Surface characterization and frictional force between stainless steel brackets and archwires in orthodontic patients using chlorhexidine- and Persica-containing mouthrinses: A randomized controlled trial.

BACKGROUND: The aim of this study was to compare the effect of chlorhexidine- and Persica-containing mouthrinses on the surface characterization of orthodontic appliance and friction between the orthodontic stainless steel wires and brackets. MATERIALS AND METHODS: In this randomized controlled trial, 75 orthodontic patients (aged 13-30) were allocated (n = 25) into two experimental groups (prescribed by Persica- or chlorhexidine-containing mouthrinse) and one control group (no prescription). The ovoid stainless steel archwires were placed, and the maxillary first premolar stainless steel edgewise brackets were ligated to wires by elastomeric rings. The patients were recalled after 2 weeks, and then, the archwires were removed and replaced. The surface analysis of archwires and brackets was evaluated using scanning electron microscopy and atomic force microscopy. The frictional forces between the archwires and brackets were measured using a universal testing machine. The data for surface roughness were analyzed by the nonparametric Kruskal-Wallis and Mann-Whitney tests. The frictional forces data were analyzed using a two-way analysis of variance and Tukey's post hoc test using SPSS software. The level of significance was P < 0.05. RESULTS: The retrieved brackets showed minor changes in their surface topography. The surface roughness of archwires after the intervention was significantly greater for the chlorhexidine than that of Persica (P < 0.05). The friction force between the archwires and brackets was also significantly higher for the chlorhexidine than that of Persica (P < 0.05). CONCLUSION: The Persica-containing mouthrinse from the biomechanical and biochemical standpoints may be a better option for oral hygiene in orthodontic patients compared with the chlorhexidine.

ESTIMATION OF DIAGNOSTIC REFERENCE LEVELS AND ACHIEVABLE DOSES FOR PEDIATRIC PATIENTS IN COMMON COMPUTED TOMOGRAPHY EXAMINATIONS: A MULTI-CENTER STUDY.

This study was conducted to determine first local diagnostic reference levels (DRLs) and achievable doses (ADs) for pediatric patients during the most common computed tomography (CT) procedures in Yazd province. The DRL was obtained based on volume CT dose index (CTDIvol) and dose length product (DLP) for four various age groups of children. Data were collected from the most commonly performed pediatric CT scans, including abdomen-pelvis, chest, brain and sinus examinations, at six high-loaded institutes. The patients' data (766 no.) in terms of CTDIvol and DLP were obtained from four age groups: ≤1-, 1-5-, 5-10- and 10-15-y-old. The 75th percentiles of CTDIvol and DLP were considered as DRL values and the 50th percentiles were described as ADs for those parameters. Consequently, the acquired DRLs were compared with other national and international published values. The DRLs in terms of CTDIvol for abdomen-pelvis, chest, brain and sinus examinations were 3, 8, 9 and 10 mGy; 4, 5, 5 and 5 mGy; 25, 28, 29 and 38 mGy; and 23, 24, 26 and 27 mGy for four different age groups of ≤1-, 1-5-, 5-10- and 10-15-y-old, respectively. The DRL values in terms of DLP were 75, 302, 321 and 342 mGy.cm; 109, 112, 135 and 170 mGy.cm, 352, 355, 360 and 481 mGy.cm; and 206, 211, 228 and 245 mGy.cm, respectively, for the mentioned age groups. In this study, the DRL and AD values in the brain examination were greater among the other studied regions. The DRL plays a critical role in the optimization of radiation doses delivered to patients and in improving their protection. This study provides the local DRLs and ADs for the most common pediatric CT scanning in Yazd province to create optimum situation for the clinical practice.

Asymmetric Head Gear: A Comparison between Unilateral Outer Bow Expansion and Unilateral Outer Bow Shortening - an Energy Approach using the Finite Element Method.

OBJECTIVE: To compare the influence of outer bow length difference and unilateral outer bow expansion on the 'asymmetric effect' of the headgear. METHODS: Twelve 3D finite element models of a headgear with two tubes were designed, which were similar except for the outer bow length or the degree of unilateral expansion in Solid-Works 2011. A 3N force was applied to the outer bow ends in ANSYS Workbench 12.1 and the distalising, lateral forces to molars, moments and the energy of the system were evaluated. RESULTS: As the degree of unilateral expansion increased, the net differences in all findings were increased up to a point, and then changed. There was an increasing pattern in the length difference group. Buccal movement was observed in the intact/shorter side molar. CONCLUSION: Unilateral shortened outer bow asymmetric headgears are more efficient and more predictable in clinical application than the unilateral outer bow expansion.

A Comparison of Radiographic Film Densitometry Using a New Computerized Tool with a Digital Densitometer.

OBJECTIVES: The purpose of this study was to develop and test a new tool for radiographic densitometry by combining periapical films and aluminum step wedge. MATERIALS AND METHODS: We reviewed 50 Kodak E-speed intraoral films. An aluminum step wedge consisting of 16 steps was constructed. Each step was 1mm×3m×10mm. The step wedge was exposed to varying exposure times, ranging from 0.05 second to 0.5 second, increasing in 0.05 second increments. Films were digitalized after processing and the MATLAB software algorithm was ran subsequently. Density of the films was measured again using a digital densitometer. In order to compare the two imaging techniques, three steps were selected. Output data from the MATLAB algorithm were compared with data obtained from the digital densitometer. RESULTS: The new method could detect significant differences between subsequent exposure times in step 7, while the densitometer did that in steps 7 and 12. The new method's sensitivity in determining density changes was 5.26%, 84.1% and 93.02% in steps 2, 7, and 12 respectively. CONCLUSIONS: Our new method has an acceptable sensitivity for determining density changes of at least 7 mmEq/Al.

