Use of Antimicrobial Silver Coatings on Fixed Orthodontic Appliances, Including Archwires, Brackets, and Microimplants: A Systematic Review.

Orthodontic treatments, while essential for achieving optimal oral health, present challenges in infection control due to the propensity for bacterial adhesion and biofilm formation on orthodontic appliances. Silver-coated orthodontic materials have emerged as a promising solution, leveraging the potent antimicrobial properties of silver nanoparticles (AgNPs). Antibacterial coatings are used in orthodontics to prevent the formation of bacterial biofilms. This systematic review evaluated the literature on antimicrobial silver coatings on fixed orthodontic appliances, including archwires, brackets, and microimplants. Two evaluators, working independently, rigorously conducted a comprehensive search of various databases, including PubMed, PubMed Central, Embase, Scopus and Web of Science. This systematic review comprehensively examined in vitro studies investigating the antimicrobial efficacy of silver-coated orthodontic archwires, brackets, and microimplants. The review registered in PROSPERO CRD42024509189 synthesized findings from 18 diverse studies, revealing consistent and significant reductions in bacterial adhesion, biofilm formation, and colony counts with the incorporation of AgNPs. Key studies demonstrated the effectiveness of silver-coated archwires and brackets against common oral bacteria, such as Streptococcus mutans and Staphylococcus aureus. Microimplants coated with AgNPs also exhibited notable antimicrobial activity against a range of microorganisms. The systematic review revealed potential mechanisms underlying these antimicrobial effects, highlighted implications for infection prevention in orthodontic practice, and suggested future research avenues. Despite some study heterogeneity and limitations, the collective evidence supports the potential of silver-coated orthodontic materials in mitigating bacterial complications, emphasizing their relevance in advancing infection control measures in orthodontics.

Investigation of mechanical properties, remineralization, antibacterial effect, and cellular toxicity of composite orthodontic adhesive combined with silver-containing nanostructured bioactive glass.

BACKGROUND: The formation of white spots, which represent early carious lesions, is a major issue with fixed orthodontics. The addition of remineralizing agents to orthodontic adhesives may prevent the formation of white spots. The aim of this study was to produce a composite orthodontic adhesive combined with nano-bioactive glass-silver (nBG@Ag) for bracket bonding to enamel and to investigate its cytotoxicity, antimicrobial activity, remineralization capability, and bond strength. METHODS: nBG@Ag was synthesized using the sol-gel method, and characterized using transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy with an attenuated total reflectance attachment (ATR-FTIR). The cytotoxicity test (MTT) and antimicrobial activity of adhesives containing 1%, 3%, and 5% (wt/wt) nBG@Ag were evaluated, and the shear bond strength of the adhesives was measured using a universal testing machine. Remineralization was assessed through microhardness testing with a Vickers microhardness tester and scanning electron microscopy (SEM). Statistical analyses were conducted using the Shapiro-Wilk test, Levene test, one-way ANOVA, Robust-Welch test, Tukey HSD method, and two-way ANOVA. RESULTS: The biocompatibility of the adhesives was found to be high, as confirmed by the lack of significant differences in the cytotoxicity between the sample and control groups. Discs made from composites containing nBG@Ag exhibited a significant reduction in the growth of Streptococcus mutans (p < 0.05), and the antibacterial activity increased with higher percentages of nBG@Ag. The shear bond strength of the adhesives decreased significantly (p < 0.001) after the addition of nanoparticles, but it remained above the recommended value. The addition of nBG@Ag showed improvement in the microhardness of the teeth, although the differences in microhardness between the study groups were not statistically significant. The formation of hydroxyapatite deposits on the tooth surface was confirmed through SEM and energy-dispersive X-ray spectroscopy (EDX). CONCLUSION: Adding nBG@Ag to orthodontic adhesives can be an effective approach to enhance antimicrobial activity and reduce enamel demineralization around the orthodontic brackets, without compromising biocompatibility and bond strength.

Does surface priming increase the bond strength of orthodontic brackets? An experimental study.

