Elemental composition, corrosion resistance and mechanical properties of computer-aided design and computer-aided manufacturing fixed retainers versus conventional fixed retainers.

PURPOSE: To investigate the elemental composition, corrosion resistance, and mechanical properties of computer-aided design and computer-aided manufacturing (CAD-CAM) retainers versus conventional fixed retainers (FRs). METHODS: Eight different retainer wires were investigated. Energy dispersive X-ray spectroscopy was used to determine the elemental composition. Leakage was analysed according to ISO 10271:2020 guidelines. Hardness was tested using the Vickers method with a load of 0.3 kg. The tensile force and tensile strength were evaluated. Multiple comparisons among wires of hardness, tensile force, and strength were conducted using the Welch t-test, with Bonferroni correction. RESULTS: Nickel was present in all wires. The CAD-CAM-FR wire, which contained more nickel than the other wires, had no measurable leakage. The gold-plated wires had the highest total leakage, but did not exceed the ISO standard limit. The hardness of the stainless-steel twisted wires was the highest and that of the CAD-CAM-FR wire was the lowest. The tensile strength of the CAD-CAM-FR wire was significantly lower than that of the other wires and similar to the other twisted-wire retainers. CONCLUSION: The CAD-CAM-FR wire is likely to have high corrosion resistance and flexibility due to its low hardness.

Changes in enamel hardness, wear resistance, surface texture, and surface crystal structure with glass ionomer cement containing BioUnion fillers.

This study investigated the potential of BioUnion filler containing glass ionomer cement (GIC) to enhance the properties of enamel surrounding restorations, with a specific focus on the effect on hardness. The hardness of the bovine enamel immersed in the cement was measured using Vickers hardness numbers. Following sliding and impact wear simulations, the enamel facets were examined using confocal-laser-scanning microscopy and scanning-electron microscopy. Surface properties were further analyzed using energy-dispersive X-ray spectroscopy and X-ray diffraction (XRD). A significant increase in Vickers hardness numbers was observed in the BioUnion filler GIC after 2 days. Furthermore, the mean depth of enamel facets treated with BioUnion filler GIC was significantly less than that of untreated facets. Characteristic XRD peaks indicating the presence of hydroxyapatite were also observed. Our findings imply that GIC with BioUnion fillers enhances the mechanical properties of the tooth surface adjacent to the cement.

Age dependence of the maturation of the midpalatal suture in the stability of orthodontic anchoring screws.

INTRODUCTION: Orthodontic anchoring screws (OASs) have been placed around midpalatal sutures in patients of various ages. Our previous study found that OAS placement more than 1.5 mm from midpalatal suture was more successful than placement directly at the suture. This study aimed to investigate the relationship between age and midpalatal suture maturation, considering factors affecting the failure of OASs using cone-beam computed tomography. METHODS: In total, 150 patients who underwent cone-beam computed tomography were selected. The total depth and sutured depth of the midpalatal suture corresponding area to anterior (interpremolar zone) and posterior region (mesial and distal borders of the first molar) were measured, and the ratio of sutured depth to total depth (sutured ratio) was calculated. RESULTS: The mean sutured ratios at interpremolar zone and mesial and distal borders of the first molar according to age were 40%, 60%, and 63% in the younger group (≤17 years), 46%, 76%, and 76% in the middle group (18-25 years), and 47%, 74%, and 76% in the older group (≥26 years), respectively. The sutured ratio of the anterior region was significantly lower than that of the posterior region (P <0.01). Each mean sutured ratio of the middle and older group was significantly higher than that of the younger group on both sides (P <0.01). According to the cervical vertebral maturation, the mean sutured ratio of cervical vertebral stages 5-6 was significantly higher than cervical vertebral stages 1-3 on the distal side (P <0.05). CONCLUSIONS: Incomplete closure of the midpalatal suture was observed frequently, even in the older group. This might be caused by insufficient calcification of the midpalatal suture, including in elder patients. To prevent OAS placement to the unsutured area, the midpalatal suture should be avoided regardless of age.

Influence of masticating cycles and chewing patterns on inadvertent enamel wear caused by zirconia brackets.

