Comparative evaluation of two cetylpyridinium chloride-based mouthwashes on the mechanical properties and strength loss of elastomeric chains used in dentistry: An vitro study.

Objectives: Evaluate the strength degradation of polymeric ligature chains after their immersion in cetylpyridinium chloride-based mouthwashes. Methods: 240 elastomeric samples from four different manufacturers (Rocky Mountain®, Ormco®, Morelli® and Dentaurum®) in two types of configurations (with and without intermodular links) and divided in 3 groups (distilled water, Vitis CPC Protect® and PERIO·AID® 0.05%) at 5 follow-up periods (0-24 h, 7-14 -21 days) were immersed twice a day for 60 s, following the manufacturers' protocols. A universal traction machine was used to perform the measurements and a post hoc multiple comparisons were based on the Bonferroni test and extended to a 3-way ANOVA test (α = 0.05). Results: There was a drop in strength up to 35.9% at 24 h. After a week, the short chains (52%) degraded less than the long ones (57.3%) with significant differences (p < 0.001) and the same pattern was observed until 21 days (p < 0.001). At 24 h, the degradation of the chains exposed in distilled water was 25.8%, in VITIS CPC Protect® 28.6% and in PERIO· AID® 0.05%, 27% with significant differences (p < 0.001). At 21 days, the VITIS CPC Protect® group obtained a much greater loss of strength, being this drop statistically significant (p < 0.001). The chains from Ormco® and RMO® experienced the least loss of force when immersed in the control group or PERIO AID® 0 0.05% (48% and 51%), while Dentaurum's in VITIS CPC Protect® lost more than 75%. Conclusions: The orthodontic elastomeric chains suffer a sharp drop in strength during the first days of treatment. When comparing the mouthwashes, there were statistically significant differences in terms of strength degradation. Clinical significance: Based on the results, some types of chains, such as the ones without intermodular links from Ormco® showed better properties throughout the study. When immersed in PERIO·AID®0.05%, all showed significantly better results over time. Thus, PERIO·AID®0.05% can be recommended as a complementary oral hygiene element in dental treatments when elastomeric chains are used.

Effects of Oil Pulling and Chlorhexidine Mouth Rinse on the Force Decay of Orthodontic Elastomeric Chains: A Comparative In Vitro Study.

BACKGROUND AND OBJECTIVES: Oil pulling is a traditional Indian folk remedy for maintaining oral hygiene among orthodontic patients. This study aimed to assess the effects of oil pulling and compare them with those of chlorhexidine (CHX) and distilled water on the force decay of elastomeric chains. METHODS: Twenty-one samples were tested in three groups. Each of these groups contained seven samples per group. The samples evaluated contained distilled water, 0.2% CHX, and sesame oil. The samples were dipped in various mouth rinses, and force degradation was measured using a dynamometer (dynamic universal testing machine, Instron 8801, Instron, Norwood, MA) during days 0, 1, 7, 14, 21, and 28. The significance level was considered at 1%. RESULTS: Force degradation was observed more in distilled water, followed by sesame oil, and less in CHX at the end of 28 days. Significant differences in values (p < 0.01) were found among the three groups in all the timelines in the study except on days 14 and 21. CONCLUSION: Chlorhexidine showed the least amount of force decay, followed by oil pulling and distilled water. However, if oil pulling is practiced daily as a household remedy along with regular oral hygiene practices, it can save time and money and enhance general health.

Influence of pH levels and beverage exposure on force decay and color stability of orthodontic elastomeric chains: An experimental study.

