Material testing of reconditioned orthodontic brackets

Comparative evaluation of different debonding and reconditioning methods for orthodontic ceramic brackets regarding effectiveness for reuse : An in vitro study

PURPOSE

To investigate the reusability of ceramic brackets in terms of shear bond strength, friction behavior, slot dimension, fracture strength, and color stability.

METHODS

A total of 90 conventionally debonded and 30 by an Er:YAG laser debonded ceramic brackets were collected. All the used brackets were inspected under a stereomicroscope at 18 × magnification and sorted according to their adhesive remnant index (ARI). Five groups were formed (n = 10): (1) new brackets as a control group, (2) flamed and sandblasted, (3) flamed and acid bathed, (4) laser-reconditioned, and (5) laser-debonded brackets. The bracket groups were tested regarding different properties such as shear bond strength, friction behavior, slot size, fracture strength, and color stability. Analysis of variance (ANOVA) and nonparametric Kruskal-Wallis tests were used for statistical analysis (significance level: p < 0.05).

RESULTS

Shear bond strength values of the acid reconditioned brackets were significantly lower (8.0 ± 3.1 MPa) compared to the control group (12.9 ± 2.9 MPa). Laser-reconditioned (32.8 ± 2.7%) and laser-debonded (30.9 ± 2.4%) brackets showed the lowest force loss due to friction (control group 38.3 ± 3.0%). No significant differences were observed between groups regarding slot size and fracture strength. All groups had color differences of [Formula: see text]< 10. Scanning electron microscope images and ARI scores indicated that most of the residues on the bracket bases were removed.

CONCLUSION

All reconditioning methods yielded adequate results regarding bracket properties. Yet, focusing on the need to protect the enamel and the bracket base, laser debonding seems to be the most suitable method for reconditioning ceramic brackets.

In vitro wearing away of orthodontic brackets and wires in different conditions: A review

Introduction

The release of metallic ions from orthodontic brackets and wires typically depends on their quality (chemical composition) and the medium to which they are exposed, e.g., acidic, alkaline, substances with a high fluoride concentration, etc. This review examines corrosion and wear of orthodontic brackets, wires, and arches exposed to different media, including: beverages (juices), mouthwashes and artificial saliva among others, and the possible health effects resulting from the release of metallic ions under various conditions.

Objective

This review aims to determine the exposure conditions that cause the most wear on orthodontic devices, as well as the possible health effects that can be caused by the release of metallic ions under various conditions.

Sources

A search was carried out in the Scopus database, for articles related to oral media that can corrode brackets and wires. The initial research resulted in 8,127 documents, after applying inclusion and exclusion criteria, 76 articles remained.

Conclusion

Stainless steel, which is commonly used in orthodontic devices, is the material that suffers the most wear. It was also found that acidic pH, alcohols, fluorides, and chlorides worsen orthodontic material corrosion. Further, nickel released from brackets and wires can cause allergic reactions and gingival overgrowth into patients.

Are Metal Ions That Make up Orthodontic Alloys Cytotoxic, and Do They Induce Oxidative Stress in a Yeast Cell Model?

Compositions of stainless steel, nickel-titanium, cobalt-chromium and β-titanium orthodontic alloys were simulated with mixtures of Fe, Ni, Cr, Co, Ti and Mo metal ions as potential oxidative stress-triggering agents. Wild-type yeast Saccharomyces cerevisiae and two mutants ΔSod1 and ΔCtt1 were used as model organisms to assess the cytotoxicity and oxidative stress occurrence. Metal mixtures at concentrations of 1, 10, 100 and 1000 µM were prepared out of metal chlorides and used to treat yeast cells for 24 h. Every simulated orthodontic alloy at 1000 µM was cytotoxic, and, in the case of cobalt-chromium alloy, even 100 µM was cytotoxic. Reactive oxygen species and oxidative damage were detected for stainless steel and both cobalt-chromium alloys at 1000 µM in wild-type yeast and 100 µM in the ΔSod1 and ΔCtt1 mutants. Simulated nickel-titanium and β-titanium alloy did not induce oxidative stress in any of the tested strains.

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.

In vivo determination of aluminum, cobalt, chromium, copper, nickel, titanium and vanadium in oral mucosa cells from orthodontic patients with mini-implants by Inductively coupled plasma-mass spectrometry (ICP-MS)

Miniscrews are used as orthodontic anchorage devices in the dentistry clinical practice but the in vivo metallic release from these structures has been not previously investigated. The aim of this study was to determine the content of Al, Co, Cr, Cu, Ni, Ti and V in oral mucosa cells of control subjects, patients under orthodontic treatment and with both, orthodontic treatment and miniscrew, in order to know the contribution of these mini-implants to the total metallic content. ICP-MS measurements revealed the following ascending order: Cr<Ni<Ti<Cu<Al, and Co and V were practically undetected. Significant differences in comparison to the control group were found for Cu in the orthodontic group, and for Ni in both, orthodontic and orthodontic+miniscrew groups. Potential correlations among metallic elements and with some clinical factors were also explored. These findings suggest that miniscrews do not increase significantly the metal release.

In vitro and in vivo evidence of the cytotoxic and genotoxic effects of metal ions released by orthodontic appliances: A review

Intraoral fixed orthodontic appliances are frequently used in the clinical practice of dentistry. They are made from alloys containing different metals at various percentages. The use of these appliances leads to the long-term exposure of patients to these materials, and the potential toxic effects of this exposure raises concerns about patient safety. Thus, the biocompatibility (corrosion behaviour and toxicity) of these materials has to be evaluated prior to clinical use. In the present report, the most recent studies in the scientific literature examining metal ion release from orthodontic appliances and the toxic effects of these ions have been reviewed with a special focus on cytotoxicity and genotoxicity. Previous studies suggest that a case-by-case safety evaluation is required to take into account the increasing variability of materials, their composition and the manufacturing processes. Moreover, in vivo toxicity studies in regard to metal release, cytotoxicity and genotoxicity are still scarce. Therefore, in vitro and in vivo monitoring studies are needed to establish cause-effect relationships between metal ion release and biomarkers of cytotoxicity and genotoxicity. Further investigations could be performed to elucidate the toxic mechanisms involved in the observed effects with a special emphasis on oxidative damage.