An investigation of the corrosion behavior of zinc-coated stainless steel orthodontic wires: the effect of physical vapor deposition method.

BACKGROUND: Releasing of metal ions might implicate in allergic reaction as a negative subsequent of the corrosion of Stainless Steel (SS304) orthodontic wires. The aim of this study was to evaluate the corrosion resistance of zinc-coated (Zn-coated) SS orthodontic wires. METHODS: Zinc coating was applied on SS wires by PVD method. Electrochemical impedance spectroscopy (EIS), Potentiodynamic polarization tests and Tafel analysis methods were used to predict the corrosion behavior of Zn-coated and uncoated SS wires in both neutral and acidic environments. RESULTS: The values of Ecorr ,icorr and Rct ,which were the electrochemical corrosion characteristics, reported better corrosion behavior of Zn-coated SS wires against uncoated ones in both artificial saliva and fluoride-containing environments. Experimental results of the Tafel plot analyses were consistent with that of electrochemical impedance spectroscopy analyses for both biological solutions. CONCLUSION: Applying Zn coating on bare SS orthodontic wire by PVD method might increase the corrosion resistance of the underlying stainless-steel substrate.

Clinical effect of chlorhexidine and sodium fluoride on corrosion behavior and surface topography of nitinol orthodontic archwires.

BACKGROUND: Alterations in the mechanical properties of the materials utilized in orthodontic appliances could affect the working properties of the appliances, thereby affecting clinical progress and outcome. Numerous studies have confirmed the correlation between alloy corrosion and raised surface roughness, which has a direct impact on the working characteristics of orthodontic archwires. METHODS: Thirty nickel-titanium (NiTi) orthodontic archwires were utilized in this study. Patients were randomly selected and allocated into three groups according to the randomization plan; (The control group): subjects practiced regular oral hygiene; (The fluoride group): subjects used fluoride for intensive prophylaxis; (The chlorhexidine group): subjects used chlorhexidine. Representative samples were evaluated by SEM, and then SEM images with high resolution were examined using Image J software to determine the surface roughness and obtain the results for further statistical analysis. RESULTS: Our findings indicated a significant difference was found between the three groups regarding the anterior and posterior parts between the control and the two other groups and a non-significant difference between NaF and CHX groups. Overall, the p-value for group comparisons was 0.000 for both parts, indicating a highly significant difference especially between the control and NaF groups. CONCLUSION: Mouthwashes containing sodium fluoride demonstrated more significant surface alterations than the control and CHX groups and should be prescribed in accordance with orthodontic materials to reduce side effects.

Simple Method for Re-tightening IMF Wires without Breakage.

AIM: This clinical technique aims to retighten intermaxillary fixation (IMF) wires when loosened intra/postoperatively. BACKGROUND: Intermaxillary fixation is one of the most important steps to obtain stable and functional occlusion in maxillofacial trauma. However, IMF wires tend to loosen over time. This loosened wire is generally removed and a new wire is used for IMF. Removal and refixation is time-consuming for surgeon and unconformable for the patient. TECHNIQUE: We recommend a simple technique for re-tightening IMF wires without breakage, with the use of shepherd's crook explorer by making a small circular loop. CONCLUSION: This technique of re-tightening by looping further stretches and tightens the wire to regain stabilized occlusion with maximal intercuspation. CLINICAL SIGNIFICANCE: This technique eliminates the need for removal and refixation of IMF wires, thereby improving patient comfort, yet obtaining stable occlusion over a long period of time. How to cite this article: Madhu SK, Dominic S, Baptist J, et al. Simple Method for Re-tightening IMF Wires without Breakage. J Contemp Dent Pract 2024;25(3):289-291.

Heating of metallic orthodontic devices during anti-aging treatment with vacuum and electromagnetic fields: In vitro study.

