Effectiveness of photopolymerization in composite resins using a novel 445-nm diode laser in comparison to LED and halogen bulb technology.

Challenges especially in the minimal invasive restorative treatment of teeth require further developments of composite polymerization techniques. These include, among others, the securing of a complete polymerization with moderate thermal stress for the pulp. The aim of this study is to compare current light curing sources with a blue diode laser regarding curing depth and heat generation during the polymerization process. A diode laser (445 nm), a LED, and a halogen lamp were used for polymerizing composite resins. The curing depth was determined according to the norm ISO 4049. Laser output powers of 0.1, 0.5, 1, and 2 W were chosen. The laser beam diameter was adapted to the glass rod of the LED and the halogen lamp (8 mm). The irradiation time was fixed at 40 s. To ascertain ΔT values, the surface and ground area temperatures of the cavities were simultaneously determined during the curing via a thermography camera and a thermocouple. The curing depths for the LED (3.3 mm), halogen lamp (3.1 mm) and laser(0.5/1 W) (3/3.3 mm) showed no significant differences (p < 0.05). The values of ΔTsurface as well as ΔTground also showed no significant differences among LED, halogen lamp, and laser(1 W). The ΔTsurface values were 4.1LED, 4.3halogen lamp, and 4.5 °C for the laser while the ΔTground values were 2.7LED, 2.6halogen lamp, and 2.9 °C for the laser. The results indicate that the blue diode laser (445 nm) is a feasible alternative for photopolymerization of complex composite resin restorations in dentistry by the use of selected laser parameters.

The influence of enamel sandblasting on the shear bond strength and fractography of the bracket-adhesive-enamel complex tested in vitro by the DIN 13990:2017-04 standard.

OBJECTIVES: This study was conducted in order to investigate whether enamel sandblasting as an adjunct or substitute to the acid-etch technique has an effect on the shear bond strength (SBS) and fractography of the bracket-adhesive-enamel complex using the DIN 13990:2017-04 standard. MATERIALS AND METHODS: Upper central incisor brackets (discovery®, Dentaurum, Germany) were bonded using Transbond XT™ (3M Unitek, Germany) on bovine incisors prepared by four different methods (15 samples each): sandblasting with 27 µm Al2O3 at 1.2 bar (s), acid etching with 37.4% phosphoric acid (a), sandblasting with 27 µm Al2O3 at 1.2 bar followed by acid etching (s1a), and sandblasting with 50 µm Al2O3 at 5.7 bar followed by acid etching (s2a). The SBS and adhesive remnant index (ARI) were measured, followed by one-way analysis of variance and Fisher's exact tests at 5%. RESULTS: The SBS in groups s (5.6 ± 2.2 MPa), a (17.1 ± 4.3 MPa), s1a (18.3 ± 4.3 MPa), and s2a (18.5 ± 4.6 MPa) indicated that the s group was significantly inferior to all the other groups (p < 0.001). Likewise, the ARI analysis indicated a different performance of the s group (mostly ARI of 0) compared to the other groups (p < 0.001) and a tendency for different ARI between the a and s1a/s2a groups. CONCLUSIONS: In vitro enamel sandblasting could not substitute acid etching and did not offer improved SBS when used before acid etching, regardless of air pressure and powder granulation. Sandblasting without acid etching produced less residual resin on the tooth after debonding. CLINICAL RELEVANCE: The clinical use of adjunct enamel sandblasting prior to etching to enhance SBS has to be questioned.

Time-dependent behavior of porcine periodontal ligament: A combined experimental, numeric in-vitro study.

