Torquing an upper central incisor with aligners--acting forces and biomechanical principles.

The forces delivered by aligners during torquing have still not been investigated. The purpose of this study was to measure the forces delivered to an upper central incisor during torquing with three different materials of the same thickness, and to describe the biomechanical principles of torquing with aligners. Five identical appliances were manufactured from each of three materials, all with a thickness of 1.0 mm (Ideal Clear®, Erkodur®, and Biolon®). An upper central incisor, as part of the measuring device, was torqued in defined steps in the vestibular and palatal directions with the respective appliance in place. For statistical analysis, the resulting forces, Fx (forces acting in the palatal and facial directions) and Fz (intrusive force as a side-effect) at a displacement of ±0.15 and ±0.8 mm from the tooth at the gingival margin were calculated. The mean Fx forces for ±0.15 mm displacement ranged from -1.89 N [standard deviation (SD) 0.48] to 0.11 N (SD 0.1). The mean Fz forces were between -0.97 N (SD 0.57) and -0.07 N (SD 0.22). The highest intrusive forces were measured during palatal displacement of the measuring tooth. An influence of direction of displacement on the levels of force was observed, especially for Fz at the greater displacement of ±0.8 mm. In relation to the intended amount of root movement during torquing, aligners tend to 'lift up' and therefore no effective force couple can be established for further root control. The force delivery properties are also influenced by the material used and the shape of the tooth.

Influence of thermoplastic appliance thickness on the magnitude of force delivered to a maxillary central incisor during tipping.

INTRODUCTION: The aim of the study was to quantify the forces delivered by thermoplastic appliances made of 2 materials with 2 thicknesses to a maxillary central incisor during tipping. METHODS: Two materials were tested, each in 2 thicknesses: Erkodur (Erkodent Erich Kopp GmbH, Pfalzgrafenweiler, Germany) 1.0 and 0.8 mm, and Biolon (Dreve Dentamid GmbH, Unna, Germany), 1.0 and 0.75 mm. For each material, 5 appliances were produced. To measure the forces applied, an isolated measuring tooth, part of a standardized resin model, was deflected in 0.05 degrees steps from 0 degrees to 0.42 degrees in the vestibular and palatine directions, after placing the respective appliance on the model. For statistical analysis, the force components Fx/tipping and Fz/intrusion at a displacement of +/- 0.151 mm from the incisor edge were selected. Means and standard deviations were calculated. The Wilcoxon 2-sample test for group pairings was used. RESULTS: The norms for the mean Fx forces ranged from 1.62 (SD, 0.41) to 5.35 N (SD, 0.63). The mean Fz forces were between 0.07 (SD, 0.13) and -2.47 N (SD, 0.34). The highest intrusive forces were measured during vestibular displacement of the measuring tooth. The forces delivered by the thick appliances were overall significantly higher (P <0.0001) than those of the thin materials. The forces delivered by the Biolon appliances were generally significantly higher (P <0.0001) than those for the Erkodur materials. CONCLUSIONS: The forces applied were mostly too high when compared with those stated in the literature as ideal. In addition to thickness, the thermoforming process influences the magnitude of the force delivered by a thermoformed appliance.

Initial forces generated by three types of thermoplastic appliances on an upper central incisor during tipping.

The force properties of thermoformed appliances have not been systematically investigated. Therefore, the aim of the present study was to quantify the forces delivered by thermoplastic appliances manufactured from three different materials, with the same thickness, on a central upper incisor, during tipping. Five identical appliances were manufactured from three different materials all with a thickness of 1.0 mm (Ideal Clear, Erkodur, and Biolon). For measuring the forces, an isolated measuring tooth, as part of a standardized resin model incorporated in a newly developed measuring device, was tipped in nine 2.7 arc minute (0.04629 degree) steps, from 0 to 0.416 degrees in the vestibular and palatal directions around a rotational axis through the virtual apex, after positioning an appliance on the model. For statistical analysis, the force components Fx/tipping and Fz/intrusion at a displacement of +/-0.151 mm from the incisor edge were determined. Means and standard deviations (SDs) were calculated. The Kruskal-Wallis test for overall effects and the Wilcoxon two-sample test for individual group pairings were used (P < 0.05 significance level). The mean Fx forces ranged from -2.82 N (SD 0.62) to 5.42 N (SD 0.56). The mean Fz forces were between -0.14 N (SD 0.52) and -2.3 N (SD 0.43). The highest intrusive forces were measured during vestibular displacement of the measuring tooth. The forces delivered by the Biolon appliance were found to be much greater (P < 0.01) than those of the other materials. The forces delivered by the materials investigated were mostly higher than those stated in the literature.

The use of a neodymium-iron-boron magnet device for positioning a multi-stranded wire retainer in lingual retention--a pilot study in humans.

