Effect of printing orientation on mechanical properties of 3D-printed orthodontic aligners.

PURPOSE: The purpose of this study was to assess differences in the fundamental mechanical properties of resin-made three-dimensional (3D) printed orthodontic aligners according to the printing orientation. METHODS: Twenty resin 3D-printed dumbbell-shaped specimens and 20 orthodontic aligners were fabricated and postcured in nitrogen. Half of the specimens and aligners were built in horizontal (H), the other half in vertical (V) directions. The dumbbell-shaped specimens were loaded in a tensile testing machine, while parts of the aligners were embedded in acrylic resin, ground, polished, and then underwent instrumented indentation testing (IIT). Mechanical properties that were assessed included the yield strength (YS), breaking strength (BS), plastic strain (ε), Martens hardness (HM), indentation modulus (EIT), elastic index (ηIT), and indentation relaxation (RIT). Data were analyzed statistically with independent t­tests or Mann-Whitney tests at α = 5%. RESULTS: No significant differences were found between specimens or aligners printed either in a horizontal or a vertical direction (P > 0.05 in all instances). Overall, the 3D-printed aligners showed acceptable mechanical propertied in terms of YS (mean 19.2 MPa; standard deviation [SD] 1.7 MPa), BS (mean 19.6 MPa; SD 1.2 MPa), ε (mean 77%; SD 11%), HM (median 89.0 N/mm2; interquartile range [IQR] 84.5-90.0 NN/m2), EIT (median 2670.5 MPa; IQR 2645.0-2726.0 MPa), ηIT (median 27.5%; IQR 25.9-28.1%), and RIT (mean 65.1%; SD 3.5%). CONCLUSION: Printing direction seemed to have no effect on the mechanical properties of 3D-printed resin aligners, which are promising for orthodontic use.

Effect of in vivo aging on the surface and electrochemical properties of magnetic attachments used in facial prostheses: A retrieval analysis study.

STATEMENT OF PROBLEM: Reasons associated with the failure of facial prosthesis are of major concern and may be associated with deterioration of both elastomeric materials and magnetic attachments. However, the extent of deterioration of these components is unclear. PURPOSE: The purpose of this in vitro study was to evaluate selected retrieved facial prostheses and provide information regarding the electrochemical characterization of the recovered magnetic attachments. MATERIAL AND METHODS: Five facial prostheses (RP1, RP2, RP3, RP4, RP5) fabricated at the University of Texas, M.D. Anderson Cancer Center were retrieved following clinical use. The intaglio and external surfaces of the prostheses along with the incorporated magnetic attachments were photographed. The areas with the detected failures on the retrieved prostheses, as well as the recovered magnetic attachments, were evaluated under a reflected light stereomicroscope at ×16 nominal magnification and photographed with a digital camera. Five magnetic attachments recovered from the prostheses (retrieved group RT) were evaluated for degradation of their corrosion resistance after electrochemical testing in artificial sweat solution and were compared with 5 unused magnetic attachments (control group, CT). To identify the elemental composition of the intact magnet surface, 1 specimen from the control group was investigated by X-ray energy dispersive spectroscopy (EDS). Means and standard deviations of the open circuit potential (EOCP), the zero-circuit potential (Ecorr), and Icorr were calculated and statistically analyzed by a t test (α=.05 for all tests). RESULTS: The main reasons of failure were discoloration, degradation and rupture of the silicone elastomer, marginal misfit, and delamination of the polyurethane sheet. Additional findings were tarnish and discoloration of the magnetic attachments accompanied by considerable smear build-up. EDS results verified the Ni plating of tested magnets. Electrochemical testing revealed that retrieved magnets showed significantly lower OCP (P<.001) and Ecorr (P<.001) but similar Icorr (P=0.083) while the pseudopassivity region of unused magnets vanished in the retrieved group, denoting a degradation of electrochemical properties after clinical use. CONCLUSIONS: In vivo aging exerts extended degradation on the elastomer part of facial prostheses as well as deterioration of their surface integrity and electrochemical properties.