BACKGROUND: The physical appearance of an individual plays a primary role as it influences the opinion of the viewer. For this reason, orthodontic therapy to improve perceived aesthetics is in high demand among patients. This factor, combined with the increase in the number of non-invasive facial aesthetic treatments, has led to the need to understand potential risk factors in the application of medical devices to the perioral skin in patients with fixed orthodontic appliances. The aim of this study was to evaluate in vitro heating of the orthodontic bracket following electromagnetic fields and negative pressure (V-EMF) used as an anti-aging treatment. METHODS: Two different types of titanium alloy wires, one made of "beta-Titanium" alloy and the other "Ni-Ti" (DW Lingual Systems GmbH-Bad Essen-Germany) were used. The orthodontic wires and brackets mounted on a resin mouth were covered with porcine muscle tissue, then subjected to anti-aging therapy with a Bi-one LifeTouchTherapy medical device (Expo Italia Srl-Florence-Italy) which generates a combination of vacuum and electromagnetic fields (V-EMF) already adopted for antiaging therapy. During administration of the therapy, the orthodontic brackets and porcine tissue were thermally monitored using a Wavetek Materman TMD90 thermal probe (Willtek Communications GmbH-Germany). In total 20 orthodontic mouths were used, 10 with Beta Titanium wires and 10 with Nickel Titanium wires. RESULTS: A temperature increase of about 1°C was recorded in each group. The outcome of the present research shows that the absolute temperatures measured on orthodontic appliances, which, despite having a slightly different curve, both show an increase in temperature of 1.1°C at the end of the session, thus falling well within the safety range of 2°C as specified by the standard CENELEC EN 45502-1. Therefore, V-EMF therapy can be considered safe for the entire dental system and for metal prostheses, which tend to heat up at most as much as biological tissue (+0.9°C/1.1°C vs. 1.1°C/1.1°C). CONCLUSION: In conclusion, anti-aging therapy with V-EMF causes a thermal increase on orthodontic brackets that is not harmful to pulp health.

Effectiveness of a low-intensity static magnetic field in accelerating upper canine retraction: a randomized controlled clinical trial.

INTRODUCTION: Neodymium-iron-boron magnets have been suggested as a contemporary method for accelerating the process of orthodontic tooth movement (OTM). A limited number of clinical trials evaluated their effectiveness in accelerating OTM which is desirable for both orthodontists and patients. The present study aimed to investigate the effectiveness of a low-intensity static magnetic field (SMF) in accelerating upper canine retraction movement. MATERIALS AND METHODS: Seventeen patients (mean age 20.76 ± 2.9 years) with their orthodontic treatment decision to extract the upper and lower first premolars due to bimaxillary protrusion malocclusion were included in this split-mouth study. Canine retraction was performed using Nickel-titanium (Ni-Ti) closed-coil springs (150 g of force on each side). The experimental side received SMF via an auxiliary wire that carried 4-neodymium iron-born magnets with an air gap of 2 mm between the magnets to produce a magnetic field density of 414 mT in the region corresponding to the lateral ligament of the upper canine. To determine the rate of upper canine retraction and upper molar drift, alginate impressions were taken once a month to create plaster casts, which were analyzed digitally via a three-dimensional method. RESULTS: The rate of upper canine retraction was significantly greater (P < 0.05) on the SMF side than that on the control side during the first and second months, with an overall duration (19.16%) that was greater than that on the control side. The peak acceleration occurred during the second month (38.09%). No significant differences in upper molar drift were detected between the experimental and control sides (P > 0.05). CONCLUSION: A low-intensity static magnetic field was effective at accelerating upper canine retraction. The difference between the two sides was statistically significant but may not be clinically significant. The SMF did not affect upper molar drift during the upper canine retraction phase. TRIAL REGISTRATION: The trial was retrospectively registered at the ISRCTN registry ( ISRCTN59092624 ) (31/05/2022).

Comparison of torque expression among passive self-ligating brackets with different slot depths: An in vitro study.