OBJECTIVE: To evaluate the effects of metal primer II (MP II) on the shear bond strength (SBS) of orthodontic brackets bonded to teeth and bis-acryl composite provisional material (Bis-Acryl). MATERIAL AND METHODS: Twenty extracted human premolars specimens and 20 premolar shaped Bis-Acryl specimens were obtained and randomly divided into two surface groups. The first group consisted of human premolars (T) bonded to brackets in the conventional way while in the second (T-MP) MP II was applied on the bracket base before bonding. Similarly, one group of provisional material (PM) was prepared according to conventional treatment and another with the application of MP-II metal bonder (PM-MP). In all cases Ortho-brackets (Victory Series, 3 M) were bonded employing Transbond XT resin cement. Then the brackets were debonded under shear and the results were statistically analyzed by two-way analysis of variance and Holm Sidak at α = .05. The debonded surfaces of all specimens were examined by light microscopy and the Adhesive Remnant Index (ARI) was recorded. RESULTS: The SBS results exhibited significant differences er (p < .001). For both the T and TM the application of MP-II increased the SBS compared to respective control groups (p < .001). The T-C group was found inferior compared to PM-C (p < .001) and the same is true for the comparison between T-MP and PM-MP (p < .001). ARI indexes demonstrated that the tooth groups were characterized by a predominantly adhesive failure at the resin-dentin interface. In contrast, the control group for provisional crowns (PM-C) showed a predominantly cohesive failure mode, which moved to predominantly adhesive after the application of MP II. CONCLUSION: The application of MP II enhances the SBS on both, human enamel and provisional crown materials.

Comparison of transverse dimensional and incisor changes between wide and narrow orthodontic archwires: a randomized controlled trial.

OBJECTIVES: To clinically compare the effects of broader archwires to standard archwires, using conventional brackets in both cases, on the transverse and incisor changes in maxillary and mandibular arches during leveling and alignment. MATERIALS AND METHODS: Fifty-two patients presenting with crowding were allocated into two groups; one group received the broad Damon archwires while the other received standard 3M OrthoForm III Ovoid archwires. All participants were treated with conventional brackets using similar archwire sequences (0.014, 0.018, 0.016 × 0.022/0.016 × 0.025, 0.019 × 0.025 NiTi/CuNiTi archwires). Digital casts were obtained from alginate impressions before treatment (T0) and six weeks after inserting 0.019 × 0.025 NiTi archwires (T1). Pretreatment (T0) and post-alignment (T1) lateral cephalograms were obtained for each patient. The primary outcomes were the changes in the transverse arch dimensions and incisor inclination. The secondary outcomes were the horizontal and vertical linear changes in incisor position. RESULTS: Complete data were collected for 47 patients. There was a significant increase in arch width during treatment within each group, except for upper inter-molar width in 3M group (P = 0.071). Damon wire induced a statistically significant increase in maxillary inter-second premolar width (P = 0.042), and mandibular inter-first premolar (P = 0.043), inter-second premolar (P = 0.008) and inter-molar widths (P = 0.033) compared to 3M group. The increase in incisor proclination and the linear change in incisor position were significant within each group, with less mandibular incisor proclination (P = 0.004) and horizontal advancement (P = 0.038) in the Damon group. CONCLUSIONS: Damon archwires created a comparatively greater increase in the maxillary inter-second premolar width and the mandibular inter-first premolar, inter-second premolar, and inter-molar widths, and less proclination and horizontal advancement in mandibular incisors. The study provides invaluable evidence that using broad archwires with self-ligating brackets is the reason behind any greater expansion observed in this system rather than the unique mechanical and biological features exerted by the self-ligating system. CLINICAL RELEVANCE: Our results suggest that Damon archwire might be a better alternative compared to the narrower standard archwires that are usually used with conventional brackets, especially in the mandibular arch, in cases where mild to moderate crowding is planned to be resolved with a non-extraction approach. However, as arch expansion in the absence of posterior crossbites raises the question of long-term stability, the reported advantage of the use of wide wires should be interpreted with caution and should be considered in the retention phase, bearing in mind that achieving a good post-treatment occlusion is important for enhancing post-treatment stability.