INTRODUCTION: The aim of this study was to analyze the time-dependent in-vitro behavior of the periodontal ligament (PDL) by determining the material parameters using specimens of porcine jawbone. Time-dependent material parameters to be determined were expected to complement the results from earlier biomechanical studies. METHODS: Five mandibular deciduous porcine premolars were analyzed in a combined experimental-numeric study. After selecting suitable specimens (excluding root resorption) and preparing the measurement system, the specimens were deflected by a distance of 0.2 mm at loading times of 0.2, 0.5, 1, 2, 5, 10, and 60 seconds. The deflection of the teeth was determined via a laser optical system, and the resulting forces and torques were measured. To create the finite element models, a microcomputed tomography scanner was used to create 3-dimensional x-ray images of the samples. The individual structures (tooth, PDL, bone) of the jaw segments were reconstructed using a self-developed reconstruction program. A comparison between experiment and simulation was conducted using the results from finite element simulations. Via iterative parameter adjustments, the material parameters (Young's modulus and Poisson's ratio) of the PDL were assessed at different loading velocities. RESULTS: The clinically observed effect of a distinct increase in force during very short periods of loading was confirmed. Thus, a force of 2.6 N (±1.5 N) was measured at the shortest stress duration of 0.2 seconds, and a force of 1.0 N (±0.5 N) was measured at the longest stress duration of 60 seconds. The numeric determination of the material parameters showed bilinear behavior with a median value of the first Young's modulus between 0.06 MPa (2 seconds) and 0.04 MPa (60 seconds), and the second Young's modulus between 0.30 MPa (10 seconds) and 0.20 MPa (60 seconds). The ultimate strain marking the transition from the first to the second Young's modulus remained almost unchanged with a median value of 6.0% for all loading times. CONCLUSION: A combined experimental-numeric analysis is suitable for determining the material properties of the PDL. Microcomputed tomography allows high-precision recordings with only minimum effort. This study confirms the assumption of time dependency and nonlinearity of previous studies.

Comparison of the efficacy of tooth alignment among lingual and labial brackets: an in vitro study.

Background/objective: The aim of this study was to evaluate the efficacy of tooth alignment with conventional and self-ligating labial and lingual orthodontic bracket systems. Materials/methods: We tested labial brackets (0.022″ slot size) and lingual brackets (0.018″ slot size). The labial brackets were: (i) regular twin brackets (GAC-Twin [Dentsply]), (ii) passive self-ligating brackets including (Damon-Q® [ORMCO]; Ortho classic H4™ [Orthoclassic]; FLI®SL [RMO]), and (iii) active self-ligating brackets (GAC In-Ovation®C [DENTSPLY] and SPEED™[Strite]). The lingual brackets included (i) twin bracket systems (Incognito [3M] and Joy™ [Adenta]), (ii) passive self-ligating bracket system (GAC In-Ovation®LM™ [Dentsply]), and (iii) active self-ligating bracket system (Evolution SLT [Adenta]). The tested wires were Thermalloy-NiTi 0.013″ and 0.014″ (RMO). The archwires were tied to the regular twin brackets with stainless steel ligatures 0.010″ (RMO). The malocclusion simulated a displaced maxillary central incisor in the x-axis (2 mm gingivally) and in the z-axis (2 mm labially). Results: The results showed that lingual brackets are less efficient in aligning teeth when compared with labial brackets in general. The vertical correction achieved by labial bracket systems ranged from 72 to 95 per cent with 13″ Thermalloy wires and from 70 to 87 per cent with 14″ Thermalloy wires. In contrast, the achieved corrections by lingual brackets with 13″ Thermalloy wires ranged between 25-44 per cent and 29-52 per cent for the 14" Thermalloy wires. The anteroposterior correction achieved by labial brackets ranged between 83 and 138 per cent for the 13″ Thermalloy and between 82 and 129 per cent for the 14″ Thermalloy wires. On the other hand, lingual brackets corrections ranged between 12 and 40 per cent for the 13″ Thermalloy wires and between 30 and 45 per cent for the 14″ Thermalloy wires. Limitation: This is a lab-based study with different labial and lingual bracket slot sizes (however they are the commonly used ones in clinical orthodontics) and study did not consider saliva, periodontal ligament, mastication and other oral functions. Conclusions: The effectiveness of lingual brackets in correcting vertical and anteroposterior displacement achieved during the initial alignment phase of orthodontic treatment is lower than that of the effectiveness of labial brackets.

Imaging of Dental Hard Tissue Surfaces Prepared by an Ultrashort Pulsed Laser System (USPL).

The aim of this study was to compare surface structures of laser-irradiated dental hard tissues using confocal (CFM), atomic force (AFM), and scanning electron microscopy (SEM). The general potential of the AFM in analyzing laser-irradiated surfaces was determined in this context. Specimens of human enamel and dentin were irradiated using an 8.6 W Nd:YVO4 laser with a pulse duration of 8 ps, λ Center=1,064 nm, and a pulse repetition rate of 500 kHz. Surface topology of irradiated areas (1 mm2) was investigated using AFM, CFM, and SEM. Surface roughness R z was measured only with the AFM and the CFM. For non-irradiated enamel and dentin surfaces, roughnesses for CFM and AFM are in the nanometer range. However, major differences in roughness were determined for laser-prepared surfaces. For enamel, R z (CFM)=2.33 µm is much higher compared with R z (AFM)=0.09 µm; in the case of dentin, R z (CFM)=5.35 µm is also much higher compared with R z (AFM)=0.093 µm. Information regarding structural properties of surfaces needs real dimensions, particularly for use in dentistry. In this respect, AFM technology provides no additional results that lead to a significant improvement.

