Cephalometric and digital model analysis of dentoskeletal effects of infrazygomatic miniscrew vs. Essix- anchored Carriere Motion appliance for distalization of maxillary buccal segment: a randomized clinical trial.

TRIAL DESIGN: Parallel. OBJECTIVE: To compare skeletally anchored Carriere Motion appliance (CMA) for distalization of the maxillary buccal segment vs. Essix anchored CMA. METHODS: Thirty-two class II malocclusion patients were randomly allocated into two equal groups. One group was treated with infrazygomatic (IZC) miniscrew- anchored CMA (IZCG) and the other group treated with Essix retainer- anchored CMA (EXG). Two lateral cephalograms and two digital models for upper and lower arches were taken for each patient: immediately before intervention and after distalization had been completed. RESULTS: Distalization period was not significantly different between the two groups. In contrast to EXG, IZCG showed insignificant difference in ANB, lower incisor proclination, and mesial movement of the lower first molar. There was significant rotation with distal movement of maxillary canine and first molar in both groups. CONCLUSION: IZC anchored CMA could eliminate the side effects of class II elastics regarding lower incisor proclination, mesial movement lower molars with a more significant amount of distalization of the maxillary buccal segment but with significant molar rotation. TRIAL REGISTRATION: The ClinicalTrials.gov Protocol Registration and Results System (PRS) has this RCT registered as (NCT05499221) on 12/08/2022.

Static friction, surface roughness, and antibacterial activity of orthodontic brackets coated with silver and silver chitosan nanoparticles.

BACKGROUND: To determine the effect of silver and silver chitosan nanocoatings on monocrystalline ceramic, polycrystalline ceramic, and metallic brackets regarding friction, roughness, and antibacterial effect against Streptococcus mutans. METHODS: A total of 99 upper right premolar brackets with a 0.022 × 0.025 -inch slot were divided into three groups, each 33 according to coating material; the non-coated group, silver nanoparticles (AgNPs), and silver chitosan nanoparticles (Ag-CsNPs) groups. Each group was equally subdivided into the following three subgroups regarding bracket materials: monocrystalline ceramic, polycrystalline ceramic, and metallic brackets. A universal testing machine determined static friction on a custom-made acrylic jig. Then a profilometer machine was used to collect roughness data, and finally, the anti-cariogenic effect was measured with the disc diffusion technique's "minimum zone of inhibition" against Streptococcus mutans. Two-way ANOVA was used to compare data between groups and subgroups, followed by the Bonferroni test for multiple pair-wise comparisons. RESULTS: The nanocoating effect on ceramic brackets' static friction was non-significant. The AgNPs and Ag-CsNPs coated metallic group revealed a significant increase in static friction-a significant effect of the nanocoating in the surface roughness of monocrystalline and polycrystalline ceramic brackets. A significant favorable effect of AgNPs and Ag-CsNPs against Streptococcus mutans was observed. CONCLUSIONS: AgNPs and Ag-CsNPs coats are unsuitable for decreasing friction in metallic brackets or improving roughness in polycrystalline ceramic brackets. Nano coating can improve roughness in monocrystalline ceramic brackets. Coating brackets with AgNPs and Ag-CsNPs has a tremendous antibacterial effect on Streptococcus mutans, a substantial factor in the incidence of dental caries.

Effect of self-assembling peptide and other remineralizing agents on preventing initial enamel lesions around orthodontic brackets: An in vitro comparative study.