Little information is available about enamel wear caused by zirconia brackets, an inadvertent side effect of orthodontic treatment. The purpose of this study was to examine potential enamel damage induced by contact with zirconia brackets. Sliding and impact wear simulations were performed using bovine enamel specimens positioned at a 25° slant to a zirconium ball to determine wear behaviour. Different chewing patterns, tapping and grinding, were simulated. Specimens were profiled using confocal laser scanning microscopy, and the mean maximum depth and surface roughness were measured. Scanning electron microscopy was also performed. The mean maximum depth of wear values differed according to the number of mastication cycles, with a higher number of cycles producing higher depths of wear. The facet wear depth was significantly greater with the tapping pattern than with the grinding pattern. Scanning electron microscopic observation of the wear facets revealed that surface textures at the edges were rougher than those at the centre of all facets. The results of this study indicated that enamel wear was induced by contact with zirconia brackets during the early period of mastication, and that the patterns and number of cycles of mastication affected the wear progression of enamel.

Influence of pre-drilling diameter on the stability of orthodontic anchoring screws in the mid-palatal area.

PURPOSE: The aim of this study was to investigate the stability of orthodontic anchor screws (OASs) in the mid-palatal area according to pre-drilling diameter. METHODS: The success rate of 161 OASs (83 patients, φ2.0 mm, 6.0 mm in length) placed in a corresponding area to the mesial and distal borders of the first molar (mesial zone and distal zone) was assessed according to placement location and pre-drilling diameter (1.2 and 1.5 mm). Placement torque values from 73 OASs with a pre-drilling diameter of 1.2 mm were compared between success and failure groups. RESULTS: The success rates of OASs pre-drilled with φ1.2 and 1.5 mm were 94.5% and 83.0%, respectively (P < 0.05); corresponding rates in the mesial zone were 100.0% and 77.3% (P < 0.005), and those in the distal zone were 89.2% and 88.6%, respectively. Placement torques of OASs predrilled with φ1.2 mm in the success and failure groups were 25.9 and 19.2 N·cm, respectively (P < 0.05). CONCLUSION: A smaller pre-drilling diameter was associated with a higher success rate of OASs in the mid-palatal area, especially in the mesial zone. When pre-drilling diameter of 1.2 mm was used for φ2.0 mm OAS, greater placement torque was indicative of greater OAS stability.

Pain and removal force associated with bracket debonding: a clinical study.

OBJECTIVE: Pain is a problem during bracket removal, and more comfortable treatment is needed. This study examined the association of pain with the removal force required for ceramic brackets, compared with metal and plastic brackets, to determine which removal method resulted in less pain and discomfort. METHODOLOGY: 81 subjects (mean age, 25.1 years; 25 males and 56 females) were enrolled, from whom 1,235 brackets (407 ceramic, 432 plastic, and 396 metal) were removed. Measured teeth were distinguished at six segments. Pain was measured with a visual analogue scale (VAS) during the removal of each bracket. An additional grip was placed on the grips of debonding pliers with right-angled beaks; a mini loading cell sensor pinched by the grips was used to measure removal force during debonding. VAS and force values were statistically analyzed. The Kruskal-Wallis test followed by the Mann-Whitney U test with Bonferroni correction were performed for multiple comparisons; multiple regression analysis was also performed. RESULTS: Forces in the upper and lower anterior segments were significantly smaller (p<0.05) than those in the other segments. Pain tended to be greater in the upper and lower anterior segments than in the posterior segments. In all segments, the removal force was greater for metal brackets than for plastic or ceramic brackets. Ceramic brackets caused significantly greater pain than plastic brackets for the upper and lower anterior segments. Debonding force was involved in the brackets, following adjustments for pain, upper left segment, age, and sex. CONCLUSIONS: Pain and discomfort are likely to occur during bracket debonding.

Evaluation of torque moment in esthetic brackets from bendable alloy wires.