The aim of this study was to evaluate the time requirement of a newly developed device made of neodymium-iron-boron (NdFeB) magnets for positioning a multi-stranded, canine-to-canine retainer during bonding compared with dental floss and a transfer tray. Forty-five patients aged between 12 and 33 years (26 male, 19 female) previously treated with fixed appliances were enrolled in the study. The patients were randomly allocated to three groups (15 per group). For each group a mandibular canine-to-canine retainer of 0.018 inch Dentaflex multi-stranded wire (Dentaurum) was prefabricated for each patient on a cast. The bonding procedure was identical, except for the method of positioning the wire during adhesive fixation: group A dental floss, group B a small prefabricated transfer tray of dental resin and group C the NdFeB magnet device. For each group, the time required for the complete bonding process was measured. Kruskal-Wallis and Wilcoxon-Mann-Whitney tests were used for group and pairwise comparisons, respectively. The three methods required statistically significant different times (P < 0.001). The Wilcoxon-Mann-Whitney test revealed that wire positioning with the magnet device was significantly faster [4.98 minutes; standard deviation (SD) 0.68 minutes] than with dental floss (7.65 minutes, SD 1.14 minutes; P = 0.0001) or with transfer tray (5.75 minutes, SD 0.57 minutes; P = 0.001). The NdFeB magnet device is a timesaving appliance for positioning a multi-stranded, canine-to-canine retainer during bonding when compared with dental floss and an individually prefabricated transfer tray.

Measurement of the midpalatal suture width.

OBJECTIVE: To conduct a pilot study to investigate the potentiality to determine the midpalatal sutural width radiographically with a flat-panel volume computed tomography (fpVCT) in a porcine model. MATERIALS AND METHODS: Bone samples from the midpalatal suture of five young (16 weeks) and five old (200 weeks) sus scrofa domestica were gathered. The midpalatal suture width was measured via fpVCT and compared to respective histological preparations. Results with P < .05 were considered significant. RESULTS: The data obtained by fpVCT and by histomorphometric analysis reveal a highly significant age dependency of the measured suture width (both P < .0001), with lower suture width values in older subjects compared to the younger group. The averaged suture widths measured in the fpVCT images shows a distinctively higher mean compared to the histomorphometric data with high statistical significance (P < .0001). The evaluated difference between both methods was almost constant. CONCLUSION: fpVCT is a powerful tool for determining midpalatal sutural width.

Detection and size differentiation of simulated tooth root defects using flat-panel volume computerized tomography (fpVCT).

OBJECTIVE: Our aim was to evaluate the capacity of flat-panel volume computerized tomography (fpVCT) to enable the observer to detect and differentiate 3 different sizes of simulated tooth root defects in radiographs. STUDY DESIGN: Three simulated tooth root defects of different sizes and a defect-free area (160 sites in total) were randomly distributed on the buccal and lingual surface of 20 mandibular premolar roots of Sus scrofa domestica with round burs. For the imaging of the specimens, an fpVCT prototype was used. Findings were evaluated by 3 observers. RESULTS: Cavity 0 (no lesion) was correctly identified in 53%, cavity 1 in 69%, cavity 2 in 96%, and cavity 3 in 89%. Altogether, the simulated cavities were classified in a correct manner in 77%. The values were compared using receiver operating characteristic curves. The area under the curve (AUC) for cavity 0 versus the pooled results for cavities 1-3 was found to be 0.72. The AUC for the pooled results for 0-2 (no pathologic impact) versus cavity 3 (potential pathologic impact) was 0.94. There was no significant dependence of the results on the observer (P = .37). Results with P < .05 were considered to be significant. CONCLUSIONS: Flat-panel volume computerized tomography, which is currently used only as a research tool, has a high potential in detection and differentiation at an early stage of external root resorption cavities with pathologic relevance..

Imaging of the midpalatal suture in a porcine model: flat-panel volume computed tomography compared with multislice computed tomography.

OBJECTIVE: An investigation was conducted to compare the image quality of prototype flat-panel volume computed tomography (fpVCT) and multislice computed tomography (MSCT) of suture structures. STUDY DESIGN: Bone samples were taken from the midpalatal suture of 5 young (16 weeks) and 5 old (200 weeks) Sus scrofa domestica and fixed in formalin solution. An fpVCT prototype and an MSCT were used to obtain images of the specimens. The facial reformations were assessed by 4 observers using a 1 (excellent) to 5 (poor) rating scale for the weighted criteria visualization of the suture structure. A linear mixed model was used for statistical analysis. Results with P < .05 were considered to be statistically significant. RESULTS: The visualization of the suture of young specimens was significantly better than that of older animals (P < .001). The visualization of the suture with fpVCT was significantly better than that with MSCT (P < .001). CONCLUSION: Compared with MSCT, fpVCT produces superior results in the visualization of the midpalatal suture in a Sus scrofa domestica model.