Effect of heat treatment and nitrogen atmosphere during post-curing on mechanical properties of 3D-printed orthodontic aligners.

OBJECTIVES: Three-dimensional (3D)-printed aligners present a promising orthodontic treatment modality, whose clinical success largely depends on the material's mechanical properties. The aim of this study was to evaluate the mechanical properties of resin-made 3D-printed aligners and assess the effect of two different post-curing conditions. MATERIALS AND METHODS: Forty dumbbell-shaped specimens and 40 resin aligners were 3D-printed and divided into four equal groups according to post-curing conditions: presence or absence of oxygen during post-curing and water heat treatment at 85°C for 15 s or none. Samples from the central incisor of the aligner (n = 5/group) were studied by Attenuated Total Reflection Fourier-transform infrared spectroscopy (ATR-FTIR). The dumbbell-shaped specimens were loaded up to fracture under tensile mode and yield strength, ultimate tensile strength, elastic and plastic strain were calculated. The first mandibular molar area from 3D-printed aligners (n = 10/group) was cut and embedded in acrylic resin and then underwent metallographic grinding and polishing followed by instrumented indentation testing to determine the following mechanical properties: Martens hardness, indentation modulus, elastic index, and indentation relaxation. After descriptive statistics, differences according to each post-curing protocol, as well as their combination, were analyzed with linear regression modeling at a 5% significance level. RESULTS: All groups showed identical ATR-FTIR spectra, while no statistically significant effects were seen for either post-curing protocol (N2 presence and heat treatment) or their combination (P > .05 in all instances). CONCLUSIONS: The mechanical properties of 3D-printed resin aligners were not considerably affected either by post-curing in N2 atmosphere or heat treatment.

Effects of intraoral aging on mechanical properties of directly printed aligners vs. thermoformed aligners: an in vivo prospective investigation.

OBJECTIVE: The objective of this study was to examine the impact of intraoral aging on the mechanical properties of directly printed aligners (DPA) compared to thermoformed aligners (TA). MATERIALS AND METHODS: This prospective in vivo experiment included three types of aligners: DPAs (group DP) fabricated from Tera Harz TC-85 DAC resin (Graphy, Korea), TA (group INV) made from a polyurethane-based polymer (Align Technology, Inc., CA, USA), and TA (group DUR) made from polyethylene glycol terephthalate based polymer (Scheu-Dental, Germany). Each group was categorized into retrieved (Clin) and unused aligners (Ctr). Thirty patients (10 per group) wore the aligners for 7 days, thereby generating the retrieved samples. Thirty unused aligners were employed as control samples. The following mechanical properties were determined: Martens Hardness (HM), indentation modulus (EIT), elastic index (ηIT), and indentation relaxation (RIT). Intergroup comparisons were conducted using ANOVA/Kruskal-Wallis test. Comparisons between retrieved and control samples were done using Wilcoxon-Mann-Whitney-U/Student's t-test/Welch's test. RESULTS: Statistically significant differences between the groups were found for both control and used samples (P < .001). Pairwise comparisons also revealed significant differences between the samples. The mechanical properties did not differ significantly between unused and retrieved INV- and DUR-aligners, whereas for DP-aligners significant differences for ηIT and RIT were found following intraoral service (P-values .012 and .002, respectively). CONCLUSIONS: Group DUR showed generally more favorable mechanical properties compared to DP and INV. The much higher RIT and EIT in DP aligners suggest their higher rigidity and force decay, which could compromise their clinical efficacy.

Development of Bi- and Tri-Layer Nanofibrous Membranes Based on the Sulfated Polysaccharide Carrageenan for Periodontal Tissue Regeneration.