OBJECTIVES: To examine the torque moment that occurs between esthetic brackets and bendable alloy (stainless steel [SS], titanium-molybdenum [Ti-Mo], and titanium-niobium [Ti-Nb]) wires. MATERIALS AND METHODS: This study examined ceramic (CR), zirconium oxide (ZC), polycarbonate (PC), and conventional metallic brackets (MT) (upper, 0.018-inch and 0.022-inch slots) combined with SS, Ti-Mo, and Ti-Nb wires using elastic module ligation. The torque moments delivered by various wire and bracket combinations were measured using a torque gauge apparatus. The wire torque angles at 5-40° were examined. RESULTS: The torque value increased in the order of CR, ZC, MT, and PC brackets for both 0.018-inch and 0.022-inch slots. The fracture points of the CR and ZC brackets combined with SS and Ti-Mo wires were approximately more than 30° and 35°, respectively. No fracture points were detected in the combination of ZC brackets and Ti-Nb wires. CONCLUSIONS: The current study identified the material characteristics of CR, ZR, and PC brackets during torque tooth movements. The present results demonstrate a characteristic combined effect between different esthetic brackets and bendable alloy wires.

Influence of one-step professional mechanical tooth cleaning pastes on surface roughness and morphological features of tooth substrates and restoratives.

PURPOSE: This study investigated the influence of professional mechanical tooth cleaning (PMTC) pastes on the surface texture of different subject materials. METHODS: Two one-step PMTC pastes, Clinpro Cleaning Paste for PMTC (CP) and PRG Pro-Care Gel (PG), and multiple-step PMTC pastes, Merssage Regular (MR), Merssagge Fine (MF), and Merssage Plus (MP), were used. For comparison, PMTC was performed using distilled water without paste (DW). The subjected materials used were bovine enamel (ENA) and dentin (DEN), a resin composite (FSU), and lithium disilicate (IEC). The prepared specimens were polished using a #2000-grit silicon carbide paper. PMTC was performed using a brush at 1,000 rpm for 15 s. RESULTS: The surface roughness (Ra) values of the specimens before and after PMTC were measured by laser scanning microscopy. The Knoop hardness number (KHN) of the subjected material was obtained. The types of PMTC pastes and subject materials had a significant influence on the Ra values and KHN. For the majority of subject materials, the descending order of Ra values after PMTC was MR > MF > CP > PG > MP > DW. The descending order of KHN of the materials was IEC > ENA > FSU > DEN. CONCLUSION: Although one-step PMTC pastes appeared to be effective, it is important to consider the subject material during PMTC.

Pain and removal force associated with bracket debonding: a clinical study

Abstract Objective: Pain is a problem during bracket removal, and more comfortable treatment is needed. This study examined the association of pain with the removal force required for ceramic brackets, compared with metal and plastic brackets, to determine which removal method resulted in less pain and discomfort. Methodology: 81 subjects (mean age, 25.1 years; 25 males and 56 females) were enrolled, from whom 1,235 brackets (407 ceramic, 432 plastic, and 396 metal) were removed. Measured teeth were distinguished at six segments. Pain was measured with a visual analogue scale (VAS) during the removal of each bracket. An additional grip was placed on the grips of debonding pliers with right-angled beaks; a mini loading cell sensor pinched by the grips was used to measure removal force during debonding. VAS and force values were statistically analyzed. The Kruskal-Wallis test followed by the Mann-Whitney U test with Bonferroni correction were performed for multiple comparisons; multiple regression analysis was also performed. Results: Forces in the upper and lower anterior segments were significantly smaller (p<0.05) than those in the other segments. Pain tended to be greater in the upper and lower anterior segments than in the posterior segments. In all segments, the removal force was greater for metal brackets than for plastic or ceramic brackets. Ceramic brackets caused significantly greater pain than plastic brackets for the upper and lower anterior segments. Debonding force was involved in the brackets, following adjustments for pain, upper left segment, age, and sex. Conclusions Pain and discomfort are likely to occur during bracket debonding.

Finite element analysis of stress caused by palatal orthodontic anchor screws.