Aim of study: To assess the impact of pH level on force decay and color stability of orthodontic elastomeric chains (EOC) after exposure to commonly used beverages. Materials and methods: A total of 120 chain cuts were prepared from 2 different manufacturers (GC Orthodontics Europe GmbH, Breckerfeld, Germany, and FORESTADENT® - Bernhard Foerster GmbH, Pforzheim, Germany). According to the distance between loops, two types of chains were selected from each manufacturer: short and medium ones. Chains were immersed into 10 commonly used beverages with different pH values. After 7 days, force degradation was evaluated with the universal machine for mechanical testing (Model 4411; Instron, Canton, USA) and color change using a VITA Easyshade® digital spectrophotometer. Kruskal-Wallis with post-hoc Dunn's test for intergroup comparison and Wilcoxon rank test for intragroup comparison. Results: Initial force varied among EOC brands, with GC short chains having the highest force and Forestadent medium chains the lowest. The most pronounced force decay occurred within 24 h, notably affecting Forestadent short chains the most, followed by Forestadent medium, GC short, and GC medium chains. Despite a higher force drop rate over seven days, short EOCs maintained higher forces than medium EOCs. GC EOCs consistently maintained higher forces after seven days compared to Forestadent EOCs. After the immersion of EOC in different solutions for 24 h, only Evian water, Soy milk, and Coconut water did not change color. After 7 days, the greatest color change was recorded in coffee. Conclusion: There is no correlation between pH value and force decay of polyurethane chains. Short chains showed more constant force delivery and greater value of remaining force in comparison to medium ones. Color stability was mostly affected by coffee, followed by matcha tea, soy milk, and apple juice.

Force degradation of two orthodontic accessories analyzed in vivo and in vitro.

OBJECTIVE: To compare force degradation of elastomeric chains and NiTi coil springs in vivo and in vitro, and evaluate the effects of pre-stretched and reused elastomeric chains in the oral cavity during the time. METHODS: In the in vitro groups, 4-unit elastomeric chains and NiTi coil springs with an initial force of 200 g were placed in dry air and artificial saliva. The volunteers wore clear retainers which were used to hold the sample of 4-unit chains, pre-stretched 4-unit chains, and NiTi coil springs with the initial force of 200 g in the in vivo groups. After the first 4 weeks, 4-unit specimens were stretched to 200 g again for another 4 weeks in vivo. The force value and the percentage of force degradation were recorded at each measurement time interval in the in vivo and in vitro groups. RESULTS: The force degradation of elastomeric chains was greatest within the initial 4 hours, followed by a more stable phase after 1 week. The average force degradation of 4-unit elastomeric chains after 4 weeks was in vivo (64.8%) > artificial saliva (55.0%) > dry air (46.42%) (P < 0.05). The force degradation of NiTi coil springs in vivo (15.36%) or in artificial saliva (15.8%) was greater than in dry air (7.6%) (P < 0.05). NiTi coil springs presented a gentler force decay than elastomeric chains during the period (P < 0.05). In vivo, the force degradation of pre-stretched and reused elastomeric chains decreased less than the regular style(P < 0.05). CONCLUSION: The force degradation of the elastomeric chains and NiTi coil springs varied in different environments. NiTi coil springs presented a gentler force decay than elastomeric chains during the period. Orthodontists should consider the force degradation characteristics of orthodontic accessories in clinical practice.

Comparison of in vivo and in vitro force decay of elastomeric chains/modules: a systematic review and meta analysis.

BACKGROUND: The study evaluated and compared the force decay of orthodontic elastomeric chains/modules in both in vivo and in vitro settings. METHODS: A protocol in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was formulated and registered with the International Prospective Register of Systematic Reviews. A total of 53 articles (44 in vitro and 9 in vivo studies) found via search of the electronic databases of Cochrane and the National Library of Medicine (MEDLINE; PubMed), and manual search of the gray literature from institutional library resources, were selected. Data extraction, quality analysis, risk of bias assessment, and meta-analysis of the level of force decay of elastomeric chains/modules were conducted per standard protocol, and suitable statistical analyses were applied. RESULTS: The mean force decay in the in vivo setting was 41.9% at 24 hours, 42.6% after 1 week, 46.8% after 2 weeks, and 55.0% after 3 weeks. Similarly, the force decay in the in vitro studies was 38.9% at 24 hours, 42.1% after 1 week, 44.6% after 2 weeks, and 51.1% after 3 weeks. However, at the 95% confidence interval, the force decay rates of in vivo and in vitro studies overlap, with a statistically insignificant difference in force decay observed in the in vivo and in vitro settings. CONCLUSIONS: This systematic review and meta-analysis observed more force decay in the in vivo studies versus the in vitro studies (although this difference was statistically insignificant), with the maximum force decay occurring during the initial days, with a reduction to approximately 50% within 3 weeks. Hence, change of the elastomeric chains/module, at intervals of 3 weeks, is advised. (PROSPERO registration no. CRD42020209535).