Periodontitis is a microbially-induced inflammation of the periodontium that is characterized by the destruction of the periodontal ligament (PDL) and alveolar bone and constitutes the principal cause of teeth loss in adults. Periodontal tissue regeneration can be achieved through guided tissue/bone regeneration (GTR/GBR) membranes that act as a physical barrier preventing epithelial infiltration and providing adequate time and space for PDL cells and osteoblasts to proliferate into the affected area. Electrospun nanofibrous scaffolds, simulating the natural architecture of the extracellular matrix (ECM), have attracted increasing attention in periodontal tissue engineering. Carrageenans are ideal candidates for the development of novel nanofibrous GTR/GBR membranes, since previous studies have highlighted the potential of carrageenans for bone regeneration by promoting the attachment and proliferation of osteoblasts. Herein, we report the development of bi- and tri-layer nanofibrous GTR/GBR membranes based on carrageenans and other biocompatible polymers for the regeneration of periodontal tissue. The fabricated membranes were morphologically characterized, and their thermal and mechanical properties were determined. Their periodontal tissue regeneration potential was investigated through the evaluation of cell attachment, biocompatibility, and osteogenic differentiation of human PDL cells seeded on the prepared membranes.

Fracture toughness and hardness of in-office, 3D-printed ceramic brackets.

OBJECTIVES: Three-dimensional (3D) printing technology is a promising manufacturing technique for fabricating ceramic brackets. The aim of this research was to assess fundamental mechanical properties of in-office, 3D printed ceramic brackets. MATERIALS AND METHODS: 3D-printed zirconia brackets, commercially available polycrystalline alumina ceramic brackets (Clarity, 3 M St. Paul, MN) and 3D-printed customized polycrystalline alumina ceramic ones (LightForce™, Burlington, Massachusetts) were included in this study. Seven 3D printed zirconia brackets and equal number of ceramic ones from each manufacturer underwent metallographic grinding and polishing followed by Vickers indentation testing. Hardness (HV) and fracture toughness (K1c) were estimated by measuring impression average diagonal length and crack length, respectively. After descriptive statistics calculation, group differences were analysed with 1 Way ANOVA and Holm Sidak post hoc multiple comparison test at significance level α = .05. RESULTS: Statistically significant differences were found among the materials tested with respect to hardness and fracture toughness. The 3D-printed zirconia proved to be less hard (1261 ± 39 vs 2000 ± 49 vs 1840 ± 38) but more resistant to crack propagation (K1c = 6.62 ± 0.61 vs 5.30 ± 0.48 vs 4.44 ± 0.30 MPa m1/2 ) than the alumina brackets (Clarity and Light Force respectivelty). Significant differences were observed between the 3D printed and the commercially available polycrystalline alumina ceramic brackets but to a lesser extent. CONCLUSIONS: Under the limitations of this study, the 3D printed zirconia bracket tested is characterized by mechanical properties associated with advantageous orthodontic fixed appliances traits regarding clinically relevant parameters.

Εffect of cleansers on the composition and mechanical properties of orthodontic aligners in vitro.

BACKGROUND: The aim of the study was to investigate the effect of three aligner cleaners on the composition and mechanical properties of two types of orthodontic aligners. MATERIALS AND METHODS: The cleaners tested were two alkaline peroxide solutions (Retainer Brite-RB; Retainer Cleaner-RC) and one peroxide-free (Steraligner-ST) and the aligners Clear Aligner (C, polyester) and Invisalign (I, polyester-urethane). The aligners were immersed in the cleaner solutions as instructed every day (15 min for RB, RC; 5 min for ST) for a two-week period. The acidity of the solutions was tested with a pH meter. The changes in the chemical composition of the aligners were studied by attenuated total-reflection Fourier transform infrared spectrometry (ATR-FTIR), while Instrumented Indentation Testing (IIT) was used for assessment of changes in Martens Hardness (HM), modulus (EIT), elastic index (nIT) and relaxation (RIT). RESULTS: RB and RC were weakly acidic (pH = 6.3), whereas ST was mildly acidic (pH = 4.8). The ATR-FTIR analysis demonstrated evidence of acidic hydrolysis of C in ST and I in RB. The IIT-derived properties of I were not affected by the cleaners. However, for C a significant change was found in HM (all cleaners), nIT (all cleaners) and RIT (RB, ST). Although the chemical changes support a hydrolytic material deterioration, the results of mechanical properties may interfere with the material residual stresses during fabrication. CONCLUSIONS: Caution should be exerted in the selection of aligner cleaners. The mild acidic cleanser was more aggressive to the polyester, whereas an alkaline peroxide to the polyester-urethane aligner.

