Measurement and comparison of bracket transfer accuracy of five indirect bonding techniques.

OBJECTIVE: To measure and compare bracket transfer accuracy of five indirect bonding (IDB) techniques. MATERIALS AND METHODS: Five IDB techniques were studied: double polyvinyl siloxane (double-PVS), double vacuum-form (double-VF), polyvinyl siloxane vacuum-form (PVS-VF), polyvinyl siloxane putty (PVS-putty), and single vacuum-form (single-VF). Brackets were bonded on 25 identical stone working models. IDB trays were fabricated over working models (n  =  5 per technique) to transfer brackets to another 25 identical stone patient models. The mesiodistal (M-D), occlusogingival (O-G), and faciolingual (F-L) positions of each bracket were measured on the working and patient models using digital photography (M-D, O-G) and calipers (F-L). Paired t-tests were used to compare bracket positions between working and patient models, and analysis of variance was used to compare bracket transfer accuracy among the five techniques. RESULTS: Between the working and patient models, double-VF had the most teeth with significant differences (n  =  6) and PVS-VF the fewest (n  =  1; P < .05). With one exception, all significant differences were ≤0.26 mm and most (65%) were ≤0.13 mm. When the techniques were compared, bracket transfer accuracy was similar for double-PVS, PVS-putty, and PVS-VF, whereas double-VF and single-VF showed significantly less accuracy in the O-G direction. CONCLUSIONS: Although overall differences in bracket position were relatively small, silicone-based trays had consistently high accuracy in transferring brackets, whereas methods that exclusively used vacuum-formed trays were less consistent.

Minimally invasive resin infiltration of arrested white-spot lesions: a randomized clinical trial.

BACKGROUND: The authors conducted a randomized, single-masked clinical trial involving patients who had completed orthodontic treatment to assess changes in the appearance of white-spot lesions (WSLs) that were treated with resin infiltration. METHODS: The authors divided affected teeth into control and treatment groups. In the treatment group, they restored teeth with WSLs by using resin infiltration. They evaluated changes in WSLs photographically by using a visual analog scale (VAS) (0 = no change, 100 = complete disappearance) and area measurements (in square millimeters). The authors analyzed the data by using two-way analysis of variance. RESULTS: The mean VAS ratings for treated teeth demonstrated marked improvement relative to that for control teeth immediately after treatment (67.7 versus 5.2, P < .001) and eight weeks later (65.9 versus 9.2, P < .001). The results for treated teeth showed a mean reduction in WSL area of 61.8 percent immediately after treatment and 60.9 percent eight weeks later, compared with a -3.3 percent change for control teeth immediately after treatment and a 1.0 percent reduction eight weeks later. CONCLUSIONS: Resin infiltration significantly improved the clinical appearance of WSLs, with stable results seen eight weeks after treatment. PRACTICAL IMPLICATIONS: Resin infiltration, a minimally invasive restorative treatment, was shown to be effective for WSLs that formed during orthodontic treatment.

A novel biomimetic orthodontic bonding agent helps prevent white spot lesions adjacent to brackets.

OBJECTIVE: To compare changes in enamel microhardness adjacent to orthodontic brackets after using bonding agents containing various compositions of bioactive glass compared to a traditional resin adhesive following a simulated caries challenge. MATERIALS AND METHODS: Extracted human third molars (n  =  10 per group) had orthodontic brackets bonded using one of four novel bioactive glass (BAG)-containing orthodontic bonding agents (BAG-Bonds) or commercially available Transbond-XT. The four new adhesives contained BAG in varying percentages incorporated into a traditional resin monomer mixture. Teeth were cycled through low-pH demineralizing and physiologic-pH remineralizing solutions once each day over 14 days. Microhardness was measured on longitudinal sections of the teeth 100, 200, and 300 µm from the bracket edge and beneath the brackets, at depths of 25 to 200 µm from the enamel surface. Normalized hardness values were compared using three-way analysis of variance. RESULTS: Significantly less reduction in enamel microhardness was found with the experimental adhesives at depths of 25 and 50 µm at all distances from the bracket edge. In all groups, there were no significant changes in enamel microhardness past 125-µm depth. Results varied with the different BAG-Bonds, with 81BAG-Bond showing the smallest decrease in enamel microhardness. CONCLUSIONS: The BAG-Bonds tested in this study showed a reduction in the amount of superficial enamel softening surrounding orthodontic brackets compared to a traditional bonding agent. The results indicate that clinically, BAG-Bonds may aid in maintaining enamel surface hardness, therefore helping prevent white spot lesions adjacent to orthodontic brackets.