Resin infiltration versus fluoride varnish for visual improvement of white spot lesions during multibracket treatment. A randomized-controlled clinical trial.

AIMS: This study aimed to evaluate the visual improvement of resin infiltration of white spot lesions (WSL) during orthodontic treatment with the multibracket appliance (MBA) compared to fluoride varnish. METHODS: Patients aged 12-17 years with at least one WSL with an International Caries Detection and Assessment System (ICDAS) score of 1-2 during an active MBA treatment were included and randomized to receive either resin infiltration (Icon) or fluoride application (Flairesse). Standardized digital images were obtained before, one-day, one-week, one-month, three-months and six-months after treatment using a DSLR camera and a matching polarization filter. A grey reference card was used for color standardization. A Matlab routine was used to measure the color difference between adjacent healthy enamel and treated WSL. The independent-samples t-test was used for intergroup and paired-samples t-test for intragroup comparison. RESULTS: Images of 116 teeth from 36 patients were analyzed. The ΔE for the "Icon" treated WSL was smaller (T1ICON = 5.0 ± 1.4) than in the fluoride group (T1Fluoride = 8.4 ± 3.2). Caries infiltration significantly improved the aesthetic appearance of WSL (p < 0.001), which remained satisfactory at six months (T5ICON = 5.2 ± 1.6). CONCLUSION: WSL infiltration management during orthodontic treatment was superior to topical fluoridation in not only arresting the enamel lesions but also significantly improving the aesthetic appearance of demineralized regions around the brackets. CLINICAL RELEVANCE: WSL treatment in orthodontic patients is usually initiated after debonding. Research has shown that the earlier WSL is treated, the better the aesthetic outcome. There is limited data on the efficacy of resin infiltration of WSL during orthodontic treatment.

The effect of freezing on the fracture pattern of adhesive on debonding: an in-vitro study.

The purpose of this study was to quantitatively evaluate adhesive remnants on the enamel surface following bracket debonding using a freezing element. Thirty-six sound premolars were used in this study. In each case, a bracket was bonded onto each tooth with conventional light-cured composite resin and de-bonded after one week. Freezing of the underlying composite through the bracket was performed immediately before debonding with a portable cryosurgical system (-55 °C). Specimens were divided into three groups according to the duration of freezing: a control group without freezing was used as a reference and two interventional groups with different durations of freezing (15 or 40 s). Brackets were removed by using debonding pliers to squeeze the wings of the bracket in an occluso-gingival manner. Adhesive remnants on the tooth were then quantitatively evaluated by stereo-microscopy. Pearson's Chi-squared test was used to investigate the relationship between the proportion of remaining resin and the group of teeth. In the control group, 100% of the composite remained on the enamel surface of all specimens. Significantly less adhesive remnants were found in the intervention groups (p = 0.001 for the 15 s group and p = 0.043 for the 40 s group). There was no significant difference between the two interventions (p = 0.165) in terms of the proportion of remaining adhesive remnants. Freezing of the bracket and the underlying adhesive resin prior to bracket debonding may favorably alter the behavioral pattern of composite fracture, thus reducing the extent of adhesive remnants on the enamel. Increasing the freezing time from 15 to 40 s did not exert significant effects on adhesive remnants following debonding. Further research now needs to investigate the effect of freezing on the mechanical properties of the adhesive remnants and its in-vivo effect on pulp vitality over both short- and long-terms.

Effect of fence tray matching care on excess adhesive and bracket placement accuracy for orthodontic bonding: an in vitro study.

