Evaluation of the Biocompatibility of Orthodontic Brackets and Wires: An In-Vitro Study

Background

Orthodontic treatment involves the use of various materials, including brackets and wires, which come into direct contact with oral tissues. Biocompatibility of these materials is crucial to ensure patient safety and treatment success. This study aims to evaluate the biocompatibility of orthodontic brackets and wires through an in-vitro investigation.

Materials and Methods

Orthodontic brackets and wires commonly used in clinical practice were selected for this study. A series of in-vitro tests were conducted to assess the biocompatibility of these materials. Cell culture assays were performed to evaluate cytotoxicity, cell proliferation, and inflammatory response. In addition, scanning electron microscopy (SEM) was used to examine the surface characteristics of the materials.

Results

The cytotoxicity assays revealed minimal adverse effects on cell viability, with cell viability percentages ranging from 90% to 95% for all materials tested. Cell proliferation assays demonstrated similar rates of cell growth on the surfaces of both brackets and wires. SEM analysis indicated smooth surfaces with minimal irregularities, suggesting favorable biocompatibility.

Conclusion

The findings of this in-vitro study suggest that the orthodontic brackets and wires examined exhibit satisfactory biocompatibility characteristics. Minimal cytotoxicity and favorable cell proliferation indicate that these materials are well suited for use in orthodontic treatment. Further clinical studies are warranted to validate these findings and ensure the safety and efficacy of orthodontic appliances in patient care.

Applications of Lab on a Chip in Antimicrobial Susceptibility of Staphylococcus aureus: A Systematic Review

Background and Objectives: Staphylococcus aureus is a prevalent bacterium capable of inducing various infections, including skin and soft tissue infections, bloodstream infections, pneumonia, and surgical site infections. The emergence of antimicrobial resistance in S. aureus, particularly methicillin-resistant S. aureus, has raised substantial concerns within global healthcare settings. Prior to antibiotic prescription, the ideal approach is antimicrobial susceptibility testing (AST); however, this is frequently perceived as excessively complex and time-intensive. Lab-on-a-chip (LOC) technology holds promise in addressing these challenges and advancing fundamental microbiological research while also aiding in the development of therapeutic strategies. This systematic review aims to evaluate the potential utility of LOC for AST of S. aureus. Materials and Methods: This study adhered to the PRISMA guidelines. Various databases, including SCOPUS, PubMed/MEDLINE, SCIELO, and LILACS, in addition to gray literature sources, were employed in the review process. Results: Sixteen studies were included in this systematic review. All these studies detailed the effectiveness, rapidity, and predictability of LOC systems for assessing S. aureus susceptibility to various antibiotics. When comparing the LOC approach to traditional manual methods, it was evident that LOC requires a minimal quantity of reagents. Furthermore, most studies reported that the entire LOC procedure took 10 min to 7 h, with results being equally accurate as those obtained through traditional AST protocols. Conclusions: The potential application of LOC for AST of S. aureus is emphasized by its ability to provide rapid access to minimum inhibitory concentration data, which can substantially aid in selecting the most suitable antibiotics and dosages for treating challenging infections caused by this microorganism. Moreover, the rapid AST facilitated by LOC holds promise for enhancing the appropriateness and efficacy of therapy in clinical settings.

Potential Clinical Application of Organs-on-a-Chip in Periodontal Diseases: A Systematic Review of In Vitro Studies

The periodontium is a unique organ from the standpoint of building an organ-on-a-chip (OoC) since it is a system that is continually threatened by microorganisms, their noxious compounds, and antigenic components. At the same time, periodontal health depends on a balanced connection between the host and the bacteria in the oral cavity, which is a complex micro-ecological environment. The objective of this systematic review of in vitro studies is to revise the potential clinical application of OoC in periodontal diseases. PRISMA was used to guide this analysis. The review framework made use of several databases, including SCOPUS, PubMed/MEDLINE, SCIELO, and LILACS as well as the gray literature. This systematic review comprised seven studies. The clinical efficacy of OoC in periodontal diseases was observed in models of the gingival crevice for the research of periodontitis, periodontal medication analysis, the interaction of multiple microbial species, pH measurements in in situ-grown biofilm, testing antimicrobial reagents, evaluation of mucosal interactions with microorganisms, and a device for quantitative exploration of microorganisms. OoC has the potential to advance our understanding of periodontal diseases by providing a more accurate representation of the oral microenvironment and enabling the development of new treatments.

Comparison of the sliding resistance between three models of self-ligating ceramic brackets: An in vitro and micro-morphological study

OBJECTIVE

The main objective of our study was to compare a new model of self-ligating ceramic bracket (Clarity™ Ultra by 3M™), to its competitors by evaluating their resistance to sliding during an in vitro simulation of canine retraction.

