Three-dimensional positions of the center of resistance of the maxillary canine distal movement under orthodontic force loading.

Using finite-element analysis, we aimed to determine the center of resistance (CRes) of the maxillary canine for setting orthodontic forces. The inclination of the canine was measured by first loading from the mesial to the distal side of the mesial root surface, then the position and direction of the load that minimized the inclination were investigated. The CRes was defined as the set of midpoints of the minimum distances between two inclination lines. Twenty-one CRes values were calculated from a set of seven lines. These CRes data were then aggregated as a 95% confidence ellipsoid of width 0.170×0.016×0.009 mm with center points 4.269, 0.224, and 4.315 mm in the apical, mesial, and lingual directions from the origin, respectively. Further studies are required to effectively apply the CRes identified in this study to clinical applications.

Three-dimensional location and distribution of the center of resistance in the maxillary first molar applied to occlusal force.

We aimed to investigate the center of resistance (CRes) of the maxillary first molar to set the occlusal force through finite element analysis. The inclination of the molar was measured, with loading to the root on the crown, and the position and direction of the load that minimized the inclination were investigated. The CRes was defined as the set of midpoints of the minimum distances between the two lines. Nine hundred and ninety CRes points were estimated from forty-five lines. The CRes was estimated as the point 1.22 mm (Z), -0.74 mm (X), and 0.23 mm (Y) from the origin in the apical, distal, and buccal side directions, respectively, with an ellipsoid area of 1.578 (Z) mm×0.097 (X) mm×0.100 (Y) mm. Further research is required to make effective use of the CRes identified in this study for clinical applications.

Can hypochlorous acid be a powerful sanitizer to replace alcohol for disinfection ? -Its bactericidal, degradation of the solutions under various storage condition, and steel rust effects.

Coronavirus disease pandemic has led to a shortage of disinfectant alcohol (DA; 76.9-81.4% ethanol solution) in Japan. This study investigated the availability of hypochlorous acid (HA) as an alternative disinfectant to DA in clinical environment. HA is a safe and economical disinfectant with a broad antibacterial spectrum and low risk of hand irritation, which is used worldwide. In this study, HA and sodium hypochlorite solution (SH) were degraded over time and the degradation was accelerated by temperature and lighting. Results of bactericidal effects of HA revealed that the realistic effective concentration should be 200 ppm. Compared with DA, the dental carbon steel burs were more severely rusted by SH and HA. These results indicated that high concentration of HA generated on-site could be an effective and safe disinfectant for use immediately after generation with consideration of object materials in clinical environment, as an alternative to DA.

Semi-powered exoskeleton that regulates the muscular activity of jaw movement for oral functional rehabilitation/training.

The sequential oral functions of mastication and swallowing are well tuned in humans. To prevent oral hypofunction as a risk factor for systemic frailty by oral motor training, semi-powered exoskeleton was developed and evaluated its loading/assist effects by monitoring electromyography signals and saliva secretion in healthy persons. The actuator of the driving unit combined mechanical and powered mechanics and was driven alternatively by an unpowered stainless-steel spring system for jaw-opening training by loading and a powered shape-memory alloy spring system to assist jaw closing. Sequential device movement was controlled by two electronic circuits with two magnetic switching systems to match human jaw movement. This exoskeleton realized a 25% increase of jaw-opening muscular activity for training, 15% saving of jaw-closing muscular activity for assistance, and 15% enhancement of saliva secretion, which could contribute to the prevention of oral frailty by maintenance and strengthening of oral function in the upcoming super-aging society.

Low temperature polytetrafluoroethylene (PTFE) coating improves the appearance of orthodontic wires without changing their mechanical properties.

A strong esthetic demand exists for white-colored rather than metallic-colored dental appliances. Polytetrafluoroethylene (PTFE), which is chemically stable with extremely low friction, is a suitable white-colored coating for dental appliances. In the conventional PTFE coating process, base materials are heated to approximately 400°C, which could change their mechanical properties. Examination of the PTFE-coating of stainless steel, nickel titanium (Ni-Ti), and ß-titanium (Ti-Mo and Ti-Nb) revealed that the conventional 380°C coating, but not the newly developed low temperature coating at 200°C, reduced elasticity and bendability, and changed the crystal structure, especially in Ni-Ti and Ti-Nb wires. PTFE-coating at 200°C resulted in less discoloration, microbial adhesion, and friction against brackets, and higher tolerance of wear than did the conventional 380°C coating. These results suggest that low temperature PTFE coating is an excellent method for improving the metallic appearance of orthodontic wires without changing their mechanical properties.