OBJECTIVE: This study aimed to evaluate the effect of fence tray matching care (FTMC) in bracket bonding by measuring excess adhesive, as well as linear and angular deviations, and by comparing it with the half-wrapped tray (HWT). MATERIALS AND METHODS: An intraoral scanner was used to acquire data on the maxillary dental arch of a patient with periodontitis.Furthermore, 20 maxillary dental arch models were 3D printed. Using 3Shape, PlastyCAD software, and 3D printing technology, 10 FTMC (method I) and HWT (method II) were obtained. By preoperative preparation, intraoperative coordination, and postoperative measurement, the brackets were transferred from the trays to the 3D-printed maxillary dental arch models. Additionally, the bracket's excess adhesive as well as linear and angular deviations were measured, and the differences between the two methods were analyzed. RESULTS: Excess adhesive was observed in both methods, with FTMC showing less adhesive (P< 0.001), with a statistical difference. Furthermore, HWT's vertical, tip and torque, which was significantly greater than FTMC (P< 0.05), with no statistical difference among other respects. The study data of incisors, canines, and premolars, showed that the premolars had more adhesive residue and were more likely to have linear and angular deviations. CONCLUSIONS: The FTMC had higher bracket bonding effect in comparison to HWT, and the adhesive residue, linear and angular deviations are smaller. The fence tray offers an intuitive view of the precise bonding of the bracket, and can remove excess adhesive to prevent white spot lesions via care, providing a different bonding method for clinical applications.

Enamel surface roughness following debonding resin clean up using high speed air-turbine and electric handpieces. In vitro study.

BACKGROUND: High speed electric handpieces have recently been growing in popularity among dental professionals. Advantages include smoother surface preparation and increased cutting efficiency. AIM: The primary objective was to compare enamel surface roughness following resin cleanup after bracket debonding using highspeed air turbine versus electric handpiece. The secondary objective was to record the time needed for resin-clean up. METHOD: Forty deidentified freshly extracted human premolars were cleaned and sectioned at the cement-enamel junction. The crowns were embedded in acrylic blocks. Enamel surface roughness parameters (Ra, Rz, Rp and Rv) were measured using a stylus profilometer. Brackets were bonded using a light-cure orthodontic adhesive and stored in distilled water for 24 h. Following bracket debonding, the specimens were randomly divided into 2 groups: First group: resin clean-up was carried out using a 12-fluted carbide bur mounted on a high-speed air turbine; and second group: where an electric handpiece was used. Surface roughness parameters were measured following resin clean up and after polishing using pumice and a rubber cup. Time needed for resin clean-up was recorded. Differences in enamel surface roughness and time between groups were compared using repeated measures ANOVA and independent samples t-test, respectively at P ≤ 0.05. RESULTS: The electric handpiece groups showed significantly higher values for Ra, Rz and Rp both following resin cleanup and polishing. Time taken for resin cleanup was significantly longer for the electric handpiece group. CONCLUSION: Considering both surface roughness and time, electric handpiece do not seem to add greater effectiveness or efficiency to resin cleanup following orthodontic bracket debonding.

Evaluation of the surface characteristics and antibacterial properties of Titanium dioxide nanotube and methacryloyloxyethylphosphorylcholine (MPC) coated orthodontic brackets-a comparative invitro study.

OBJECTIVES: White spot lesions are the most common iatrogenic effect observed during orthodontic treatment. This study aimed to compare the surface characteristics and antibacterial action of uncoated and coated orthodontic brackets. MATERIALS AND METHODS: Sixty commercially available stainless steel brackets were coated with TiO2 nanotubes and methacryloyloxyethylphosphorylcholine. The sample was divided into Group 1: uncoated orthodontic brackets, Group 2: Stainless steel brackets with TiO2 nanotubes coating, Group 3: Stainless steel brackets with methacryloyloxyethylphosphorylcholine coating, and Group 4: Stainless steel brackets with TiO2 nanotubes combined with methacryloyloxyethylphosphorylcholine coating. Surface characterization was assessed using atomic force microscopy and scanning electron microscopy. Streptococcus mutans was selected to test the antibacterial ability of the orthodontic brackets, total bacterial adhesion and bacterial viability were assessed. The brackets were subjected to scanning electron microscopy to detect the presence of biofilm. RESULTS: The surface roughness was the greatest in Group 1 and least in Group 2 followed by Group 4 and Group 3 coated brackets. The optical density values were highest in Group 1 and lowest in Group 4. Comparison of colony counts revealed high counts in Group 1 and low counts in Group 4. A positive correlation between surface roughness and colony counts was obtained, however, was not statistically significant. CONCLUSIONS: The coated orthodontic brackets exhibited less surface roughness than the uncoated orthodontic brackets. Group 4 coated orthodontic brackets showed the best antibacterial properties. CLINICAL RELEVANCE: Coated orthodontic brackets prevent adhesion of streptococcus mutans and reduces plaque accumulation around the brackets thereby preventing formation of white spot lesions during orthodontic treatment.

