Comparison of Bond Strength Between Two Resin Cement Types and Additive Manufacturing or Cast Cobalt-Chromium Alloys.

OBJECTIVE: To compare the bond strength of two types of resin cement to that of additive manufacturing (AM) or cast cobalt-chromium (Co-Cr) alloys. MATERIALS AND METHODS: Two types of resin luting cement, composite resin and methyl methacrylate (MMA), were bonded to AM or cast Co-Cr alloys, and shear bond tests were performed after seven days of storage in distilled water at 37°C. Co-Cr alloy adhesive elements AM to the enamel surface of the labial aspect of a bovine mandibular central incisor crown were bonded with two types of resin luting cement and subjected to 1,000 cycles of storage in water for one day and 28 days or thermal cycling, followed by shear bonding tests. Residual cement on the metal and enamel surfaces after the bonding tests was evaluated using an optical microscope. The normality of the results was evaluated using statistical software Statcel4, analysis of variance, or Kruskal-Wallis test, depending on normality, and multiple comparison tests were performed using the Tukey-Kramer or Steel-Dwass tests. RESULTS: After one day, the shear bond strength (SBS) was 25.9 MPa for Panavia V5 (PV; Kuraray Noritake Dental Corporation, Niigata, Japan) and 23.5 MPa for Super-Bond (SB; Sun Medical Corporation, Shiga, Japan), with no significant difference between the two cement types (P > 0.05). After 28 days, the SBS decreased to 4.1 MPa for PV and 6.7 MPa for SB, showing a significant difference between the two cements (P < 0.05). Following 1,000 thermal cycles, the SBS was 2.0 MPa for PV and 5.6 MPa for SB, with SB exhibiting a significantly higher value (P < 0.05). The adhesive strength was significantly lower after 28 days of storage and thermal cycling compared to after one day of storage (P < 0.05). The Co-Cr alloy exhibited more residual cement on the enamel surface due to interfacial fracture with the resin cement. The Co-Cr alloy showed more residual cement on the enamel surface due to interfacial fracture with the resin cement. CONCLUSION: MMA-based resin cement showed optimal bond strength and may be suitable for clinical use in computer-aided design (CAD)/computer-aided manufacturing (CAM) orthodontic appliances.

3D Printer-Assisted Layered Fabrication of a Novel Appliance for Oral Myofunctional Therapy and Functional Evaluation of Its Effects on Orofacial Muscles During Wear.

Aim Balanced function of the orofacial muscles is important for normal occlusion and dentition; however, patients with malocclusion often present with myofunctional disorder (MFD). Myofunctional therapy (MFT) has received much attention as a method for reducing MFD. Moreover, prefabricated functional appliances (PFAs) have been developed as a method to eliminate abnormal muscle pressure and guide the tongue into the correct position. However, PFAs have disadvantages, such as poor intraoral retention, limited usage time due to discomfort and poor patient compliance, and changes in the axis of the mandibular anterior teeth. Therefore, this study aimed to develop a new custom-made splint-type orthodontic appliance with CAD/CAM technology. Moreover, we evaluated the characteristics of the appliance and conducted functional tests to determine the effects of the appliance on the orofacial muscles and the discomfort associated with its use. Materials and methods Twenty-five volunteers (nine females and 16 males; mean age 28.4 ± 3.4 years) with normal swallowing function were included in the study. Lip-closing strength (LCS), electromyogram during swallowing, oxygen saturation, and pulse rate were measured and compared when the appliance was not worn and when it was worn. In addition, tongue habits were evaluated, and the maximum tongue pressure was measured when the appliance was not worn. The subjects were asked to answer a questionnaire using a numerical rating scale (NRS) regarding discomfort when wearing the appliance. The evaluation items were swallowing difficulty, speaking difficulty, and breathlessness, which were rated on an 11-point scale ranging from 0 to 10. Statistical tests were conducted using IBM SPSS version 28.0.1 (IBM, Armonk, NY, USA) with the Shapiro-Wilk and Levene's test, followed by the Wilcoxon signed rank sum test. The significance level was set at α = 0.05. The measurement error for each measurement item was evaluated using an intraclass correlation coefficient. Results A new custom-made splint-type orthodontic appliance was fabricated for each subject. The fit and retention of the appliance in the mouth were good when fitted, and a comparison of the functional test measurements of 25 subjects with and without the appliance showed that the LCS decreased significantly (p<0.05) before and after wearing the appliance. However, no statistically significant differences were found for the other items. The Mann-Whitney U test regarding the effects of sex, previous orthodontic treatment, or MFT, and oral habits did not statistically significantly influence the effects of wearing the device. In the NRS results, "difficulty swallowing" was observed in half of the subjects, "difficulty breathing" was rarely observed, and "difficulty speaking" was observed in all subjects. Conclusions A novel custom-made splint-type orthodontic appliance was designed and fabricated using digital workflow and 3D printing technology. This appliance was designed to correct oral habits and was made from a new material classified as a class II medical appliance according to the international harmonized classification.

