Effect of radiofrequency electromagnetic fields (RF-EMFS) from mobile phones on nickel release from orthodontic brackets: An in vitro study.

BACKGROUND: The worldwide dramatic increase in the use of cell phones has generated great concerns about their potential adverse health effects. OBJECTIVE: The aim of the present study was to evaluate the effects of radiofrequency electromagnetic fields (RF-EMFs) emitted from mobile phones on the level of nickel release from orthodontic brackets. METHODS: Twenty stainless steel brackets were divided randomly into experimental and control groups (n=10). Brackets were immersed in artificial saliva at 37°C for 6 months. Experimental group were exposed to GSM 900MHz RF-EMFs emitted from a mobile phone stimulator for 4hours. The specific absorption rate (SAR) was 2.287W/kg. The concentration of nickel in the artificial saliva in both groups was evaluated by using the cold-vapour atomic absorption spectrometry. The Mann-Whitney test was used to assess significant differences in nickel release between the exposed and non-exposed groups. RESULTS: The mean nickel levels in the exposed and non-exposed groups were 11.95 and 2.89µg/l, respectively. This difference between the concentrations of nickel in the artificial saliva of these groups was statistically significant (P=0.001). CONCLUSION: Exposure to RF-EMFs emitted from mobile phones can lead to human exposure to higher levels of nickel in saliva in patients with orthodontic appliances. As nickel exposure can lead to allergic reaction in humans and considering this point that about 10-20% of the population can be hypersensitive to nickel, further studies are needed to evaluate the effects of radiofrequency electromagnetic fields (RF-EMFs) emitted from common devices such as mobile phones or Wi-Fi routers on the level of nickel release from orthodontic brackets.

Laser-treated stainless steel mini-screw implants: 3D surface roughness, bone-implant contact, and fracture resistance analysis.

BACKGROUND/OBJECTIVES: This study investigated the biomechanical properties and bone-implant intersurface response of machined and laser surface-treated stainless steel (SS) mini-screw implants (MSIs). MATERIAL AND METHODS: Forty-eight 1.3mm in diameter and 6mm long SS MSIs were divided into two groups. The control (machined surface) group received no surface treatment; the laser-treated group received Nd-YAG laser surface treatment. Half in each group was used for examining surface roughness (Sa and Sq), surface texture, and facture resistance. The remaining MSIs were placed in the maxilla of six skeletally mature male beagle dogs in a randomized split-mouth design. A pair with the same surface treatment was placed on the same side and immediately loaded with 200 g nickel-titanium coil springs for 8 weeks. After killing, the bone-implant contact (BIC) for each MSI was calculated using micro computed tomography. Analysis of variance model and two-sample t test were used for statistical analysis with a significance level of P <0.05. RESULTS: The mean values of Sa and Sq were significantly higher in the laser-treated group compared with the machined group (P <0.05). There were no significant differences in fracture resistance and BIC between the two groups. LIMITATION: animal study CONCLUSIONS/IMPLICATIONS: Laser treatment increased surface roughness without compromising fracture resistance. Despite increasing surface roughness, laser treatment did not improve BIC. Overall, it appears that medical grade SS has the potential to be substituted for titanium alloy MSIs.

Effect of UV Photofunctionalization on Biologic and Anchoring Capability of Orthodontic Miniscrews.

PURPOSE: Treatment of titanium with UV light immediately before use, or photofunctionalization, is gaining traction as a simple method to improve the biologic capability and clinical performance of dental implants. The objective of this study was to examine the effect of photofunctionalization on the biologic capability and mechanical anchorage of orthodontic miniscrews. MATERIALS AND METHODS: Untreated and photofunctionalized Ti-6Al-4V orthodontic miniscrews were placed into rat femurs. Photofunctionalization was performed by treating miniscrews with UV light for 12 minutes using a photo device immediately before placement. After 3 weeks of healing, miniscrews were pushed laterally to measure the resistance against the tipping force. The miniscrews were also evaluated for morphology and chemistry of tissue formed around them using scanning electron microscopy and energy dispersive spectroscopy. Rat bone marrow-derived osteoblasts were cultured on Ti-6Al-4V disks with and without photofunctionalization. The number of osteoblasts attached to the disks and the behaviors, alkaline phosphatase activity, and mineralization capability of osteoblasts were evaluated. RESULTS: Photofunctionalization converted both disk and screw surfaces from hydrophobic to superhydrophilic. In vivo biomechanical testing showed that the displacement of untreated screws was 1.5 to 1.7 times greater than that of photofunctionalized screws when subjected to lateral tipping force. Robust bone formation was observed around photofunctionalized miniscrews with strong elemental peaks of calcium and phosphorus, whereas the tissue around untreated miniscrews appeared thin and showed no clear peak of calcium. The attachment, initial spreading, adhesion, and expression of functional phenotypes of osteoblasts were significantly increased on photofunctionalized Ti-6Al-4V disks. CONCLUSION: These in vivo and in vitro results comprehensively and consistently demonstrate that photofunctionalization increases the bioactivity of Ti-6Al-4V and improves the anchoring capability of orthodontic miniscrews.

