In vitro neuronal cytotoxicity of latex and nonlatex orthodontic elastics

Metals and Metalloids Release from Orthodontic Elastomeric and Stainless Steel Ligatures: In Vitro Risk Assessment of Human Exposure

Elastomeric ligatures are increasingly used as a part of esthetic orthodontic treatment, particularly in children. The aim of the present study was to experimentally test whether these appliances may contribute to exposure to toxic elements. In the present study, elastomeric ligatures (ELs) were incubated in artificial human saliva for 1 month (a typical period of their use) and the release of 21 metals (Ba, Cd, Co, Cr, Cu, Fe, Li, Mn, Mg, Mo, Ni, Pb, Rb, Tl, Ti, Sb, Sr, Sn, Zn, U, V) and 2 metalloids (As and Ge) was studied using inductively coupled plasma-mass spectrometry. For comparison, stainless steel ligatures (SLs) were incubated for 1, 3, and 6 months (since sometimes their use is prolonged) under similar conditions. The determined metal levels were compared to the corresponding safety limits for human exposure. During 1 month, the ELs released Cd, Co, Cr, Mn, Ni, and Sn at total mean ± SD level of 0.31 ± 0.09, 0.98 ± 0.30, 3.96 ± 1.31, 14.7 ± 8.5, 13.8 ± 4.8, and 49.5 ± 27.7 μg, respectively. Other elements were always below the detection limits. In case of SL, the release of Co, Cr, Fe, Ni, Mn, and Sn was observed, and the determined values increased over the studied period. After 6 months, their total mean ± SD levels amounted to 28.6 ± 0.2, 21.7 ± 0.2, 623.5 ± 3.0, 1152.7 ± 1.8, 5.5 ± 0.3, and 22.6 ± 0.2 μg, respectively. The released metal levels from both ligature types were always below safety limits. The release of Ni from SL during 6 months would constitute 5.0 and 11.5% of tolerable intake in adults and children, respectively. The results of this in vitro study highlight that the use of ligatures in orthodontic treatment can be considered safe in terms of metal exposure although elastic ligatures replaced on a monthly basis appear to be advantageous in comparison to the prolonged use of stainless steel appliances.

Force decay evaluation of latex and non-latex orthodontic intraoral elastics: in vivo study

Objective:

This clinical study was conducted in order to evaluate force decay over time of latex and non-latex orthodontic intraoral elastics.

Methods:

Patients (n = 15) were evaluated using latex and non-latex elastics in the periods of : 0, 1, 3, 12 and 24 hours. The rubber bands were transferred to the testing machine (EMIC DL-500 MF), and force values were recorded after stretching the elastic to a length of 25mm. Paired t test was applied and analysis of variance (ANOVA) was used to evaluate the variation of force generated. LSD (Fisher’s least significant difference) post-hoc test was thus employed.

Results:

As regards the initial forces (zero time), the values of force for non-latex elastic were slightly higher than for the latex elastic. In the subsequent times, the forces generated by the latex elastic showed higher values. Regarding the material degradation, at the end of 24 hours the highest percentage was observed for non-latex elastic.

Conclusions:

The latex elastics had a more stable behavior during the studied period, compared with non-latex.

Influence of temperature and humidity on the long-term storage of latex and non-latex orthodontic elastics

OBJECTIVES

The objective of this study was to evaluate the influence of long-term storage on latex and non-latex orthodontic elastics.

MATERIALS AND METHODS

The sample consisted of 300 orthodontic elastics, 150 latex and 150 non-latex (American Orthodontics^® *(AO) and Morelli^®) of medium force and a standard size of 3/16'' divided into 20 groups, 10 for each manufacturer, with 15 specimens each. The groups (G1*-G10* and G1-G10) were made up based on the manufacturer, storage temperature (ambient and refrigerated), material, and ambient humidity (exposed and non-exposed). The elastics were stretched and their forces measured in five progressive increases of 100% of their inner diameter, starting at a level of 200% stretching, by the MESDAN LAB 3000^® (MESDAN, Italy) testing machine. The tests were carried out at two different times: immediately in as-received state and again after 1 year. Data were analysed using SPSS 16.0 software, the Student's t-test, one-way analysis of variance (ANOVA) and the Tukey's post-test.