Validation of Machine Learning Models for Craniofacial Growth Prediction.

This study identified the most accurate model for predicting longitudinal craniofacial growth in a Japanese population using statistical methods and machine learning. Longitudinal lateral cephalometric radiographs were collected from 59 children (27 boys and 32 girls) with no history of orthodontic treatment. Multiple regression analysis, least absolute shrinkage and selection operator, radial basis function network, multilayer perceptron, and gradient-boosted decision tree were used. The independent variables included 26 coordinated values of skeletal landmarks, 13 linear skeletal parameters, and 17 angular skeletal parameters in children ages 6 to 12 years. The dependent variables were the values of the 26 coordinated skeletal landmarks, 13 skeletal linear parameters, and 17 skeletal angular parameters at 13 years of age. The difference between the predicted and actual measured values was calculated using the root-mean-square error. The prediction model for craniofacial growth using the least absolute shrinkage and selection operator had the smallest average error for all values of skeletal landmarks, linear parameters, and angular parameters. The highest prediction accuracies when predicting skeletal linear and angular parameters for 13-year-olds were 97.87% and 94.45%, respectively. This model incorporates several independent variables and is useful for future orthodontic treatment because it can predict individual growth.

Comparison of Mandibular Volume and Linear Measurements in Patients with Mandibular Asymmetry.

In patients with mandibular asymmetry, the volume of the mandible divided by the mandibular median plane is significantly larger on the non-deviated (N-Dev) side than on the deviated (Dev) side. However, it has been reported that there is no significant difference between the volumes of the N-Dev and Dev sides when the mandibular ramus and body are divided. The purpose of this study was to investigate which region is responsible for the volume difference between the N-Dev and Dev sides. Cone Beam Computed Tomography (CBCT) images of patients with mandibular asymmetry were analyzed by measuring the volume, and linear analysis of the mandibular body, ramus, and condyle on the N-Dev and Dev side was performed. In this study, CBCT images of 37 patients (8 Japanese, 16 Korean, and 13 Egyptian) aged ≥ 18 years with mandibular asymmetry (men: 20, women: 17) were used to evaluate mandibular asymmetry. In patients with mandibular asymmetry, the N-Dev side showed significantly larger values than the Dev side for both volume and linear condyle, ramus, and mandibular body measurements. These results do not differ according to sex or ethnicity. Therefore, it is suggested that the N-Dev side of mandibular asymmetry is large without any regional specificity in pathophysiology.

Association of Mandibular Posterior Anatomic Limit with Skeletal Patterns and Root Morphology Using Three-Dimensional Cone Beam Computed Tomography Comprehensive Analysis.

This study aimed to clarify the relationship between the mandibular posterior anatomic limit (MPAL) and skeletal anteroposterior and vertical skeletal patterns, with consideration of factors that may be related. In total, 230 people were included: 49 Japanese, 122 Egyptian, and 59 Korean people. The MPAL was measured at 0, 2, 4, and 6 mm from the root furcation along the sagittal and cuspal lines at the distance from the distal root of the mandibular right second molar to the mandibular cortex of the lingual bone. Eight different MPALs were evaluated using multiple regression analysis with explanatory variables for anteroposterior and vertical skeletal patterns and qualitative variables for age, sex, population, the presence of third molars, number of roots, presence of C-shaped roots, and Angle malocclusion classification. The MPAL was significantly larger as the mandibular plane angle decreased. The MPAL near the root apex was significantly larger as the A-nasion-point B angle increased, and the MPAL near the root apex measured at the cuspal line was significantly larger for C-type roots. The present study showed that a C-shaped root affected the MPAL in addition to the anteroposterior and vertical skeletal patterns.

Effects of root contact length on the failure rate of anchor screw.

PURPOSE: This study aimed to evaluate the causal relationship between root contact and root contact length of orthodontic miniscrew implants (miniscrews), and assessed factors for implant failure through cone-beam computed tomography (CBCT) images. METHODS: First, a logistic regression analysis was performed to investigate the most relevant factors for implant failure based on sex, age, vertical skeletal pattern, horizontal skeletal pattern, and presence of root contact in 59 patients (mean age: 21.2, age range: 13-54 years) who had miniscrew implants. Next, 38 miniscrews (1.6 mm in diameter and 8.0 mm in length) with root contact were investigated in the patients. Root contact length was measured using CBCT taken after miniscrew implant placement. RESULTS: The results showed that root contact was the most critical risk factor for failure of miniscrew implants in patients. Logistic regression analysis showed that the risk approximately doubled as the root contact length increased by 1.0 mm. CONCLUSION: Avoiding proximity to the root during miniscrew implant placement is essential to prevent implant failure.

Mechanical properties of orthodontic wires covered with a polyether ether ketone tube.