Ultraviolet photofunctionalization increases removal torque values and horizontal stability of orthodontic miniscrews.

INTRODUCTION: The objective of this study was to examine the effects of ultraviolet-mediated photofunctionalization of miniscrews and the in-vivo potential of bone-miniscrew integration. METHODS: Self-drilling orthodontic miniscrews made from a titanium alloy were placed in rat femurs. Photofunctionalization was performed by treating the miniscrews with ultraviolet light for 12 minutes with a photo device immediately before implantation. Maximum insertion torque (week 0), removal torque (weeks 0 and 3), and resistance to lateral tipping force (week 3) were examined. RESULTS: The removal torque at 3 weeks of healing was higher for the photofunctionalized screws than for the untreated screws. The regenerated bone tissue was more intact and contiguous around the photofunctionalized miniscrews than around the untreated ones. The miniscrew-bone complex seemed to produce interface failure, not cohesive fracture, in both groups. The displacement of untreated screws under a lateral tipping force was greater than that of photofunctionalized miniscrews. CONCLUSIONS: These results suggest that photofunctionalization increases the bioactivity of titanium-alloy miniscrews and improves the anchoring capability of orthodontic miniscrews, even without modification of the surface topography.

Effects of ultraviolet irradiation on the bond strength of a composite resin adhered to stainless steel crowns.

PURPOSE: A technique whereby the practitioner could improve the esthetic appearance of anterior stainless steel crowns (SSC) could provide a cost-effective alternative to more expensive commercially available preveneered SSCs, which may not be uniformly available. The purpose of this study was to evaluate the effects of ultraviolet (UV) irradiation of the metal crown surface on the shear bond strength of composite resin adhered to stainless steel crowns. METHODS: Seventy extracted anterior bovine teeth randomly divided into 2 groups (n=35/group), were restored with primary maxillary left central incisor SSCs. Surface roughening with a green stone was performed on the labial surfaces, and the crowns of the experimental group were exposed to UV irradiation for 80 minutes. All samples were treated with metal-composite adhesive, followed by composite opaquer. Standardized composite blocks were bonded on the treated surfaces, and the shear bond strength was tested at 1 mm/minute. The values were recorded in MPa and statistically analyzed. RESULTS: The mean value of shear bond strength was significantly higher for the experimental group (19.7 ± 4.3 MPa) than the control group (16.3 ± 4.5 MPa). CONCLUSION: Ultraviolet irradiation of primary tooth stainless steel crowns significantly increased the shear bond strength of composite resin adhered to the facial surface.

Effect of Er:YAG, CO(2) and diode laser irradiation on surface properties of zirconia endosseous dental implants.

BACKGROUND AND OBJECTIVES: Zirconia implants (ZI) are becoming more popular in implant dentistry, as a result of their favorable esthetic outcome. However, little is known about the impact laser application has on this material in the course of peri-implantitis treatment. The objective of this investigation was to analyze the influence of Er:YAG, CO(2) and diode laser irradiation on polished ZI. MATERIAL AND METHODS: Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic disks were irradiated at different power settings with either an Er:YAG, CO(2) or diode laser. The surface of the disks was analyzed by scanning electron microscopy (SEM) and confocal 3D white light microscopy (CWLM). In addition energy-dispersive X-ray (EDX) analysis was performed on all disks. Six specimens were used for each parameter set of each laser. RESULTS: SEM analysis demonstrated that, regardless of the power settings, neither the diode laser nor the Er:YAG laser caused any visible surface alterations to ZI. The results of the CWLM were in agreement with the SEM pictures. However, Er:YAG irradiation did penetrate through the disks. At various power settings, the CO(2) treatment was characterized by material cracking and melting. The increased roughness values (from CWLM) of the ZI underlined the SEM observations. CONCLUSION: In contrast to diode and Er:YAG laser irradiation, the CO(2) laser revealed distinct surface alterations to zirconia at various laser parameters. However, the Er:YAG laser cannot be recommended for the treatment of ailing implants, as the laser beam penetrates the material. In this respect, currently, diode lasers seem to be the only laser systems offering surface preservation and safety in the treatment of peri-implantits with ZI.