Mechanical and electrochemical characterization of 3D printed orthodontic metallic appliances after in vivo ageing.

OBJECTIVES: Three-dimensional (3D) printing technology is a promising technique for fabricating custom orthodontic metallic appliances. Aim of this study was to assess the effect of intraoral aging on the mechanical / electrochemical properties of 3D-printed orthodontic metallic appliances. METHODS: Twelve molar orthodontic distalization appliances 3D-printed from cobalt chromium (Co-Cr) alloy were retrieved after intraoral use and twenty blocks fabricated under similar conditions were used as control. The samples' microstructural / elemental composition assessment was assessed with SEM/EDS, while their mechanical properties (modulus of elasticity [EIT], Martens hardness [HM] and the elastic index [ηIT]) were measured by instrumented indentation testing. Finally, the samples' electrochemical features were assessed with a potentiostat-connected cell arrangement in terms of open circuit potential (OCP), corrosion potential (Ez), current density (I300) and breaking potential (Epit). Results were analyzed by t-test / Mann-Whitney test (α = 0.05). RESULTS: The used Co-Cr alloy was found to have a highly homogenous structure with no significant differences between retrieved and new specimens in HM (4037.7 ± 215.6 vs 4090.9 ± 259.8 N/mm2), EIT (120.0 ± 13.2 vs 123.8 ± 12.9 GPa), or nIT (28.4 ± 2.6 vs 28.6 ± 2.9 %) (P > 0.05 in all instances). Metallic surfaces retained the same oxidation tendency and oxide dissolution rate in passive region in both groups (P > 0.05 for OCP, Ez, and I300). However, intraorally-aged specimens had a significantly lower breakdown potential due to degraded protection efficacy of surface oxide (P = 0.003 for Epit). SIGNIFICANCE: The tested 3D-printed Co-Cr orthodontic appliances present clinically-acceptable mechanical properties that remained unaffected by intraoral ageing, which however degraded the protection of surface oxide against pitting corrosion.

Electrochemical characterization of three types of Co-Cr based alloys manufactured by casting and selective laser melting according to ISO 10271.

OBJECTIVE: To characterize the effect of elemental composition and manufacturing process on the electrochemical properties of Co-Cr-Mo, Co-Cr-W and Co-Cr-Mo-W alloys. METHODS: Six Co-Cr based alloys were included in this study. All alloys are Co-Cr based alloys, classified in three different types according to their elemental composition. The first group has Mo as the third alloying element while the second one has W instead of Mo. The third one has both alloying elements. The groups are further divided by the manufacturing process (casting or Selective Laser Melting(SLM)). All groups were subjected to static immersion, open circuit potential, anodic scan, SEM/EDX analysis, static and cyclic tarnish testing according to ISO 10271 requirements. The ionic release was evaluated by inductively coupled plasma mass spectrometry and the results were statistically analyzed by two way ANOVA and Tukey test (a=0.05). RESULTS: No statistical differences were identified for Co-Cr-Mo alloy for all elements and their total ionic release between casting and SLM manufacturing processes, in contrast to significantly lower values for SLM groups for the other two groups. All groups tested demonstrated similar performance in OCP and AS testing while no gross elemental changes before and after AS were identified following EDX analysis. All alloys fulfilled the requirements of tarnish resistance CONCLUSIONS: The ionic release is dependent on alloy type and manufacturing process while all groups were found to fulfill the requirements of international standards for ionic release, corrosion and tarnish resistance and thus an acceptable clinical performance is anticipated.

New aesthetic in-house 3D-printed brackets: proof of concept and fundamental mechanical properties.