MATERIAL AND METHODS

The sample consisted of 120 brackets (30 brackets in each group: Victory Twin Series LP™, Clarity Ultra™ by 3M™, Damon Clear 2™ by Ormco™ and Empower™ 2 Clear by American Orthodontics™). Canine retraction was simulated using a universal testing machine connected to a software that measured the average sliding resistance (ASR) for each group. Five brackets from each group were randomly selected and observed under a digital optical microscope at ×50 magnification. ANOVA test and Tukey's analysis were carried to detect statistically significant differences between the groups' sliding resistance values, at the risk of α=0.05.

RESULTS

Measured ASR values of control group (metallic Victory Twin) were the highest ones (70.55g), followed by 3M™ (33.22g) then Damon™ (6.72g) and AO™ (5.49g) (P-value<0.0001). Through microscopic observations, we found that the 3M™ bracket has the lowest percentage of slot chamfering (8%) compared to the other brackets (12%). The 3M™ bracket also has the widest slot followed by AO, and then Damon™. All three bracket types have oversized slots compared to the manufacturer's description, the least oversized being the 3M™ bracket, followed by AO™ and then Damon™. 3M™ and Damon™ brackets have covers that concealed the entire wire in the vertical dimension whereas the AO™ bracket has a curvilinear cover that only shields the gingival part of its slot. Wire-play is zero for the 3M™ group, and 0.1mm for the other two groups.

CONCLUSION

Clarity Ultra™ ceramic bracket produced by 3M™ does not perform well against friction forces compared to its competitors and that is due to its micro-morphological characteristics.

The Influence of 2-Methacryloyloxyethyl Phosphorylcholine Polymer Materials on Orthodontic Friction and Attachment of Oral Bacteria

There is no clinical evidence of the usage of 2-methacryloyloxyethyl phosphorylcholine (MPC) polymers in dental practice. We performed in vitro studies to determine whether the application of an MPC coating to stainless steel orthodontic wires confers low-friction and antimicrobial properties to these wires. The friction test on MPC-coated wires was performed using a precision universal/tensile tester. MPC polymer was coated on a 50 × 50 mm stainless steel plate, and samples were assessed using an antimicrobial activity test. To verify the effect of MPC polymer-treated wires on experimental tooth movement models in vitro, examinations were performed on typodonts to determine the improvement in tooth movement efficiency. The polymer treatment wire groups demonstrated significantly enhanced tooth movement compared with the untreated wire groups, at both 50 g and 100 g traction forces. The results indicated that MPC coating inhibited the attachment of oral bacteria, such as Streptococcus mutans, on a stainless steel plate. Additionally, the coating seemed to improve the efficiency of tooth movement by reducing the occurrence of friction. The application of an MPC coating onto stainless steel wires, which are used as orthodontic materials, may reduce static friction and bacterial adherence to the oral cavity and improve tooth movement.

Canine root/cortical bone relation (CRCR) and the orthodontic tooth movement

This observational study evaluates three-dimensionally the relation between the root of maxillary canine and overlying labial cortical plate of bone during orthodontic canine retraction. Eighty-four bilateral maxillary canines in 42 patients were retracted in the extraction space of first premolars, using conventional orthodontic NiTi retraction spring delivering 150gm. Three-dimensional evaluation at the cusp tip, root apex, and the overlying cortical bone was done based on Classification of Root/Cortical bone relation (CRCR) before and after canine retraction. 168 observations of the canines pre- and post-retraction showed a mean distal movement of the canine cusp tip of 3.78(± 2.05) mm, while the canine root apex was almost stationary. Scarcely, 5.4% of the canine roots and root apices persisted in the medullary bone during retraction, while 16.1% contacted the overlying cortical bone. Fenestration of the overlying cortical bone by the canine roots or root apices occurred in 78.6% of the sample. The unembellished intimacy between the canine root and apex to the overlying thick dense cortical bone might have the decelerating effect on the maxillary canine retraction. The natural bone plate labial to the maxillary canine root did not yield infront nor enlarge due to canine retraction, but else defeated the current orthodontic biomechanical implementation.

Comparative Evaluation of Two Bracket Systems' Kinetic Friction: Conventional and Self-Ligating

Friction is an intensely studied feature in orthodontics, as the sliding mechanics approach remains one of the most utilized techniques in current practice, and the question of whether self-ligating brackets produce less friction than conventional brackets still stands. The objective of this study was to compare a self-ligating system with different closing mechanisms and a conventional system with different ligating mechanisms regarding their frictional properties. Laboratory measurements were performed using an advanced materials testing machine generating tensile strength and load at maximum Load values, which were statistically analyzed and compared. These two parameters have been associated with the frictional resistance generated at the archwire–bracket slot interface. Statistically significant results were obtained when comparing the active self-ligating brackets with the passive self-ligating (tensile strength mean 1.953, SD 0.4231; load at maximum moad mean 6.000, SD 1.3000) and conventional brackets (tensile strength mean 1.953, SD 0.4231; load at maximum load mean 6.000, SD 1.3000), as well as when comparing the passive self-ligating brackets with the conventional brackets (tensile strength mean 1.708, SD 0.8628; load at maximum load mean 5.254, SD 2.645). The active self-ligating brackets tended to produce more friction when compared to the passive self-ligating brackets but were similar to conventional brackets with stainless steel ligatures.