OBJECTIVE: To investigate and compare the effect of self-assembling peptide SAP (P11-4), casein phosphopeptide-amorphous calcium phosphate fluoride paste (CPP-ACPF), and fluoride varnish (FV) on preventing enamel demineralization around orthodontic brackets. MATERIAL AND METHODS: Orthodontic brackets were bonded to the buccal surfaces of 80 freshly extracted human maxillary premolars. Teeth were randomly assigned to four groups (n=20) according to the remineralizing agent used as follows: SAP (P11-4) group (Curodont™ Protect/Credentis), CPP-ACPF group (MI Paste Plus®/Recaldent™), fluoride varnish group (Profluoride varnish®/VOCO), and control group. All products were applied according to the manufacturer's instructions. Specimens were cycled in daily refreshed demineralizing and remineralizing solutions for 8h and 16h, respectively, for 28 days. The calcium/phosphorus ratio (Ca/P) and surface microhardness (SMH) were evaluated at baseline and at two and four weeks. Two-way ANOVA (analysis of variance), one-way ANOVA and repeated measures ANOVA were used for statistical analysis. RESULTS: Two-way ANOVA demonstrated significant differences between remineralizing agents and time points. After 4 weeks, the SAP (P11-4) group had had significantly higher Ca/P ratio and SMH (1.68±0.11 and 346.47±55.38) compared to other groups, followed by CPP-ACPF (1.52±0.19 and 283.53±64.75), FV (1.37±0.14 and 262.80±82.98), and the control group (1.31±0.10 and 213.00±41.95). Significantly higher Ca/P ratio and SMH were observed at 2 weeks in the control group (1.44±0.10 and 269.63±57.37) and FV group (1.52±0.09 and 321.17±55.24) compared to 4 weeks. No significant differences were found regarding Ca/P ratio and SMH at 2 weeks in the CPP-ACPF (1.55±0.15 and 295.14±53.88) and SAP P11-4 groups (1.64±0.10 and 320.18±58.04) compared to 4 weeks. CONCLUSION: SAP (P11-4) had the greatest remineralizing efficacy compared to FV and CPP-ACPF. Moreover, extended period of time improved the preventive efficacy of SAP (P11-4) compared to the other regimens.

A 3-dimensional finite element analysis to evaluate the impact of force direction, insertion angle, and cortical bone thickness on mini-screw and its surrounding bone.

Background. The present study aimed to assess the stress and strain distribution on mini-screws and the surrounding bone in cases of different cortical bone thicknesses (CBTs), mini-screw insertion angles, and force directions using finite element analysis (FEA). Methods. Inventor professional version 8 software was used to construct 24 three-dimensional assemblies of mini-screws inserted with different insertion angles (30º, 60º, and 90º) in alveolar bone blocks with different CBTs (0.5, 1, 1.5, and 2 mm). The models simulated mini-screws inserted in bones with different CBTs and different insertion angles. A 2-N load was applied in two directions to mini-screw heads. The resultant stresses of the applied load were collected from the output of the ANSYS program. Results. The results indicated that force direction affected bone strains as the horizontal force generated more strains on cortical bone than the oblique one. Force applied to 60º inserted mini-screws generated much more strains on cortical bone than 90º and 30º inserted mini-screws. In a 60º inserted mini-screw, the horizontal force generated about 45% more strains on cortical bone than the oblique one. The exerted microstrain on bone decreased as CBT increased. Conclusion. It can be concluded that inserting mini-screws at 60º to the bone surface should be avoided as it generates much more strains on cortical bone than 90º and 30º, especially when a force parallel to the bone surface is applied.

Evaluation of zinc-oxide nanocoating on the characteristics and antibacterial behavior of nickel-titanium alloy.

OBJECTIVE: To investigate the effect of ZnO nanocoating on mechanical properties of NiTi orthodontic wires and antibacterial activity. METHODS: 0.016 x 0.022-in NiTi orthodontic wires were coated with ZnO nanoparticles using an electrochemical deposition method with three electrodes system in 0.1M Zn(NO3)2. Mechanical properties and frictional resistance of the coated wires were investigated using an universal testing machine. Antibacterial effect of ZnO coating was also investigated. RESULTS: A stable adhered ZnO nanocoating on NiTi wires was obtained. The coated wires have a significant antibacterial activity against S. aureus, S. pyogens and E. coli, and a reduction of frictional forces by 34%. CONCLUSION: ZnO nanocoating may improve the antibacterial effects of NiTi wires and reduce the frictional resistance. Coating may be implanted in orthodontic practice for faster and safer treatment.

