RESUMEN
PURPOSE: To investigate a novel in-office three-dimensionally (3D) printed polymer bracket regarding slot precision and torque transmission. METHODS: Based on a 0.022â³ bracket system, stereolithography was used to manufacture brackets (Nâ¯= 30) from a high-performance polymer that met Medical Device Regulation (MDR) IIa requirements. Conventional metal and ceramic brackets were used for comparison. Slot precision was determined using calibrated plug gages. Torque transmission was measured after artificial aging. Palatal and vestibular crown torques were measured from 0 to 20° using titanium-molybdenum (T) and stainless steel (S) wires (0.019â³â¯× 0.025â³) in a biomechanical experimental setup. The Kruskal-Wallis test with post hoc test (Dunn-Bonferroni) was used for statistical analyses (significance level pâ¯< 0.05). RESULTS: The slot sizes of all three bracket groups were within the tolerance range according to DIN 13996 (ceramic [C]: 0.581⯱ 0.003â¯mm; metal [M]: 0.6⯱ 0.005â¯mm; polymer [P]: 0.581⯱ 0.010â¯mm). The maximum torque values of all bracket-arch combinations were above the clinically relevant range of 5-20â¯Nmm (PS: 30⯱ 8.6â¯Nmm; PT: 27.8⯱ 14.2â¯Nmm; CS: 24⯱ 5.6â¯Nmm; CT: 19.9⯱ 3.8â¯Nmm; MS: 21.4⯱ 6.7â¯Nmm; MT: 16.7⯱ 4.6â¯Nmm). CONCLUSIONS: The novel, in-office manufactured polymer bracket showed comparable results to established bracket materials regarding slot precision and torque transmission. Given its high individualization possibilities as well as enabling an entire in-house supply chain, the novel polymer brackets bear high potential of future usage for orthodontic appliances.
RESUMEN
OBJECTIVES: As part of orthodontic treatment, air polishing is routinely used for professional tooth cleaning. Thus, we investigated the effects of static powder polishing on sliding behaviour and surface quality of three different bracket materials (polymer, ceramic, metal), including a 3D-printed bracket. METHODS: Two bracket types of each material group were polished with an air-polishing device using sodium bicarbonate. Exposure times were set at 10, 20, and 60â¯s; the application distance was 5â¯mm. The force loss due to sliding resistance was tested with an orthodontic measurement and simulation system (OMSS) using a 0.016â¯inchâ¯× 0.022â¯inch stainless steel archwire. Untreated brackets served as control. Polishing effects and slot precision were evaluated using an optical digital and scanning electron microscope. RESULTS: Sliding behaviour and slot precision differed significantly between and within the groups. Prior to polishing, polymer brackets showed the least force loss, ceramic brackets the highest. With progressive polishing time, the resistance increased significantly with titanium brackets (26 to 37%) and decreased significantly with steel brackets (36 to 25%). Polymer brackets showed the smallest changes in force loss with respect to polishing duration. Slot precision showed the largest differences between material groups and was primarily manufacturer-dependent with hardly any changes due to the polishing time. CONCLUSION: Powder polishing can positively or negatively affect the sliding properties of the bracket-archwire complex but is more dependent on the bracket-archwire material combination (i.e., manufacture-dependent slot precision). For titanium brackets, resistance only increased after 60â¯s of polishing. For ceramic brackets, effective reduction was observed after 10â¯s of polishing. Polymer brackets, including the 3D-printed brackets, showed better sliding properties than ceramic or metal brackets even after polishing for 60â¯s. Removal of plaque and dental calculus should lead to a noticeable improvement of the sliding properties and outweighs structural defects that may develop.