Reducing Friction in Orthodontic Brackets: A Matter of Material or Type of Ligation Selection? In-Vitro Comparative Study

(1) Background: Orthodontic appliances have changed and improved with the increasing demand for orthodontic treatment of the general population. Patients desire for shorter orthodontic treatments and for the wearing of more aesthetic devices has led to the technological development of orthodontic brackets; these were manufactured from aesthetic materials (ceramics, composite polymers) and presented different designs regarding the way archwires are ligated to the bracket. The aim of this study was to determine whether there were any differences between the static frictional forces generated by stainless steel (metallic) and polycrystalline alumina (ceramics) conventional and self-ligating brackets. (2) Methods: Static friction assessment was carried out in vitro with a universal testing machine, HV-500N-S (Schmidt Control Instruments, Hans Schmidt & Co. GmbH), intended for measuring compression and traction forces. (3) Results: The study revealed significant differences in static frictional forces at the bracket-archwire interface between the tested brackets. Stainless steel brackets produced lower static friction forces than polycrystalline alumina and self-ligating brackets generally produced lower static frictional forces than conventional brackets. The reduction of frictional forces was noticeable in the first stages of treatment, when thin, flexible orthodontic archwires (0.016” NiTi) are used. Engaged with large rectangular stainless steel archwires, (0.019 × 0.025” SS), the frictional forces produced by conventional and self-ligating metal brackets were similar, no significant differences being observed between the two types of metallic design. However, in the case of tested ceramic brackets, the results showed that the self-ligating type allows a reduction in frictional forces even in advanced stages of treatment compared to conventionally ligation. (4) Conclusions: From the perspective of an orthodontic system with low frictional forces, metal brackets are preferable to aesthetic ones, and self-ligating ceramic brackets are preferable to conventional ceramic brackets.

Comparison of the friction forces delivered by different elastomeric patterns and metal ligature on conventional metal brackets with a NiTi arch wire versus a self-ligating system: An in vitro study

OBJECTIVES

The aim of this study was to measure the frictional resistance of different types of ligatures used on conventional and self-ligating brackets.

MATERIALS AND METHODS

Monoblock (conventional) and Portia (self-ligating) brackets were used and the archwire used was nickel-titanium. On conventional brackets the ligatures tested were the Elastomeric type and steel 0.30 tie-wire. The groups were divided according to the ligature types (n=8): (1) conventional elastomeric ligature; (2) relaxed conventional elastomeric ligature; (3) elastomeric ligature in shape-8; (4) double vertical elastomeric ligatures; (5) double-crossed elastomeric ligatures; (6) crossed ligature; (7) steel wire ligature; and (8) self-ligating ligature (self-ligating bracket). A segment of five brackets, each ligature types, was mounted. The archwire, between the bracket and the ligature, was connected on Instron® Universal test machine to simulate the frictional resistance. The maximum frictional resistance was obtained, and the mean values were submitted to the analysis of variance (ANOVA) and the Tukey's post-hoc test (α=0.05).

RESULTS

The elastomeric ligature in shape-8 showed the highest value compared with other groups (P<0.05). Although the crossed elastomeric ligature presented the lowest mean value and it was not statistically different regarding relaxed conventional elastomeric ligature, steel wire ligature and self-ligating (P≥0.05).

CONCLUSIONS

The frictional resistance was influenced by ligature types. Elastomeric Ligature in shape-8 showed the highest frictional force. Crossed Elastomeric Ligature had the lowest frictional force value.

A Novel Technique for Shortening Orthodontic Treatment: The “JET System”

We have developed a novel technique, the Jiyugaoka Enjoyable Treatment (JET) system, to complete orthodontic treatment in a short time. It entails the use of the regional acceleratory phenomenon (RAP), light continuous forces and low friction in cases involving extraction. In the JET system, tooth extraction not only creates space, but also triggers the RAP; thus tooth extraction accelerates orthodontic treatment. We describe for the first time how to use the JET system to shorten treatment time in a patient in whom four premolars were extracted. A 15 year old girl patient exhibited an Angle Class I bimaxillary protrusion with moderate crowding in the maxillary (−5.0 mm) and mandibular arches (−3.5 mm). Her facial appearance was slightly asymmetric, and her facial profile was convex. Immediately after the simultaneous extraction of the maxillary first premolars and mandibular second premolars, orthodontic treatment was started with a combination of passive self-ligating brackets and super-elastic nickel-titanium closed coil springs that provided orthodontic forces of less than 50 gf (1.8 ozf). The appliance was adjusted once a month. The total treatment time was 13 months. Cephalometric superimpositions showed a slight anchorage loss, and panoramic radiographs showed a slight apical root resorption but no significant reduction in the crest bone height. At the 3-year 6-month retention follow-up, stability was excellent. The JET system might shorten the orthodontic treatment period without serious anchorage loss or other adverse effects.