Evaluation of zinc-oxide nanocoating on the characteristics and antibacterial behavior of nickel-titanium alloy

ABSTRACT Objective: To investigate the effect of ZnO nanocoating on mechanical properties of NiTi orthodontic wires and antibacterial activity. Methods: 0.016 x 0.022-in NiTi orthodontic wires were coated with ZnO nanoparticles using an electrochemical deposition method with three electrodes system in 0.1M Zn(NO3)2. Mechanical properties and frictional resistance of the coated wires were investigated using an universal testing machine. Antibacterial effect of ZnO coating was also investigated. Results: A stable adhered ZnO nanocoating on NiTi wires was obtained. The coated wires have a significant antibacterial activity against S. aureus, S. pyogens and E. coli, and a reduction of frictional forces by 34%. Conclusion: ZnO nanocoating may improve the antibacterial effects of NiTi wires and reduce the frictional resistance. Coating may be implanted in orthodontic practice for faster and safer treatment.

RESUMO Objetivos: Avaliar o efeito do nanorrevestimento de óxido de zinco (ZnO) sobre as propriedades mecânicas e propriedades antibacterianas de fios ortodônticos de NiTi. Métodos: Fios 0,016" x 0,022" de NiTi foram revestidos com nanopartículas de ZnO por meio de um método de deposição eletroquímica com um sistema de três eletrodos a 0,1M Zn(NO3)2. Uma máquina universal de testes foi utilizada para avaliar as propriedades mecânicas e a resistência friccional dos fios revestidos. Além disso, também foram analisadas as propriedades antibacterianas do revestimento de ZnO. Resultados: Obteve-se uma aderência estável das nanopartículas de ZnO sobre os fios NiTi. Os fios revestidos apresentaram atividade antibacteriana significativa contra S. aureus, S. pyogens e E. coli, e apresentaram uma redução de 34% na força de atrito. Conclusão: O revestimento com nanopartículas de óxido de zinco pode melhorar as propriedades antibacterianas e reduzir a resistência friccional dos fios de NiTi. Assim, o revestimento dos fios pode ser utilizado na Ortodontia visando tratamentos mais rápidos e seguros.

Enamel around orthodontic brackets coated with flash-free and conventional adhesives.

OBJECTIVE: To evaluate enamel roughness and color after debonding flash-free adhesive precoated brackets and brackets coated with conventional orthodontic adhesives using nonbonded enamel as control. MATERIALS AND METHODS: A total of 80 extracted human premolars were divided into the following four groups: group I: APCTM Flash-Free adhesive precoated brackets; group II: APCTM PLUS adhesive precoated brackets; group III: noncoated brackets, which were coated manually at the time of bonding (all three brackets were ClarityTM Advanced ceramic brackets [3M Unitek, Monrovia, CA, USA]); group IV: nonbonded enamel (control). Bonded premolars were subjected to demineralization, and then brackets were debonded. Each group was then divided into two subgroups to assess enamel around the debonded brackets, and also enamel in the control group, using an atomic force microscope and spectrophotometer. In addition, 12 samples were used to assess the bracket/adhesive/enamel junction with a scanning electron microscope. RESULTS: Mean values of root mean square roughness (Rq) and maximum profile valley depth (Rv) for APCTM Flash-Free, APCTM PLUS, and ClarityTM Advanced groups were 140 nm and 482 nm, 210 nm and 727 nm, and 447 nm and 1243 nm, respectively. All three groups showed higher roughness and depth values than the control enamel. Spectrophotometer results yielded ∆E* of 3.7 ± 0.6, 5.1 ± 0.4, and 7.1 ± 0.6 for APC™ Flash-Free, APC™ PLUS, and ClarityTM Advanced groups respectively. Color coordinates showed progressively higher L* and b* values and progressively lower a* values from group I to group III. CONCLUSIONS: Under the same demineralization conditions, enamel around debonded APC™ Flash-Free adhesive precoated brackets showed less roughness and color changes compared to the other two groups.

Colour change of ceramic brackets with the use of coloured beverages in adolescent patients: A randomized clinical trial.