Ion release from a novel orthodontic resin bonding agent for the reduction and/or prevention of white spot lesions. An in vitro study.

OBJECTIVE: To measure ion release from four sol-gel bioactive glass-containing orthodontic resin bonding agents (BAG-Bonds) following immersion into simulated body fluid (SBF) at pH values of 4 and 7. MATERIALS AND METHODS: Four BAG-Bonds, two containing fluoride, were developed. Prepared in our laboratory, the BAG-Bonds were composed of a mixture of resin monomers and bioactive glasses (BAGs). Workability of the final BAG-Bonds determined the amount of filler added to each, and this varied according to BAG composition. Commercially available Transbond-XT was used as the control. Three disks (10 mm × 2 mm) of each material were individually suspended in 3.5 mL of SBF at pH 4 and pH 7. SBF was analyzed to measure pH and ions released at 1 hour, 10 hours, and 100 hours. Calcium was measured by atomic absorption analysis, phosphate by ultraviolet visible spectrometry, and fluoride by an ion-specific electrode. The data were compared using a three-way analysis of variance, with P ≤ .05. RESULTS: Significant differences in calcium and phosphate ion release were found between the four BAG-Bonds and the control at multiple time points. Significant changes in pH were also found. There was no measureable release of fluoride from any of the materials. CONCLUSIONS: The BAG-Bonds showed the capacity for buffering acidic oral environments and significant release of calcium ions into their surrounding environment, and they hold the potential to be biomimetic bonding agents that may reduce white spot lesion formation.

Cell types and response properties of neurons in the ventral division of the medial geniculate body of the rabbit.

Although there is evidence for multiple classes of thalamic relay neurons in the auditory thalamus, correlative anatomical and physiological studies are lacking. We have used the juxtacellular labeling technique, in conjunction with Nissl, Golgi, and immunocytochemical methods, to study the morphology and response properties of cells in the ventral division of the medial geniculate body of the rabbit. Single units in the ventral division of the medial geniculate body (MGV) were characterized extracellularly with monaural and binaural tone and noise bursts (100- to 250-msec duration). Characterized units were filled with biocytin and visualized with an antibody enhanced diaminobenzidine reaction. A total of 31 neurons were physiologically characterized and labeled with the juxtacellular technique. Labeled neurons were fully reconstructed from serial sections by using a computer microscope system. Three subregions of the rabbit MGV were identified, each characterized by differences in Nissl architecture, calcium-binding protein expression, and by the dendritic orientation of tufted relay neurons. In general, the dendritic fields of relay neurons were closely aligned with the cellular laminae. Qualitative and quantitative analyses revealed two types of presumptive relay neurons within the MGV. Type I cells had thick dendrites with a greater total volume and morphologically diverse appendages compared with the Type II cells whose dendrites were thin with a moderate number of small spines. Both classes were acoustically responsive and exhibited a variety of response patterns, including onset, offset, and sustained responses. In terms of binaural characteristics, most (ca. 53%) labeled neurons were of the EE type, with the remaining cells classified as EO (27%) or EI (20%) response types. Two types of presumptive interneurons were also seen: bipolar neurons with large dendritic fields and a small neurogliaform variety. Cell types and dendritic orientation within the MGV are discussed in terms of the physiological organization of the rabbit auditory thalamus.