The effect of whitening toothpastes on polyurethane and silicone orthodontic clear ligatures: A clinical study

Color Stability of Orthodontic Elastomeric Ligatures in the Oral Environment: A Clinical Trial

Objectives: Despite the recent advances in orthodontic appliances, color change of elastomeric ligatures over time remains a problem causing patient dissatisfaction. This study aimed to assess the color stability of different types of orthodontic elastomeric ligatures in the oral environment. Materials and Methods: This clinical trial was conducted on 67 patients. After applying the exclusion criteria, 11 participants were excluded, and 56 remained. Four different brands of elastomeric ligatures namely Ortho Technology, Ortho Organizers, American Orthodontics, and SIA were randomly used in the four quadrants of each patient (n=14 from each brand). Discoloration of ligatures was scored in the oral cavity by orthodontists and patients on the day of placement (T0) and 28 days later (T1). Photography and CIE L*a*b* color space were used to assess the color change (∆E). Data were analyzed by the Kruskal-Wallis and Bonferroni tests. Results: All brands showed discoloration. The highest ∆E was identified in SIA and Ortho Technology, while the lowest was recorded in Ortho Organizers. The lowest ∆b (yellowness) and the greatest reduction in L* (lightness) and ∆a (redness) were observed in Ortho Organizers. According to the opinion of patients and orthodontists at T0 and T1, SIA was the least visible followed by Ortho Technology. No significant difference was found between orthodontists and patients at T0 and T1 regarding the visibility of ligatures (P>0.05). Conclusion: After 28 days, all brands of elastomeric ligatures showed considerable discoloration. Ortho Organizers showed the highest color stability.

Effect of Over-the-counter Whitening Toothpaste and Mouthwash in Orthodontics: A Literature Review

Aim

To summarize and analyze all the available literature on the use of over-the-counter toothpaste and mouthwashes with whitening agents and their possible effects on orthodontic treatment.

Background

Tooth color change frequently occurs during orthodontic treatment and represents a self-perceived need. According to the patient's perspective, there is a preference for the use of toothpaste and mouthwashes with some whitening effect.

Materials and methods

An electronic bibliographic search in English was carried out until June 2022, in PubMed, Scopus, and Web of Science databases. Randomized or nonrandomized clinical trials and experimental laboratory studies were included.

Review results

A total of 57 papers were obtained from an electronic search and 11 studies were included in the review. Outcomes such as strength force elastomeric, color stability, frictional resistance, ion release, shear bond strength (SBS), and adhesive remnant index (ARI) were evaluated.

Conclusion

Toothpaste and mouthwashes with whitening action did not have a favorable effect on most of the outcomes evaluated. In some cases regular toothpaste showed a better effect and in other cases, there were no differences with the control group. Only in the outcome release of ions from wires to whitening effect in teeth with or without attached brackets, they have a better performance.

Clinical significance

Due to the unfavorable effects of over-the-counter whitening toothpaste and mouthwashes on orthodontic materials and appliances, their use should be justified during treatment.

How to cite this article

Chinchay-Ruesta S, Ortiz-Pizarro M, Rodríguez-Díaz DR, et al. Effect of Over-the-counter Whitening Toothpaste and Mouthwash in Orthodontics: A Literature Review. Int J Clin Pediatr Dent 2023;16(S-3):S311-S316.