Friction and archwire engagement in contemporary self-ligating appliance systems : An in vitro comparison

PURPOSE

The aim of this study was to compare classical friction (FR) in passive self-ligating brackets (P-SLBs), active self-ligating brackets (A-SLBs) and a traditional twin bracket, in vitro, and to identify the point of initiation of bracket-archwire engagement.

METHODS

Nine bracket systems of 0.022 in slot size were FR tested: 5 P‑SLB systems; 4 A‑SLB systems; and a control group of twin brackets with elastomeric ligatures. Single upper right central incisor brackets were mounted on a custom metal fixture for testing. Straight sections of various round and rectangular nickel-titanium (NiTi) archwires (0.016, 0.018, 0.018 × 0.018, 0.020 × 0.020, 0.016 × 0.022, 0.017 × 0.025, 0.019 × 0.025, and 0.021 × 0.025 in) were ligated to the bracket and peak static FR (cN) was measured with an Instron Universal Testing Machine. Ten unique tests each utilizing a new bracket and new archwire were conducted for each group in the dry state.

RESULTS

FR was significantly different between control, P‑SLB and A‑SLB systems (P < 0.001). P‑SLB groups displayed no significant differences in FR between each other, regardless of archwire size. A‑SLB groups did exhibit significant differences in FR between each other depending on both the bracket system and archwire size. Each A‑SLB system tested possessed a distinctly different pattern of initiation of bracket-archwire engagement.

CONCLUSIONS

FR between the archwire and bracket slot differs between P‑SLB and A‑SLB systems, with a distinct pattern of FR and bracket-archwire engagement for each A‑SLB system. Understanding the different bracket-wire interactions of SLB systems should help orthodontic clinicians to plan effective and efficient biomechanics with the bracket system of their choice.

Friction evaluation of an elastic chain positioned under or over the wire in self-ligating brackets

Objectives:

This study aimed to evaluate the frictional resistance produced by active and passive self-ligating brackets on stainless steel archwires in the absence or presence of elastomeric chains under or over the wire.

Materials and Methods:

Four types of self-ligating brackets were used: Two active and two passive. For each commercial brand, five brackets were bonded to an acrylic plate and the frictional resistance was evaluated with 0.018” and 0.019” × 0.025” stainless steel wires in three situations: Without elastomeric chain, with elastomeric chain placed under and over the wire.

Results:

The bracket type, cross-section of the wire, and type of ligation had significant interactions with each other; the frictional resistance was significantly lower with the use of passive self-ligated brackets, while no difference was found when a 0.018” wire was tested. Moreover, the frictional resistance in the absence of an elastomeric chain, or when the chain was under the wire, was significantly lower in comparison with the values obtained when the chain was placed on the wire.

Conclusion:

Frictional resistance of passive and active self-ligated brackets is influenced by the ligation methods and the cross-sectioning of archwires.

Comparative analysis of passive play and torque expression in self-ligating and traditional lingual brackets

INTRODUCTION

The aim of this study was to determine and compare the play and torque expression of self-ligating and conventionally ligated lingual brackets, with square and rectangular slots, when engaged with archwires of different size, cross section and material.

METHODS

Passive play and torque expression of 3 types of archwires and 5 types of brackets from four different manufacturers were measured and compared using a dynamometer. Each archwire was tested five times in each bracket; passive play was compared to ideal values, while torque expression was tested at 5, 10 and 20 Nmm as clinically efficacious values.

RESULTS

Regarding full thickness stainless steel archwires, the lowest passive play was found in STb brackets (2.66 ± 0.89°, Ormco, Glendora, CA, USA), which was statistically significantly lower than for ALIAS brackets (4.44 ± 0.75°, Ormco), In-Ovation L brackets (6.14 ± 3.22°, Dentsply GAC, Bohemia, NY, USA), Harmony brackets (7.76 ± 2.94°, American Orthodontics, Sheboygan, WI, USA) and eBrace brackets (9.46 ± 3.94°, Riton Biomaterial, Guangzhou, China). Increasing the torsional load to the greatest torsional load clinically applicable, there were no statistically significant differences between STb, ALIAS, In-Ovation L and Harmony brackets.

CONCLUSIONS

STb and ALIAS brackets generated the lowest passive play; STb and In-Ovation L brackets showed the lowest angle of play at the greatest torque expression. These measurements allow to understand the accuracy of lingual systems and at the same time the amount of overcorrections to be applied in the setup in order to obtain high quality orthodontic treatments.