In vivo dose perturbation effects of metallic dental alloys during head and neck irradiation with intensity modulated radiation therapy.

A patient with base of tongue squamous sell carcinoma, with significant CT artifact-inducing metallic alloy, non-removable dental restorations in both the mandible and maxilla was identified. Simultaneous with IMRT treatment, thermoluminescent dosimeters (TLDs) were placed in the oral cavity. After a series of three treatments, the data from the TLDs and software calculations were analyzed. Analysis of mean in vivo TLD dosimetry reveals differentials from software predicted dose calculation that fall within acceptable dose variation limits. IMRT dose calculation software is a relatively accurate predictor of dose attenuation and augmentation due to dental alloys within the treatment volume, as measured by intra-oral thermoluminescent dosimetry. IMRT represents a safe and effective methodology to treat patients with non-removable metallic dental work who have head and neck cancer.

Effects of the Nd:YAP laser on coronal restorative materials: implications for endodontic retreatment.

With new wavelengths that allow light transmission by optical fibers, the laser is now often used in endodontics either during treatment or retreatment. The aims of this study were to (i) specify the effects of laser irradiation on restorative materials in terms of topographic effects and (ii) describe different protocols for the first steps of retreatment. The laser used in this study was an optical fiber Nd:YAP (Lokki dt, Vienne, France) with a wavelength of 1.34 microns. Samples of the following restorative materials were prepared: amalgam, composite, permanent and temporary cements, and prosthodontic alloy. The handpiece of the Nd:YAP laser was fixed perpendicular to the surface of the different preparations. All trials were performed with the fiber tip either in contact with or at a distance of 2 mm from the material. The surface effects in all cases were (i) the creation of craters in the center of the lased areas, (ii) a border of fusion material at the edge of the craters, and (iii) cracks or fractures at a distance from the target areas. For the cements, amalgam and composite, the effects included a projection of material from the center to the edge of the lased area and/or the apparent photovolatization of light particles. For all materials the laser induced deeper absorption in the areas of direct contact than when it was held at a distance. This suggests that the fiber should be in contact with the restorative material for lasing in the straight part of the canal when the objective is either to pass through the material or alongside it between material and tooth. If the practitioner cannot determine the direction of the curve of the canal, lasing should be performed at a distance to weaken the material and thus permit more efficient use of an ultrasonic device. Lasing should in all cases be performed under close X-ray monitoring. Provided that sufficient caution is used, the laser may be helpful in removing restorative materials during retreatment.

Bactericidal efficacy of carbon dioxide laser against bacteria-contaminated titanium implant and subsequent cellular adhesion to irradiated area.

BACKGROUND AND OBJECTIVE: The aim of this study was to assess CO2 laser ability to eliminate bacteria from titanium implant surfaces. The changes of the surface structure, the rise in temperature, and the damage of connective tissue cells after laser irradiation were also considered. STUDY DESIGN/MATERIALS AND METHODS: Streptococcus sanguis and Porphyromonas gingivalis on titanium discs were irradiated by an expanded beam of CO2 laser. Surface alteration was observed by a light, and a scanning electron, microscope. Temperature was measured with a thermograph. Damage of fibroblastic (L-929) and osteoblastic (MC3T3-E1) cells outside the irradiation spot and adhesion of the cells to the irradiated area were also estimated. RESULTS: All the organisms (10(8)) of S. sanguis and P. gingivalis were killed by the irradiation at 286 J/cm2 and 245 J/cm2, respectively. Furthermore, laser irradiation did not cause surface alteration, rise of temperature, serious damage of connective tissue cells located outside the irradiation spot, or inhibition of cell adhesion to the irradiated area. CONCLUSION: CO2 laser irradiation with expanded beam may be useful in removing bacterial contaminants from implant surface.

In vivo dose increase in the presence of dental alloys during 60Co-gamma-ray therapy of the oral cavity.