OBJECTIVES: Three-dimensional (3D) printing technology is an emerging manufacturing process for many orthodontic appliances, and the aim of this study was to evaluate the mechanical properties of resin-based materials as alternatives for the in-house preparation of orthodontic brackets. MATERIAL AND METHODS: Two types of 3D printed resins used for temporary (T) and permanent (P) crown fabrication were included in this study. Ten blocks from each resin were manufactured by a 3D printer and, after embedding them in acrylic resin, the samples were subjected to metallographic grinding and polishing, followed by instrumented indentation testing (IIT). Martens hardness (HM), indentation modulus (EIT), and elastic index (ηIT) were determined with a Vickers indenter recording force-indentation depth curves from each specimen. After calculating descriptive statistics, differences between material types were investigated with Wilcoxon rank sum test accounting for clustering of measurements within specimens at alpha = 5%. RESULTS: No statistically significant differences in the mechanical properties of the two tested materials were seen: HM: median 279 N/mm2 (interquartile range [IQR] 275-287 N/mm2) for T and median 279 N/mm2 (IQR 270-285 N/mm2) for P (P value = 0.63); EIT: median 5548 MPa (IQR 5425-5834 MPa) for T and median 5644 (IQR 5420-5850 MPa) for P (P value = 0.84); ηIT: median 47.1% (46.0-47.7%) for T and median 46.0% (IQR 45.4-47.8%) for P (P value = 0.24). CONCLUSIONS: Under the limitations of this study, it may be concluded that the mechanical properties of the two 3D printed resins tested are equal, and thus, no differences in their clinical performance are expected.

In-house 3D-printed aligners: effect of in vivo ageing on mechanical properties.

OBJECTIVE: To investigate alterations in the mechanical properties of in-house three-dimensional (3D) printed orthodontic aligners after intraoral ageing. MATERIALS AND METHODS: Sixteen 3D-printed aligners (TC-85DAC resin, Graphy, Seoul, Korea) were used for the purpose of the study, which were divided into 10 control (not used) aligners and 6 materials retrieved from 4 patients after 1-week service (retrieved group). Samples from the control group were analysed by attenuated total reflectance-Fourier-transform infrared (ATR-FTIR) spectroscopy. Samples from control/retrieved groups were embedded resin and subjected to instrumented indentation testing (IIT) to record force-indentation depth curves, calculating the following (as per ISO 14577-1, 2002 standard): Martens hardness (HM), indentation modulus (EIT), and elastic index (ηIT), and the indentation relaxation index (RIT). Differences between control and retrieved 3D-printed aligners were checked with Mann-Whitney/t-tests at an alpha = 5%. RESULTS: ATR-FTIR analysis showed that aligners were made of a vinyl ester-urethane material. The results of the IIT testing were: HM (control: median 91.5 N/mm2, interquartile range [IQR] 88.0-93.0/as-retrieved: median 90.5 N/mm2, IQR 89.0-93.0); EIT (control, mean 2616.3 MPa, standard deviation [SD] 107.0 MPa/retrieved, mean 2673.2 MPa, SD 149.4 MPa); ηIT (control: median 28.6%, IQR 28.2-30.9%/as-retrieved: median 29.0%, IQR 28.7-29.2%); and RIT (control: median 45.5%, IQR 43.0-47.0%/as-retrieved: median 45.1%, IQR 45.0-45.3%). No differences between as-retrieved and control aligners were found for any of the mechanical properties tested (P > 0.05 in all instances). CONCLUSION: The mechanical properties of the in-house 3D-printed aligners tested were not affected after 1 week in service period.

Comparative analysis of mechanical properties of orthodontic aligners produced by different contemporary 3D printers.

