Initial arch wires used in orthodontic treatment with fixed appliances.

BACKGROUND: Initial arch wires are the first arch wires inserted into fixed appliance at the beginning of orthodontic treatment. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which are most efficient and which cause the least amount of root resorption and pain during the initial aligning stage of treatment. This is the third update of a Cochrane review first published in 2010. OBJECTIVES: To assess the effects of initial arch wires for the alignment of teeth with fixed orthodontic braces, in terms of the rate of tooth alignment, amount of root resorption accompanying tooth movement, and intensity of pain experienced by patients during the initial alignment stage of treatment. SEARCH METHODS: We searched Cochrane Oral Health's Trials Register, CENTRAL, MEDLINE, Embase, and two ongoing trials registries on 4 July 2022. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of different initial arch wires used to align teeth with fixed orthodontic braces. We included people with full-arch fixed orthodontic appliances on the upper arch, lower arch, or both arches. DATA COLLECTION AND ANALYSIS: Two independent review authors were responsible for study selection, data extraction, and assessment of risk of bias in included studies. We contacted corresponding authors of included studies to obtain missing information. We resolved disagreements by discussion between the review authors. Our main outcomes were alignment rate (movement of teeth in mm), root resorption, time to alignment, and intensity of pain measured on a 100-mm visual analogue scale (VAS). We pooled data from studies with similar interventions and outcomes using random-effects models. We reported mean differences (MDs) with 95% confidence intervals (CIs) for continuous data, risk ratios (RRs) with 95% CIs for dichotomous data, and alignment rate ratios with 95% CIs for time-to-event data. Two independent review authors assessed the certainty of evidence. We resolved disagreements by discussion between the review authors. MAIN RESULTS: We included 29 RCTs with 1915 participants (2581 arches) in this review. Studies were generally small (sample sizes ranged from 14 to 200 participants). Duration of follow-up varied between three days and six months. Eleven studies received funding, six received no funding, and 12 provided no information about funding sources. We judged eight studies at high risk of bias, nine at low risk, and 12 at unclear risk. We grouped the studies into six main comparisons. Multistrand stainless steel wires versus wires composed of other materials Six studies with 409 participants (545 arches) evaluated multistrand stainless steel (StSt) wires versus wires composed of other materials. We are very uncertain about the effect of multistrand StSt wires versus other wires on alignment rate (4 studies, 281 participants, 417 arches; very low-certainty evidence). There may be little to no difference between multistrand StSt wires and other wires in terms of intensity of pain (MD -2.68 mm, 95% CI -6.75 to 1.38; 2 studies, 127 participants, 127 arches; low-certainty evidence). Conventional nickel-titanium wires versus superelastic nickel-titanium wires Four studies with 266 participants (274 arches) evaluated conventional nickel-titanium (NiTi) wires versus superelastic NiTi wires. There may be little to no difference between the different wire types in terms of alignment rate (124 participants, 124 arches, 2 studies; low-certainty evidence) and intensity of pain (MD -0.29 mm, 95% CI -1.10 to 0.52; 2 studies, 142 participants, 150 arches; low-certainty evidence). Conventional nickel-titanium wires versus thermoelastic copper-nickel-titanium wires Three studies with 210 participants (210 arches) evaluated conventional Ni-Ti versus thermoelastic copper-nickel-titanium (CuNiTi) wires. We are very uncertain about the effects of the different arch wires on alignment rate (1 study, 66 participants, 66 arches; very low-certainty evidence). There may be little to no difference between conventional NiTi wires and thermoelastic CuNiTi wires in terms of time to alignment (alignment rate ratio 1.30, 95% CI 0.68 to 2.50; 1 study, 60 participants, 60 arches; low-certainty evidence). Superelastic nickel-titanium wires versus thermoelastic nickel-titanium wires Twelve studies with 703 participants (936 arches) evaluated superelastic NiTi versus thermoelastic NiTi wires. There may be little to no difference between superelastic NiTi wires and thermoelastic NiTi wires in alignment rate at four weeks (MD -0.28 mm, 95% CI 0.62 to 0.06; 5 studies, 183 participants, 183 arches; low-certainty evidence). We are very uncertain about the effects of the different wires on root resorption (2 studies, 52 participants, 312 teeth; very low-certainty evidence). Superelastic NiTi wires compared with thermoelastic NiTi wires may result in a slight increase in time to alignment (MD 0.5 months, 95% CI 0.21 to 0.79; 1 study, 32 participants, 32 arches; low-certainty evidence) but are probably associated with a slight increase in intensity of pain (MD 6.96 mm, 95% CI 1.82 to 12.10; 3 studies, 94 participants, 138 arches, moderate-certainty evidence). Single-strand superelastic nickel-titanium wires versus coaxial superelastic nickel-titanium wires Three studies with 104 participants (104 arches) evaluated single-strand superelastic NiTi versus coaxial superelastic NiTi wires. Use of single-strand superelastic NiTi wires compared with coaxial superelastic NiTi wires probably results in a slight reduction in alignment rate at four weeks (MD -2.64 mm, 95% CI -4.61 to -0.67; 2 studies, 64 participants, 64 arches, moderate-certainty evidence). Different sizes of nickel-titanium wires Two studies with 149 participants (232 arches) compared different types of NiTi wires. There may be little to no difference between different sizes of NiTi wires in terms of pain (low-certainty evidence). AUTHORS' CONCLUSIONS: Superelastic NiTi wires probably produce slightly more pain after one day than thermoelastic NiTi wires, and single-strand superelastic NiTi wires probably have a lower alignment rate over four weeks compared with coaxial superelastic NiTi wires. All other evidence on alignment rate, root resorption, time to alignment, and pain is of low or very low certainty in all comparisons. Therefore, there is insufficient evidence to determine whether any particular arch wire material or size is superior to any other. The findings of this review are imprecise and unreliable; well-designed larger studies are needed to give better estimates of the benefits and harms of different arch wires. Orthodontists should exercise caution when interpreting the findings of this review and be prepared to adapt their treatment plans based on individual patient needs.