RESULTS

There was a statistically significant difference between the average forces exerted by the latex elastics compared to the non-latex elastics for all distention levels evaluated, except for 300%; however, the different storage conditions of temperature and humidity did not interfere in the mechanical properties.

CONCLUSION

Both the latex and non-latex elastics may be stored under any of the conditions tested in the present study, since there were no changes in the potential of the force exerted by the elastics in relation to their percentage stretch over a 1-year period.

Mechanical and biological properties of acrylic resins manipulated and polished by different methods

This study evaluated the influence of the manipulation technique and polishing method on the flexural strength and cytotoxicity of acrylic resins. Two manipulation techniques and three polishing methods were used in the fabrication of acrylic plates that were divided into 6 groups (n=10). Groups MM, MC and MW: mass technique with mechanical polishing, chemical polishing and without polishing, respectively; and Groups SM, SC and SW: Saturation technique with mechanical polishing, chemical polishing and without polishing, respectively). Flexural strength was tested in a universal testing machine and the cytotoxicity assay used cell cultures (L-929) for periods of 24 h to 168 h. Flexural strength and cytotoxicity data were assessed using two-way and three-way ANOVA, respectively (α=0.05), followed by post hoc Bonferroni test for multiple comparisons. The effect of combinations of manipulation techniques and polishing methods on flexural strength showed significant differences only between Group SC and Groups MW, MM and MC (p<0.01). Cell viability ranged from 51% (3.9%) to 87,6% (3.2) in the 24-h time interval, and from 87.8% (5.0) to 95.7% (3.1%) in the 168-h time interval. With the increase of cell viability, from the third day (72 h), there was no significant difference among the groups, except between MM and SC (p<0.01) at 72 h. In conclusion, the manipulation technique and polishing method had more influence on the cytotoxicity than on flexural strength.

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.

Latex and nonlatex orthodontic elastics: In vitro and in vivo evaluations of tissue compatibility and surface structure

Objective: 

To test the null hypothesis that there is no difference between latex and nonlatex orthodontic elastics with respect to tissue compatibility and surface structure.

Materials and Methods: 

Latex and nonlatex elastics were implanted in the subcutaneous connective tissue of 45 Wistar rats. In the control groups, no material was implanted (sham). After 24 hours, 3, 7, 14, and 21 days, the animals were euthanized; tissue samples were processed and analyzed by descriptive and semi-quantitative microscopic analysis and quantification of plasma extravasation. The surface structure of elastics was evaluated by scanning electron microscopy (SEM). The results were analyzed by analysis of variance (ANOVA), Tukey test and Kruskal-Wallis test at 5% significance level.

Results: 

Peri-implant plasma extravasation was significantly higher (P &lt; .05) in the animals that received latex elastics compared with those with nonlatex elastics and those that were control animals. The microscopic analysis revealed a more intense inflammatory infiltrate in the initial periods without statistically significant difference (P &gt; .05) between the experimental and control groups. The SEM analysis revealed that the latex elastics presented microspheres and porosities, while the nonlatex elastics exhibited crystals on their surface and absence of porosities.

Conclusion: 

The null hypothesis was rejected since the latex elastics were more irritating to the connective tissue than the nonlatex elastics in the initial periods and presented a more porous surface.

Cytotoxicity of elastomeric power chains in artificial saliva: an in vitro study

INTRODUCTION

The main aim of this paper is to investigate the cytotoxicity of elastomeric power chains after stretching and immersion in a solution of artificial saliva.

MATERIALS AND METHOD

Two brands of grey polyurethane power chains available from two different firms (GAC, G&H) were selected for cytotoxicity assay. Each segment was stretched up to an initial force of approximately 200 g. Then each segment was kept stretched using appropriate equipment. The samples were tested in artificial saliva at two pH levels, pH7 and pH4. Following incubation, the saliva was removed, filtered and placed in contact with cell culture media using the RD line.

RESULTS AND DISCUSSION

At this supernatant dilution, no statistically significant difference was observed between the different groups of power chains studied in terms of cell viability. The GAC and G&H power chains, whether stretched or not and immerged in either pH7 or pH4 saliva, showed no toxic effect on RD cells (human cell line).