OBJECTIVE: The aim of this study was to compare the mechanical properties of orthodontic aligners among different commercially available 3D printing devices. MATERIALS AND METHODS: Five 3D printers (Ka:rv LP 550, Swinwon; "KAR"), (L120, Dazz 3D; "L12"), (MiiCraft 125, Miicraft Jena; "MIC"), (Slash 2, Uniz; "SLS") and (Pro 95, SprintRay; "PRO") were used to prepare orthodontic aligners with dental resin (Tera Harz TC-85DAW, Graphy). The central incisors of each aligner were cut, prepared and evaluated in terms of Martens-Hardness (HM), indentation-modulus (EIT ) and elastic-index (ηIT ) as per ISO14577-1:2002. Force-indentation curves were recorded and differences among printers were checked with generalized linear regressions (alpha=5%). RESULTS: Statistically significant differences were seen for all mechanical properties (P < .05), which were in descending order: HM (N/mm2 ) as median (Interquartile Range [IQR]): SLS 108.5 (106.0-112.0), L12 103.0 (102.0-107.0), KAR 101.5 (97.5-103.0), MIC 100.0 (97.5-101.5) and PRO 94.0 (93.0-96.0); EIT (MPa) as mean (Standard Deviation [SD]): SLS 2696.3 (124.7), L12 2627.8 (73.5), MIC 2566.2 (125.1), KAR 2565.0 (130.2) and PRO 2491.2 (53.3); and ηIT (%) as median (IQR): SLS 32.8 (32.3-33.1), L12 31.6 (30.8-32.3), KAR 31.3 (30.9-31.9), MIC 30.5 (29.9-31.2) and PRO 29.5 (29.1-30.0). Additionally, significant differences existed between liquid crystal display (LCD) and digital light processing (DLP) printers for HM (P < .001), EIT (P = .002) and ηIT (P < .001), with aligners from the former having higher values than aligners from the latter printer. CONCLUSION: Under the limitations of this study, it may be concluded that the mechanical properties of 3D-printed orthodontic aligners are dependent on the 3D printer used, and thus, differences in their clinical efficacy are anticipated.

ATR-FTIR Analysis and One-Week Stress Relaxation of Four Orthodontic Aligner Materials.

The aim of this study was to estimate possible differences in the chemical composition and relaxation of orthodontic aligner materials. Four commercially available thermoplastic materials CAM (Scheu-Dental, Iserlohn, Germany), COP (Essix, Dentsply Raintree Essix Sarasota,FL, USA), DUR (Great Lakes Dental Technologies, Tonawanda, NY) and ERK (Erkodent Erich Kopp, Pfalzgrafenweiler Germany) were included in this study. Rectangular strips from each material were prepared according to the manufacturer's instructions and subjected to attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy and stress relaxation characterization. The reduction in applied stress (RAS) after one week was estimated and statistically analyzed by one-way ANOVA at the 0.05 level of significance. All specimens were subjected to optical microscopy before and after stress relaxation testing under transmittance polarized illumination. ATR-FTIR microscopy revealed that all materials are made of polyethylene terephthalate glycol (PETG) while no significant differences were identified in RAS values among materials tested, which ranged from 6%-10% (p ≥ 0.05). All samples illustrated the developments of shear bands during relaxation testing according to optical microscopy findings. The tested materials illustrated similar chemical composition and relaxation behavior and thus no differences in their clinical efficacy are anticipated.

A study of the mechanical properties of as-received and intraorally exposed single-crystal and polycrystalline orthodontic ceramic brackets.