Asymmetric Outer Bow Length and Cervical Headgear Force System: 3D Analysis Using Finite Element Method.

OBJECTIVES: This study sought to assess distal and lateral forces and moments of asymmetric headgears by variable outer bow lengths. MATERIALS AND METHODS: Four 3D finite element method (FEM) models of a cervical headgear attached to the maxillary first molars were designed in SolidWorks 2010 software and transferred to ANSYS Workbench ver. 11 software. Models contained the first molars, their periodontal ligament (PDL), cancellous and cortical bones, a mesiodistal slice of the maxillae and the headgear. Models were the same except for the outer bow length in headgears. The headgear was symmetric in model 1. In models 2 to 4, the headgears were asymmetric in length with differences of 5mm, 10mm and 15mm, respectively. A 2.5 N force in horizontal plane was applied and the loading manner of each side of the outer bow was calculated trigonometrically using data from a volunteer. RESULTS: The 15mm difference in outer bow length caused the greatest difference in lateral (=0.21 N) and distal (= 1.008 N) forces and also generated moments (5.044 N.mm). CONCLUSION: As the difference in outer bow length became greater, asymmetric effects increased. Greater distal force in the longer arm side was associated with greater lateral force towards the shorter arm side and more net yawing moment. CLINICAL RELEVANCE: A difference range of 1mm to 15 mm of length in cervical headgear can be considered as a safe length of outer bow shortening in clinical use.

Effect of laser-assisted bleaching with Nd:YAG and diode lasers on shear bond strength of orthodontic brackets.

The aim of the present study was to assess the effect of laser-assisted bleaching with neodymium:yttrium-aluminum-garnet (Nd:YAG) and diode lasers on shear bond strength (SBS) of orthodontic brackets. One hundred and four extracted human premolars were randomly divided into four groups: group 1: No bleaching applied (control group); group 2: Teeth bleached with 40 % hydrogen peroxide; group 3: Teeth treated with 30 % hydrogen peroxide activated with Nd:YAG laser (1064 nm, 2.5 W, 25 Hz, pulse duration of 100 µs, 6 mm distance); and group 4: Teeth treated with 30 % hydrogen peroxide activated with diode laser (810 nm, 1 W, CW, 6 mm distance). Equal numbers of teeth in groups 2, 3, and 4 were bonded at start, 1 h, 24 h, and 1 week after bleaching. A universal testing machine measured the SBS of the samples 24 h after bonding. After bracket debonding, the amount of residual adhesive on the enamel surface was observed under a stereomicroscope to determine the adhesive remnant index (ARI) scores. The SBS in the unbleached group was significantly higher than that in the bleached groups bonded immediately and 1 h after laser-assisted bleaching (P < 0.05). In groups 3 and 4 at start and group 2 at start and 1 h after laser-assisted bleaching, the SBS was found to be significantly lower than that in the control group. Significant differences in the ARI scores existed among groups as well. The SBS of brackets seems to increase quickly within an hour after laser-assisted bleaching and 24 h after conventional bleaching. Thus, this protocol can be recommended if it is necessary to bond the brackets on the same day of bleaching.

Effect of chlorhexidine-containing prophylactic agent on the surface characterization and frictional resistance between orthodontic brackets and archwires: an in vitro study.

BACKGROUND: The purpose of this study was to assess the surface characterization and frictional resistance between stainless steel brackets and two types of orthodontic wires made of stainless steel and nickel-titanium alloys after immersion in a chlorhexidine-containing prophylactic agent. METHODS: Stainless steel orthodontic brackets with either stainless steel (SS) or heat-activated nickel-titanium (Ni-Ti) wires were immersed in a 0.2% chlorhexidine and an artificial saliva environment for 1.5 h. The frictional force was measured on a universal testing machine with a crosshead speed of 10 mm/min over a 5-mm of archwire. The surface morphology of bracket slots and surface roughness of archwires after immersion in chlorhexidine were also characterized using a scanning electron microscope (SEM) and an atomic force microscope (AFM), respectively. RESULTS: There was no significant difference in the frictional resistance values between SS and Ni-Ti wires immersed in either chlorhexidine or artificial saliva. The frictional resistance values for the SS and Ni-Ti wires immersed in 0.2% chlorhexidine solution were not significantly different from that in artificial saliva. No significant difference in the average surface roughness for both wires before (as-received) and after immersion in either chlorhexidine or artificial saliva was observed. CONCLUSIONS: One-and-half-hour immersion in 0.2% chlorhexidine mouthrinse did not have significant influence on the archwires surface roughness or the frictional resistance between stainless steel orthodontic brackets and archwires made of SS and Ni-Ti. Based on these results, chlorhexidine-containing mouthrinses may be prescribed as non-destructive prophylactic agents on materials evaluated in the present study for orthodontic patients.