Estimation of three-dimensional long axes of the maxillary and mandibular first molars with regression analysis.

The purpose of this study was to determine the long axes of molars with multiple roots through ordinary least squares regression (LSR) and to compare them with the axes defined by principal component analysis (PCA). Three-dimensional radiological images of 20 dry skulls were obtained by cone-beam computed tomography (CBCT). Data from maxillary and mandibular first molars were extracted from the CBCT DICOM data with a three-dimensional image visualization system. The obtained data were reconstructed, converted to STL files, and three-dimensional coordinate values were extracted. The long axes were estimated by an algorithm to synchronize the LSR line with the horizontal axis which was translated to the vertical axis. The axes of the molars defined by LSR were compared with the axes of the molars defined by PCA. The coordinate point number of each molar was 5400-5800. The algorithm for determining the tooth axes in this study consisted of four stages containing three steps each. The distance between the two axes calculated by the two methods (LSR and PCA) on the horizontal plane through the origin was less than 10-12 mm and the deviations between them were less than 0.003°. The long axes of the molars estimated by LSR agree almost exactly with the axes estimated by PCA, and the accuracy is sufficient for clinical usage; however, the distance between them would shorten with a more severe convergence condition of the α value at each stage of this LSR system.

Effects of magnetic fields from electric toothbrushes on fluoride- and oral bacteria-induced corrosion of orthodontic metallic wires.

Corrosion of metallic materials in the oral cavity could trigger metal allergy in patients. To clarify the risk elevation of magnetic fields (MFs) exposure on metallic corrosion when combined with fluoride-containing dental care products and indigenous oral bacteria, we investigated electric toothbrush-derived MF-induced corrosion of orthodontic stainless steel (SUS) and nickel titanium (Ni-Ti) wires in the presence of fluoride and oral bacteria, i.e. Streptococcus (S) mutans and S. sanguinis. MFs induced an electric current in the wires under both environments. Oral bacteria corroded SUS wires, and fluoride corroded SUS and Ni-Ti wires as previously reported; however, no additive or synergistic effects of MF exposure on fluoride- and microbiologically-induced metallic corrosion were observed. These results suggest that the MFs from electric toothbrushes do not increase the risk of corrosion of metallic appliances, given that the oral environment of patients is exposed to oral bacteria and fluoride-containing products.

Five-axis laser milling system that realizes more accurate zirconia CAD/CAM crowns by direct milling from fully sintered blocks.

Directly milling zirconia computer-aided design (CAD)/computer-aided manufacturing (CAM) crowns from fully sintered zirconia blocks using a five-axis laser milling system, compared with three-axis milling and full sintering by heating milled semi-sintered crowns, was investigated. The mechanical characteristics of zirconia specimens were similar across groups. The order of the marginal gap was three-axis>conventional (lingual thickness of 1.5 mm>0.5 mm)>five-axis group (close to zero). The marginal shape was almost perfectly circular in all groups. The internal corner shape and gap were almost perfect for the five-axis milled crown but not for conventional and three-axis crowns. The roundness of the marginal and internal shapes was almost perfect in the five-axis milling group but not for the three-axis and conventional groups. These small distortions result in large marginal gaps. Results of the present study suggest the superiority of the five-axis milling system in creating a zirconia prosthesis.

Intraoral electric potential via oral bacterial power generation -A novel mechanism of biofilm formation.