OBJECTIVE: To clinically evaluate colour change of ceramic orthodontic brackets with the use of coloured beverages as ceramic brackets' resistance to discoloration has become a major concern. MATERIAL AND METHODS: A prospective two parallel groups-split mouth randomized trial with a 1:1 allocation ratio. Two equal groups including 40 adolescent patients from the orthodontic department (Faculty of Dentistry, Mansoura University, Egypt), scheduled for maxillary premolar extractions were bonded with 2 types of mono-crystalline ceramic brackets: Type 1 (Inspire ICETM) and Type 2 (Radiance PlusTM). Participants in each group were asked to rinse with either black tea or Cola. After extraction, the colour of the 80 debonded brackets was compared to that of 20 control brackets from each type by spectrophotometer according to the international standard CIELAB colour space (CIE L*a*b*). The latter consists of three coordinates: L* (lightness value), a* and b* (the colour channels). The total colour difference ΔE* is the distance between two colours in this three-dimensional colour space. The colour change was also assessed by digital image analysis according to the RGB model. RESULTS: Type 1 brackets showed mean ΔE* values of 2.24±0.25 in black tea and 1.76±0.1 in Cola groups (P<0.001), while Type 2 brackets showed means of 1.99±0.15 in black tea and 1.56±0.1 in Cola groups (P<0.001). The mean RGB values were 174.3±12.02 in black tea and 185.6±6.9 in the Cola groups of type 1 brackets (P<0.001), while were 166.5±17.8 in black tea and 190.8±8.9 in Cola groups of type 2 brackets (P<0.001). CONCLUSION: Black tea showed more significant effect than Cola on the two bracket types. Bracket type affected the colour change in each beverage group.

In vitro testing of shear bond strength of orthodontic brackets bonded to different novel CAD/CAM ceramics.

Background. The present study aimed to evaluate the bond strength of metal bracket (MB) and ceramic bracket (CB) bonded to different CAD/CAM ceramic substrates etched with hydrofluoric acid (HFA) vs. phosphoric acid (PA). Methods. A total of 120 CAD/CAM ceramic blocks in 12 groups were fabricated from three different CAD/CAM ceramic materials: VITABLOCS Mark II, VITAENAMIC, and IPS e.max CAD. Each ceramic material group was divided into two etching groups: one treated with 9.5% HFA and the other treated with 37%. Sixty metal and CBs of the upper right central incisor were bonded to the HFA-treated blocks. Another 60 metal and CBs were bonded to the PA treated blocks. All the bonded specimens were thermocycled before shear bond strength (SBS) testing. Then the bond failure mode was recorded Results. There were no significant differences in SBS values between the three CAD/CAM ceramic materials. The HFA-treated specimens exhibited significantly higher SBS values than the PA-treated specimens. Also, the SBS values of CBs were significantly higher than the metal brackets (MBs). The adhesive remnant index (ARI) score was 4 for most of the groups, indicating that almost no adhesive remained on the porcelain surface. Conclusion. The CAD/CAM ceramic type did not influence SBS; however, HFA exhibited significantly higher SBS compared to PA.

Characteristics of adhesive bonding with enamel deproteinization.

OBJECTIVE: To evaluate the effect of using sodium hypochlorite (NaOCl) on the bond characteristics of orthodontic metal brackets bonded to enamel surface using three adhesive systems. METHODS: One hundred twenty premolars were selected and randomly divided into two equal groups of 60 teeth/ each (Groups I and II). The teeth of Group I were left untreated while those of Group II were exposed to 5.25% NaOCl for 1 minute. The teeth in either group were randomly subdivided into three equal subgroups of 20 teeth/ each (A, B and C), according to the type of adhesive system used to bond the brackets. In Subgroup A, phosphoric acid + Transbond XT primer and adhesive were used. In subgroup B, Transbond Plus self-etching primer (SEP) + Transbond XT adhesive were utilized. In subgroup C, phosphoric acid + SmartBond LC adhesive were used. The shear bond strength (SBS) and the degree of adhesive penetration to enamel surface were assessed. Data analyses were performed using ANOVA, post-hoc (LSD), t and chi-square test. RESULTS: Transbond XT had significantly higher SBS than SmartBond LC (p< 0.05). Phosphoric acid provided significantly higher SBS and degree of adhesive penetration than SEP (p< 0.05). NaOCl significantly increased SBS and degree of adhesive penetration in Subgroups B and C (p< 0.05). CONCLUSION: Adhesion quality of Transbond XT adhesive is better than SmartBond LC. Phosphoric acid is more effective than SEP. NaOCl enhances the bond characteristics.