Percentage of patients shifting to another treatment modality: An experience-guided decision.

OBJECTIVE: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. MATERIAL AND METHODS: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). RESULTS: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. CONCLUSIONS: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.

Formulation of arginine-loaded mesoporous silica nanoparticles (Arg@MSNs) modified orthodontic adhesive.

OBJECTIVES: The objective of this study was to synthesize arginine loaded mesoporous silica nanoparticles (Arg@MSNs), develop a novel orthodontic adhesive using Arg@MSNs as modifiers, and investigate the adhesive performance, antibacterial activity, and biocompatibility. METHODS: Arg@MSNs were synthesized by immobilizing arginine into MSNs and characterized using transmission electron microscope (TEM), dynamic light scattering (DLS), and Fourier Transform Infrared Spectrometer (FT-IR). Arg@MSNs were incorporated into Transbond XT adhesive with different mass fraction to form functional adhesives. The degree of conversion (DC), arginine release behavior, adhesive performance, antibacterial activity against Streptococcus mutans biofilm, and cytotoxicity were comprehensively evaluated. RESULTS: TEM, DLS, and FT-IR characterizations confirmed the successful preparation of Arg@MSNs. The incorporation of Arg@MSNs did not significantly affect DC and exhibited clinically acceptable bonding strength. Compared to the commercial control, the Arg@MSNs modified adhesives greatly suppressed the metabolic activity and polysaccharide production while increased the biofilm pH values. The cell counting kit (CCK)-8 test indicated no cytotoxicity. CONCLUSIONS: The novel orthodontic adhesive containing Arg@MSNs exhibited significantly enhanced antibacterial activities and inhibitory effects on acid production compared to the commercial adhesive without compromising their bonding strength or biocompatibility. CLINICAL SIGNIFICANCE: The novel orthodontic adhesive containing Arg@MSNs exhibits potential clinical benefits in preventing demineralization of enamel surfaces around or beneath orthodontic brackets due to its enhanced antibacterial activities and acid-producing inhibitory effects.

Bleaching versus color change resistant adhesive in the discoloration of bracket-bonded tooth surfaces: an in vitro study.

OBJECTIVES: The aim of this study was to compare the effect of office bleaching of teeth bonded with Transbond XTTM (3M Unitek, Monrovia, CA, USA) (TRXT) and the use of color change resistant Orthocem (FGM, Joinville, Brazil) in bracket bonding on coffee-induced enamel discoloration. MATERIALS AND METHODS: Eighty premolars were distributed in equal numbers (n = 20) to group 1 (TRXT + distilled water), group 2 (TRXT + coffee solution), group 3 (TRXT + coffee solution + bleaching), and group 4 (Orthocem + coffee solution). Color was measured using a SpectroShade Micro (MHT, International, Verona, Italy) device at the beginning (T0), after coloring (T1), after bleaching (T1B), and after debonding (T2). ΔE color change values were calculated as T1-T0, T1B-T0 and T2-T0 differences. The conformity of the data to the normal distribution was examined with the Shapiro-Wilk test. Multiple comparisons were made with Tamhane's T2 test and Tukey's HSD test using one-way analysis of variance in the comparison of normally distributed data, and multiple comparisons were made with Dunn's test using the Kruskal-Wallis H test for comparison of non-normally distributed data. The significance level was set at p < 0.050. RESULTS: A statistically significant (p < 0.001) difference was found between the T1-T0 and T2-T0 stages for group 1-4 ΔE values. A statistically significant (p < 0.001) difference was also found when the T1B-T0 ΔE values of group 3 were compared with the T1-T0 ΔE values of groups 1, 2, and 4. CONCLUSIONS: After coffee-induced enamel discoloration, bleaching of teeth bonded with TRXT produced acceptable color difference of the incisal, middle, and gingival regions of the crown. In teeth bonded with Orthocem, acceptable color difference was seen only in the middle of the crown. CLINICAL RELEVANCE: The presented study will guide the clinician on how enamel discoloration side effect of fixed orthodontic appliance can reduce.

