006, is biocompatible and exhibits...
OBJECTIVES
Gummetal® (Maruemu Works, Osaka, Japan), a new orthodontic wire material successfully used in clinical applications since 2006, is biocompatible and exhibits exceptionally high elasticity, nonlinear elastic behavior, plasticity and strength. Systematic comparisons of friction behavior are lacking; thus, the friction of Gummetal® in the binding modus was compared to commonly used low friction wires.
MATERIALS AND METHODS
In vivo tests were run with Gummetal®, CoCr (cobalt-chromium Elgiloy®, Rocky Mountain Orthodontics, Denver, CO, USA), β‑Ti (β-Titanium TMA®, Ormco, Orange, CA, USA), NiTi (nickel-titanium, NiTi-SE, Dentalline, Birkenfeld, Germany), and stainless steel (SS; Ref. 251-925, 3M Unitek, Monrovia, CA, USA) [dimensions: 0.014 inch (0.35 mm), 0.016 inch (0.40 mm), 0.016 × 0.022 inch (0.40 × 0.56 mm), and 0.019 × 0.025 inch (0.48 × 0.64 mm)-β-Ti not available in the dimension 0.014 inch]. These were combined with Discovery® (Dentaurum, Ispringen, Germany), Micro Sprint® (Forestadent, Pforzheim, Germany), Clarity™ (3M Unitek), and Inspire Ice™ (Ormco) and slots in the dimension 0.022 inch (0.56 mm) and, except for the 0.019 × 0.025 inch wires, in the dimension 0.018 inch (0.46 mm). They were ligated with a 0.010 inch (0.25 mm) steel ligature (Smile Dental, Ratingen, Germany). Brackets were angulated by applying a moment of force of 10 Nmm against the wire, which was pulled through the slot at 0.2 mm/s.
RESULTS
In 660 tests using 132 bracket-wire combinations, friction loss for Gummetal® was comparable to and, in a few combinations with Micro Sprint®, significantly lower (p < 0.05) than SS and CoCr. The friction for Gummetal® was significantly lower (p < 0.05) than NiTi, and β‑Ti. In some bracket-wire combinations, lower friction was found with round wires compared to rectangular wires, except for the combination with Inspire Ice™, which was higher but not significant. Slot size did not have a significant effect on friction in most combinations.
CONCLUSION
The low friction associated with Gummetal® wires during arch-guided tooth movement will be a valuable addition to the armamentarium of orthodontists.
Topics: Dental Alloys; Dental Stress Analysis; Friction; Materials Testing; Orthodontic Appliance Design; Orthodontic Brackets; Orthodontic Wires; Titanium
PubMed: 34228140
DOI: 10.1007/s00056-021-00317-y -
Brazilian Dental Journal 2017The aim was to evaluate the flexural strength and the effects of deflection on the surface roughness of esthetic orthodontic wires. The sample consisted of 70 archwire...
The aim was to evaluate the flexural strength and the effects of deflection on the surface roughness of esthetic orthodontic wires. The sample consisted of 70 archwire 0.014-inch: polytetrafluorethylene (PTFE)-coated Nickel-Titanium (Niti) archwires (Titanol Cosmetic-TC, Flexy Super Elastic Esthetic-FSE, esthetic Nickel Titanium Wire-ANT); epoxy resin-coated Niti archwires (Spectra-S, Niticosmetic-TEC); gold and rhodium coated Niti (Sentalloy-STC) and a control group (superelastic Niti (Nitinol-NS). The initial roughness was evaluated with a rugosimeter. After that, the wires were submitted to flexural test in an universal testing machine. Each wire was deflected up to 2 mm at a speed of 1 mm/min. After flexural test, the roughness of the wires was evaluted on the same surface as that used for the initial evaluation. The data of roughness and flexural strength were analyzed by one-way ANOVA and Tukey's test (a=0.05). Student t-test compared roughness before and after deflection (a =0.05). The roughness of S and ANT (epoxy resin and PTFE-coated wires, respectively), before and after deflection, was significantly higher than the other groups (p<0.05). Wire deflection significantly increased the roughness of the wires S and STC (p<0.05). The flexural strength of groups FSE and NS (PTFE and uncoated) was higher compared with that of the other groups (p<0.05). We concluded that the roughness and flexural strength of the orthodontic wires does not depend on the type of the esthetic coating, but it is influenced by the method of application of this coating. The deflection can increase the roughness of the esthetic orthodontic wires.
Topics: Coated Materials, Biocompatible; Dental Stress Analysis; Esthetics, Dental; Humans; Materials Testing; Orthodontic Wires; Surface Properties
PubMed: 28301016
DOI: 10.1590/0103-6440201700630