Effect of archwire cross-section changes on force levels during complex tooth alignment with conventional and self-ligating brackets.

INTRODUCTION: Our objective was to investigate the effect of archwire cross-section increases on the levels of force applied to teeth during complex malalignment correction with various archwire-bracket combinations using an experimental biomechanical setup. METHODS: The study comprised 3 types of orthodontic brackets: (1) conventional ligating brackets (Victory Series [3M Unitek, Monrovia, Calif] and Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo]), (2) self-ligating brackets (SmartClip, a passive self-ligating bracket [3M Unitek]; and Time3 [Rocky Mountain Orthodontics, Denver, Colo] and SPEED [Strite Industries, Cambridge, Ontario, Canada], both active self-ligating brackets), and (3) a conventional low-friction bracket (Synergy [Rocky Mountain Orthodontics]). All brackets had a nominal 0.022-in slot size. The brackets were combined with 0.014-in and 0.016-in titanium memory wires, Therma-Ti archwires (American Orthodontics, Sheboygan, Wis). The archwires were tied to the conventional brackets with both stainless steel ligatures of size 0.010-in and elastomeric rings. A malocclusion of the maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis) was simulated. RESULTS: The forces recorded when using the 0.014-in archwires ranged from 1.7 ± 0.1 to 5.0 ± 0.3 N in the x-axis direction, and from 1.2 ± 0.1 to 5.5 ± 0.3 N in the z-axis direction. When we used the 0.016-in archwires, the forces ranged from 2.6 ± 0.1 to 6.0 ± 0.3 N in the x-axis direction, and from 2.0 ± 0.2 to 6.0 ± 0.4 N in the z-axis direction. Overall, the increases ranged from 16.0% to 120.0% in the x-axis and from 10.4% to 130.0% in the z-axis directions. CONCLUSIONS: Increasing the cross section of the wire increased the force level invariably with all brackets. Wires of size 0.014 in produced relatively high force levels, and the force level increased with 0.016-in wires.

A comparative experimental investigation of torque capabilities induced by conventional and active, passive self-ligating brackets.

INTRODUCTION: A proper selected bracket-archwire combination displays a determining factor in the efficacy of torque applied to a tooth at the final stages of an orthodontic treatment. The objective of the current study was to assess the torque capabilities of various bracket systems combined with diverse archwire materials and cross-sections. METHODS: The study comprised of four different 0.018-inch slot orthodontic brackets: the passive and the active self-ligating 1. Swiss Nonligating Bracket (SNB) and 2. SPEED and the metallic and the plastic conventional ligating 3. Mini Mono and 4. Brilliant, respectively, and four different archwire types: stainless steel and Nitinol: 0.016×0.016 inch and 0.016×0.022 inch. A 20 degrees labial crown torque (+20 degrees) and then a 20 degrees palatal crown torque (-20 degrees) were applied gradually on the upper right central incisor. Maximum torquing moments and torque play were registered. RESULTS: Highest torquing moments were expressed by combining SPEED® with 0.016×0.022 inch stainless steel archwire. Lowest moments, but highest torque loss were registered by inserting a 0.016×0.016 inch Nitinol archwire in conventional ligating brackets. CONCLUSIONS: Active self-ligating system manifests the best torque effectiveness. An evident dependence of the torque expression is displayed both on the type of ligation and on the material of the archwire.

Long- and short-term effects of headgear traction with and without the maxillary second molars.

INTRODUCTION: A quantitative assessment of maxillary first molar distalization with and without the maxillary second molar (M2) was carried out. METHODS: Fifty-six cervical headgear patients undergoing fixed appliance orthodontic treatment were divided into 2 groups: before (G - M2) and after (G + M2) eruption of the maxillary second molars (ages, 11.87 ± 1.20, and 13.05 ± 1.55 years, respectively). The tightness of the dental contact point (TDCP) and the space between the second premolar and the maxillary first molar were measured at 6 levels of headgear force (0-15 N) at 3 intervals 6 months apart (T0, T1, T2). RESULTS: Relationships were found between space and TDCP, time, and presence or absence of the maxillary second molar at T1 and T2 (P <0.001). The TDCP decreased and space increased with increase in initial headgear force. An increase in initial force beyond 6 to 9 N did not significantly increase the initial maxillary first molar distalization. The G - M2 TDCP and space measurements were similar to those of G + M2 at T2 with the eruption of the maxillary second molar. From T0 to T1, maxillary first molar distalization was greater in G - M2. In comparison with our previous headgear-alone study, initial distalization with a fully bonded appliance was reduced by 4-fold. CONCLUSIONS: Headgear therapy is more effective before the eruption of the maxillary second molar. Once it erupts, the distalization pace of the maxillary first molar is reduced, but it can nevertheless be pursued at a slower pace when the maxillary second molar is present.