Effects of different primers and colouring solutions on orthodontic bonding: shear bond strength and colour change.

OBJECTIVES: This in vitro study evaluated the effect of different colouring solutions and primer systems used in the bonding of brackets on enamel colour change and bond strength. MATERIALS AND METHODS: 120 premolar teeth were divided into four main groups; brackets were bonded with 37% orthophosphoric acid + Transbond XT Primer in Group 1, 3 M Single Bond Universal in Group 2, Transbond Plus SEP in Group 3, and G-Premio Bond in Group 4. Each group was divided into three subgroups, and the teeth were placed in a cup containing coffee and tea mixture, in a cup containing cola and in distilled water. A bond strength test was applied to all teeth. Colour measurements of all teeth were performed at 2 different times: before bonding and after the bond strength test. RESULTS: The average bond strength of the 37% orthophosphoric acid group was higher than that of the other groups. The effect of primer and solution groups on colour change was statistically significant (p = 0.001 and p = 0.023, respectively). CONCLUSIONS: In this study, the bond strength was clinically sufficient in all primer groups. The highest colour change was observed when the tea-coffee solution and Transbond Plus SEP primer were used. CLINICAL RELEVANCE: This study has identified enamel discoloration and bond strength from different colouring solutions and primer systems used for bonding braces, which can be used to inform clinicians and patients to achieve better treatment results.

Evaluation of enamel surface integrity after orthodontic bracket debonding: comparison of three different system.

OBJECTIVE: This study aimed to evaluate enamel surface integrity and time consumed during residual cement removal after bracket debonding using different adhesive removal burs with and without a dental loupe. MATERIAL AND METHODS: Sixty human-extracted premolars were collected, cleaned, mounted, and prepared for orthodontic bracket bonding. Teeth were randomly divided into three main groups (n = 20) based on the adhesive removal method: tungsten carbide system (TC), sof-lex discs system (SD), and diamond system (DB) groups. Then, each group was subdivided into two subgroups (naked eye and magnifying loupe subgroups). The brackets were bonded and then debonded after 24 h, and the Adhesive Remnant Index (ARI) was assessed. The adhesive remnants were removed by different systems, and the final polishing was performed by Silicone OneGloss. The enamel surface roughness was evaluated before bracketing (T0), after residual cement removal (T1), and finally after polishing (T2) using surface Mitutoyo SJ-210 profilometry and Scanning Electron Microscopy (SEM) to determine the Enamel Damage Index (EDI) score. The time consumed for adhesive removal was recorded in seconds. RESULTS: The Kruskal Wallis test showed a statistically significant difference in roughness values at T1 compared to T2 between subgroups (p < 0.001). When comparing EDI at T1 and T2, the Kruskal-Wallis H-test showed statistically significant differences in all subgroups. The pairwise comparisons revealed that EDI scores showed a statistically significant difference at T1 and T2 between DB vs. TC and SD (p = 0.015) but not between TC vs. SD (p = 1.000), indicating the highest roughness value observed in the DB group. The time for cement removal was significantly shorter in the magnifying loupe group than in the naked eye group and was shortest with the TC group, whereas the time was the longest with the DB group (p < 0.05). CONCLUSION: All three systems were clinically satisfactory for residual orthodontic adhesive removal. However, TC system produced the lowest enamel roughness, while the DB system created the greatest. The polishing step created smoother surfaces regardless of the systems used for resin removal.