Comprehensive comparison of canine retraction using NiTi closed coil springs vs elastomeric chains.

OBJECTIVES: To compare canine retraction using NiTi closed coil springs vs elastomeric chains comprehensively in a split-mouth randomized controlled trial. MATERIALS AND METHODS: The canines in 64 quadrants were randomly retracted into the first premolar extraction spaces using NiTi closed coil springs or elastomeric chains, in the maxilla and mandible. The retraction force was 150 g. Cone beam computed tomography scans and study models were obtained before the start of canine retraction and 6 months later. The rate and total amount of canine retraction, canine rotation, tipping, and root resorption were evaluated. A visual analogue scale was used to evaluate patients' pain experience. RESULTS: The two methods were statistically similar for dental changes, rate of canine retraction, and root resorption. However, patients reported significantly more days of pain with the elastomeric chain compared to the NiTi closed coil springs. CONCLUSIONS: Within the constraints of the current study, using either NiTi closed coil springs or elastomeric chains as force delivery systems for canine retraction results in no significant difference in the rate of canine retraction, tipping, rotation, or root resorption. Pain experience during retraction using elastomeric chains is more significant yet needs further investigation.

Comparison of the force decay over time of four different brands of elastomeric chains (elongated to 25mm grey/transparent and closed/open): An in-vitro study.

Elastomeric chains are widely used by orthodontists for incisor retraction and space closure. However, force degradation and permanent deformation are expected to occur. OBJECTIVES: The present study was designed to compare the force degradation of closed, open, grey and transparent power chains from four orthodontic companies (American orthodontics® (AO®), Dentsply®, Ormco® and Rocky Mountain Orthodontics® (RMO®)) over time. MATERIALS AND METHODS: Universal testing machine was used to measure the force of the power chains elongated to 25mm at 0hours, and after storage in artificial saliva at 24hours, 1 week, 2 weeks, 3 weeks, and 4 weeks. A Tukey's honestly significant difference test was performed. RESULTS: Most of the power chains showed less than 30% of force decay at 24hours of elongation. The AO® transparent open elastomeric chains presented the lowest percentage of force remaining at almost all times: 24hours (58.9%), 1 week (67.7%), 2 weeks (43.2%), 3 weeks (72.4%), and 4 weeks (63%). Most of the power chains had an increase of force measured after 2 weeks of storage in artificial saliva. Three of the sixteen groups (Ormco® grey open, RMO® grey and transparent closed) displayed an increase in the force at 4 weeks of elongation compared to the force registered at 0hours. CONCLUSION: The results indicated that the force generated by elastomeric chains at 4 weeks remains optimal for a physiologic tooth movement.

[An in vitro study of the stretching time-associated force loss generated by elastomeric chains and NiTi closed coil springs]. / Poteria sily élastomernykh tsepochek i nikel'-titanovykh zakryvaiushchikh pruzhin v zavisimosti ot vremeni rastiazheniia.

The purpose of the study was to evaluate the force loss of orthodontic elastomeric chains with NiTi closed spring in artificial saliva by time. METHODS: The study samples comprised 40 elastomeric chains (20 Dentaurum, and 20 G & H) and 15 NiTi closed spring (GAC). The elastomeric chains were submerged in 36,6 ºC artificial saliva and stretched on the instrument of resin plates at a distance of 30 mm. With an electronic dynamometer the delivered force was evaluated at different intervals: at baseline, after 1 day, 4, 7, 14, 21 and 28 days. Specimens of 15 NiTi coil springs were tested by dynamometer to evaluate force loss following 1, 2, or 3 months of use. RESULTS: It was observed a significant force loss of elastomeric chains after 24 hours. There was a force loss of elastomeric chains (from 34±1.3% to 53.86±2% after 28 days of activation). NiTi springs showed force loss (~13%) following 28 days of use, with a further significant loss (~6%) at 4-8 weeks; force levels remained steady thereafter. CONCLUSION: There was higher force loss in the different commercially elastomeric chains (~60%) in comparison to NiTi springs (21%).