BACKGROUND: Although ceramic brackets have been extensively used for decades in orthodontics there is not till today any study focusing on the possible deterioration of mechanical properties after in vivo ageing. OBJECTIVES: To determine whether the mechanical properties of alumina orthodontic brackets change after intraoral ageing thereby assessing the validity of a theoretical model established for the performance of ceramics in wet environments. MATERIALS AND METHODS: Two alumina brackets, one single crystal (Radiance, American Orthodontics, Sheboygan, WI) and one polycrystalline (Clarity, 3M, St. Paul, MN) were included in this study. Ten brackets for each group were collected from different patients after a minimum of 3-month intraoral exposure, whereas as-received brackets of the same manufacturers were used as controls. The specimens were subjected to Raman spectroscopy and were then embedded in epoxy resin and metallographic ground and polished. The mechanical properties of four groups (radiance control: RAC, radiance-retrieved RAR, clarity control: CLC and clarity-retrieved CLR) were determined using instrumented indentation testing according to ISO 14577-2002. The mechanical properties tested were Martens hardness (HM), indentation modulus (EIT), the ratio of elastic to total work, commonly known as elastic index (ηIT), and fracture toughness (KIC). The numerical results were statistically analysed employing two-way analysis of variance (ANOVA) and Tukey multiple comparison test at a = 0.05. RESULTS: Raman analysis revealed that both brackets are made of a-Al2O3 (corundum). No statistically significant differences were found for HM (N/mm2): RAC = 7249 (1507), RAR = 6926 (1144), CLC = 8052 (1360), CLR = 7390 (2393), or for EIT (GPa): RAC = 141 (27), RAR = 139 (23), CLC = 139 (28), CLR = 131 (47). However, significant differences were identified between the two alumina brackets tested for ηIT (%): RAC = 55.7 (4.2), RAR = 54.0 (3.5), CLC = 62.5 (4.4), CLR = 61.8 (4.7), while KIC was measured only for the polycrystalline bracket (Clarity) because of the complicated fractured pattern of the single-crystal bracket. Both brackets share equal HM and EIT before and after orthodontic intraoral ageing. LIMITATIONS: Whereas the study assessed the changes after intraoral exposure per theoretical model, which describes the reduction of critical stress to induce fracture after wetting, long-term intraoral ageing could have induced more pronounced effects. CONCLUSIONS/IMPLICATIONS: The results of this study indicate that 3 months of intraoral ageing do not change the mechanical properties of single-crystal and polycrystalline orthodontic brackets tested, thus indicating that the Griffith theory may not be applied to the case of manufactured ceramic brackets owing possibly to internal defects.

Changes in Roughness and Mechanical Properties of Invisalign® Appliances after One- and Two-Weeks Use.

The aim of this study was to estimate the possible changes of surface roughness and the mechanical properties of Invisalign® appliances over one- and two-week of service. Forty appliances with attachments were retrieved after the end of orthodontic treatment from different patients. Half of them had been used for one week (1W), and the rest for two weeks (2W). Ten unused Invisalign® appliances were used as the control (CON). An equal number of teeth possessing attachments were cut of aligners deriving from all groups (1W, 2W, and CON), and the Sa, Sq, Sz, Sc, and Sv roughness parameters of the internal surface of the aligner attachment area and the opposite lingual side (which was in contact to enamel) were determined by optical profilometry. Then, ten first molars originating from all groups were embedded in acrylic resin, and were ground and polished. Instrumented indentation testing (IIT) was performed in order to determine the Martens hardness (HM), indentation modulus (EIT), and relaxation index (RIT), according to ISO 14577-2002. The produced data were statistically processed by one- or two-way analysis of variance (ANOVA) and multiple comparison post-hoc tests (a = 0.05). Both the surface roughness and mechanical properties of the retrieved groups (1W and 2W) showed statistically significant differences compared with CON, but without statistically significant differences between each other. The roughness variables of the as-received material were shown to be reduced after intraoral service demonstrating a wear effect. Ageing has a detrimental effect on the surface roughness and mechanical properties of Invisalign® appliances, although this effect is restricted to the first week of clinical usage.

Galvanic coupling of steel and gold alloy lingual brackets with orthodontic wires: Is corrosion a concern?

OBJECTIVES: The aim of this research was to assess galvanic behavior of lingual orthodontic brackets coupled with representative types of orthodontic wires. MATERIALS AND METHODS: Three types of lingual brackets: Incognito (INC), In-Ovation L (IOV), and STb (STB) were combined with a stainless steel (SS) and a nickel-titanium (NiTi) orthodontic archwire. All materials were initially investigated by scanning electron microscopy / x-ray energy dispersive spectroscopy (SEM/EDX) while wires were also tested by x-ray diffraction spectroscopy (XRD). All bracket-wire combinations were immersed in acidic 0.1M NaCl 0.1M lactic acid and neutral NaF 0.3% (wt) electrolyte, and the potential differences were continuously recorded for 48 hours. RESULTS: The SEM/EDX analysis revealed that INC is a single-unit bracket made of a high gold (Au) alloy while IOV and STB are two-piece appliances in which the base and wing are made of SS alloys. The SS wire demonstrated austenite and martensite iron phase, while NiTi wire illustrated an intense austenite crystallographic structure with limited martensite. All bracket wire combinations showed potential differences below the threshold of galvanic corrosion (200 mV) except for INC and STB coupled with NiTi wire in NaF media. CONCLUSIONS: The electrochemical results indicate that all brackets tested demonstrated galvanic compatibility with SS wire, but fluoride treatment should be used cautiously with NiTi wires coupled with Au and SS brackets.