Force loss in archwire-guided tooth movement of conventional and self-ligating brackets.

This study aimed to investigate the differences in the force loss during simulated archwire-guided canine retraction between various conventional and self-ligating brackets. Three types of orthodontic brackets have been investigated experimentally using a biomechanical set-up: 1. conventional ligating brackets (Victory Series and Mini-Taurus), 2. self-ligating brackets (SmartClip: passive self-ligating bracket, and Time3 and SPEED: active self-ligating brackets), and 3. a conventional low-friction bracket (Synergy). All brackets had a nominal 0.022″ slot size. The brackets were combined with three rectangular 0.019×0.025″ archwires: 1. Remanium (stainless steel), 2. Nitinol SE (nickel-titanium alloy, NiTi), and 3. Beta III Titanium (titanium-molybdenum alloy). Stainless steel ligatures were used with the conventional brackets. Archwire-guided tooth movement was simulated over a retraction path of up to 4mm using a superelastic NiTi coil spring (force: 1 N). Force loss was lowest for the Victory Series and SmartClip brackets in combination with the steel guiding archwire (35 and 37.6 per cent, respectively) and highest for the SPEED and Mini-Taurus brackets in combination with the titanium wire (73.7 and 64.4 per cent, respectively). Force loss gradually increased by 10 per cent for each bracket type in combination with the different wires in the following sequence: stainless steel, Nitinol, and beta-titanium. Self-ligating brackets did not show improved performance compared with conventional brackets. There was no consistent pattern of force loss when comparing conventional and self-ligating brackets or passive and active self-ligating brackets.

Force levels in complex tooth alignment with conventional and self-ligating brackets.

INTRODUCTION: The force applied to the teeth is a variable of orthodontic treatment that can be controlled. Poor control of the applied force can lead to adverse biologic effects as well as undesirable tooth movements. The selected archwire-bracket combination is a primary determining factor in the force level applied to a tooth during orthodontic treatment. The aim of this research was to use an experimental biomechanical setup to measure forces generated during complex orthodontic tooth movements with various archwire-bracket combinations. METHODS: The materials consisted of 3 types of 0.022-in slot orthodontic brackets: (1) conventional brackets (Victory Series [3M Unitek, Monrovia, Calif] and Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo]), (2) self-ligating brackets (SmartClip [3M Unitek] and Time3 [American Orthodontics, Shegoygan, Wis]), and (3) a conventional low-friction bracket (Synergy [Rocky Mountain Orthodontics]); and 4 archwire types: (1) 0.012-in stainless steel (3M Unitek), (2) 0.0155-in coaxial (Advanced Orthodontics [Näpflein, Düsseldorf, Germany]), (3) 0.012-in Orthonol (Rocky Mountain Orthodontics), and (4) 0.012-in Thermalloy (Rocky Mountain Orthodontics). Stainless steel ligatures and elastomeric rings were used. The materials were used in different combinations in a simulated malocclusion that represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis). RESULTS: The lowest forces were measured when the brackets were combined with either the coaxial or the Thermalloy archwires; the forces ranged from 3.4 ± 0.2 to 0.7 ± 0.1 N in the x-axis direction, and from 4.5 ± 0.3 to 0.5 ± 0.1 N in the z-axis direction. The highest forces were measured in combination with stainless steel archwires; the forces ranged from 6.3 ± 0.3 to 3.0 ± 0.1 N in the x-axis direction, and from 6.3 ± 0.3 to 1.7 ± 0.1 N in the z-axis direction. CONCLUSIONS: We recommend 0.0155-in coaxial and 0.012-in Thermalloy archwires for leveling and alignment. Elastomeric rings, when used with conventional brackets, increased the force applied to the teeth.

Biomechanical time dependency of the periodontal ligament: a combined experimental and numerical approach.