This study used finite element (FE) analysis to investigate the stability of miniscrews (screws) placed at the median palate. FE models with variable suture maturity and screw-suture distances were used to examine the relationship with screw stability. Four groups were classified by extent of maturation of the midpalatal suture (0%, 60%, 75%, and 100%). The placement position was set at the center of the suture (0.0 mm), or 0.5, 1.0, and 1.5 mm to the side of the suture, and von Mises stress values in bone and screw displacement were compared among models. The stress value for the unsutured model, in which the screw was placed at the center of the suture, was greater than 30 MPa. Stress values for models in which screws were placed to the side (0.5-1.5 mm) were less than 28 MPa. Maximum screw displacement was greater in the 0.0-mm incomplete suture model than at other placement positions. Because bone conditions vary among patients, placement position and suture maturation should be examined on cone beam-computed tomography images, to ensure screw stability.

Effects of composition on the hardness of orthodontic adhesives.

Although there have been improvements in bracket systems precoated with adhesive, removal of adhesive remnants continues to be problematic. This study compared the hardness and maintainability of precoated adhesive with other commercial adhesives. Knoop hardness values were measured after light- or chemical-induced initial curing, immersion in distilled water at 37°C for 24 h and 1,000 and 10,000 thermal cycles after 24 h. Additionally, the forces required to move brackets by 0.5 mm were measured during bracket positioning, and brackets bonded to bovine enamel were examined by field-emission scanning electron microscopy. The Knoop hardness values of the precoated adhesives were lower than those of commercial resin composite adhesives, and hardness was dependent on the amount of filler in the resin matrix. The ability to maintain the device position may depend on the resin matrix composition. Precoated adhesives with less filler and more matrix material are light curable, and remnant resin may be easily removed.

Changes in surface properties of dental alloys with atmospheric plasma irradiation.

Chemical transitions after atmospheric pressure plasma irradiation were investigated by evaluating intermolecular attractions and atomic and molecular reactions. Gold, titanium and stainless-steel alloy samples were ground with #800 grit SiC waterproof paper and nitrogen gas atmospheric plasma irradiation was conducted. The surface free energies of the treated alloys were calculated and compared statistically. X-ray photoelectron spectroscopy analysis was performed.The surface free energies of all metal surfaces treated by plasma irradiation were 1.5-times higher than those of the untreated metals. The energy of the hydrogen bonding component increased, and all alloy surfaces were coated with metal oxide after only a short period of plasma irradiation. The surfaces oxidized by plasma exhibited a high active energy, mainly due to an increase in the hydrogen bonding component. Reactions with oxygen in the air were promoted on the clean surfaces with exposed reactive elements.

Effect of the vertical position of the canine on the frictional/orthodontic force ratio of Ni-Ti archwires during the levelling phase of orthodontic treatment.

This study investigated the effect of the vertical position of the canine on changes in the frictional/orthodontic (F/O) force ratio of nickel-titanium (Ni-Ti) archwires during the initial levelling phase of orthodontic treatment. Frictional and orthodontic forces were measured by using low-friction brackets and Ni-Ti archwires with three different cross-sectional sizes and force types. To simulate canine malocclusion (first premolar extraction case), the upper right canine was displaced gingivally by 1 to 3 mm and the inter-bracket distance between the upper right lateral incisor and second premolar was set at 15 mm or 20 mm. A three-point bending test was performed to measure the orthodontic force of each Ni-Ti archwire. Frictional forces were measured with a universal testing machine and dental arch models by pulling parallel to the end of the archwire at a crosshead speed of 0.5 mm/min. F/O force ratio was calculated and analysed statistically. At a displacement of 3 mm, few archwires had F/O force ratios of less than 1.0, at which orthodontic force overcame frictional force, thus ensuring extrusion of the canine. For effective tooth movement, orthodontists should use Ni-Ti archwires with an F/O force ratio of less than 1.0.

Easy Debonding of Ceramic Brackets Bonded with a Light-Cured Orthodontic Adhesive Containing Microcapsules with a CO2 Laser.

