Combined Effects of Different Bracket Bonding Adhesives and Different Resin Removal Methods on Enamel Discoloration: A Preliminary Study.

Introduction: This study aimed to investigate the effects of 3 orthodontic bracket adhesives and 3 resin removal methods on enamel discoloration. Methods: Ninety metal orthodontic brackets were bonded to 90 intact human premolars, using 3 adhesives (total etch composite (Transbond), self-etch composite (OptiBond), and light-curedresin-modified glass ionomer cement (RMGI, Fuji); n = 3 × 30). Each "bracket bonding" group (n = 30) was randomly divided into three subgroups of 10 specimens each, each with a different method of remnant resin removal (using only tungsten carbide burs; using tungsten carbide burs plus Sof-Lex polisher discs; using tungsten carbide burs and Stainbuster burs; n = 3 × 30). After bracket debonding and coffee staining (at 37°C for one week), the color change parameters (Δa, Δb, ΔL, and ΔE) were measured and then analyzed statistically (α = 0.05). Results: All 9 mean ΔE values were significantly greater than 3.7 and 1.0 (P values ≤0.002, t-test). The effects of composites and resin removal methods on the ΔE parameter (and their interaction) were significant (P values ≤0.008, two-way ANOVA). There were significant pairwise comparisons between total etch (Transbond) and each of the other composites (P values ≤0.008, Tukey). Nonetheless, the difference between self-etch (OptiBond) and RMGI (Fuji) was not significant (P=0.967). There were significant pairwise comparisons between the ΔE parameter of group "Bur + Stainbuster" and ΔE of each of the other methods (both P values ≤0.017). Conclusions: All 9 pairs of adhesives and resin removal techniques will cause quite visible discolorations. Still, self-etch composites or RMGI might be recommended over total etch composites. Moreover, using Stainbuster burs together with tungsten carbide burs is recommended to reduce discoloration. However, the coloration caused by each composite type can change drastically given the following adhesive removal technique used.

Low-level laser therapy, piezocision, or their combination vs. conventional treatment for orthodontic tooth movement : A hierarchical 6-arm split-mouth randomized clinical trial.

PURPOSE: The use non-invasive or minimally invasive methods to accelerate orthodontic tooth movements (OTM) is desirable. In this regard, low-level laser therapy (LLLT, photobiomodulation) and piezocision are suggested. However, because the efficacies of these methods remain controversial/inconclusive, we investigated and compared these two methods. METHODS: Sixty-four quadrants in 32 patients were randomized into three parallel intervention groups of 22, 22, and 20 (6 parallel arms, n = 64 treatment/control sides). Bilateral first premolars were extracted and canine retraction commenced. In each group, one side of the mouth was randomly selected as control, while the other side underwent each of three interventions: LLLT (940 nm, 8 J, 0.5 W, 16 s, 12 sites), piezocision, and "LLLT + piezocision". At the 3rd, 6th, and 9th follow-up weeks, canine retraction and anchorage loss were measured. Data were analyzed statistically (α = 0.05). RESULTS: After 9 weeks, LLLT, piezocision, and LLLT + piezocision improved canine retraction by 0.51, 1.14, and 1.93 mm, respectively. LLLT accelerated canine retraction (compared to control) by 1.6-, 1.4-, and 1.2-fold in the 3rd, 6th, and 9th week, respectively. These statistics were 2.1-, 1.7-, and 1.5-fold for piezocision and 2.7-, 2.1-, and 1.8-fold for LLLT + piezocision. Compared to controls, each intervention showed significant retraction acceleration (p < 0.05). The effect of LLLT + piezocision was greater than that of isolated piezocision (p < 0.05), which itself was greater than that for isolated LLLT (p < 0.05). CONCLUSION: All three methods accelerated OTM, with the combination of LLLT + piezocision producing the strongest and LLLT producing the weakest acceleration.

Efficacy of the systemic co-administration of vitamin D3 in reversing the inhibitory effects of sodium alendronate on orthodontic tooth movement: A preliminary experimental animal study.