The effect of salbutamol sulphate inhalation (an anti-asthmatic medication) on the surfaces of orthodontic Archwires.

OBJECTIVES: This study aimed to compare the surface roughness and friction of different orthodontic archwires after exposure to salbutamol sulphate inhalation, an anti-asthmatic medication. METHODS: Orthodontic archwires (stainless-steel [StSt], nickel-titanium [NiTi], beta-titanium [ß-Ti], and copper-NiTi [Cu-NiTi]) were equally divided into two groups. The exposed groups were subjected to 20 mg salbutamol sulphate for 21 days and kept in artificial saliva. The control groups were only kept in artificial saliva. Surface changes were visualized using scanning electron microscopy (SEM). The average surface roughness (Ra) was evaluated using atomic force microscopy (AFM), and friction resistance forces were assessed using a universal testing machine. Statistical analyses were performed using t-tests and ANOVA followed by post hoc tests. RESULTS: Salbutamol sulphate did not change the surface roughness of StSt and NiTi archwires (p > .05). However, the change in the surfaces of ß-Ti and Cu-NiTi archwires was significant (p < .001). The frictional forces of exposed StSt, NiTi, and Cu-NiTi archwires did not change (p > .05). However, the frictional forces of ß-Ti archwires increased significantly after exposure to salbutamol sulphate (p = .021). Brushing with fluoride after exposure to salbutamol sulphate increased the frictional forces of ß-Ti only (p = .002). CONCLUSIONS: Salbutamol sulphate inhalation significantly affected the surface texture of ß-Ti and Cu-NiTi orthodontic archwires and increased the friction of ß-Ti archwires. These deteriorating effects were not detected on the surface of StSt and NiTi archwires. Therefore, we suggest that ß-Ti and copper titanium archwires should be used cautiously in individuals under salbutamol sulphate inhalation treatment.

Shear bond strength between dental adhesive systems and an experimental niobium-based implant material.

This study aimed to investigate adhesive shear bond strength (SBS) on an ultrafine-grained niobium alloy (UFG-Nb) that is a potential dental implant material. SBS of three adhesive systems combined with three composites to UFG-Nb was compared to corresponding SBS to Ti-6Al-4V and to zirconia. Specimens of the substrates UFG-Nb, Ti-6Al-4V and zirconia with plane surfaces were sandblasted with Al2O3, cleaned and dried. Three adhesive systems (Futurabond U, Futurabond M + , Futurabond M + DCA; all VOCO GmbH, Cuxhaven, Germany) were applied each on specimens of each substrate and light cured. One composite (BifixSE, BifixQM, GrandioSO; all VOCO GmbH) was applied and light cured resulting in 27 groups (n = 10) for all substrate-adhesive-composite-combinations. SBS was measured after 24 h of storage. To simulate aging equally prepared specimens underwent 5000 thermocycles before SBS measurement. There was no significant difference in SBS within the non-aged groups. Among the artificially aged groups, GrandioSO-groups showed a greater variance of SBS than the other composites. All significant differences of corresponding UFG-Nb-, Ti-6Al-4V- and zirconia-groups with same adhesive-composite-combination (ACC) were observed between UFG-Nb and zirconia or Ti-6Al-4V and zirconia but never between the two metallic substrates. The similarity between these materials might show in their adhesive bonding behavior. As there were no differences comparing corresponding groups prior to and after artificial aging, it can be concluded that aging does not affect SBS to UFG-Nb, Ti-6Al-4V and zirconia using the tested ACCs. Adhesive bonding of established ACCs to UFG-Nb is possible resulting in SBS comparable to those on Ti-6Al-4V and zirconia surfaces.

Microstructural and mechanical characterization of six Co-Cr alloys made by conventional casting and selective laser melting.