OBJECTIVE: An easy debonding method for ceramic brackets using a light-cured Bis-GMA resin containing heat-expandable microcapsules and CO2 laser was investigated. BACKGROUND: Ceramic brackets are used frequently in orthodontic treatment because of their desirable esthetic properties. However, the application of heavy force to ceramic brackets in debonding can fracture the tooth enamel and ceramic brackets, causing tooth pain. MATERIALS AND METHODS: In total, 60 freshly extracted bovine permanent mandibular incisors were divided randomly into 10 groups of 6 specimens each, corresponding to the number of variables tested. Ceramic brackets were bonded to bovine permanent mandibular incisors using an orthodontic bonding agent containing heat-expandable microcapsules at different levels (0-30 wt%) and resin composite paste, and cured by a curing device. The bond strengths were measured before and after CO2 laser irradiation, and the temperature increase in the pulp chamber in fresh human first premolars was also evaluated. RESULTS: With CO2 laser irradiation for 5 sec to the bracket, the bond strength in the 25% microcapsule group decreased significantly, to ∼0.17-fold, compared with that of the no-laser group (p < 0.05). The maximum temperature increase in the pulp chamber was 5.3°C with laser irradiation, which was less than the level that induces pulp damage. CONCLUSIONS: From these results, it seems likely that the combined use of a light-cured orthodontic bonding agent containing microcapsules and a CO2 laser is a simple debonding system for ceramic brackets, with less debonding time and enamel damage.

Three-dimensional evaluation of the location of the mandibular canal using cone-beam computed tomography for orthodontic anchorage devices.

This study investigated guidelines for placement of monocortical screws in the mandible, particularly the mandibular canal. In this study of 35 patients, we used cone-beam computed tomography to determine the distance from the alveolar crest to the superior border of the mandibular canal (DMC) and the shortest distance from the buccal and lingual cortex to the mandibular canal (attaining distance) in the areas between premolars (premolar area), between the second premolar and first molar (middle area), and between the first and second molars (molar area). The DMC values for these areas were 16.55, 18.94, and 16.58 mm, respectively, and were similar in adults and adolescents. When the attaining distance was 8 mm, the heights on the buccal and lingual sides of the areas were 9 and 16.6 mm, 13.7 and 14.7 mm, and 15.3 and 12 mm, respectively. Risk of proximity to the mandibular canal should be considered at above heights or greater when an orthodontic anchorage device (OAD) 8 mm in length is placed. Careful attention is needed for placements on lingual side in adolescents. By reducing the OAD length to 6 mm, placement safety increases in all areas except the premolar area, especially on the buccal side.

CO2 laser debonding of a ceramic bracket bonded with orthodontic adhesive containing thermal expansion microcapsules.

We have been studying an easy bracket debonding method using heating of an orthodontic adhesive containing thermal expansion microcapsules. However, heating with a high-temperature heater brings obvious risks of burns around the oral cavity. Thus, we examined safer and more effective bracket debonding methods. The purpose of this in vitro study was to examine the reduction in debonding strength and the time taken using a bracket bonded with an orthodontic adhesive containing thermal expansion microcapsules and a CO2 laser as the heating method while maintaining safety. Ceramic brackets were bonded to bovine permanent mandibular incisors using bonding materials containing various microcapsule contents (0, 30, and 40 wt%), and the bond strengths were measured after laser irradiation for 4, 5, and 6 s and compared with nonlaser-treated groups. Subsequently, the temperature in the pulp chamber during laser irradiation was measured. After laser irradiation for 5 or 6 s, the bond strengths of the adhesive containing 40 wt% microcapsules were significantly decreased to ∼0.40 - 0.48-fold (4.6-5.5 MPa) compared with the nonlaser groups. The mean temperature rise of the pulp chamber was 4.3 °C with laser irradiation for 6 s, which was less than that required to induce pulp damage. Based on these results, we conclude that the combined use of a CO2 laser and an orthodontic adhesive containing thermal expansion microcapsules can be effective and safe for debonding ceramic brackets with less enamel damage or tooth pain.

Effect of orthodontic adhesive thickness on force required by debonding pliers.