During irradiation of the mouth cavity, dental metallic materials emit secondary electrons and thus increase the applied radiation dose in their vicinity. Therefore, local destruction of the mucous membrane contacting metallic dental crowns and fillings may be observed. Available data on this dose increase are based on measurements with beam arrangements perpendicular to the metallic surface. Since the dose modification depends on the beam direction in relation to specimen surface, a reliable prediction of dose modification in the close vicinity of dental caps on fillings under complex beam arrangements, as applied in the irradiation of head and neck region from the published data is not possible. Therefore, we measured dose increase in the immediate surrounding of metallic dental material using thermoluminescence dosimetry on the phantom and during routinely applied 60Co gamma ray therapy. Phantom measurements were carried out using several oblique irradiation angles and rotational therapy. In vivo measurements were carried out at alloy specimens containing gold, palladium, and amalgam in six patients and at permanently fixed golden teeth in five patients. In vivo, the following relative dose increase values according to a simultaneously measured reference value were obtained at the surface of different dental materials: 61% for fixed golden caps. 68% for the specimen containing gold, 33% for the specimen of palladium and 61% for the specimen of amalgam. The measured dose increases due to metallic dental material during routinely applied external 60Co beam irradiation are lower compared with those of perpendicular beam arrangements. Although, the extent of dose modification is less than expected, we still advocate protection of the oral mucosa to prevent painful lesion spots.

[The in-vivo determination of dosage intensification due to dental alloys in the therapeutic irradiation of the oral cavity]. / In-vivo-Bestimmung der Dosiserhöhung durch Dentallegierungen bei therapeutischer Bestrahlung der Mundhöhle.

BACKGROUND: In the course of therapeutic irradiation of regions in the mouth cavity dosage increase due to the emission of secondary electrons in the vicinity of dental materials can be observed. This could induce local destruction of the mucous membrane in contact with metallic dental crowns and fillings. As at now, only rough estimates of this dosage increase could be made with the help of measurements carried out with models. PATIENTS AND METHODS: The degree of dosage increase in the immediate surrounding of metallic dental material was measured in an in-vivo study during therapeutic irradiation with 60Co gamma rays in the area of mouth cavity of 11 patients. Measurements were carried out by thermoluminescent dosimetry at permanently fixed golden teeth and alloy specimens containing gold and palladium and amalgam. RESULTS: The following relative dosage values according to a simultaneously measured reference value were measured at the surface of the different dental materials: 161% near fixed golden caps, 168% near the specimen containing gold in a high percentage, 133% near the specimen of palladium and 161% near the specimen of amalgam. CONCLUSION: The in vivo measured dosage increases due to metallic dental prosthesis are less than values obtained using back scatter arrangements for irradiating phantoms. Despite this, they could be of clinical relevance. Thus the usage of a mucous membrane protection during irradiation with 60Co, as a means of preventing local lesions of the oral mucosa, due to dental alloys within the treatment volume remains inevitable.

Measurement of absorbed doses near metal and dental material interfaces irradiated by x- and gamma-ray therapy beams.

Soft-tissue damage adjacent to dental restorations is a deleterious side effect of radiation therapy which is associated with low-energy electron scatter from dental materials of high electron density. This study was designed to investigate the enhancement of dose to soft tissue (or water) close to high electron-density materials and to measure the detailed lateral and depth-dose profiles in soft-tissue-simulating polymer adjacent to planar interfaces of several higher atomic-number materials: 18-carat gold dental casting alloy; Ag-Hg dental amalgam alloy; Ni-Cr dental casting alloy; and natural human tooth structure. Interleaved stacks of calibrated thin radiochromic dosimeter films and tissue-simulating polymer were used for these measurements. Assemblies of these polymer-dosimeter stacks on both sides of the dental materials were irradiated in one fixed direction by collimated 60Co gamma-ray or 10 MV x-ray beams directed perpendicularly to the material interfaces. In another test, designed to simulate more closely therapeutic treatment conditions, a phantom constructed on both sides of a row of restored and unrestored whole teeth (restoration materials: gold alloy crown; Ni-Cr alloy crown; Ag-Hg mesial-occlusal-distal (MOD) amalgam filling; unrestored tooth) was irradiated in one fixed direction by the collimated photon beams. Results indicate that the dose-enhancement in 'tissue' is as great as a factor of 2 on the backscatter side adjacent to gold and a factor of 1.2 adjacent to tooth tissue, but is insignificant on the forward-scatter side because of the predominant effect of attenuation by the high-density, high atomic-number absorbing material.