STATEMENT OF PROBLEM: Three Co-Cr alloy types (Co-Cr-Mo, Co-Cr-W, and Co-Cr-Mo-W) have been commonly used in the fabrication of dental prostheses. These alloys can be manufactured using either conventional casting or selective laser melting (SLM) techniques. Nevertheless, research that directly compares these materials and/or manufacturing processes in terms of their microstructural and mechanical characteristics is sparse. PURPOSE: The purpose of this in vitro study was to conduct microstructural and mechanical analysis via X-ray interpretation, optical microscopy, scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS), image analysis, X-ray diffraction (XRD), instrumented indentation testing (IIT), and 3-point bending testing to characterize Co-Cr-Mo, Co-Cr-W, and Co-Cr-Mo-W alloys produced through conventional casting and SLM. MATERIAL AND METHODS: Six Co-Cr-based alloys were analyzed and divided into 3 types based on their elemental composition (Co-Cr-Mo, Co-Cr-W, and Co-Cr-Mo-W). Additionally, each group was categorized based on the manufacturing process used (casting or SLM). X-ray scans were used to assess porosity. The microstructures of the specimens were assessed through SEM/EDS examination and XRD analysis. IIT was used to determine the Martens hardness (HM) and elastic index (ηIT), while the elastic modulus (E) was estimated through the 3-point bending test. The mechanical properties were statistically analyzed using 2-way analysis of variance (ANOVA) and the Tukey multiple comparison post hoc test, with alloy type and manufacturing process as discriminating variables (α=.05). RESULTS: All cast groups exhibited gross porosity, while no pores or other flaws were found in the SLM groups. Based on the XRD results, the crystalline structure of all Co-Cr specimens consisted of the face-centered cubic γ phase (γ-fcc), along with the hexagonal close-packed ε phase (ε-hcp) and Cr23C6 carbide. Different microstructures were identified between the cast and SLM alloys. Significant differences were identified for the mean standard deviation HM (ranging from 2601 ±94 N/mm2 to 3633 ±61 N/mm2) and mean ±standard deviation ηIT (ranging from 16.8 ±0.3% to 20.9 ±0.3%) among alloys prepared by the same manufacturing process, while all SLM alloys had statistically higher HM and ηIT results than their cast counterparts (P<.05). No statistically significant differences were identified for the mean ±standard deviation Eb (ranging from 170 ±25 GPa to 244 ±36 GPa) among the groups prepared with the same manufacturing process (P>.05), but the SLM alloys had significantly higher results (P<.05) than the cast alloys. CONCLUSIONS: In general, the manufacturing procedure significantly affected the porosity, microstructure, and mechanical properties of the tested Co-Cr alloys. SLM decreased the internal porosity, provided a uniform microstructure, and improved the mechanical properties for all the tested alloy types.

MRI susceptibility artefacts caused by orthodontic wire.

OBJECTIVES: To evaluate magnetic susceptibility artefacts produced by orthodontic wires on MRI and the influence of wire properties and MRI image sequences on the magnitude of the artefact. METHODS: Arch form orthodontic wires [four stainless steels (SS), one cobalt chromium (CC) alloy, 13 titanium (Ti) alloys] were embedded in a polyester phantom, and scanned using a 1.5-T superconducting magnet scanner with an eight-channel phased-array coil. All wires were scanned with T1-weighted spin echo (SE) and gradient echo (GRE) sequences according to the American Society for Testing and Materials (ASTM) F2119-07 standard. The phantom also scanned other eight sequences. Artefacts were measured using the ASTM F2119-07 definition and OsiriX software. Artefact volume was analysed according to metal composition, wire length, number of wires, wire thickness, and imaging sequence as factors. RESULTS: With SE/GRE, black/white artefacts volumes from all SS wires were significantly larger than those produced by CC and Ti wires (P < .01). With the GRE, the black artefacts volume was the highest with the SS wires. With the SE, the black artefacts volume was small, whereas white artefacts were noticeable. The cranio-caudal extent of the artefacts was significantly longer with SS wires (P < .01). Although a direct relationship of wire length, number of wires, and wire thickness with artefact volume was noted, these factors did not influence artefact extension in the cranio-caudal direction. CONCLUSIONS: Ferromagnetic/paramagnetic orthodontic wires create artefacts due to local alteration of magnetic field homogeneity. The SS-type wires produced the largest artefacts followed by CC and Ti.

The dimensions of preformed nickel-titanium archwires measured at the bracket positions corresponding to the central incisor, canine, and first molar.