Effect of Bleaching Mouthwash on Force Decay of Orthodontic Elastomeric Chains.

INTRODUCTION: Force decay elastomeric chains are significant, and it is a clinical problem. AIM: The aim of this study was to evaluate the effects of bleaching agent in the mouthwash on the force decay of orthodontic chains. MATERIALS AND METHODS: In this experimental study, 160 gray closed elastomeric chains were randomly divided into three groups (one control and two test groups). Four loops of chains were stretched for 25 mm on custom-made jig. Control group specimens were immersed in artificial saliva during the test period. Test group specimens were immersed twice a day for 30 seconds in the whitening (LISTERINE® HEALTHY WHITE™) and daily sodium fluoride (LISTERINE® TOTAL CARE ZERO) mouthwashes. All specimens were immersed in artificial saliva at 37°C. Force was measured at different time points (initial, 1, 7, 14, 21, 28 days). Statistical analysis was performed by two-way analysis of variance (ANOVA) and Bonferroni methods (a = 0.05). RESULTS: Force of elastomeric chains was decreased dramatically in all groups during the experiment. After 24 hours, force was decreased by 42.18, 48.34, and 53.38% in control group, daily, and bleaching mouthwash groups respectively. The corresponding numbers after 4 weeks were 66.30, 76.73, and 86.48. The difference between three groups at days 1 and 28 was statistically significant (p < 0.05). CONCLUSION: Within the limitations of the current in vitro study, bleaching and sodium fluoride mouthwashes could cause force decay of orthodontic elastomeric chains. Whitening mouthwash is more weakening for elastomeric chains. CLINICAL SIGNIFICANCE: Use of whitening mouthwash by orthodontic patients could decrease the force of elastomeric chains, so it could be recommended to use them for a short time.

Does acidic drinks vs. controls differents interfere with the force of orthodontic chain elastics? / Bebidas ácidas versus diferentes controles interferem com a força de elásticos ortodônticos em cadeia?

This study aimed to investigate alterations in physical properties of orthodontic elastomeric chains when in contact with different controls and acidic beverages. Elastomeric chains were divided into 6 groups (n=18) of elastic chain segments, distributed as follows: Group CW (Deionized water) Group CS (Artificial saliva), Group CC (Coca-Cola®) Group SP (Sprite®) Group GA (Guaraná Antártica®) and Group FA(Fanta®). Elastics were stretched in 50% of the initial length and were held for initial, 1, 7, 14, 21 and 28 day time intervals. Force magnitudes were measured at 23.5 mm of activation using a digital meter. Force decay were assessed using analysis of variance(ANOVA) and Tukey's test(p<.05). Control Group CS saliva demonstrated the highest elastic decay values, with statistical difference between time of 24h with time intervals of 14, 21 and 28 days (p<.05). In comparison between groups, there was statistical difference between Group CS and Groups CW and FA in all experimental time-intervals, with group CC in time-intervals 7, 14, 21 and 28 days and with Group GA in time-intervals 7, 14 and 21 days (p<.05). In decreasing order: Coca-cola®, Fanta®, Guarana Antartica® and Sprite® demonstrated capacity to influence elastomeric chain decay, however with less influence than the saliva medium.

Este estudo objetivou investigar as alterações das propriedades físicas de cadeias elastoméricas ortodônticas quando em contato com diferentes controles e bebidas ácidas. Cadeias elastoméricas foram divididas em 6 grupos (n=18) de segmentos de elásticos em cadeia, assim distribuídos: Grupo CW (água deionizada), Grupo CS (saliva artificial), Grupo CC (Coca-Cola®), Grupo SP (Sprite®), Grupo GA (Guaraná Antártica®) e Grupo FA (Fanta®). Os elásticos foram esticados em 50 % do comprimento inicial e mantidos pelos intervalos de tempo inicial, 1, 7, 14, 21 e 28 dias. Magnitudes de força foram medidos em 23.5 mm de ativação usando um medidor digital. Degradação da Força foi avaliada através da análise de variância (ANOVA) e teste de Tukey (p<.05). Grupo Controle CS saliva demonstrou os maiores valores de degradação elástica, com diferença estatística entre o tempo de 24 h com intervalos de tempo de 14, 21 e 28 dias (p<.05). Na comparação entre os grupos, houve diferença estatística entre o Grupo CS e os Grupos CW e FA em todos os intervalos de tempos experimentais, com grupo CC nos intervalos de tempo de 7, 14, 21 e 28 dias e com o Grupo GA nos intervalos de tempo de 7, 14 e 21 dias (p<.05). Em ordem decrescente: Coca-cola®, Fanta®, Guaraná Antartica® e Sprite® demonstraram capacidade de influenciar a degradação da cadeia elastomérica, porém com menos influência do que o meio de saliva.