OBJECTIVES: To evaluate the esthetics and frictional force of an orthodontic wire passed through a newly designed tube made of a polyether ether ketone (PEEK) resin. MATERIALS AND METHODS: Two types of standard PEEK tubes were prepared at 0.5 × 0.6ф and 0.8 × 0.9ф, and different archwires were passed through the tubes. Color values were determined according to brightness and hues. Friction was assessed with different bracket-wire combinations, and surface roughness was determined by stereomicroscopy before and after the application of friction. RESULTS: The PEEK tube showed a color difference that was almost identical to that of coated wires conventionally used in clinical practice, indicating a sufficient esthetic property. The result of the friction test showed that the frictional force was greatly reduced by passing the archwire through the PEEK tube in almost all of the archwires tested. CONCLUSIONS: Use of the new PEEK tube demonstrated a good combination of esthetic and functional properties for use in orthodontic appliances.

Mechanical and frictional properties of aesthetic orthodontic wires obtained by hard chrome carbide plating.

BACKGROUND/PURPOSE: Although aesthetic wire coating has been increasing in demand, it has problems that changes in mechanical properties and increase in frictional force. The aim of this study was to evaluate the coating of the wire, as characterized by aesthetics, in terms of low and constant friction and mechanical properties. MATERIALS AND METHODS: Hard chrome carbide-plated (HCCP) wires (HCCP group), commercially available polymer-coated wires (P group), rhodium-coated wires (R group), and uncoated wires (control group) were used. For all wire types, a stainless steel wire of dimensions 0.017 inch × 0.025 inch was used. They were evaluated by three-point bending, friction testing, surface observation, and colorimetric testing. RESULTS: The HCCP group was not significantly different from the control group in terms of flexural strength (σ) and flexural modulus (E) (σ: p = 0.90, E: p = 0.35). However, it was significantly inferior compared to the three other groups in terms of the maximum static and kinetic frictional forces under both dry and wet conditions (p < 0.05). In the surface observation, scratches were observed on the wire after the friction test. In the colorimetric test, no significant difference was observed between the HCCP group and the R group (p > 0.05). CONCLUSION: The mechanical properties of the HCCP wire were not significantly different compared to the control group. The frictional force of the HCCP wire was significantly lower than the other group. Therefore, the HCCP wire was suggested to increase the efficiency of tooth movement in clinics.

Chewing prevents stress-induced hippocampal LTD formation and anxiety-related behaviors: a possible role of the dopaminergic system.

The present study examined the effects of chewing on stress-induced long-term depression (LTD) and anxiogenic behavior. Experiments were performed in adult male rats under three conditions: restraint stress condition, voluntary chewing condition during stress, and control condition without any treatments except handling. Chewing ameliorated LTD development in the hippocampal CA1 region. It also counteracted the stress-suppressed number of entries to the center region of the open field when they were tested immediately, 30 min, or 60 min after restraint. At the latter two poststress time periods, chewing during restraint significantly increased the number of times of open arm entries in the elevated plus maze, when compared with those without chewing. The in vivo microdialysis further revealed that extracellular dopamine concentration in the ventral hippocampus, which is involved in anxiety-related behavior, was significantly greater in chewing rats than in those without chewing from 30 to 105 min after stress exposure. Development of LTD and anxiolytic effects ameliorated by chewing were counteracted by administering the D1 dopamine receptor antagonist SCH23390, which suggested that chewing may activate the dopaminergic system in the ventral hippocampus to suppress stress-induced anxiogenic behavior.

Chewing reduces sympathetic nervous response to stress and prevents poststress arrhythmias in rats.

Reducing stress is important in preventing sudden death in patients with cardiovascular disease, as stressful events may cause autonomic imbalance and trigger fatal arrhythmias. Since chewing has been shown to inhibit stress-induced neuronal responses in the hypothalamus, we hypothesized that chewing could ameliorate stress-induced autonomic imbalance and prevent arrhythmias. To test this hypothesis, we analyzed changes in radiotelemetered electrocardiograms in rats that were allowed to chew a wooden stick during a 1-h period of immobilization stress. Chewing significantly reduced the occurrence of ventricular premature beats (VPBs) and complex ventricular ectopy after immobilization and prevented stress-induced prolongation of the QT interval of VPBs throughout the 10-h experimental period. It also prevented prolongation of the QRS complex and fluctuations in the QT interval in normal sinus rhythm beats preceding VPBs during both immobilization and in the poststress period. Fast Fourier transform-based spectral analysis of heart-rate variability further showed that chewing significantly inhibited the stress-induced increase in the power ratio of low-to-high frequency activity (LF/HF: a marker of sympathetic activity) during immobilization and in addition was associated with blunting of the stress-induced increase in plasma noradrenaline observed at the termination of immobilization. Similar suppressive effects on the occurrence of VPBs and the LF/HF were observed in rats that were administered the ß-adrenergic blocker propranolol before immobilization. These results indicate that chewing can ameliorate sympathetic hyperactivity during stress and prevent poststress arrhythmias and suggest that chewing may provide a nonpharmacological and cost-effective treatment option for patients with a high risk of stress-induced fatal arrhythmia.