INTRODUCTION: Variation in the thickness of commercially available preformed rectangular archwires at the bracket positions has not been thoroughly studied. Therefore, this study measured the edgewise (height) and flatwise (width) dimensions of preformed rectangular nickel-titanium (NiTi) archwires at bracket positions corresponding to the central incisor, canine, and first molar and compared them among bracket positions. METHODS: Sixty types of preformed rectangular NiTi mandibular archwires indicated as 0.019 × 0.025-in were obtained from 14 manufacturers. The height and width dimensions of archwires were measured at 4 points (3 bracket positions corresponding to the central incisor, canine, and first molar, and 1 terminal end) of each side of each archwire using a micrometer and compared with the indicated dimensions using 1-sample t tests. Furthermore, the measured dimensions were compared among the 3 bracket positions using a 1-way analysis of variance and Bonferroni post-hoc test. RESULTS: The measured dimensions were significantly smaller than the indicated dimensions for all points except the central incisor point for height and significantly smaller than the indicated dimensions for all points for width. Comparisons among points showed that for height, the central incisor point was significantly larger than the first molar and terminal points. However, no significant differences were found for width at any point. CONCLUSIONS: The measured dimensions of preformed NiTi archwires at the bracket positions were generally smaller than the indicated dimensions, with variations observed not only among products but also among manufacturers.

Corrosion-induced changes in surface properties and roughness of orthodontic wires.

INTRODUCTION: This study aimed to investigate the surface free energy and surface roughness (SR) of metallic alloys under the influence of acid solutions. METHODS: The experiment involved the use of 270 rectangular wire samples measuring 0.019 × 0.025-in. These samples were sourced from 3 different commercial brands: Dentsply GAC, American Orthodontics, and Orthoclassic. This in vitro study categorized the samples into 3 groups based on the solutions employed: deionized water, citric acid, and phosphoric acid. Each group consisted of 90 samples, with 30 samples representing each type of alloy-stainless steel, nickel-titanium, and titanium molybdenum alloy (TMA). The wire segments were immersed in their respective solutions for 72 hours at a controlled temperature of 37°C, with continuous orbital agitation at 130 rpm. After the immersion period, the study analyzed both surface free energy and SR. The mean values obtained were subjected to an analysis of variance at a significance level of 5%. RESULTS: All alloys displayed hydrophobic behavior, as indicated by interaction free energy values <0. In acidic environments (phosphoric acid and citric acid), significant differences were observed among different brands and alloys, affecting surface energy and interaction free energy. Variations in SR among metallic alloys included steel with the lowest SR variations, followed by nickel-titanium and TMA. Notably, the TMA alloy stood out with significantly higher surface energy compared with that of the other alloys (P <0.001). CONCLUSIONS: In this study, all examined alloys demonstrated a hydrophobic nature, suggesting a limited attraction to water. Notably, TMA exhibited the least hydrophobic behavior among the alloys studied. However, when exposed to citric acid, TMA displayed the most substantial alterations in its surface properties. These results underscored the significance of accounting for the distinctive properties of each alloy and their responses to diverse challenges, such as exposure to acidic solutions, during the selection of orthodontic wires for orthodontics treatment.

Comparison of alignment efficiency of different sizes of superelastic nickel-titanium archwires in the initial phase of fixed orthodontic treatment: A single-center, double-blind randomized clinical trial.

INTRODUCTION: This 3-arm parallel, double-blind study aimed to evaluate the alignment efficiency of 3 different diameters of superelastic nickel-titanium (NiTi) archwires during the initial phase of orthodontic treatment. METHODS: Ninety-three patients with nonextraction treatment in the mandibular arch (using 0.022-in Roth prescription brackets) were randomly allocated into 3 groups: 0.012-in NiTi (group 1), 0.014-in NiTi (group 2), and 0.016-in NiTi (group 3). The alignment change was measured using the modified Little's irregularity index before archwire placement and every 4 weeks. The alignment efficiency of the 3 groups was analyzed. RESULTS: Ninety patients were analyzed (group 1: n = 29, group 2: n = 31, and group 3: n = 30; overall mean age, 16.6 years). The overall Wald test analysis revealed that wire type was not statistically significant (P = 0.91), whereas time exhibited significance as expected (P <0.001). Furthermore, the interaction between wire type and time was not significant (P = 0.93). The time-adjusted estimated difference between 0.014-in and 0.012-in was -0.49 (95% confidence interval, -2.83 to 1.85; P = 0.68). The time-adjusted estimated difference between 0.016-in and 0.012-in was -0.45 (95% confidence interval, -2.95 to 2.05; P = 0.72). No harm was observed. CONCLUSIONS: The clinical performance of 3 different sizes of NiTi archwires was similar. In addition, 0.014-in and 0.016-in NiTi archwires demonstrated better performances in aligning any irregularities because of a greater number of wire deformations in the 0.012-in group. REGISTRATION: IR.TBZMED.REC.1395.1039. PROTOCOL: The protocol was not published before trial commencement. FUNDING: None.

The effect of autoclave cycles on the mechanical properties and surface roughness of NiTi archwires: ex-vivo study.