The analysis of the non-linear and time-dependent viscoelasticity of the periodontal ligament (PDL) enables a better understanding of the biomechanical features of the key regulator tissue for tooth movement. This is of great significance in the field of orthodontics as targeted tooth movement remains still one of the main goals to accomplish. The investigation of biomechanical aspects of the PDL function, a difficult area of research, helps towards this direction. After analysing the time-dependent biomechanical properties of pig PDL specimens in an in vitro experimental study, it was possible to confirm that PDL has a viscoelastic anisotropic behaviour. Three-dimensional finite element models of mini-pig mandibular premolars with surrounding tissues were developed, based on micro-computed tomography (µCT) data of the experimental specimens. Tooth mobility was numerically analysed under the same force systems as used in the experiment. A bilinear material parameter set was assumed to simulate tooth displacements. The numerical force/displacement curves were fitted to the experimental curves by repeatedly calculating tooth displacements of 0.2mm varying the loading velocities and the parameters, which describe the nonlinearity. The experimental results showed a good agreement with the numerical calculations. Mean values of Young's moduli E1, E2 and ultimate strain ε12 were derived for the elastic behaviour of the PDL for all loading velocities. E1 and E2 values increased with increasing the velocity, while ε12 remained relatively stable. A bilinear approximation of material properties of the PDL is a suitable description of measured force/displacement diagrams. The numerical results can be used to describe mechanical processes, especially stress-strain distributions in the PDL, accurately. Further development of suitable modelling assumptions for the response of PDL under load would be instrumental to orthodontists and engineers for designing more predictable orthodontic force systems and appliances.

Mechanical and numerical investigations of biodegradable magnesium alloy screws for fracture treatment.

Small fracture treatment includes the use of so-called "Herbert screws". In the past years, novel resorbable materials were introduced as an alternative to the classical titanium implants. The purpose of this study was to evaluate the influence of ongoing resorption/corrosion processes on the mechanical stability screws made from the magnesium alloy MgYREZr®. Our samples consisted of two partly resorbed screws, explanted due to medical reasons after 6 and 12 weeks, respectively, and five unused reference screws. We performed three-point bending tests to determine the stability of all screws. Additionally, with FE-models of the screws based on µCT-scans, we investigated whether any differences in the bending behavior of the screws can be attributed to the reduction of the material volume due to resorption alone. Both partly resorbed screws failed at a lower force than the reference screws (178.6 ± 5.5 N for the reference screws, 72.5 N and 74.5 N for the screw explanted after 6 and 12 weeks, respectively). FE simulations performed with the three different geometries and original material parameters (Young's modulus Enew  = 45 GPa, yield limit σnew  = 235 MPa) showed that the early fracture could not be attributed to the changed geometry alone. Material parameters for the partly resorbed screws were determined by fitting the numerical to the experimental force-displacement curves (E6week  = 15 GPa, σ6week  = 135 MPa and E12week  = 8 GPa, σ12week  = 135 MPa, respectively). Our results showed that both geometry of the screws and different material properties contribute to the overall stability. Understanding and controlling these two factors throughout the resorption process could enhance treatment options.

Variation of the modulus of elasticity of aligner foil sheet materials due to thermoforming.

OBJECTIVE: Investigate and compare the mechanical properties of different aligner materials before and after deep drawing and determine differences in the mechanical properties after thermoforming. MATERIALS AND METHODS: Four aligner film sheets from three manufacturers (Duran Plus® [Scheu Dental, Iserlohn, Germany]; Zendura® [ClearCorrect, Bay Materials LLC, Fremont, CA, USA]; Essix ACE® and Essix® PLUS™ [Dentsply Sirona Deutschland, Bensheim, Germany]) were tested in 3­point bending with support distances of 8, 16, and 24 mm. Dimension of the specimens was 10â€¯× 50 mm2. Two groups each were tested: (1) 10 specimens were investigated in the as-received state (before thermoforming), (2) 10 specimens were deep drawn on a master plate with cuboids of the dimension 10â€¯× 10â€¯× 50 mm3. Then, specimens were cut out of the upper side and lateral walls and were measured in 3­point bending. Forces and reduction in thickness were measured and corrected theoretical forces of drawn sheets after thickness reduction as well as Young's modulus were calculated. RESULTS: At a support distance of 8 mm and a displacement of 0.25 mm Essix® PLUS™, having the highest thickness in untreated state, showed highest forces of 28.2 N, followed by Duran Plus® (27.3 N), Essix ACE® (21.0 N) and Zendura® (19.7 N). Similar results were registered for the other distances (16, 24 mm). Thermoforming drastically reduced thickness and forces in the bending tests. Forces decreased to around 10% or less for specimens cut from the lateral walls. Young's modulus decreased significantly for deep drawn foil sheets, especially for Essix® PLUS™. CONCLUSIONS: Three-point bending is an appropriate method to compare different foil sheet materials. Young's modulus is significantly affected by thermoforming.