In the early stages of biofilm accumulation, the electric charge of the dental enamel and pellicle surfaces is known to be involved. We therefore investigated the relationship between oral hygiene and intraoral electric potential (IoP) in 45 male participants using a double-blind study. IoP, but not body surface electric potential, was loosely correlated with oral hygiene condition (Oral Hygiene Index; OHI). IoP was also loosely correlated with smartphone use; however, there was no significant correlation between smartphone use and OHI. IoP elevation might be caused by OHI elevation resulting from biofilm formation as an internal factor, with smartphone use as an external factor. This in vitro study revealed the generating capacity of Streptococcus mutans accompanied by biofilm accumulation using a microbial fuel cell. These results suggest that IoP elevation is caused by biofilm accumulation induced by power generation of oral bacteria, resulting in elevation of OHI.

Crown shape of maxillary molars with delayed eruption.

The purpose of this study was to explore the crown shapes of maxillary molars with delayed eruption (DEMo1) at the position distal to the maxillary second premolar. Included teeth erupted later than the average for the maxillary first molar eruption in Japanese females (6.58 ± 0.67 years) by more than two standard deviations. Crown shapes of 12 four-cusped left DEMo1 teeth were compared with those of 25 four-cusped left maxillary first molars (U6n) and 25 four-cusped left maxillary second molars (U7n) from different patients with normal eruption. Seven landmarks were established on the reference plane containing the mesiobuccal, distobuccal and mesiolingual cusp tips of the molars; the origin was defined as the center of gravity of these three points. According to the obtained discriminant function (percentage of correct classifications, 84%), five DEMo1 teeth were classified as U6n and the other seven as U7n. The DEMo1 teeth were also classified into two subgroups, the U6n-close and U7n-close groups, according to the location of the distolingual cusp tip. These results suggest that DEMo1 teeth could include U6 and U7 with delayed eruption or could be an intermediate between U6 and U7, according to their crown shapes.

Formation and development of maxillary first molars with delayed eruption.

Cases of congenitally missing and delayed eruption of the maxillary first molar are rare. However, in recent years, we have experienced cases of suspected delayed eruption of or congenitally missing first molars. The purpose of this study was to analyze the formation of delayed erupted maxillary first molars (M1) (>2 standard deviations), which play important roles in occlusion, and normal eruption of the maxillary first molars (U6). The frequency of M1 among patients born between 1974 and 1994 in one institution with a clear total patient number and personal oral histories was 1.55 % [80 % bilateral eruption in 8 of 806 male patients (0.99 %) and 23 of 1195 female patients (1.92 %)]. To evaluate the formation and eruption of M1 according to Moorrees's tooth formation stages, panoramic X-ray films were obtained every year for 73 patients with M1 from 3 institutions (20 male and 53 female patients, total 131 M1s) without systematic histories or genetic disorders. The development/growth curve of M1 was fitted to both the logistic curve and U6 curve. The M1 development/growth curve was started behind with U6 curve; however, the straight part of the M1 curve exhibited steep inclination compared with the straight part of the U6 curve. The curve of the eruption pathway of M1 also exhibited a sigmoid S shape. These results indicate that the development and migration speed of M1 are faster than that of U6, excluding the delayed start point. These results may help orthodontists in treatment planning for patients with M1.

Rapid bonding and easy debonding of orthodontic appliances with 4-META/MMA-TBB resin using thermal heating.

4-Methacryloyloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butylborane (4-META/MMA-TBB) resin is widely used as a direct bonding adhesive for orthodontic appliances because of its strong bonding ability. However, its clinical disadvantages include long setting times and difficult debonding with subsequent residual adhesive left on the enamel surface. To resolve these problems, thermal heating was applied to orthodontic appliances. The setting time was dramatically reduced by thermal heating (160°C for 5 s), with the shear bond strength remaining the same as that stated in the manufacturer's instructions. Debonding of appliances following thermal heating (160°C for 20 s) could be easily performed, decreasing the amount of adhesive left on enamel. These conditions were not accompanied by an increase in the heat pain threshold of pulpal dentin. These results suggest that the use of thermal heating in the bonding/debonding of 4-META/MMA-TBB resin may resolve its clinical weaknesses, making its ease of use similar to light-cured resin.

Development of optical guiding forceps for a direct bonding system using lightcured resin adhesives.