OBJECTIVES: To evaluate the effect of the universal and rapid autoclave cycles on the mechanical properties and surface roughness of nickel-titanium archwires following clinical use. MATERIAL AND METHODS: Thirty-six NiTi archwires (0.016 × 0.022 inch) were equally divided into a control group (Group A) and 2 experimental groups (Group B & C). Wires in group A were tested in the "as-received" form. Wires in the two other groups were installed in patients mouth for 4 weeks, and then autoclaved using the rapid-cycle (Group B) or the universal-cycle (Group C). All wires were subjected to 3-point bending test to calculate the elastic limit, modulus of elasticity, spring-back, yield strength, resilience and toughness. Atomic force microscopy (AFM) was used for surface roughness qualitative and quantitative analysis. RESULTS: Group B showed significantly higher values of elastic limit, modulus of elasticity, resilience, yield strength and toughness than the other two groups. No significant differences were detected between groups A and C (P > 0.05). Group B showed significantly lower average surface roughness than the other two groups, but no significant differences were detected between groups A and C (P > 0.05). CONCLUSIONS: The mechanical properties and surface roughness of clinically used NiTi wires were less affected by the universal-cycle than the rapid-cycle autoclaving. However, the difference between the effect of both autoclave cycles was diminutive. CLINICAL RELEVANCE: The mechanical properties and surface roughness of the tested NiTi wires were not notably altered by clinical use and autoclaving.

Influence of titanium and titanium-zirconium alloy as implant materials on implant stability of maxillary implant retained overdenture: a randomized clinical trial.

BACKGROUND: Long-term success of implant restoration depends on many factors one of them is the sufficient implant stability which is lowered in compromised bone density sites such as the maxilla as it is categorized as type III & IV bone, so searching for a new innovation and updates in implant material and features is very mandatory. So, the aim of this study was to compare between two implant materials (roxolid and traditional titanium) on the primary and secondary stability of implant retained maxillary overdenture. METHODS: Eighteen completely edentulous patients were selected. All patients received maxillary implant-retained overdentures and lower complete dentures; patients were divided equally into two groups according to the type of implant materials. Group A received a total number of 36 implants made of roxolid material and Group B received a total number of 36 implants made of traditional titanium alloys. Implant stability was assessed using ostell device, the primary implant stability was measured at the day of implant installation however, secondary implant stability was measured after six weeks of implant placement. Paired t-test was used to compare between primary and secondary stability in the same group and an independent t-test was used to compare between the two groups with a significant level < 0.05. RESULTS: Independent t-test revealed a significant difference between the two groups with p -value = 0.0141 regarding primary stability and p-value < 0.001 regarding secondary stability, as roxolid implant group was statistically higher stability than titanium group in both. Paired t- test showed a statistically significant difference in roxolid implant group with p-value = 0.0122 however, there was non-statistically significant difference in titanium group with p-value = 0.636. Mann Whitney test showed a significant difference between the two groups regarding amount of change in stability with p value = 0.191. roxolid implant group showed a higher amount of change in stability than the titanium implant group. CONCLUSION: Within the limitation of this study, it could be concluded that: Roxolid implants showed promising results regarding primary and secondary stability compared to conventional Titanium implants and can be a better alternative in implant retained maxillary overdentures. TRIAL REGISTRATION: Retrospectively NCT06334770 at 26-3-2024.

Effect of repetitive up-and-down movements on torque/force generation, surface defects and shaping ability of nickel-titanium rotary instruments: an ex vivo study.

BACKGROUND: The screw-in effect is a tendency of a nickel-titanium (NiTi) rotary endodontic file to be pulled into the canal, which can result in a sudden increase in stress leading to instrument fracture, and over-instrumentation beyond the apex. To reduce screw-in force, repeated up-and-down movements are recommended to distribute flexural stress during instrumentation, especially in curved and constricted canals. However, there is no consensus on the optimal number of repetitions. Therefore, this study aimed to examine how repeated up-and-down movements at the working length affect torque/force generation, surface defects, and canal shaping ability of JIZAI and TruNatomy instruments. METHODS: An original automated root canal instrumentation device was used to prepare canals and to record torque/force changes. The mesial roots of human mandibular molars with approximately 30˚ of canal curvature were selected through geometric matching using micro-computed tomography. The samples were divided into three groups according to the number of up-and-down movements at the working length (1, 3, and 6 times; n = 24 each) and subdivided according to the instruments: JIZAI (#13/0.04 taper, #25/0.04 taper, and #35/0.04 taper) or TruNatomy (#17/0.02 taper, #26/0.04 taper, and #36/0.03 tape) (n = 12 each). The design, surface defects, phase transformation temperatures, nickel-titanium ratios, torque, force, shaping ability, and surface deformation were evaluated. Data were analyzed with the Kruskal-Wallis and Dunn's tests (α = 0.05). RESULTS: The instruments had different designs and phase transformation temperatures. The 3 and 6 up-and-down movements resulted in a smaller upward force compared to 1 movement (p < 0.05). TruNatomy generated significantly less maximum torque, force, and surface wear than JIZAI (p < 0.05). However, TruNatomy exhibited a larger canal deviation (p < 0.05). No statistical differences in shaping ability were detected between different up-and-down movements. CONCLUSIONS: Under laboratory conditions with JIZAI and TruNatomy, a single up-and-down movement at the working length increased the screw-in force of subsequent instruments in severely curved canals in the single-length instrumentation technique. A single up-and-down movement generated more surface defects on the file when using JIZAI. TruNatomy resulted in less stress generation during instrumentation, while JIZAI better maintained the curvature of root canals.