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

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

Shear bond strength of orthodontic brackets bonded with primer-incorporated orthodontic adhesives and unpolymerized 3-dimensional printing materials on 3-dimensional-printed crowns.

INTRODUCTION: The use of 3-dimensional (3D) printing techniques in fabricating crowns has increased the demand for bracket bonding onto these surfaces. The objective was to evaluate the shear bond strength (SBS) of orthodontic brackets bonded onto 3D-printed crowns using primer-incorporated orthodontic adhesives and 3D printing materials as orthodontic adhesives. METHODS: A total of 160 crowns were printed with two 3D printing materials, DentaTOOTH (Asiga, Sydney, Australia) (group A) and NextDent C&B Micro Filled Hybrid (3D Systems, Soesterberg, Netherlands) (group N). Each group was randomly divided into 4 adhesive subgroups (n = 20): Transbond XT (for groups A [ATX] and N [NTX]; 3M Unitek, Monrovia, Calif), Ortho Connect (for groups A [AOC] and N [NOC]; GC Corporation., Tokyo, Japan), Orthomite LC (for groups A [AOM] and N [NOM]; Sun Medical, Co Ltd, Moriyama, Shiga, Japan), and unpolymerized liquid state of 3D printing resin (for groups A [AA] and N [NN]). SBS was measured with a universal testing machine at a crosshead speed of 0.5 mm/min. The adhesive remnant index and the mode of failure were analyzed under the microscope. Statistical analysis was performed at a significance level of α = 0.05. RESULTS: When used as adhesives (AA and NN), 3D printing materials showed no statistically significant difference in SBS compared with Transbond XT (ATX and NTX, respectively). In group N, NN showed a significantly higher SBS than primer-incorporated orthodontic adhesives (NOC and NOM; P <0.001). Adhesive failures were only observed in primer-incorporated orthodontic adhesives (AOC, NOC, AOM, and NOM). CONCLUSIONS: Primer-incorporated orthodontic adhesives, as well as unpolymerized 3D printing materials employed as orthodontic adhesives on 3D-printed crowns, exhibited comparable bonding strength to Transbond XT without surface modification. Despite variations in adhesive-related factors, all measurements stayed within clinically acceptable ranges, highlighting the potential of these materials for orthodontic bonding on 3D-printed crowns, simplifying clinical procedures without compromising bond strength.

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

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

Cleaning performance of electric toothbrushes around brackets applying different brushing forces: an in-vitro study.

Throughout treatment with fixed orthodontic appliances, effective plaque control is crucial to maintaining dental health. This in-vitro study evaluated the cleaning performance of eleven different brush heads of seven electric toothbrushes (oscillating-rotating and sonic motions) and varying brushing forces around orthodontic brackets. Six Mini Diamond® Twin brackets were placed on black-stained front teeth. Teeth were coated with white titanium oxide and brushed in a machine six times for one minute with two different brushing forces (1 N and 1.5 N). Eleven different brush heads were evaluated (either oscillating-rotating or sonic movements). The teeth were scanned and planimetrically evaluated after brushing. Three detailed plaque areas (DPAs) were created: proximal (< 1 mm to bracket), mid-tier (1-2 mm to bracket), and distant (> 2 mm to bracket). The proportion of contaminated proximal, mid-tier, and distant surfaces (white regions) in relation to the respective DPA was calculated. Independent of brushing forces, places with a higher distance (> 2 mm) to the orthodontic bracket had the least amount of residual contamination, followed by areas with a minor (1-2 mm) and proximal distance (< 1 mm). In all of the brushes tested and for both estimated brushing forces, the region with the highest residual contamination was the proximal area. The brush heads of the Paro® Sonic toothbrush left the least amount of residual contamination. The cleaning performance of electric toothbrushes around brackets on upper incisors varied across the brushes examined. The proximal area has the most residual contamination. Furthermore, 9 out of 11 toothbrushes cleaned more successfully with 1.5 N than with 1 N brushing force.