Numerical and biomechanical analysis of orthodontic treatment of recovered periodontally compromised patients.

OBJECTIVE: Generate a finite element (FE) model to simulate space closure and retraction mechanics for anterior maxillary teeth in periodontally compromised dentition, and compare the biomechanical effect of initial force systems with varying magnitude. MATERIALS AND METHODS: The geometry of an idealized finite element model (FEM) of a maxilla was adapted such that the teeth showed reduced periodontal support together with extruded and flared incisors. In a first step, leveling and alignment of the front teeth were simulated. In a second step, force systems for orthodontic space closure of residual spaces on both sides distal to the lateral incisors were simulated. A combined intrusion and retraction cantilever was modeled, to simulate en masse retraction mechanics with segmented arches and elastic chains. A commercial FE system was used for all model generations and simulations. RESULTS: Results of the simulations indicated that a force of 1.0 N is too high for space closure of flared front teeth in periodontally damaged dentition, as extreme strains may occur. En masse retraction using cantilever mechanics with lower forces showed a uniform intrusion and retraction movement and thus proved to be a better option for treating patients with a periodontally compromised dentition. CONCLUSION: The outcome of this study indicates that increased periodontal stresses resulting from severe attachment loss should be seriously considered by careful planning of the orthodontic mechanics and reduction of the applied forces is suggested. The presented cantilever mechanics seems to be an appropriate means for en masse retraction of periodontally compromised extruded front teeth.

Effect of mini-implant length and diameter on primary stability under loading with two force levels.

Mini-implants are widely utilized as anchorage units in orthodontic treatment. Nevertheless, there are factors that interfere with their clinical performance. The aim of this study was to examine the impact of length and diameter on the primary stability of two different types of orthodontic mini-implants loaded with two force levels. A total of 90 self-drilling mini-implants were inserted in bovine ribs in vitro, 62 of which were used in data analysis. The mini-implants were of two types, Aarhus (n=29) and Lomas (n=33), of two lengths (7 and 9 mm, n=26 and n=28, respectively), and of two diameters (1.5 and 2 mm, Lomas only, n=6 and n=8, respectively). A closed nickel-titanium (NiTi) coil spring was attached to each mini-implant. Half of the preparations were loaded with a low force of 0.5 N and the other half with a force of 2.5 N. Mini-implant deflections during force application were non-invasively registered using a three-dimensional (3D) laser-optical system. The results were analysed with analysis of variance for the effects of implant type, implant length, and force level, and with a t-test for the study of the effect of diameter in two different diameter variants of the same (Lomas) implant. In the low-force group, implant displacements were not statistically significant difference according to the investigated parameters. In the high-force group, the 9 mm long mini-implants displaced significantly less (10.5±7.5 µm) than the 7 mm long (22.3±11.3 µm, P<0.01) and the 2 mm wide significantly less (8.8±2.2 µm) than the 1.5 mm implants (21.9±1.5 µm, P<0.001). The force level at which significance occurred was 1 N. The rotation of the Lomas mini-implants in the form of tipping was significantly higher than that of the Aarhus mini-implants at all force levels. Implant length and diameter become statistically significant influencing parameters on implant stability only when a high force level is applied.

Impact of the endocannabinoid system on murine cranial and alveolar bone phenotype.