BBB-targeting, protein-based nanomedicines for drug and nucleic acid delivery to the CNS

The increasing incidence of diseases affecting the central nervous system (CNS) demands the urgent development of efficient drugs. While many of these medicines are already available, the Blood Brain Barrier and to a lesser extent, the Blood Spinal Cord Barrier pose physical and biological limitations to their diffusion to reach target tissues. Therefore, efforts are needed not only to address drug development but specially to design suitable vehicles for delivery into the CNS through systemic administration. In the context of the functional and structural versatility of proteins, recent advances in their biological fabrication and a better comprehension of the physiology of the CNS offer a plethora of opportunities for the construction and tailoring of plain nanoconjugates and of more complex nanosized vehicles able to cross these barriers. We revise here how the engineering of functional proteins offers drug delivery tools for specific CNS diseases and more transversally, how proteins can be engineered into smart nanoparticles or 'artificial viruses' to afford therapeutic requirements through alternative administration routes.

Mechanisms of cell death induced by infusion sets leachables in in vitro experimental settings

Leachable materials that are released from infusion sets during their use can induce local and systemic toxic effects. We studied the mechanisms and kinetics of cell death induced by infusion sets leachates in vitro using L-929 and bEnd. 3 cells. Changes in cell morphology and metabolic activity were determined using light microscopy and the MTT test, respectively. Detailed analysis of the mechanisms of cell death was performed using membrane integrity and caspases 3 and 7 activity tests, annexin V-FITC/7-AAD analysis by FACS, and DAPI nuclear staining followed by confocal microscopy. Infusion sets released toxic leachables and induced toxic effects. Latex flashball was the most toxic part of the studied infusion sets, and it potently induced cell oncosis via increased permeability of the cell membrane. Latex-induced decrease in cells metabolic activity and cell death were not accompanied by activation of caspases 3 and 7, changes in nuclear morphology, or substantial annexin V-FITC cell staining. Leachables from the tube part of the infusion sets were less toxic, and induced some biochemical changes without altering the cells morphology. Further studies are needed to reveal the in vivo toxicity of infusion sets and its correlation with the results of in vitro toxicity studies.

Natural rubber latex allergy: implications for the orthodontist

Natural rubber latex (NRL) allergy can have potentially serious consequences, and reports of orthodontic patients reacting to NRL have increased significantly over recent years. It is therefore important for the orthodontist to know how to manage patients with an NRL allergy and how to deal with possible reactions to NRL. Safe and effective practice depends on recognizing patients who are at risk of NRL allergy, and an awareness of materials and equipment that contain NRL and the availability of suitable NRL-free alternatives.

An investigation into UV light exposure as an experimental model for artificial aging on tensile strength and force delivery of elastomeric chain

This study investigated the effect of ultraviolet type A light (UVA) exposure on the tensile properties of elastomeric chain. UVA light exposure was used as model for artificial aging, simulating prolonged storage of elastomeric chain. Tensile strength (n = 60) was measured after exposing Ormco, Forestadent and 3M chains to UVA light for 0, 2, 3, and 4 weeks. Force decay was measured (n = 60) using chain exposed for 5, 10, and 14 days. The chains were subsequently stretched at a constant distance and the resulting forces measured at 0, 1, 24 hours and 7, 14, 21, and 28 days. This test simulated a clinical scenario of pre-stretching and subsequent shortening of elastomeric chain. Tensile strength had statistically significant difference and was directly related to the duration of ultraviolet (UV) light exposure. Forestadent chain, which had the second highest value for the 'as received' product, showed the most consistent values over time with the lowest degradation. Ormco showed the lowest values for 'as received' as well as after UV exposure; 3M chain had the highest loss of tensile strength. Force decay was also significantly different. UV light exposure of 10 days or more appears to mark a 'watershed' between products: 3M had most survivors, Forestadent chain had some survivors, depending on the time the chain was stretched for. None of the Ormco product survived UV light exposure for more than 5 days. UVA light exposure may be used as a model for artificial aging as it reduces force delivery and tensile strength of exposed chains.