Quality assessment tools used in systematic reviews of in vitro studies: A systematic review

BACKGROUND

Systematic reviews (SRs) and meta-analyses (MAs) are commonly conducted to evaluate and summarize medical literature. This is especially useful in assessing in vitro studies for consistency. Our study aims to systematically review all available quality assessment (QA) tools employed on in vitro SRs/MAs.

METHOD

A search on four databases, including PubMed, Scopus, Virtual Health Library and Web of Science, was conducted from 2006 to 2020. The available SRs/MAs of in vitro studies were evaluated. DARE tool was applied to assess the risk of bias of included articles. Our protocol was developed and uploaded to ResearchGate in June 2016.

RESULTS

Our findings reported an increasing trend in publication of in vitro SRs/MAs from 2007 to 2020. Among the 244 included SRs/MAs, 126 articles (51.6%) had conducted the QA procedure. Overall, 51 QA tools were identified; 26 of them (51%) were developed by the authors specifically, whereas 25 (49%) were pre-constructed tools. SRs/MAs in dentistry frequently had their own QA tool developed by the authors, while SRs/MAs in other topics applied various QA tools. Many pre-structured tools in these in vitro SRs/MAs were modified from QA tools of in vivo or clinical trials, therefore, they had various criteria.

CONCLUSION

Many different QA tools currently exist in the literature; however, none cover all critical aspects of in vitro SRs/MAs. There is a need for a comprehensive guideline to ensure the quality of SR/MA due to their precise nature.

Comparison of frictional resistance between four types of brackets in combination with stainless steel and beta-titanium archwires

Objectives:

The objective of the study was to evaluate and compare the frictional resistance generated by four different types of brackets in combination with stainless steel (SS) and titanium molybdenum alloy (TMA) archwires.

Materials and Methods:

Maxillary premolar brackets were used in this study. These brackets were divided into eight groups comprising seven samples each. Of the eight groups, four groups were combined with SS and four groups were combined with TMA archwires. The testing was done in the presence of human saliva. The static frictional resistance was calculated for each group. One-way ANOVA and post hoc Tukey tests were done to compare the friction generated by each group.

Results:

There was a statistically significant difference between the friction generated by the monocrystalline brackets and the other bracket groups (P < 0.001). There was no statistically significant difference in static friction generated between self-ligating and conventionally ligated brackets. There was a statistically significant difference between the frictional resistance produced by SS and TMA wires (P = 0.02) with regard to monocrystalline ceramic brackets only.

Conclusion:

Monocrystalline ceramic brackets (Radiance) were found to generate the highest frictional resistance during sliding mechanics when compared to other brackets in combination with both SS and TMA wires. Self-ligating brackets did not show a statistically significant reduction in friction when compared to conventional ligation. There was a statistically significant difference between SS and TMA wires when used with monocrystalline brackets.

Rates of tooth movement and bone remodeling activity: Self-ligating versus conventional brackets

Background

Bracket systems have been developed with the purpose of reducing frictional resistance between the archwire and accessories. The aim of this research was to compare rates of tooth movement and regions of cellular bone modeling activity along tooth root surfaces of teeth moved with conventional vs. self-ligating brackets.

Material and Methods

The experiments were conducted in 20 male dogs. Bands were cemented in all intermediate incisors, with conventional brackets (Morelli) on the right side and hybrid self-ligating ones (T3-American Orthodontics) on the left side. A 0.019” x 0.025” stainless steel wire was inserted passively in the slot of these brackets with chain elastics (250 gf) to perform sliding mechanics. Clinical records of the orthodontic mechanics were made before and after 15 days of the tooth movement. The dental segments of the animals were prepared for light microscopy. Statistical analysis of variance and the Tukey correction with a P value at 5% were used.

Results

There were no significant differences in tooth movement rates between the two types of brackets but differences, in the bone modeling activity, suggested that tooth movement with the self-ligating brackets resulted in more tipping and less translational movement than tooth movement with the conventional brackets.

Conclusions

The rates of tooth movement were similar between the two systems. The histological evaluation of cellular bone modeling activity along tooth root surfaces showed more translation movement of teeth with the conventional brackets, and more tipping movement of teeth with self-ligating brackets.

Key words:Edgewise, histological reactions, orthodontic movement, self-ligating, brackets.

Impact of passive self-ligation and conventional elastic ligation on orthodontic force in the simulation of a mandibular lateral incisor linguoversion

INTRODUCTION

This study compared three-dimensional forces delivered to the displaced tooth and its adjacent teeth between passive self-ligation (PSL) and conventional elastic ligation (CL) in simulation of mandibular lateral incisor linguoversions.