PURPOSE: The endocannabionoid signaling system has been demonstrated to be present in the skeleton, with involvement in the regulation of skeletal homeostasis. However, investigations substantiating these findings in cranial and alveolar bones are missing to date. The aim of our study was to investigate a potential impact of the endocannabinoid system on cranial and alveolar bone structures and phenotypes. BASIC PROCEDURES: CB1-/-, CB2-/- and WT mice (n = 5) were scanned via µCT. Reconstructed datasets were processed for analyses. Cranial cephalometric measurements were performed with OnyxCeph3TMsoftware. Alveolar bone densities were determined via mean grey value measurements with Mimics research 18.0. Alveolar bone heights around teeth in upper and lower jaws were morphometrically analyzed. Alveolar osteoclasts were quantified via TRAP staining of paraffin-embedded histologies. Bone-marrow derived macrophages isolated from murine hind legs were analyzed for CD40 and MMR expression via flow cytometry. MAIN FINDINGS: CB2-/- mice exhibited significantly higher bone densities with mean grey values of 138.3 ± 22.6 compared to 121.9 ± 9.3 for WT for upper jaws, and 134.6 ± 22.9 compared to 116.1 ± 12.9 for WT 134.6 ± 22.9. Concurrently, CB2 receptor knockout entailed reduced alveolar bone heights of about 50% compared to WT mice. Antigen-presenting cell marker expression of MMR was significantly diminished in bone-marrow derived macrophages of CB2-/- mice. Cranium dimensions as much as alveolar osteoclasts were unaffected by receptor knockouts.CB1 receptor knockout did not involve statistically significant alterations in the parameters investigated compared to WT mice. PRINCIPAL CONCLUSIONS: The endoncannabinoid system, and particularly CB2 receptor strongly affects murine alveolar bone phenotypes. These observations suggest CB2 as promising target in the modulation of oral bone phenotypes, probably by impact on bone dynamics via osteal immune cells.

Numeric modeling of torque capabilities of self-ligating and conventional brackets.

INTRODUCTION: The purpose of this study was to investigate the torque capabilities of conventional and self-ligating brackets by using the finite element method. METHODS: Three types of brackets were selected: self-ligating Hanson Speed (Strite Industries, Cambridge, Ontario, Canada) and Damon MX (Ormco, Glendora, Calif), and conventionally ligated Discovery (Dentaurum, Pforzheim, Germany). All brackets had a 0.022-in slot size. From the maxillary left incisor to the maxillary right canine, 4 brackets were included in the finite element models generated. Torque of 20 degrees was applied to the maxillary right incisor with 0.46 x 0.64 mm(2) (0.018 x 0.025 in) and 0.48 x 0.64 mm(2) (0.019 x 0.025 in) archwires. Three kinds of wire alloys were used: stainless steel, titanium molybdenum, and nickel titanium. For the conventional Discovery brackets, 2 types of ligation were modeled: elastic and stainless steel wire ligatures. The torque angle/torque moment characteristics in the simulated movement were calculated by using the MSC.Marc/Mentat 2005 FE software package (MSC Software Corporation, Santa Ana, Calif). RESULTS: The torque angle/torque moment curves seemed to be dominated by the characteristics of the wire. The change of wire dimension increased the torque moments less than the change of wire alloy (125% increase for a 0.48 x 0.64 mm(2) instead of a 0.46 x 0.64 mm(2) stainless steel wire, and 220% for a 0.46 x 0.64 mm(2) stainless steel instead of a nickel-titanium wire). The combined change of the wire alloy and wire dimension resulted in a 600% increase for a 0.48 x 0.64 mm(2) stainless steel instead of a 0.46 x 0.64 mm(2) nickel-titanium wire.The play of the 0.46 x 0.64 mm(2) wires was about 9.0 degrees, and the play of the 0.48 x 0.64 mm(2) wires was about 7.5 degrees, with slightly more play for the Damon. The ligation effect of Discovery brackets with elastic and stainless steel ligatures could be compared with the behavior of the Damon. The Speed showed different behavior, with the lowest torquing moments and the smallest torque play. CONCLUSIONS: Improving the adaptation of torque movements to the biomechanical reactions of the periodontium is best done by proper selection of both wire dimension and wire alloy. The effect of the bracket system is of minor importance, with the exception of brackets with an active clip (eg, Speed), which had the least play and the lowest torquing moments of all the wires.

Nickel concentration in the saliva of patients with nickel-titanium orthodontic appliances.

INTRODUCTION: The purpose of this study was to examine whether nickel-titanium (Ni-Ti) archwires cause an increase of nickel concentration in the saliva of 18 orthodontic patients to estimate the possible risk of these archwires in patients who have nickel hypersensitivity. METHODS: Saliva samples were collected before orthodontic treatment, after placement of the bands and brackets, 2 weeks later and before placing the Ni-Ti archwires, immediately after placing the Ni-Ti archwires, 4 weeks after placing the wires, and 8 weeks after placing the wires. RESULTS: By using mass spectrometry, no statistically significant differences were found in the nickel concentrations in the samples taken without appliances, in those obtained 2 weeks after placement of the bands and brackets, and 4 and 8 weeks after placement of the archwires. Samples taken immediately after placement of the bands and brackets and the Ni-Ti archwires showed slight but significant increases in nickel concentration of 78 and 56 microg per liter, respectively, compared with the pretreatment value of 34 microg per liter. CONCLUSIONS: Nickel leaching occurred after placement of the bands and brackets and after placement of the Ni-Ti archwires, associated with an increase of the nickel ion concentration in the patient's saliva. This effect decreased within 10 weeks.