INTRODUCTION: Bisphosphonates can severely slow down orthodontic tooth movement (OTM) by reducing bone turnover. This calls for materials and methods to reverse or neutralize their effects on OTM. We propose systemic vitamin D3 (D3) for this purpose. METHODS: Thirty-two male Wistar rats were randomized into 4 groups of 8 each. Three groups were administered D3 (3 systemic doses of 24,000 IU/kg each), alendronate (ALN) (5 doses of 7 mg/kg each), and ALN+D3 (same doses as mentioned above). One group served as the negative control. The incisors were distalized at 30 g of force for 2 weeks. OTMs were measured blindly. Radicular pressure areas were searched histologically (blindly) for capillaries, Howship's lacunae, osteoclasts, and osteoblasts. Data were analyzed statistically (α = 0.05, α = 0.0083, ß <0.1). RESULTS: OTMs in the groups D3, ALN+D3, ALN, and control were 1.900 ± 0.237, 1.629 ± 0.219, 0.975 ± 0.145, and 1.565 ± 0.324 mm (analysis of variance, P <0.001), respectively. OTM in the ALN group was smaller than all other groups (Tukey, P <0.001). OTM in the D3 group was greater than in the control group (P = 0.054). The ALN+D3 group had greater OTM than the ALN group (P <0.001) but was not significantly different from the D3 (P = 0.153) or control (P = 0.951) groups. All histologic variables were significantly different across groups (Kruskal-Wallis, P <0.001). All the markers in the D3 group were more frequent than those of the other groups (Mann-Whitney U, P <0.001). There were fewer markers in the ALN group than in the control group (P ≤0.001). The ALN+D3 group had more markers than the ALN group in terms of capillaries, osteoclasts, and osteoblasts (P ≤0.007). The ALN+D3 group was similar to the control group regarding capillaries, osteoclasts, and osteoblasts (P ≥0.382). CONCLUSIONS: Systemic vitamin D3 may accelerate OTM and increase histologic biomarkers of bone turnover. ALN reduces OTM and its histologic biomarkers. Systemic vitamin D3 can reverse this inhibitory effect of ALN on OTM back to normal.

Effects of cold chemical (glutaraldehyde) versus autoclaving sterilization on the rate of coating loss of aesthetic archwires: A double-blind randomized clinical trial.

OBJECTIVE: The effect of any sterilization methods (cold chemical, or hot) on film removal from coated archwires has not yet been investigated. Thus, we assessed it. MATERIALS AND METHODS: This double-blind randomized clinical trial was performed on 120 observations: 40 macroscopically intact coated archwires from 4 brands were purchased (n=10 archwires/brand). Five wires from each brand underwent cold and 5 underwent hot sterilization. Wires were applied in 40 non-extractions patients at alignment phase of treatment (one month). Afterwards, 3 inter-bracket segments from each wire were examined microscopically, and the percentage of coating loss was recorded for each segment. Coating losses of the 4 brands and 2 sterilization methods were compared using a two-way ANOVA and a Welch t-test (α=0.05). Surfaces were also evaluated using scanning electron microscopy. RESULTS: The mean surface coating loss of hot (autoclave) and cold (glutaraldehyde) sterilization methods was 25.6±28.7 and 28.1±30.8 percent respectively. The mean surface coating removal of the Ortho Organizers, American Orthodontics, SIA, and Gestenco brands were 24.1±28.4, 36.7±36.0, 23.0±24.4, and 23.6±28.0 percent, respectively. The two-way ANOVA indicated a lack of overall significant differences among wire brands (P=0.189) and between sterilization types (P=0.629). However, the interaction of sterilization and brands was significant (P=0.005). CONCLUSIONS: Within the limitations of this 1-month clinical trial limited to 4 coated NiTi archwire brands only, the average coating removal of examined brands might not differ much, amounting to about 26% within a month. Glutaraldehyde and autoclave sterilization might not affect the average speed of coating loss in all brands, although each sterilization method might be favourable for certain brands.