Characteristics of adhesive bonding with enamel deproteinization

ABSTRACT Objective: To evaluate the effect of using sodium hypochlorite (NaOCl) on the bond characteristics of orthodontic metal brackets bonded to enamel surface using three adhesive systems. Methods: One hundred twenty premolars were selected and randomly divided into two equal groups of 60 teeth/ each (Groups I and II). The teeth of Group I were left untreated while those of Group II were exposed to 5.25% NaOCl for 1 minute. The teeth in either group were randomly subdivided into three equal subgroups of 20 teeth/ each (A, B and C), according to the type of adhesive system used to bond the brackets. In Subgroup A, phosphoric acid + Transbond XT primer and adhesive were used. In subgroup B, Transbond Plus self-etching primer (SEP) + Transbond XT adhesive were utilized. In subgroup C, phosphoric acid + SmartBond LC adhesive were used. The shear bond strength (SBS) and the degree of adhesive penetration to enamel surface were assessed. Data analyses were performed using ANOVA, post-hoc (LSD), t and chi-square test. Results: Transbond XT had significantly higher SBS than SmartBond LC (p< 0.05). Phosphoric acid provided significantly higher SBS and degree of adhesive penetration than SEP (p< 0.05). NaOCl significantly increased SBS and degree of adhesive penetration in Subgroups B and C (p< 0.05). Conclusion: Adhesion quality of Transbond XT adhesive is better than SmartBond LC. Phosphoric acid is more effective than SEP. NaOCl enhances the bond characteristics.

RESUMO Objetivo: avaliar os efeitos do uso de hipoclorito de sódio (NaOCl) sobre as características de colagem de braquetes ortodônticos metálicos na superfície do esmalte, utilizando três sistemas adesivos. Métodos: cento e vinte pré-molares foram selecionados e divididos aleatoriamente em dois grupos iguais, cada um com 60 dentes (Grupos I e II). Os dentes do Grupo I não foram tratados, enquanto os do Grupo II foram expostos ao NaOCl a 5,25% por 1 minuto. Os dentes de ambos os grupos foram subdivididos, aleatoriamente, em três subgrupos iguais, cada um com 20 dentes (A, B e C), de acordo com o tipo de sistema adesivo utilizado para colar os braquetes. No Subgrupo A, foi utilizada a combinação ácido fosfórico + Transbond XT (primer e adesivo). No Subgrupo B, foi utilizada a combinação Transbond Plus autocondicionante (SEP) + Transbond XT (adesivo). No Subgrupo C, foi utilizada a combinação ácido fosfórico + SmartBond LC (adesivo). Foram avaliados a resistência ao cisalhamento e o grau de penetração do adesivo na superfície do esmalte. A análise dos dados foi realizada utilizando-se os testes ANOVA, post-hoc (LSD), t e qui-quadrado. Resultados: o Transbond XT teve uma força de adesão significativamente maior do que o SmartBond LC (p< 0,05). O ácido fosfórico propiciou força de adesão e grau de penetração do adesivo significativamente maiores do que o SEP (p< 0,05). O NaOCl aumentou significativamente a força de adesão e o grau de penetração do adesivo nos Subgrupos B e C (p< 0,05). Conclusão: a qualidade da adesão do adesivo Transbond XT é melhor que a do SmartBond LC. O ácido fosfórico é mais eficiente do que o SEP. O NaOCl melhora as características da colagem.