Biomechanical analysis of initial incisor crowding alignment in the periodontally reduced mandible using the finite element method.

AIMS: To reduce remaining plaque niches due to dental malocclusion after periodontal treatment and to avoid reinflammation of periodontitis, severe anterior crowding can be treated orthodontically. The treatment indication is motivated by aesthetic and functional needs. In this study the biomechanical behaviour of crowded lower front teeth in reduced periodontium is analysed. METHODS: Using the finite element (FE) method, a model of the mandible was constructed with an anterior crowding of 4 mm and a vertical bone loss of 4 mm in the front tooth area. A 0.3 mm (0.012″) round superelastic nickel titanium (NiTi) arch wire was fitted to an ideal positioned teeth set-up and was inserted into the brackets of teeth 34 to 44 in the crowded model. The premolars were used as the anchorage unit. Material parameters were adopted from previous investigations, including bone (homogenous, isotropic, E = 2 GPa), teeth (E = 20 GPa) and healthy periodontal ligament (PDL, bilinear elastic; E1 = 0.05 MPa; E2 = 0.2 MPa; ε12 = 7%). All simulations were compared to simulations with a physiological periodontal model to assess the effect of bone loss at teeth 42 to 32. Additionally, the influence of three arch wire materials (nonsuperelastic NiTi, superelastic NiTi and stainless steel) were analysed in a reduced model, including only brackets in position of the crowded front teeth, wire and ligatures. Wire force levels and stresses were determined to assess the influence of material variation. RESULTS: Initial tooth mobility is increased by a factor of 2.5 in case of a moderate periodontal defect. Front teeth with reduced attachment display increased strains in the periodontal ligament up to a factor of 2. Forces in the model with reduced periodontium were decreased by a factor of 2. Comparing different aligning arch wires, stainless steel appears to have the highest force and stress levels. Force levels of this alloy were 7.5 times higher than with the superelastic NiTi wire. Force levels of nonsuperelastic NiTi appeared to be 1.8 times higher than superelastic NiTi. Calculated stresses with stainless steel were 5 times higher than with the nonsuperelastic NiTi and 10 times higher than with superelastic NiTi. CONCLUSION: Periodontally reduced incisors 42 to 32 are associated with an increased load on periodontal tissue and increased level of tooth mobility during fixed orthodontic treatment. This has to be considered by reducing orthodontic force levels and by selecting mechanics that reduce the load to the tissue.

Numerical investigations of bone remodelling around the mouse mandibular molar primordia.

The formation of the alveolar bone, which houses the dental primordia, and later the roots of tooth, may serve as a model to approach general questions of alveolar bone formation. In this respect, this study aimed to investigate the potential interactions between the alveolar bone formation and tooth eruption by using finite element (FE) methods, and to figure out whether the expanding tooth systems induce shear stresses that lead to alveolar bone formation. 3D geometric surface models were generated from the 3D histological data of the heads of mice (C57 Bl/6J) ranging from stages embryonic (E) to postnatal (P) stages E15 to P20 using the reconstruction software 3-Matic. Bone, dentin, enamel and dental follicle around the primordia were generated and converted into 3D FE models. Models were imported into the FE software package MSC.Marc/Mentat. As material parameters of embryonic dentine, pulp, enamel, dental follicle, and bony structures basically are unknown, these were varied from 1% to 100% of the corresponding known material parameters for humans and a sensitivity analysis was performed. Surface loads were applied to the outside surface of dental follicle ranging from 0.1 to 5.0N/mm2. The validity of the model was analysed by comparing the activity pattern of the alveolar bone as determined in the histological study with the loading pattern from the numerical analysis. The results show that when varying the surface loads, the distribution of shear stresses remained same, and while varying the material properties of the hard tissues, the location of highest shear stresses remained stable. Comparison of the histologically determined growth regions with the distribution of shear stresses computed in the numerical model showed a very close agreement. The results provide a strong proof to support Blechschmidt's hypothesis that the bone in general is created under the influence of shear forces.