Surface topography of plain nickel-titanium (NiTi), as-received aesthetic (coated) NiTi, and aesthetic NiTi archwires sterilized by autoclaving or glutaraldehyde immersion: A profilometry/SEM/AFM study.

BACKGROUND AND AIM: Surface topography is a crucial factor in bracket sliding mechanics. Literature on surface roughness of aesthetic archwires is scarce, and there is no study on surface topography of such archwires affected by any sterilization methods. The aim of this study was to compare the surface topography of plain nickel-titanium (NiTi) versus as-received aesthetic coated NiTi wires versus aesthetic wires sterilized by autoclaving or glutaraldehyde immersion. MATERIALS AND METHODS: This in vitro study was performed on 80 atomic force microscopy (AFM) observations, 160 profilometry observations, and 40 scanning electron microscopy (SEM) images from rectangular wires of the brands 'American Orthodontics, Ortho Organizers, SIA, and Gestenco'. AFM consisted of 8 subgroups of NiTi orthodontic wires, consisting of 4 subgroups of 4 brands of coated orthodontic wires and 4 subgroups of 4 brands of uncoated wires from the same brands. Profilometry consisted of 16 subgroups of NiTi orthodontic wires, consisting of 4 subgroups of 4 brands of coated orthodontic wires and 12 subgroups of 4 brands of uncoated wires from the same brands (4 as-received wire subgroups, 4 autoclaved, and 4 cold-sterilized subgroups). Scanning electron microscopy (SEM) and AFM images were subjectively evaluated. AFM and profilometry data were analysed statistically (α=0.05). RESULTS: Overall, the difference between surface roughness parameters of coated versus uncoated archwires was not significant (P>0.05). However, surface roughness of brands differed significantly. Mann-Whitney did not show any significant differences between sterilized wires (both sterilization methods together as one group) and unsterilized wires (both unsterilized coated and uncoated as one group) (P>0.460). After excluding plain uncoated NiTi group, the coated wires in 3 sterilization groups (no sterilization, autoclaving, glutaraldehyde) were not significantly different in terms of average overall surface roughness (Ra) and maximum roughness depths (Rq) of different sterilization groups (P>0.1) but the average maximum peak to valley heights (Rz) values of 3 sterilization groups were significantly different (P=0.0415). Dunn test showed that among three post-hoc pairwise comparisons of Rz values, only the comparison of "no sterilization versus autoclaving" was significant (P<0.05) and the other two were non-significant. CONCLUSION: Coating might not affect the surface roughness considerably. Brands have different surface roughnesses. Autoclaving but not cold sterilization might affect the surface roughness of coated archwires.

Effects of debonding of orthodontic brackets on topography and surface roughness of composite restorations.

BACKGROUND: To increase bond strength of brackets bonded to composite restorations, underlying composite restorations are usually roughened. This and subsequent bracket debonding might deteriorate smoothness of composite restoration, leading to clinical and aesthetic problems. Since this was not assessed before, this study was conducted. METHODS: Seventy intact human premolars were collected and filled with composite restorations. They were randomly divided into 3 groups: control (n=10), surface treatments before bracket bonding (bur, sandblasting, overall n=40), and surface roughening without bracket bonding (bur, sandblasting, overall n=20). The 40 specimens with bracket bonding steps were divided into two subgroups of with and without polishing after debonding of brackets (each n=10). After aging the composites in two steps and treating surfaces according to abovementioned protocols, their surface topographies were evaluated under stereomicroscopy (80×), scanning electron microscopy (using Zachrisson-Arthun index, at 500× and 1000× zooms), and by profilometry. Profilometry parameters and Zachrisson-Arthun index were statistically compared among different groups (α=0.05, 0.005). RESULTS: According to Kruskal-Wallis test, all profilometry parameters or the Zachrisson and Arthun index were significantly different between groups involving bracket debonding and control (P≤0.001). Three-way ANOVA indicated that bracket debonding, polishing after debonding, and surface treatments before bracket bonding had a significant effect on Ra and Rz (P≤0.05). Tukey post hoc test showed that bur and sandblasting methods were not significantly different (P>0.05). CONCLUSION: Bur-roughening or sandblasting of composite surface before bonding brackets can increase surface roughness, while polishing can reduce it back to control levels.