INTRODUCTION: The aim of this study was to assess the interaction between a 0.019×0.025-inch (″) stainless steel archwire and two types of passive self-ligating brackets with the same slot height (0.022″) and different slot depths (0.028″ and 0.026″, and to measure the archwire/slot play as well as to compare the torque expression with archwire torsions of 12°, 24°, and 36°. MATERIAL AND METHODS: An experimental device was developed along with a universal testing machine to measure torque expression in two types of brackets with 0.028″ and 0.026″ slot depths. Analysis of variance (ANOVA) and Tukey's test were performed to identify the differences between groups. RESULTS: The 0.026″ slot bracket presented greater archwire/slot play when compared to the 0.028″ bracket. Torque expression with torsions of 24° and 36° were significantly higher in the 0.028″ depth brackets when compared to the 0.026″ depth brackets. CONCLUSION: The 0.022″×0.026″ passive self-ligating brackets attached with a 0.019″×0.025″ stainless steel archwire provided no greater torque control when compared to 0.022″×0.028″ passive self-ligating brackets.

Biomechanical analysis of total arch maxillary distalization using infrazygomatic crest miniscrews: a finite element analysis study.

AIM: To evaluate the maxillary incisors and canine's immediate movement tendency using three different power arms (PA) height levels during total arch maxillary distalization supported on infrazygomatic crest (IZC) miniscrews according to finite element analysis (FEA). METHODS: Three finite element models of the maxilla were developed based on CBCT imaging of a teenage male patient presenting a Class II Division 1 malocclusion in the early permanent dentition. Maxillary complex, periodontium, orthodontic accessories, IZC miniscrews and an orthodontic wire were digitally created. The PAs were placed between canines and lateral incisors and projected at 4, 7, and 10 mm height distances. After that, distalization forces were simulated between PA and IZC miniscrews. RESULTS: The anterior teeth deformation produced in the FEA models was assessed according to a Von Mises equivalent. The stress was measured, revealing tendencies of initial maxillary teeth movement. No differences were found between the right and left sides. However, there was a significant difference among models in the under-stress areas, especially the apical and cervical root areas of the maxillary anterior teeth. More significant extrusion and lingual tipping of incisors were observed with the 4 mm power arm compared to the 7 mm and 10 mm ones. The 10 mm power arm did not show any tendency for extrusion of maxillary central incisors but a tendency for buccal tipping and intrusion of lateral incisors. CONCLUSION: The maxillary incisors and canines have different immediate movement tendencies according to the height of the anterior point of the en-masse distalization force application. Based on the PA height increase, a change from lingual to buccal tipping and less extrusion tendency was observed for the incisors, while the lingual tipping and extrusion trend for canines increased.

Correlating Frictional Forces Generated by Different Bracket Types during Sliding and Surface Topography Using Scanning Electron Microscopy and Optical Profilometer.

AIM: The study aims to correlate the frictional forces (FF) of four different types of commercially available ceramic brackets to their surface topography. MATERIALS AND METHODS: Two monocrystalline (MC) brackets (CLEAR™, Adanta, Germany; Inspire ICE™, Ormco, USA), one polycrystalline (PC) bracket (Symetri Clear™, Ormco, USA), one clear hybrid esthetic bracket (DISCREET™, Adanta, Germany), and a stainless-steel (SS) bracket (Victory™, 3M Unitek, USA) served as control. Both static friction (SF) and kinetic friction (KF) were recorded during sliding using an Instron universal machine in dry settings. The bracket slot surface topography was evaluated. A scanning electron microscope (SEM) and a profilometer machine were used for assessment before and after sliding. RESULTS: Frictional forces values during sliding were as follows in descending order; Inspire ICE™, CLEAR™, DISCREET™, Symetri Clear™, and, lastly, Victory™. Also, DISCREET™ scored the highest in surface roughness (Sa) values followed by Symetri Clear™. None of the correlations were statistically significant. CONCLUSION: Frictional forces produced during sliding were not always directly related to surface roughness. Monocrystalline ceramic brackets appeared to have the greatest FF and a low surface roughness. Furthermore, DISCREET™ scored a very low frictional value comparable to metal brackets yet showed the highest surface roughness. Metal brackets exhibited the greatest surface smoothness before sliding and the least SF. CLINICAL SIGNIFICANCE: Predicting the FFs produced during sliding mechanics would help the practitioner while choosing the bracket system to be used, and while planning the treatment mechanics, how much force to deliver, and how much tooth movement to expect. How to cite this article: AlBadr AH, Talic NF. Correlating Frictional Forces Generated by Different Bracket Types during Sliding and Surface Topography Using Scanning Electron Microscopy and Optical Profilometer. J Contemp Dent Pract 2024;25(1):41-51.