Shape covariation between the craniofacial complex and first molars in humans.

The occurrence of mutual genetic loci in morphogenesis of the face and teeth implies shape covariation between these structures. However, teeth finalize their shape at an early age, whereas the face grows and is subjected to environmental influences for a prolonged period; it is therefore conceivable that covariation might modulate with age. Here we investigate the extent of this covariation in humans by measuring the 3D shape of the occlusal surface of the permanent first molars and the shape of the craniofacial complex from lateral radiographs, at two maturations stages. A sample of Greek subjects was divided into two groups (110 adult, 110 prepubertal) with equally distributed gender. The occlusal surfaces of the right first molars were 3D scanned from dental casts; 265 and 274 landmarks (including surface and curve semilandmarks) were digitized on the maxillary and mandibular molars, respectively. The corresponding lateral cephalometric radiographs were digitized with 71 landmarks. Geometric morphometric methods were used to assess shape variation and covariation. The vertical dimension of the craniofacial complex was the main parameter of shape variation, followed by anteroposterior deviations. The male craniofacial complex was larger (4.0-5.7%) and was characterized by a prominent chin and clockwise rotation of the cranial base (adult group only). Allometry was weak and statistically significant only when examined for the sample as a whole (percent variance explained: 2.1%, P = 0.0002). Covariation was statistically significant only between the lower first molar and the craniofacial complex (RV = 14.05%, P = 0.0099, and RV = 12.31%, P = 0.0162, for the prepubertal and adult groups, respectively). Subtle age-related covariation differences were noted, indicating that environmental factors may influence the pattern and strength of covariation. However, the main pattern was similar in both groups: a class III skeletal pattern (relative maxillary retrusion and mandibular protrusion), hyperdivergency, forward rotation of the posterior cranial base and upward rotation of the anterior cranial base were associated with mesiodistal elongation of the lower molars and height reduction of their distal cusps. This pattern mimics phylogeny in humans, where flexion and counterclockwise rotation of the cranial base, considered advantageous to survival, co-occur with tooth reductions that cannot be easily explained in evolutionary terms. The similarity of the phylogenetic and covariation patterns seems to support the pleiotropic gene hypothesis.

Geometric morphometric 3D shape analysis and covariation of human mandibular and maxillary first molars.

Dental casts of 160 Greek subjects (80 males, 80 females) were scanned by a structured-light scanner. The upper and lower right first molar occlusal surface 3D meshes were processed using geometric morphometric methods. A total of 265 and 274 curve and surface sliding semilandmarks were placed on the upper and lower molar surfaces, respectively. Principal component analysis and partial least square analysis were performed to assess shape parameters. Molars tended to vary between an elongated and a more square form. The first two principal components (PCs), comprising almost 1/3 of molar shape variation, were related to mesiodistal-buccolingual ratios and relative cusp position. Distal cusps displayed the greatest shape variability. Molars of males were larger than those of females (2.8 and 3.2% for upper and lower molars respectively), but no shape dimorphism was observed. Upper and lower molar sizes were significantly correlated (r(2) = 0.689). Allometry was observed for both teeth. Larger lower molars were associated with shorter cusps, expansion of the distal cusp, and constriction of the mesial cusps (predicted variance 3.25%). Upper molars displayed weaker allometry (predicted variance 1.59%). Upper and lower molar shape covariation proved significant (RV = 17.26%, P < 0.0001). The main parameter of molar covariation in partial least square axis 1, contributing to 30% of total covariation, was cusp height, in contrast to the primary variability traits exhibited by PC1 and PC2. The aim of this study was to evaluate shape variation and covariation, including allometry and sexual dimorphism, of maxillary and mandibular first permanent molar occlusal surfaces.