Multi-bracket systems are popular orthodontic appliances and are commonly bonded directly to enamel surfaces by resin adhesives. In light-cured bonding, the tip of the curing unit must be kept at a distance from the adhesive on the tooth, which can lead to low polymerization and insufficient bond strength. The curing lights also generate low-frequency electromagnetic fields, which can be harmful to patient health. Furthermore, bacterial contamination of the light-curing tips during use presents an infection risk for patients. In this study, we describe the development of optical guiding forceps (OGFs) for polymerizing light-cured resin as a solution to these problems. With OGFs, polymerization of adhesives was deeper than with lower magnetic fields and the bonds had the same shear strength as those formed by conventional procedures. These results suggest that OGFs may have practical use in the direct bonding of orthodontic appliances as well as in provisional bonding.

Microbiologically influenced corrosion of orthodontic metallic appliances.

Biocorrosion (microbiologically influenced corrosion; MIC) occur in aquatic habitats varying in nutrient content, temperature, stress and pH. The oral environment of organisms, including humans, should be one of the most hospitable for MIC. Corrosion of metallic appliances in the oral region is one cause of metal allergy in patients. In this study, an inductively coupled plasma-optical emission spectrometer revealed elution of Fe, Cr and Ni from stainless steel (SUS) appliances incubated with oral bacteria. Three-dimensional laser confocal microscopy also revealed that oral bacterial culture promoted increased surface roughness and corrosion pits in SUS appliances. The pH of the supernatant was lowered after co-culture of appliances and oral bacteria in any combinations, but not reached at the level of depassivation pH of their metallic materials. This study showed that Streptococcus mutans and Streptococcus sanguinis which easily created biofilm on the surfaces of teeth and appliances, did corrode orthodontic SUS appliances.

Comparison of mesiodistal tooth crown diameters and arch dimensions between modern Mongolians and Japanese.

The purposes of this study were to establish normative data for mesiodistal tooth crown diameters and arch dimensions in Mongolian adults and to compare them with those of Japanese adults. The study materials comprised dental casts of 100 modern Mongolian and 100 Japanese subjects (50 males, 50 females for each) with Angle Class I normal occlusion. The mean ages were 20 years 8 months for the Mongolian subjects and 20 years 0 months for the Japanese subjects. On the dental casts, the mesiodistal tooth crown diameters (excluding wisdom teeth) and dental arch dimensions were measured. The following arch dimensions were measured: inter-canine lingual, inter-premolar lingual, inter-molar lingual, inter-molar central, coronal arch length, basal arch length, and basal arch width. In the Mongolian samples, significant sex differences were noted, and most of the items were significantly larger in males than in females. Significant differences between the Mongolian and Japanese samples were mainly noted in the premolar and molar regions, rather than in the anterior region, and were significantly smaller in the Mongolian samples. In the Mongolian samples, the molar section widths and basal arch width and length were significantly larger in males and females compared with the Japanese samples. These results suggest that the tooth crown size and arch dimensions in the Mongolian samples differed from those in the Japanese samples, and that establishment of the clinical norm for Mongolian adults might be helpful in formulating treatment plans for Mongolian patients, given that these parameters are the basic tools for diagnosis.

Repeated bonding of fixed retainer increases the risk of enamel fracture.

The aim of this study was to investigate the influences of repeated bonding, using 2 different orthodontic adhesive systems, on the shear bond strength (SBS) and the enamel surface morphology. Sixty premolars were divided into 2 groups (n = 30), and either Transbond XT (T group) or Fuji Ortho LC (F group) adhesives were used. SBS was measured 24 h after bonding, using a universal testing machine. Then, the enamel surfaces were investigated and the mode of failure was described using adhesive remnant index (ARI) scores. After each debonding, 10 teeth from each group were examined by scanning electron microscopy to determine the penetration of adhesives, the length of resin tags, and the state of the enamel surface. The other teeth were subjected to two more bonding/debonding procedures. In T group, the second debonding sequences had significantly higher bond strengths than the other sequences. The length of resin tags was greatest in the second debonding sequence, although there was no significant difference. In F group, the SBS increased with further rebonding and the failure mode tended towards cohesive failure. In both groups, the ARI scores increased with rebonding. Enamel loss could have occurred with both adhesives, although the surfaces appeared unchanged to the naked eye. From this study, we suggest that enamel damage caused by repeated bonding is of concern. To prevent bond failure, we should pay attention to the adhesion method used for bondable retainers.