This in vitro study evaluated the relationship between removal force and the thickness of three orthodontic adhesives, namely, light- and chemical-cured resin cements and a resin-modified glass ionomer cement. The thickness of each adhesive was 50, 100, 150, or 200 µm, and all adhesives were bonded on bovine incisors. Removal force was measured before (TC-0) and after 1,000 thermal cycles (TC-1000), and values were compared. At TC-0, the removal strengths for adhesive thicknesses of 50 and 100 µm were significantly lower than those for thicknesses of 150 and 200 µm (P < 0.05). At TC-1000, removal strengths for adhesive thicknesses of 50 and 100 µm were also significantly lower than those for 150 and 200 µm. Superbond Orthomite specimens showed a significant difference in removal strength between TC-0 and TC-1000 (P < 0.05) at all thicknesses. There was no significant difference in the distribution of adhesive remnant index scores at any thickness. These findings indicate that decreasing the thickness of applied orthodontic adhesive reduces the removal strength required.

Relationship between friction force and orthodontic force at the leveling stage using a coated wire

The relationship between orthodontic force and friction produced from an archwire and brackets affects the sliding of the wire in the leveling stage. Objective: The purpose of this study was to evaluate the relationship between force and friction in a small esthetic nickel-titanium (Ni-Ti) wire. Material and Methods: Five esthetic wires (three coated and two plated) and two small, plain Ni-Ti wires (0.012 and 0.014 inches) were used. We performed a three-point bending test according to ISO 15841 and the drawing test with a dental arch model designed with upper linguoversion of the lateral incisor in the arch (displacements of 0.5, 1.0, 2.0 and 3.0 mm), and evaluated the relationship between them. Results: Unloading bending forces of all wires at displacements of less than 1.0 mm were larger than friction forces, but all friction forces at displacements exceeding 2.0 mm were larger than unloading bending forces. The arch likely expands when displacement from the proximal brackets exceeds 1.0 mm. The friction force of a martensite 0.014-inch Ni-Ti wire was significantly greater than those of the other esthetic and austenitic wires. Conclusions: A wire with the smallest possible friction force should be used in cases with more than 1.0 mm displacement. .

Influence of electrolytic treatment time on the corrosion resistance of Ni-Ti orthodontic wire.

The purpose of this study was to examine the use of electrolytic treatment, which can improve the corrosion resistance of Ni-Ti orthodontic wires, to minimize adverse effects. Electrolytic treatment of Ni-Ti wires was performed in a solution composed of glycerol and lactic acid for 5, 15, or 30 min. The anodic polarization test, three-point bending test, and X-ray photoelectron spectroscopic analysis of the wire surface were performed to explore an optimal treatment condition. Breakdown potentials of treated wires increased with increasing treatment time and higher corrosion resistance was obtained by performing the electrolytic treatment for more than 5 min. The relative concentration of nickel in the layer was decreased in inverse proportion to the treatment time. The results suggest that the commercial Ni-Ti wire with low corrosion resistance can be improved by the electrolytic treatment for more than 5 min.

Relationship between friction force and orthodontic force at the leveling stage using a coated wire.

UNLABELLED: The relationship between orthodontic force and friction produced from an archwire and brackets affects the sliding of the wire in the leveling stage. OBJECTIVE: The purpose of this study was to evaluate the relationship between force and friction in a small esthetic nickel-titanium (Ni-Ti) wire. MATERIAL AND METHODS: Five esthetic wires (three coated and two plated) and two small, plain Ni-Ti wires (0.012 and 0.014 inches) were used. We performed a three-point bending test according to ISO 15841 and the drawing test with a dental arch model designed with upper linguoversion of the lateral incisor in the arch (displacements of 0.5, 1.0, 2.0 and 3.0 mm), and evaluated the relationship between them. RESULTS: Unloading bending forces of all wires at displacements of less than 1.0 mm were larger than friction forces, but all friction forces at displacements exceeding 2.0 mm were larger than unloading bending forces. The arch likely expands when displacement from the proximal brackets exceeds 1.0 mm. The friction force of a martensite 0.014-inch Ni-Ti wire was significantly greater than those of the other esthetic and austenitic wires. CONCLUSIONS: A wire with the smallest possible friction force should be used in cases with more than 1.0 mm displacement.