Clinical effect of chlorhexidine and sodium fluoride on corrosion behavior and surface topography of nitinol orthodontic archwires.

BACKGROUND: Alterations in the mechanical properties of the materials utilized in orthodontic appliances could affect the working properties of the appliances, thereby affecting clinical progress and outcome. Numerous studies have confirmed the correlation between alloy corrosion and raised surface roughness, which has a direct impact on the working characteristics of orthodontic archwires. METHODS: Thirty nickel-titanium (NiTi) orthodontic archwires were utilized in this study. Patients were randomly selected and allocated into three groups according to the randomization plan; (The control group): subjects practiced regular oral hygiene; (The fluoride group): subjects used fluoride for intensive prophylaxis; (The chlorhexidine group): subjects used chlorhexidine. Representative samples were evaluated by SEM, and then SEM images with high resolution were examined using Image J software to determine the surface roughness and obtain the results for further statistical analysis. RESULTS: Our findings indicated a significant difference was found between the three groups regarding the anterior and posterior parts between the control and the two other groups and a non-significant difference between NaF and CHX groups. Overall, the p-value for group comparisons was 0.000 for both parts, indicating a highly significant difference especially between the control and NaF groups. CONCLUSION: Mouthwashes containing sodium fluoride demonstrated more significant surface alterations than the control and CHX groups and should be prescribed in accordance with orthodontic materials to reduce side effects.

An investigation of the corrosion behavior of zinc-coated stainless steel orthodontic wires: the effect of physical vapor deposition method.

BACKGROUND: Releasing of metal ions might implicate in allergic reaction as a negative subsequent of the corrosion of Stainless Steel (SS304) orthodontic wires. The aim of this study was to evaluate the corrosion resistance of zinc-coated (Zn-coated) SS orthodontic wires. METHODS: Zinc coating was applied on SS wires by PVD method. Electrochemical impedance spectroscopy (EIS), Potentiodynamic polarization tests and Tafel analysis methods were used to predict the corrosion behavior of Zn-coated and uncoated SS wires in both neutral and acidic environments. RESULTS: The values of Ecorr ,icorr and Rct ,which were the electrochemical corrosion characteristics, reported better corrosion behavior of Zn-coated SS wires against uncoated ones in both artificial saliva and fluoride-containing environments. Experimental results of the Tafel plot analyses were consistent with that of electrochemical impedance spectroscopy analyses for both biological solutions. CONCLUSION: Applying Zn coating on bare SS orthodontic wire by PVD method might increase the corrosion resistance of the underlying stainless-steel substrate.

Comparison of cyclic fatigue resistance of four pediatric rotary file systems at body temperature: an in vitro study.

BACKGROUND: The aim of this study was to compare the cyclic fatigue resistance (CFR) of the newly developed pediatric nickel-titanium (NiTi) rotary file systems for root canal preparation of primary teeth. METHODS: Eighty pediatric NiTi rotary file systems files were used in this study, including 20 EasyInSmile X-Baby (25/0.04), 20 Scope miniScope (25/0.04), 20 EndoArt Pedo Gold (25/0.04), and 20 EndoArt Pedo Blue (25/0.04) files. Static CFR tests; performed on a custom-made stainless steel block with an inner diameter of 1.5 mm, an angle of curvature of 60° and a curved artificial canal with a radius of curvature of 5 mm. The test system was filled with distilled water and the temperature was kept constant at 35 ± 1 °C. The files were rotated in the simulated canal until fracture occurred. The number of cycles to failure (NCF) data was recorded, and all the fracture surfaces of the files were evaluated using scanning electron microscopy (SEM). One-way ANOVA and Tukey tests were used for statistical analysis of the data, and the significance level was set at p < 0.05. RESULTS: EndoArt Pedo Blue showed the highest NCF values (2668.10 ± 755.26), while the miniScope showed the lowest NCF values (453.65 ± 72.51), with a statistically significant difference between all the tested file systems (p < 0.05). There was no statistical difference in terms of fractured fragment lengths among all tested files (p > 0.05). CONCLUSION: The EndoArt Pedo Blue file system showed the best CFR performance among the four file systems specifically designed for primary teeth.

In vitro determination of genotoxicity and cytotoxicity induced by stainless steel brackets with and without surface coating in cultures of oral mucosal cells.