Magnetic fields from electric toothbrushes promote corrosion in orthodontic stainless steel appliances but not in titanium appliances.

Electric toothbrushes are widely used, and their electric motors have been reported to produce low-frequency electromagnetic fields that induced electric currents in metallic objects worn by the users. In this study, we showed that electric toothbrushes generated low-frequency magnetic fields (MFs) and induced electric currents in orthodontic appliances in artificial saliva (AS), which accelerated corrosion in stainless steel (SUS) appliances, but not in titanium (Ti) appliances; the corrosion was evaluated by using an inductively coupled plasma-optical emission spectrometer and a three-dimensional laser confocal microscope. The pH of AS used for appliance immersion did not change during or after MF exposure. These results suggested that MF-induced currents from electric toothbrushes could erode SUS appliances, but not Ti appliances, because of their high corrosion potentials. Further studies are required to clarify the mechanisms of metallic corrosion by induced currents in dental fields, which may trigger metal allergies in patients.

Relationship between masticatory rhythm, body mass and mandibular morphology in primates.

OBJECTIVE: It has been proposed that rhythmic movements such as locomotion and respiration have a period proportional to body mass(1/4). Mastication basically consists of rhythmic alternation of jaw-closing and jaw-opening movements. We studied the relation between masticatory rhythm and body mass in primates, and masticatory rhythm and mandible morphology. METHODS: We measured the chewing cycle duration (CCD), mandibular length, mandible height, mandible width and distance from the condylar process of mandible to the centre of gravity of the mandible. Body mass was quoted from the literature. RESULTS: The CCD is related to mandible morphology and was found to be proportional to body mass(1/6). CONCLUSION: These findings suggest that masticatory rhythm is correlated with body mass and mandibular morphology, and that scaling rate of masticatory rhythm to body mass is slower than for the other rhythms.

Influence of third molar space on angulation and dental arch crowding.

The influence of the third molars on mandibular incisor crowding has been extensively studied but remains controversial. The purpose of this study was to ascertain whether, in Mongolian subjects, the lower third molar can affect anterior crowding and/or the inclination of teeth in the lower lateral segments. Panoramic radiographs, 45° oblique cephalograms, and dental casts were taken from Mongolian subjects (age range 18.3-24.1 years, mean 21.0 years) exhibiting impaction of all four third molars and an Angle Class I molar relationship. The Ganss ratio was calculated using panoramic radiographs, whereas the gonial angle and angulation of lower canines, premolars and molars were measured using 45° oblique cephalograms. Little's index of irregularity was calculated using dental casts. Significant relationships between the angulation of the third and second molars and between the first molars and second premolars were found. Conversely, there was no significant correlation between the angulation of third molars, first premolars and canines. The Ganss ratio calculations showed that the lower first and second molars and the second premolars inclined mesially if there was insufficient space for the lower third molars. However, there was no significant correlation between Little's index of irregularity and third molar angulation. Furthermore, although the third molar influences the lateral segments, no obvious relationship between the third molar and anterior crowding was observed. Therefore, the angulation of the third molar appears not to cause anterior crowding.

Intraoral conversion of occlusal force to electricity and magnetism by biting of piezoelectric elements.

Very weak electrical, magnetic and ultrasound signal stimulations are known to promote the formation, metabolism, restoration and stability of bone and surrounding tissues after treatment and operations. We have therefore investigated the possibility of intraoral generation of electricity and magnetism by occlusal force in an in vitro study. Biting bimorph piezoelectric elements with lead zirconate titanate (PZT) using dental models generated appropriate magnetism for bone formation, i. e. 0.5-0.6 gauss, and lower electric currents and higher voltages, i. e. 2.0-6.0 µA at 10-22 V (appropriate levels are 30 µA and 1.25 V), as observed by a universal testing machine. The electric currents and voltages could be changed using amplifier circuits. These results show that intraoral generation of electricity and magnetism is possible and could provide post-operative stabilization and activation of treated areas of bone and the surrounding tissues directly and/or indirectly by electrical, magnetic and ultrasound stimulation, which could accelerate healing.