Development of an indirect stereolithography technology for scaffold fabrication with a wide range of biomaterial selectivity

Tissue engineering, which is the study of generating biological substitutes to restore or replace tissues or organs, has the potential to meet current needs for organ transplantation and medical interventions. Various approaches have been attempted to apply three-dimensional (3D) solid freeform fabrication technologies to tissue engineering for scaffold fabrication. Among these, the stereolithography (SL) technology not only has the highest resolution, but also offers quick fabrication. However, a lack of suitable biomaterials is a barrier to applying the SL technology to tissue engineering. In this study, an indirect SL method that combines the SL technology and a sacrificial molding process was developed to address this challenge. A sacrificial mold with an inverse porous shape was fabricated from an alkali-soluble photopolymer by the SL technology. A sacrificial molding process was then developed for scaffold construction using a variety of biomaterials. The results indicated a wide range of biomaterial selectivity and a high resolution. Achievable minimum pore and strut sizes were as large as 50 and 65 μm, respectively. This technology can also be used to fabricate three-dimensional organ shapes, and combined with traditional fabrication methods to construct a new type of scaffold with a dual-pore size. Cytotoxicity tests, as well as nuclear magnetic resonance and gel permeation chromatography analyses, showed that this technology has great potential for tissue engineering applications.

Cytotoxicity of separation orthodontic elastics

OBJECTIVE: To test the hypothesis that there is no difference in cytotoxicity between separating elastics of different manufacturers. METHODS: The present article compared latex elastics (4.0 mm, 4.4 mm and 4.8 mm) of four different manufacturers. The sample was allocated to seven groups of 9 elastics: Group A (American Orthodontics, green color, modules), Groups M1 and M2 (Morelli, blue color, modules and free in pack respectively), Groups M3 and M4 (Morelli, green color, modules and free in pack respectively), Group U (Uniden, blue color, free in pack) and Group T (Tecnident, blue color, free in pack) regarding their possible cytotoxic effects on oral tissues. Cytotoxicity assays were performed using cell culture medium containing epithelioid-type cells (Hep-2 line) derived from human laryngeal carcinoma and submitted to the methods for evaluating the cytotoxicity by the "dye-uptake" test, at time intervals 24, 48, 72 and 168 h. Data were compared by analysis of variance (ANOVA) and Tukey's test (p < 0.05). RESULTS: Results showed statistically significant difference (p < 0.05) between group U and all the other Groups (A, M1, M2, M3, M 4 and T) at 24 and 48 hours. CONCLUSIONS: Uniden elastics evoked more cell lysis at 24 and 48 h, although, all brands showed biocompatibility from 72 h onwards.

The influence of pH levels on mechanical and biological properties of nonlatex and latex elastics

OBJECTIVE

To evaluate the influence of pH levels on interarch elastics with regard to force decay and cytotoxicity.

MATERIALS AND METHODS

One nonlatex (NLAO) group and one latex (LAO) group were tested (n  =  10). Elastics were stretched to 25 mm and were held for 1, 6, 12, and 24 hours in artificial saliva solutions with pH levels of 5.0, 6.0, and 7.5. Force magnitudes were measured at 25 mm of activation. The cytotoxicity assay was performed using cell cultures (L929 mouse fibroblast cell line), which were subjected to the cell viability test with neutral red ("dye-uptake"). Force decay and cytotoxicity were assessed using analysis of variance, the Sidak method, and a Tukey's test.

RESULTS

The interactions between group, pH, and time showed no statistically significant differences (P  =  .29). When pH per time (P  =  .032) and group per time (P  =  .0009) were considered, these interactions showed statistically significant differences (P < .05). The pH did not interfere directly in the degradation results of the tested elastics. The cytotoxicity test showed that group LAO presented lower cell viability when compared with group NLAO over the course of the entire experiment. There was a gradual reduction in cell viability from 1 hour to 24 hours. A significant difference (P < .05) was found between the interactions group pH and the control group of cells, except between group NLAO at the time point of 1 hour at different pH values and at the time points of 6 and 12 hours with pH 5 (P > .05).

CONCLUSIONS

No significant correlation between pH, force decay, and cytotoxicity was observed.