Porcelain color alteration after orthodontic bonding using three different surface preparation methods.

BACKGROUND: By increasing the number of adults seeking orthodontic treatment bonding orthodontic brackets to the surfaces other than intact enamel has become necessary. The purpose of this study was to evaluate the effect of three different surface preparation methods associated with orthodontic bonding on porcelain color alteration. MATERIALS AND METHODS: In this in vitro study forty-five porcelain discs (6- mm diameter, 2- mm thickness) were fabricated. The color of the specimens was evaluated by means of a Vita Easyshade. Commision Internationale de I'Eclairage (CIE) L* a* b* system was used for color measurement. Then, the specimens were randomly divided into three groups (n = 15) with respect to the surface preparation methods including a 9.6% hydrofluoric acid (HF) + silane, sandblasting, and sandblasting + 9.6% HF + silane. Metal orthodontic brackets were bonded. Samples were stored in 37° c water for 24 hours. Afterward, the brackets were debonded with a debonding plier and porcelain surfaces were polished with a tungsten-carbide bur. The color assessment was done, and ΔE values were measured. ΔE = 3.7 units were considered as an acceptability threshold. Data were analyzed with Paired t-test and one-way ANOVA. Level of significance was set at P < 0.05. RESULTS: Orthodontic bonding changed the color parameters significantly. Mean L*, a* and b* difference were 1.35 ± 2.41, 0.19 ± 0.80, 0.89 ± 1.27 units, respectively (P = 0.003 for L*, P < 0.001 for a* and b*). There was not any significant difference in ΔE units between the groups (P = 0.456). In all the groups the mean ΔE values were below 3.7 units and within the clinically acceptable limit. CONCLUSION: Orthodontic treatment changed the CIE color parameters of porcelain surface. However, the color alteration is below the clinically acceptable threshold. With regard to color alteration, there is no difference between different surface conditioning methods.

Effects of autoclaving versus cold chemical (glutaraldehyde) sterilization on load-deflection characteristics of aesthetic coated archwires.

INTRODUCTION: The effect of any sterilization methods (cold [chemical] or hot) on load-deflection characteristics of aesthetic coated archwires has not yet been investigated. Thus, we assessed it. METHODS: In this experimental in vitro study, 90-coated archwires from 3 brands were purchased. Ten wires from each brand (n=30) underwent cold and 10 underwent hot sterilization, while 10 left unsterilized as negative controls. Load-deflection curves were established for each wire (as five 0.2mm intervals between 1.0 and 1.8mm displacements), using a three-bracket test. After determining the plateau phase that was present in all wires, the averages of plateau phase pertaining to loading and unloading curves and their discrepancies (hysteresis) were calculated for each subgroup (n=10). Average plateau values were compared using two-way ANOVA, Tukey, and independent-samples t-test (α=0.05). RESULTS: Average loading and unloading values were 906.6±129.7 and 295.9±84.5g respectively (t-test P<0.0001). Comparing loading plateaus, ANOVA indicated significant difference among wire brands (P<0.0001) but not among sterilization types (P=0.4793). Comparing unloading plateaus, ANOVA showed significant differences among wire brands (P<0.0001) and sterilization types (P=0.0008). Tukey showed that only cold sterilization and negative control differed significantly (P<0.001); cold and hot sterilization methods, or control and autoclaving were not significantly different (P>0.05). Comparing hysteresis plateaus, ANOVA indicated difference among wire brands (P<0.0053) but not among sterilization types (P=0.9166). CONCLUSIONS: Cold sterilization might reduce unloading plateau of orthodontic wires, but sterilization in general might not affect loading or hysteresis plateaus. Different brands had different plateaus of loading, unloading and hysteresis.

Effect of esthetic coating on surface roughness of orthodontic archwires.