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.

A scanning electron microscopy investigation of the precision of three orthodontic bracket slot systems.

OBJECTIVE: One of the most imprortant factors in achieving ideal teeth positions is the precision of the slot dimensions of orthodontic brackets into the archwires are inserted.This study aimed to assess the accuracy of the dimensions of orthodontic bracket slots and molar buccal tube apertures and to compare them with the specifications provided by the manufacturers. METHOD: A total of sixty brackets and ten molar buccal tubes with varying slot heights were examined using a scanning electron microscope from the mesial side. The dimensions and morphology of these bracket slots and buccal tubes apertures were assessed using the AutoCAD Software. A one-sample t-test was conducted to compare the measurements with the values provided by the manufacturer. RESULTS: The findings of the present study indicated that the height of the measured bracket slots and buccal tube apertures dimensions were significantly larger than the actual dimensions and exhibiting divergent walls. On the other hand, the depth of the brackets slots showed significantly smaller values than the actual one. CONCLUSION: A need for careful consideration when selecting a commercially accessible brand for everyday use is essential as certain materials may not meet acceptable standards.

Non-compliance treatment in a young adult full-step class II division 2 malocclusion with preadjusted lingual appliance and upper first molars extractions.

This case report describes a complex full-step class II case in a young adult patient treated with lingual straight-wire appliance and upper first molar extraction. As the patient refused a surgical treatment, she was offered the best possible camouflage with the double aim of obtaining an ideal occlusal relationship and maintaining the profile; appropriate biomechanical strategies, including extraction choice and anchorage control during space closure, were needed to achieve the planned results. This case report demonstrates the possibility of successfully resolving severe sagittal discrepancies in an adult patient without surgical treatment by means of a completely invisible non-compliance technique, with the extraction of the most compromised teeth. This report also underlines the need for careful planning during both diagnostic and treatment phases, in order to obtain the best results.

Corrosion-induced changes in surface properties and roughness of orthodontic wires.

INTRODUCTION: This study aimed to investigate the surface free energy and surface roughness (SR) of metallic alloys under the influence of acid solutions. METHODS: The experiment involved the use of 270 rectangular wire samples measuring 0.019 × 0.025-in. These samples were sourced from 3 different commercial brands: Dentsply GAC, American Orthodontics, and Orthoclassic. This in vitro study categorized the samples into 3 groups based on the solutions employed: deionized water, citric acid, and phosphoric acid. Each group consisted of 90 samples, with 30 samples representing each type of alloy-stainless steel, nickel-titanium, and titanium molybdenum alloy (TMA). The wire segments were immersed in their respective solutions for 72 hours at a controlled temperature of 37°C, with continuous orbital agitation at 130 rpm. After the immersion period, the study analyzed both surface free energy and SR. The mean values obtained were subjected to an analysis of variance at a significance level of 5%. RESULTS: All alloys displayed hydrophobic behavior, as indicated by interaction free energy values <0. In acidic environments (phosphoric acid and citric acid), significant differences were observed among different brands and alloys, affecting surface energy and interaction free energy. Variations in SR among metallic alloys included steel with the lowest SR variations, followed by nickel-titanium and TMA. Notably, the TMA alloy stood out with significantly higher surface energy compared with that of the other alloys (P <0.001). CONCLUSIONS: In this study, all examined alloys demonstrated a hydrophobic nature, suggesting a limited attraction to water. Notably, TMA exhibited the least hydrophobic behavior among the alloys studied. However, when exposed to citric acid, TMA displayed the most substantial alterations in its surface properties. These results underscored the significance of accounting for the distinctive properties of each alloy and their responses to diverse challenges, such as exposure to acidic solutions, during the selection of orthodontic wires for orthodontics treatment.