METHODS

A multisensor system was used to measure three-dimensional forces delivered to brackets attached to the mandibular left central incisor, lateral incisor, and canine (FDI tooth numbers 31, 32, and 33, respectively). Two ligation methods (PSL and CL), 3 nickel-titanium (0.014-inch) archwires similar to the arch form of normal occlusion, and 2 displacements (1 and 4 mm) were tested.

RESULTS

In 1-mm displacement, forces were significantly smaller in CL than in PSL at 32 in the labial direction and larger at 31 in the mesial direction for all 3 types of archwires (P <0.01 for both). For 2 of 3 archwires, forces were larger in CL than in PSL at 33 in the lingual direction (P <0.01). In 4-mm displacement, forces were significantly larger in CL than in PSL at 31 in the mesial direction and significantly smaller in CL than in PSL at 33 in the distal direction for all 3 archwires (P <0.05 and P <0.01, respectively). Mean forces in the vertical direction were small, ranging from -0.05 to 0.05 N.

CONCLUSIONS

Under a small amount of displacement, force magnitude in PSL was smaller than that in CL at the displaced tooth in labial-lingual directions. Under a large amount of displacement, a more "open coil spring effect" was significantly obtained in CL than PSL at both adjacent teeth of the displaced tooth.

Comparison of anchorage loss between conventional and self-ligating brackets during canine retraction - A systematic review and meta-analysis

INTRODUCTION

Anchorage is defined as the resistance to unwanted tooth movement. In orthodontics, loss of anchorage can be detrimental to treatment. The proponents of orthodontic self-ligating brackets (SLB) advocate the use of extremely light forces thereby reducing anchorage burden. Therefore, the aim of this study was to compare anchorage loss during canine retraction between conventional brackets (CB) and self-ligating brackets.

METHODS

An electronic search was conducted on the Cochrane database, Scopus, Web of Science, PubMed, Dental & Oral Science and CINAHL, along with handsearching Google Scholar and clinicaltrials.gov. Randomized or non-randomized clinical trials published in the English language on human subjects were included. Orthodontic patients undergoing canine retraction after premolar extraction bonded with self-ligating brackets as the intervention and conventional brackets as the control group in a split mouth design were included. Primary outcome studied was anchorage loss; secondary outcomes were retraction velocity and total amount of canine retraction. Two researchers carried out data extraction and study selection independently. The risk of bias was calculated using the Cochrane's Risk of Bias Assessment tool. The RevMan software was used for quantitative synthesis of data. Effect estimate of the primary and secondary outcomes was expressed using weighted mean difference and 95% confidence intervals (CIs). Heterogeneity of the studies was evaluated using the Cochrane's test for heterogeneity (I² Test); subgroup and sensitivity analyses were performed to investigate sources of heterogeneity among the studies.

RESULTS

Results of the literature search across all databases yielded 10,439 hits, out of which five studies were included in the qualitative synthesis that met the inclusion criteria. Four studies were randomized control trials (RCTs) where as one was a non-randomized control trial, with 100 subjects included in this systematic review. All studies used a split mouth design. Of the five studies included, only one reported significant differences between CB and SLB for anchorage loss, retraction velocity and total amount of canine retraction (P-value≤0.001). Four studies were included in the meta-analysis, which showed no difference in the amount of anchorage between self-ligating and conventional brackets (weighted mean difference - 0.22; 95% CI [-0.82, 0.38]; P=0.48). Multiple subgroup analyses further revealed there were no significant differences between the intervention and control groups for all outcomes studied.

CONCLUSION

This systematic review and meta-analysis found insufficient evidence to suggest a significant difference in anchorage loss between the CB and SLB groups. The scarcity of current evidence dictates that further studies are needed to canonically establish the clinical superiority of one over the other.

REVIEW REGISTRATION

PROSPERO 2019 CRD42019133217.

Systematic reviews in orthodontics: Impact of the PRISMA for Abstracts checklist on completeness of reporting

INTRODUCTION

This study evaluated and compared the completeness of reporting of abstracts of orthodontics systematic reviews before and after the publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Abstracts Checklist (PRISMA-A).

METHODS

Abstracts of systematic reviews and meta-analyses in orthodontics published in PubMed, Latin American and Caribbean Health Sciences Literature, and the Cochrane Database of Systematic Reviews databases before March 23, 2018, that met the predefined inclusion and exclusion criteria, were evaluated using the 12 items of PRISMA-A, scoring each item from 0 to 2. Abstracts were classified into 2 groups: before and after publication of the PRISMA-A checklist. Three calibrated evaluators (intraclass correlation coefficient and kappa > 0.8) assessed the scores for compliance with the checklist. The number of authors, country of affiliation of the first author, performance of meta-analysis, and topic of the article were recorded. A regression analysis was performed to assess the associations between abstract characteristics and the PRISMA-A scores.