BACKGROUND: Orthodontics is a speciality of dentistry that uses a plethora of devices made from myriad materials to manage various malocclusions. Prolonged contact of orthodontic appliances with oral tissues can lead to cellular damage, highlighting the need for biocompatible materials to mitigate health risks. OBJECTIVES: To analyze the genotoxicity and cytotoxicity produced by metal brackets and coated metallic brackets with polymeric and nanoparticle coatings in oral mucosal cells. MATERIALS & METHODS: The current study compares the toxicity of 3 different types of orthodontic brackets with control groups of oral mucosal cells. Each of the three treatment groups consisted of 10 samples of orthodontic brackets: stainless steel brackets(Group 1), nanoparticle-coated brackets(Group 2), and polymeric-coated brackets(Group 3) exposed to corrosion eluates employing an oral biomimicry model. Two types of oral mucosal cells- Human Gingival Fibroblasts and Buccal Epithelial Cells were used to study the cytotoxic and/or genotoxic effects of the elutes. Intergroup comparisons were conducted using one-way analysis of variance, while scanning electron microscopy evaluated surface characteristic. RESULTS: The interaction between metal ions and oral mucosal cells showed no statistically significant difference for toxicity assays between the three groups(p > 0.005). However, polymeric and nanoparticle-coated groups showed reduced cellular differentiation when compared with conventional stainless-steel brackets. CONCLUSION: This in-vitro study shows that polymeric or nanoparticle coating of conventional metal brackets aids in enhancing corrosion-resistant characteristics of orthodontic appliances and reduces the toxic oral environment created by metal release in the oral cavity.

The effect of single versus multiple piezocisions on the rate of canine retraction: a randomized controlled trial.

BACKGROUND: Piezocision is a minimally invasive surgical method aiming to accelerate tooth movement. However, its effect was found to be transient, appertaining to the regional acceleratory phenomenon (RAP). Hence, the aim of the study was to evaluate the effect of single and multiple piezocisions on the rate of orthodontic tooth movement (OTM). Moreover, the impact of both protocols on canine tipping and orthodontically induced inflammatory root resorption (OIIRR) has been assessed. METHODS: Thirty indicated patients for the therapeutic extraction of maxillary first premolars were enlisted in this split-mouth study, and they were randomly split into two equal groups, each including 15 subjects. In the Single Application Group (SAG), one side of the maxillary arch arbitrarily received a single piezocision before the onset of canine retraction, whereas in the Multiple Application Group (MAG), piezocisions were randomly performed on one side, three times on a monthly basis, over the 12-week study period. The contralateral sides of both groups served as the controls. Canine retraction was carried out bilaterally using nickel-titanium closed-coil springs, delivering 150 g of force, and the rate of tooth movement, as well as canine tipping were evaluated on a monthly basis, over a 3-month period. Cone-bean computed tomography scans were also conducted pre- and post- canine retraction, and OIIRR was assessed using Malmgren Index. RESULTS: The reported outcomes revealed a significant increase in the amount of canine retraction, canine tipping, as well as root resorption scores on the experimental sides in both groups SAG and MAG post-retraction (p < 0.001). However, upon comparing the experimental sides in both groups, non-significant differences have been observed between them regarding all the assessed outcomes (p > 0.05). CONCLUSIONS: Single and multiple piezocisions effectively accelerate OTM in comparison to conventional orthodontic treatment, with relative outcomes reported by both intervention frequencies. Accordingly, single piezocision is recommended as an adjunct to OTM. Furthermore, significant tooth tipping as well as a significantly higher root resorption risk accompanies both single and multiple piezocision applications in conjunction with OTM. NAME OF THE REGISTRY: Clinicaltrials.gov TRIAL REGISTRATION NUMBER: NCT05782088 DATE OF REGISTRATION: 23/03/2023 "Retrospectively registered". URL: https://clinicaltrials.gov/ct2/show/NCT05782088.

Evaluation of the re-bond strength of debonded metal and ceramic brackets following Er: YAG laser treatment.

BACKGROUND: Failure of orthodontic bracket bonds is a common occurrence during orthodontic treatment. This study investigated the impact of Er: YAG laser-based removal of adhesive from the bases of metal and ceramic brackets for re-bonding. METHODS: A total of 168 extracted premolars were collected from patients. 84 metal brackets were used to be bonded on the buccal surface of the premolars in Groups 1, 2, 3 and 4, while 84 ceramic brackets were applied in Groups I, II, III and IV. Group 1/I represented the initial bonding group, with Group 2/II being the re-bonding group with new brackets, while Groups 3/III and 4/ IV received recycled brackets treated by Er: YAG laser or flaming respectively. Both the first and second de-bonding were performed in all samples using a universal testing machine to determine the shear bond strength (SBS). The adhesive remnant index (ARI) was evaluated using a stereo-microscope. The new and the treated bracket bases were evaluated using scanning electron microscopy (SEM). Differences in initial bonding and re-bonding ability were analyzed through one-way ANOVAs, and differences in ARI were assessed with the Kruskal-Wallis test. RESULTS: Greater amounts of adhesive residue were observed on ceramic brackets treated by laser. The SBS values for recycled metal brackets in Group 3 (26.13 MPa) were comparable to Group 1 (23.62 MPa) whereas they differed significantly from Group 4 (12.54 MPa). No significant differences in these values were observed when comparing the 4 groups with ceramic brackets. ARI score in Group 4 (2-3 points) differed significantly from the three other groups (P < 0.05). For Group I, II, III and IV, similar ARI scores were observed (P > 0.05). SEM analysis didn't show apparent damage of bracket bases consisting of either metal or ceramic material treated by Er: YAG laser. CONCLUSIONS: Er: YAG laser treatment was superior to flame treatment as a means of removing adhesive without damaging the brackets. SBS values and ARI scores following Er: YAG laser treatment were similar to those for new brackets, offering further support for Er: YAG laser treatment as a viable means of recycling debonded brackets.