Force relaxation characteristics of medium force orthodontic latex elastics: a pilot study

To evaluate force extension relaxation of different brands and diameters of latex elastics subjected to static tensile testing under an apparatus designed to simulate oral environments, sample sizes of 5 elastics from American Orthodontics (AO), Tp, and Morelli Orthodontics (Mo) of equivalent medium force, (3/16, 1/4, and 5/16 inch size) were tested. The forces were read after 1-, 3-, 6-, 12- and 24-hour periods in Emic testing machine with 30 mm/min cross-head speed and load cell of 20 N. Two-way ANOVA and Bonferroni tests were used to identify statistical significance. There were statistically differences among different manufacturers at all observation intervals (P < 0.0001). The relationships among loads at 24-hour time period were as follows: Morelli>AO>Tp for 3/16, 1/4, and 5/16 elastics. The force decay pattern showed a notable drop-off of forces until 3 hours, a slight increase in some groups from 3-6 hours and a more homogeneous force pattern over 6-24 hours.

Force extension relaxation of medium force orthodontic latex elastics

OBJECTIVE

To evaluate the force extension relaxation of different manufacturers and diameters of latex elastics subjected to static tensile testing under dry and wet conditions.

MATERIALS AND METHODS

Sample sizes of 15 elastics from American Orthodontics (AO) (Sheboygan, Wis), TP (La Porte, Ind), and Morelli Orthodontics (Sorocaba SP, Brazil) were used. Equivalent medium force products were tested--3/16, 1/4, and 5/16 inch lumen size from each manufacturer--making a total of 1080 specimens. An apparatus was designed to simulate oral environments during elastics stretching. Forces were read after 1, 3, 6, 12, and 24 hour periods using the Emic Testing Machine (Emic Co., Sao Paulo, Brazil) with 30 mm/min cross-head speed and load cell of 20 N (Emic Co). Kruskal-Wallis and Dunn's tests were used to identify statistical significance.

RESULTS

Statistical differences between AO and the other brands were noted for all testing times. Significant variation in mechanical properties was observed in latex elastics from Morelli. Relationships among loads at the 0 hour time period were as follows: Morelli>AO>TP for 3/16 elastics (P = .0016), 1/4 elastics (P = .0016), and 5/16 elastics (P = .0087).

CONCLUSION

Significant differences in force extension relaxation were noted for elastics from these manufacturers. Force relaxation over the 24 hour time period was AO>Morelli>TP for 3/16 elastics, AO>TP>Morelli for 1/4 elastics, and TP>AO>Morelli for 5/16 elastics. The force decay pattern showed a notable drop-off of forces during 0 to 3 hours, a slight increase in force values from 3 to 6 hours, and a progressive force reduction over 6 to 24 hours.

Release of metal ions from orthodontic appliances by in vitro studies: a systematic literature review

In the present work, a systematic literature review on release of metal ions from orthodontic appliances under in vitro conditions is described. Detailed and schematic analysis of used materials and applied methods (immersion media, incubation time, temperature, and analytical techniques) is provided. The PubMed search identified 40 studies, among which eight met the selection criteria. One additional study was included in the review. All the authors agreed that the doses of released metal ions were far below the toxic level and the dietary intake. Although the concentrations of metal ions in immersion media greatly differed, the general conclusions were coherent. It must be underlined that the main disadvantage of in vitro tests was that the experimental setup did not reflect in vivo conditions, e.g., the presence of biofilm, which grows on the surface of the materials in oral cavity. The presence and activity of microflora to a large extent is responsible for the process of corrosion, in particular, biodeterioration. The further scheme of in vitro research should incorporate changeable conditions of oral cavity environment (pH, dynamic conditions-saliva flow) and the presence of microbiological flora (microbiological attack) in the experimental design and, first of all, the real proportions of appliance elements.

Evaluation of the cytotoxicity of latex and non-latex orthodontic separating elastics

OBJECTIVE

To test the hypothesis that a difference in cytotoxicity exists between latex and non-latex orthodontic separating elastics.