RESULTS

Of 1034 abstracts evaluated, 389 were included in the analysis. The mean PRISMA-A score was 53.39 (95% CI, 51.83-54.96). The overall score for studies published after the publication of the checklist was significantly higher than for studies published before (P ≤ 0.0001). The components returning significantly higher scores after publication of PRISMA-A were title (P = 0.024), information from databases (P = 0.026), risk of bias (P ≤ 0.0001), included studies (P ≤ 0.0001), synthesis of results (P ≤ 0.0001), interpretation of results (P = 0.035), financing and conflict of interest (P ≤ 0.0001), and registration (P ≤ 0.0001). These results showed the positive effect of PRISMA-A had on the quality of reporting of orthodontics systematic reviews. Nevertheless, the poor adherence revealed that there is still need for improvement in the quality of abstract reporting.

CONCLUSIONS

The quality of reporting of abstracts of orthodontic systematic reviews and meta-analyses increased after the introduction of PRISMA-A.

"In Vitro" Study About Variables that Influence in Arch Friction with Conventional and Self-Ligating Brackets

Many advantages have been described surrounding self-ligating (SL) brackets compared to metallic conventional ligating (CL) brackets, such as: Less total treatment time, alignment efficiency, patient comfort, plaque retention, and low friction. The objective of this in vitro simulation was to know the variables that affect arch displacement in CL and SL brackets-active (ASL) and passive (PSL)-and analyze if static friction values are affected by bracket design, arch wire section, kind of ligature, and use of a friction reducer agent (FRA) in a wet state. Larger values of static friction were found in CL with metallic ligature (ML) (8.01 ± 1.08 N/mm) and elastic ligature (EL) (6.96 ± 0.48 N/mm). Lower values were found in PSL brackets combined with FRA (0.58 ± 0.21 N/mm). The study was carried out using different stereographical models of a maxillary upper right quadrant with canine, first and second premolar, and first molar bonded brackets. A section of 25 mm of 0.019 × 0.025" stainless steel arch with a rectangular section (SS) and hybrid section (HY) was inserted into the different bracket models. Static friction values were collected using a universal test machine in wet conditions and testing the effect of a friction reducer agent (FRA). To assure the reliability of the study, different wire combinations were repeated after two weeks by the same operator and a linear analysis of regression was done. Each bracket model analysis-with the different wires, use of the FRA, and comparison among brackets in similar conditions-was done using an ANOVA test with a confidence interval of 95% and comparative Post-Hoc tests (LSD). In this in vitro simulation we found higher static friction values in CL compared to ASL and PSL. In PSL, lower values were achieved. CL brackets using ML showed the highest static friction values with a great variability. In this setting, the use of HY wires did not reduce static friction values in ASL and PSL, while in CL brackets with EL friction the values were reduced significantly. An FRA combined with ASL reduced significantly static friction values but not with PSL. In the case of CL, the FRA effect was higher with SS and better than with HY wires. ML values were similar to ASL static friction. The direct extrapolation of the results might be inaccurate, since all these findings should be tested clinically to be validated.

Reporting quality in systematic reviews of in vitro studies: a systematic review

Background: Systematic reviews (SRs) and/or meta-analyses of in vitro research have an important role in establishing the foundation for clinical studies. In this study, we aimed to evaluate the reporting quality of SRs of in vitro studies using the PRISMA checklist.Method: Four databases were searched including PubMed, Virtual Health Library (VHL), Web of Science (ISI) and Scopus. The search was limited from 2006 to 2016 to include all SRs and/or meta-analyses (MAs) of pure in vitro studies. The evaluation of reporting quality was done using the PRISMA checklist.Results: Out of 7702 search results, 65 SRs were included and evaluated with the PRISMA checklist. Overall, the mean overall quality score of reported items of the PRISMA checklist was 68%. We have noticed an increasing pattern in the numbers of published SRs of in vitro studies over the last 10 years. In contrast, the reporting quality was not significantly improved over the same period (p = .363). There was a positive but not significant correlation between the overall quality score and the journal impact factor of the included studies.Conclusions: The adherence of SRs of in vitro studies to the PRISMA guidelines was poor. Therefore, we believe that using reporting guidelines and journals paying attention to this fact will improve the quality of SRs of in vitro studies.

Orthodontic brackets friction changes after clinical use: A systematic review

Background

To evaluate the bracket-wire friction force after clinical use.

Material and Methods

A systematic search of several electronic databases (PubMed, Embase, Web of Science, Scopus, The Cochrane Library, Lilacs and Google Scholar) without limitations regarding publication year or language, was performed. In-vitro studies analyzing the changes in friction force of orthodontic brackets before/after their clinical use were considered. Risk of Bias was assessed with Downs and Black checklist. All methodological features that could interfere in the results were specifically described.

Results

Seven studies satisfied the inclusion criteria and were included in the review. All 7 studies reported at least two groups (before and after clinical use). Friction force increased after intraoral aging in most of the studies. However, there is lack of good quality evidence in this research area.