Effect of commonly used beverage, soft drink, and mouthwash on force delivered by elastomeric chain: a comparative in vitro study.

BACKGROUND: The objective was to evaluate and compare the effect of Coca-Cola®, tea, Listerine® mouthwash on the force delivered by elastomeric chain in vitro. MATERIALS AND METHODS: Four specimen groups (distilled water, Coca-Cola®, tea, Listerine® mouthwash) with a total sample size of 480 specimens. A specimen is described as a four link grey close elastomeric chain. Jigs, each with a series of pins set 25 mm apart, was used to hold stretched elastomeric chains at a constant length. These jigs allowed for complete submersion of the elastomeric chain in a water bath throughout the test period, as well as the dipping of elastomeric chains in respective control and test solutions. For 60 s, twice a day, groups were exposed to the respective solutions, the two daily exposure was separated by 9 h and force measurements were taken at six time points during the experiment, that is, 1 h, 24 h, 7 days, 14 days, 21 days, and 28 days. Force measurements were made by Instron machine by a single blinded examiner with the help of a second examiner. RESULTS: It was found out that there was highly significant difference between groups control, Coca-Cola®, Listerine®, and tea as well as there was highly significant (p < 0.01) between time periods. Group versus time was also highly significant (p < 0.01). For all groups substantial amount of force decay occurred until 7 days. The control group reached plateau between 7 and 14 days and then suddenly decreased from 14 days to 28 days. The Coca-Cola® and the Listerine® group reached a plateau between 7 and 21 days then decrease between 21 and 28 days. The tea group showed plateau phase between 7 and 28 days. After 28 days in the control group, 25% force decay occurred while the test groups force decay of 30-50% occurred. CONCLUSION: Coca-Cola®, Listerine® mouthwash, and tea cause an increase in force decay of elastomeric chains over time. Tea caused highest force decay followed by Listerine® and Coca-Cola® when compared to control group. How to cite the article: Kumar K, Shetty S, Krithika MJ, Cyriac B. Effect of commonly used beverage, soft drink, and mouthwash on force delivered by elastomeric chain: A comparative in vitro study. J Int Oral Health 2014;6(3):7-10.

Force degradation of different elastomeric chains and nickel titanium closed springs

Aim: The purpose in this study was to evaluate the degradation force of conventional synthetic orthodontic elastics and synthetic orthodontic elastics with memory properties. Methods: Specimens of each material (Plastic chain, Memory chain and Closed spring NiTi) were stretched and adapted to the test specimens composed of resin plates and orthodontic wires, simulating retraction units. Degradation force was verified in an Instron universal test machine at the following intervals: 1, 2, 18, 24, 48 h; 7, 14, 21, and 28 days. Data (gF) were analyzed statistically using Friedman and Kruskal-Wallis tests at 5% significance level. Results: It was observed a significant force reduction of Plastic chain and Memory chain after 2 h (p<0.05). For NiTi spring significantly force reduction was observed after 18 h, but no significant change was showed up to 21 days. NiTi spring showed force significantly higher than synthetic elastomeric materials (p<0.05). There was no significant difference between Memory chain and Plastic chain up to 24 h. However, from 48 h to 21 days Memory chain showed force significantly higher than Plastic chain. Conclusions: There was higher force degradation in the synthetic elastomeric materials in comparison with NiTi springs, which allows the preferential indication of these space closure jigs for clinical use.