MATERIAL AND METHODS

Five intra-oral separating elastics from different manufactures (four latex and one non-latex) were divided into five groups of 15 elastics each: Group MA (non-latex elastics, Masel), Group MO (natural latex, Morelli), Group DE (natural latex, Dentaurum), Group TP (natural latex, TP Orthodontics) and Group UN (natural latex, Unitek). The cytotoxicity assay was performed using cell cultures (epithelial HEp-2 cells originating from human laryngeal carcinoma) that were submitted to the cell viability test with neutral red (dye-uptake) at 24, 48, 72 and 168 h. Analysis of variance (anova) with multiple comparisons and Tukey's test were employed (p < 0.05).

RESULTS

The results showed no statistically significant differences between groups MA, DE, TP and UN in relation to Group CC (cell control) for experimental times of 24, 48 and 168 h (p > 0.05). Morelli, Dentaurum, TP Orthodontics and Unitek elastics induced a great amount of cell lyses at 72 h.

CONCLUSION

One can demonstrate that the Masel elastic induced less cell lysis compared with other elastics, but all trademarks were found to be clinically biocompatible.

CLINICAL RELEVANCE

Separating orthodontic elastics are used in the interdental subgingival region with the aim to separate the teeth for placement of orthodontic bands. However, latex has been known to cause allergy. As these materials are widely used in clinical orthodontics, care regarding the cytotoxicity of orthodontic elastics should be taken. Thus, clinically proven biocompatible materials should be acquired whenever possible.

Cytotoxicity of latex and non-latex orthodontic elastomeric ligatures on L929 mouse fibroblasts

This study investigated the cytotoxicity exists between latex and non-latex Orthodontic elastomeric ligatures. Six elastomeric ligatures (1 latex, 2 latex-free and 3 polyurethane) from different manufacturers were divided into 6 groups of 15 elastics each: A (Latex-free, American Orthodontics), M (Polyurethane, Morelli), G (Polyurethane,GAC International), Te (Polyurethane, Tecnident), TP (Natural latex,TP Orthodontics) and U (Latex-free,3M Unitek). The cytotoxicity assay was performed using cell cultures (L929 mouse fibroblast cell line), which were subjected to the cell viability test with neutral red ("dye-uptake") at 1, 2, 3, 7 and 28 days. Data were analyzed statistically by ANOVA and Tukey's test (α=0.05). No statistically significant differences (p>0.05) were observed between Groups M and Te in all experimental periods, except at 2 days. No significant differences (p>0.05) in cell viability were found either among Groups A, G, TP and U or between Groups M and Te at 24 h or among Groups CC, A, G, TP and U at 2 and 28 days. It may be concluded that latex-free elastomeric ligatures from American Orthodontics and Unitek trademarks induced less cell lysis compared to latex and polyurethane ligatures.

Cytotoxicity of intermaxillary orthodontic elastics of different colors: an in vitro study

Objectives:

Natural latex does not fall into the category of materials known to be entirely inoffensive. The purpose of this in vitro study was to test the hypothesis that there is no difference in the cytotoxicity between elastics of different colors and those from different manufacturers.

Material and Methods:

Different latex intraoral elastics of different colors (5/16 = 7.9 mm, mean load) were compared. The sample was divided into 7 groups of 24 elastics each: Group T (TP Orthodontics, natural latex elastics, control); Groups U1, U2, U3, U4, U5 and U6 (Uniden, natural latex elastics and colored elastics, namely, green, pink, yellow, red and purple, respectively). Cytotoxicity assays were performed by using cell culture medium containing epithelioid-type cells (Hep-2 line) derived from human laryngeal carcinoma. The cytotoxicity was evaluated by using the "dye-uptake" test, which was employed at two different moments (0 and 24 h). Data were compared by analysis of variance (ANOVA) and Tukey's test (p<0.05).

Results:

There was statistically significant difference (p<0.05) between Group T and all other groups (U1, U2, U3, U4, U5 and U6) at 0 and 24 h. No statistically significant difference (p<0.05) was found between Groups U1 and U5, U1 and U6, U2 and U3, U2 and U4, U2 and U5, U2 and U6, U3 and U4, U3 and U5, U3 and U6, U4 and U5, U4 and U6, and U5 and U6 at 0 and 24 h.

Conclusions:

The TP Orthodontics elastics promoted less cell lysis compared to the Uniden elastics regardless of their color.