BACKGROUND AND AIM: Esthetic wires are commonly used in orthodontic treatments. Surface roughness is an important factor in the friction and bacterial adhesion in these wires. Surface roughness of esthetic wires has not been assessed, except in a few recent (mostly qualitative esthetics) studies. The aim of this study was to quantitatively compare the surface roughness of 4 coated esthetic wires with that of a conventional orthodontic wire. MATERIALS AND METHODS: In this in vitro trial, 25 coated and uncoated orthodontic archwires were studied, including: NiTi Memory wire (American Orthodontics, USA) as a control group; Orthocosmetic Elastinol (Ortho Organizers, USA); Perfect (Hubit, Korea); Imagination (Gestenco, Sweden); EverWhite (American Orthodontics, USA). All were .016×.022" rectangular maxillary wires. Fifteen millimeters of wire was cut off at the posterior end and a surface area of 2000×2000nm was probed using a Scanning Probe Microscope (DS95-50E/DME, Denmark) to determine the surface roughness values. The roughness parameters of Sa, Sdq, Sv and Sy were measured and statistically compared by Kruskal-Wallis and Mann-Whitney U tests. RESULTS: The average range of the 4 parameters was the highest for the uncoated Ni-Ti Memory wire (control group) while the Perfect coated wire showed the lowest values. The differences were significant for parameters Sa and Sy (P<0.02 and P<0.023) and non-significant for Sv and Sdq. Significant differences existed between uncoated and coated wires regarding Sa and Sy values (P<0.01), being higher for the uncoated wires. CONCLUSION: Taking into account the study limitations, the surface roughness values of NiTi uncoated archwires were significantly higher than those of the coated wires.

Effect of Deep Cryogenic Treatment on Cyclic Fatigue of Endodontic Rotary Nickel Titanium Instruments.

INTRODUCTION: Cyclic fatigue is the common reason for breakage of rotary instruments. This study was conducted to evaluate the effect of cryogenic treatment (CT) in improving the resistance to cyclic fatigue of endodontic rotary instruments. METHODS AND MATERIALS: In this in vitro study, 20 RaCe and 20 Mtwo files were randomly divided into two groups of negative control and CT. CT files were stored in liquid nitrogen at -196°C for 24 h, and then were gradually warmed to the room temperature. All files were used (at torques and speeds recommended by their manufacturers) in a simulated canal with a 45° curvature until breakage. The time to fail (TF) was recorded and used to calculate the number of cycle to fail (NCF). Groups were compared using independent-samples t-test. RESULTS: Mean NCFs were 1248.2±68.1, 1281.6±78.6, 4126.0±179.2, and 4175.4±190.1 cycles, for the Mtwo-control, Mtwo-CT, RaCe-control, and RaCe-CT, respectively. The difference between the controls and their respective CT groups were not significant (P>0.3). The difference between the systems was significant. CONCLUSION: Deep CT did not improve resistance to cyclic fatigue of the evaluated rotary files.

The Effectiveness of Home Water Purification Systems on the Amount of Fluoride in Drinking Water.

STATEMENT OF THE PROBLEM: Water purification systems for domestic use have drawn significant attention over the past few years. This can be related to the improvement of public health and concern for water contamination. PURPOSE: The aim of this study was to evaluate whether home water purification systems eliminate the essential materials such as fluoride besides filtrating the heavy ions and other unwanted particles out of water. MATERIALS AND METHOD: In this experimental study, six most frequently used commercial brands of water purifiers were evaluated and compared. Specimens were collected right before and after setting up the device, and 6 months later. Then, spectrophotometry (the Harrison device) was performed to compare fluoride clearance by each home water cleaner device. RESULTS: Based on the data collected from all water purification devices in different locations, the amount of fluoride was significantly different before and right after using home water purifier and six months later (p= 0.001 and p= 0.00, respectively). CONCLUSION: The filtration of water significantly decreased its fluoride concentration. The fluoride content of purified water was approximately as much as zero in some cases.