Endodontic Ni-Ti Rotary Instruments for Glide-path, Are They Still Necessary and How to Think about the Ideal Instrument?

How to cite this article: Reda R, Maccari E, Bhandi S. Endodontic Ni-Ti Rotary Instruments for Glide-path, Are They Still Necessary and How to Think about the Ideal Instrument? J Contemp Dent Pract 2024;25(6):505-506. Keywords: Alloy, Endodontics, Glide Path, NiTi Rotary Instruments, Patency.

Cyclic Fatigue Properties of Titanium Alloys for Application in Dental Implants.

The present study investigated the cyclic fatigue properties of titanium alloys (Ti-6Al-4V and Ti-6Al-7Nb) as implant materials and compared their properties with those of commercially pure titanium. Ti-6Al-4V and Ti-6Al-7Nb cylinders with diameters of 3.0 mm were examined. The surfaces of the cylinders were roughened by sand blasting with alumina particles and acid etching. Static and cyclic tests were performed according to ISO 14801:2016. The yield force in the static test (YS) was measured in 5 specimens of each alloy using a universal testing machine. The yield force in a cyclic test (YC) was measured in 20 specimens of each alloy using the staircase method, which involved applying a cyclic load at a frequency of 10 Hz for 106 cycles. After the cyclic loading tests, cross-sections of the specimens were examined under an optical microscope. The YS values for Ti-6Al-4V and Ti-6Al-7Nb were 1463 N±93 N and 1405 N±79 N, respectively, and the YC values were 870 N±58 N and 853 N±202 N, respectively. Microscopic observation revealed cracks on the tensile side of some of the specimens, including run outs and failures. The results of this study suggest that the YC values for Ti-6Al-4V and Ti-6Al-7Nb were 40% less than those for YS. The yield force of Grade-4 Cp-Ti significantly decreased after cyclic loading. The YC values for Ti-6Al-4V and Ti-6Al-7Nb were approximately 900 N, which was markedly greater than that for commercially pure, Grade-4 titanium (700 N).

Ultrastrong steel via minimal lattice misfit and high-density nanoprecipitation.

Next-generation high-performance structural materials are required for lightweight design strategies and advanced energy applications. Maraging steels, combining a martensite matrix with nanoprecipitates, are a class of high-strength materials with the potential for matching these demands. Their outstanding strength originates from semi-coherent precipitates, which unavoidably exhibit a heterogeneous distribution that creates large coherency strains, which in turn may promote crack initiation under load. Here we report a counterintuitive strategy for the design of ultrastrong steel alloys by high-density nanoprecipitation with minimal lattice misfit. We found that these highly dispersed, fully coherent precipitates (that is, the crystal lattice of the precipitates is almost the same as that of the surrounding matrix), showing very low lattice misfit with the matrix and high anti-phase boundary energy, strengthen alloys without sacrificing ductility. Such low lattice misfit (0.03 ± 0.04 per cent) decreases the nucleation barrier for precipitation, thus enabling and stabilizing nanoprecipitates with an extremely high number density (more than 1024 per cubic metre) and small size (about 2.7 ± 0.2 nanometres). The minimized elastic misfit strain around the particles does not contribute much to the dislocation interaction, which is typically needed for strength increase. Instead, our strengthening mechanism exploits the chemical ordering effect that creates backstresses (the forces opposing deformation) when precipitates are cut by dislocations. We create a class of steels, strengthened by Ni(Al,Fe) precipitates, with a strength of up to 2.2 gigapascals and good ductility (about 8.2 per cent). The chemical composition of the precipitates enables a substantial reduction in cost compared to conventional maraging steels owing to the replacement of the essential but high-cost alloying elements cobalt and titanium with inexpensive and lightweight aluminium. Strengthening of this class of steel alloy is based on minimal lattice misfit to achieve maximal precipitate dispersion and high cutting stress (the stress required for dislocations to cut through coherent precipitates and thus produce plastic deformation), and we envisage that this lattice misfit design concept may be applied to many other metallic alloys.