Evaluation of effects of brackets and orthodontic wires on intraoral scans: A prospective in-vivo study.

OBJECTIVE: To evaluate any distortion produced by multibracket fixed orthodontic appliances on digital models obtained from intraoral scans (IOS), considering the presence of both brackets only and brackets/archwire combination. SETTING/SAMPLE: The IOS data of the arches of 20 patients (12 females and 8 males; mean age = 15.55 ± 2.84 years) were acquired using the CS3600 intraoral scanner (Carestream Dental, Atlanta, USA), without any appliances (model A), with vestibular brackets alone (model B) and then with brackets and orthodontic archwire fitted (model C). MATERIALS AND METHODS: Data were acquired between the months of January and October 2021 at the moment of indirect bonding phase. On each model, five intra-arch linear measurements were obtained (inter-canine, inter-premolar 1 and 2, inter-molar and arch depth), and after digital matching between model A and B (match 1) and A and C (match 2), the linear discrepancies were evaluated at 20 points (10 occlusal and 10 gingivolingual) previous identified on the reference model A. All measurements were performed using Geomagic Control X software (3D Systems, Morrisville, USA), and any dimensional variations and distortions were evaluated by the linear regression analysis and two-sample t-test (P ≤ .05). RESULTS: The results show an almost perfect correlation between both models B and C and the reference model A, both as regards the intra-arch linear measurements and the linear discrepancies found at the 20 identified points. CONCLUSIONS: Multibracket fixed orthodontic appliances do not produce any relevant distortions in digital models obtained via intraoral scanning. Therefore, the removal of archwire is not mandatory before IOS.

Fabrication of a novel aesthetic orthodontic bracket and evaluation of friction properties between PEEK and stainless steel wires.

BACKGROUND: Polyetheretherketone (PEEK) is a polyaromatic semi-crystalline thermoplastic polymer with mechanical and lubrication properties favorable for biomedical applications. Despite of its aesthetic appearance, ceramic brackets are unsatisfactory in brittleness and thickness, while PEEK is a potential material for aesthetic orthodontic brackets. OBJECTIVE: To fabricate a novel aesthetic orthodontic bracket and evaluate friction properties of PEEK and stainless steel wires. METHODS: All polyether ether ketone (PEEK) and ceramic samples disks were made into disks (diameter, 5 mm; thickness, 2 mm). The tested surfaces of PEEK were ground with #600, #800 and #1200 SiC papers, followed by polishing with Sof-Lex kit (3M ESPE, USA). The surface roughness was tested using a laser profilometer device (VK-X200, Keyence, Japan). The COFs of the specimens and stainless steel (SS) archwires were tested using a Universal Micro-Tribotester (UMT-3, Bruker, USA). The wear scratches on the materials' surfaces were examined by using a scanning electron microscope (SEM) (Hitachi SU8010). The elastic modulus and hardness of samples were examined with a nano-indenter (XP, Keysight Technologies, USA). RESULTS: The mean surface roughness of PEEK and Ceramic are 0.320 ± 0.028 µm and 0.343 ± 0.044 µm, respectively. PEEK has a lower Friction coefficient than Ceramic and the difference between the two groups was statistically significant (P< 0.05). The abrasive wear of Ceramic was the main wear style and was characterized by the observation of chipping fractures, while PEEK surface looked smooth without obvious scale-like desquamations and granular debris, indicating adhesive wear. CONCLUSION: Within the limitations of the present study, PEEK shows lower coefficient of friction than ceramic. PEEK has excellent properties such as low friction coefficient, smooth surface and good mechanical properties, and thus meets the requirements for orthodontic brackets. It is considered as a potential bracket material with both low friction and aesthetic performance.

A review and evaluation of orthodontic brackets, molar bands and orthodontic auxiliaries during orthognathic surgery: A prospective cohort study.

OBJECTIVE: The primary aim of this study was to provide a review of the types and frequency of orthodontic brackets, molar bands and orthodontic auxiliaries used for patients undergoing orthognathic surgery. The secondary aim was to evaluate the risk of failure of these items during orthognathic surgery. METHODS: From three Dutch hospitals, 124 adult patients were included in this prospective cohort study. Five independent researchers collected the data during surgery using a specifically created data extraction form. The type of surgery, surgeon, orthodontist and type of orthodontic bracket, molar band or auxiliary were noted for each tooth. To evaluate their failure risk, the following variables were noted: failure and site; and type and cause of failure. RESULTS: Stainless-steel brackets were the most frequently (75.8%) used bracket type seen in patients undergoing orthognathic surgery. Ceramic brackets were seen in 24.2% of the cases and were only applied in the anterior region. Molar bands were present in 58.9% of the patients and mostly with bands on the first molars in combination with bonded tubes on the second molars. In 32.2% of all cases, one or more failures were noted. One-third of all failures were described as detachment of the molar tube on the most posterior molar. Kobayashi ligatures and powerpins showed the highest risk of failure (odds ratio [OR] 3.70, 95% confidence interval [CI] = 1.91-7.15). No significant difference in failure rate was found between stainless-steel brackets, molar bands (OR 0.34, 95% CI = 0.08-1.43) and ceramic brackets (OR 0.44, 95% CI = 0.14-1.45). CONCLUSION: Stainless-steel brackets, ceramic brackets, molar bands and surgical hooks are suitable for orthognathic cases. Kobayashi ligatures and powerpins had a significantly higher risk of failure so are not recommended for temporary intraoperative maxillomandibular fixation (TIO-MMF).

Effect of power arm length combined with additional anterior torque on the axial orientation of the maxillary incisors during en-masse retraction: A finite element analysis.

INTRODUCTION: This study aimed to clarify the effect of power arm length combined with additional torque incorporated into the archwire on the controlled movement of the anterior teeth using the finite element method. METHODS: An adult patient requiring medium anchorage after extraction of the maxillary first premolars was selected for this study. The power arms were placed between the lateral incisor and the canine at 3 levels: 3 mm, 6 mm, and 9 mm. A 150 g of retraction force was applied from each height of the anterior hook to the first molar tube, with 0°, 5°, and 10° of applied lingual root torque on the incisors. RESULTS: A 3-mm hook with 10° of applied torque, a 6-mm hook with 5° of applied torque, or a 9-mm hook with no extra torque constituted the best combinations targeted at controlling the inclination of incisors during retraction. Extrusion and distal tipping of the canine were observed. Moreover, mesial tipping and mesiopalatal rotation of the molar were unavoidable. Finally, intercanine and intermolar widths were decreased. CONCLUSIONS: Adding extra torque on the incisors or using high torque brackets is recommended for patients with maxillary first premolar extraction.

Orthodontic force/torque modeling and experiment of Kitchon root-controlled auxiliary archwire.

The incidence of oral malocclusion is increasing and is seriously damaging the oral health of human beings. The Kitchon root-controlled auxiliary archwire is an individualized orthodontic arch. It is used clinically for the treatment of tooth-lingual tilt/root-lip tilt phenomenon of the central incisors. However, the bending parameters of the Kitchon root-controlled auxiliary archwire used in different patients are based on the clinical experience of the dentists. Therefore, this orthodontic treatment has a high risk and unpredictability. In this paper, the loading performance and orthodontic process of Kitchon root-controlled auxiliary archwire are analyzed. And the prediction model of support resistance and correction torque are established. The bending parameters of the Kitchon root-controlled auxiliary archwire, as well as the effect of the bending parameters on the support resistance and the correction torque, are all quantified. And the prediction models for the support resistance and the correction torque are calculated separately. The correlation coefficients of calculated data and experimental data are ξT1 > .97 and ξA1 > .96, respectively; the correlation coefficients of simulated data and experimental data are ξT2 > .96 and ξA2 > .96, respectively. The accuracy and reliability of the established prediction models are verified. It provides an effective theoretical guide for dentists to safely and efficiently perform root-controlled rotation orthodontic treatment on patients' central incisors.