Conclusions

Brackets present increased surface roughness after clinical use, and consequently increased coefficient of friction (COF) and Friction Force. Further studies are necessary to obtain more reliable results.

Key words:Friction, orthodontic brackets, systematic review.

Lubricating conditions: effects on friction between orthodontic brackets and archwires with different cross-sections

OBJECTIVE

This study investigated the effect of the condition of lubrication on the friction between brackets and NiTi archwires of different rounded cross-sections.

METHODS

Brackets (Roth, GAC) were affixed to a device connected to a universal testing machine into which segments of archwire were placed (NiTi, Nitinol, GAC) with cross-sections of 0.012-in, 0.016-in and 0.020-in. Once the wire was in the bracket slot, the following lubricants were applied: human saliva (HS: positive control), distilled water (DI), mucin-based (MUC) or carboxymethylcellulose-based (CMC) artificial saliva. In the negative control group, no lubricant was used. The combination between the wire cross-sections and the lubrication condition generated 15 groups with 15 samples each. Data were submitted to two-way analysis of variance and Tukey's test.

RESULTS

There was no significant interaction between the wire cross-section and the condition of lubrication (p= 0.901). Irrespective of whether lubricants were used or not, there was a significant increase in friction with an increase in the cross-section of the wire (p< 0.001). For any wire, the group tested in the presence of MUC was not different from that in which HS was applied. On the other hand, when the application of lubricants was suppressed, significantly higher friction values were observed. The CMC group and the DI group demonstrated intermediate behavior.

CONCLUSIONS

Friction increased with the increase of the cross-section of the NiTi archwire, but regardless of the archwire, friction with MUC artificial saliva was similar to that of HS and lower than in dry conditions.

Comparison of frictional forces during the closure of extraction spaces in passive self-ligating brackets and conventionally ligated brackets using the finite element method

BACKGROUND

This study compared the frictional force resulting from the bracket/archwire interface and the stress at the root/periodontal ligament/bone interface, between passive self-ligating brackets and conventionally ligated brackets, during the space closure stage.

MATERIAL AND METHODS

A cone beam tomography was taken to a female patient that required extraction of upper first premolars and passive self-ligating system; three months after its activation, a cone beam tomography was taken again. The designs of the maxillary bone and the entire system were possible through tomography images and stereomicroscopic photographs. Validation of the Finite Element Method (FEM) was achieved comparing the amount of movement seen through tomography images and the FEM. Space closure was simulated for each system through the FEM and a comparison was made between the frictional force at the bracket/archwire interface, and the root/periodontal ligament/bone interface.

RESULTS

The most significant representation of frictional force at bracket/archwire interface and bone stress was found at the conventionally ligated system, while the passive self-ligating system accounted for the highest distribution of stress over the root.

CONCLUSIONS

The FEM is an accurate tool used to quantify frictional force and stress concentration during the orthodontic closure. The passive self-ligating system was seen less frictional during the closure state compared to conventional brackets. Key words:Friction, orthodontic bracket, finite element analysis.

Comparison of force loss due to friction of different wire sizes and materials in conventional and new self-ligating orthodontic brackets during simulated canine retraction

AIMS

The aim of this study was to compare force loss due to friction (Fr) during simulated canine retraction using different archwire dimensions and materials between conventional and new self-ligating brackets.

METHODS

The tested brackets were (1) conventional brackets (Victory series, GAC twin and FLI twin), (2) self-ligating brackets (Damon-Q, FLI-SL, new/improved FLI-SL (I FLI-SL), SPEED, GAC innovation (R) and Ortho Classic) and (3) a low-friction bracket (Synergy). All brackets had a 0.022″ slot size. The tested archwires were stainless steel (0.018″; 0.016″x0.022″; 0.017″x0.025″; 0.018″x0.025″ and 0.019″x0.025″); nickel titanium (NiTi; 0.016″x0.022″; 0.017″x0.025″; 0.018″x0.025″ and 0.019″x0.025″) and titanium molybdenum alloy (TMA; 0.016″x0.022″; 0.017″x0.025″; 0.018″x0.025″ and 0.019″x0.025″). Canine retraction was experimentally simulated in a biomechanical set-up using a NiTi coil spring that delivered a force of 1 N. The simulated retraction path was up to 4 mm. Force loss due to friction was compared between groups using the Welch t‑test.

RESULTS

Force loss due to friction increased with increasing archwire size. Also, TMA showed the highest and stainless steel the lowest force loss due to friction. FLI-SL brackets showed the lowest Fr (31%) and Ortho Classic showed the highest (67%).

CONCLUSIONS

Increasing wire size generally showed increasing force loss due to friction. FLI-SL brackets showed the lowest, while Ortho Classic showed the highest friction.

An analysis on the potential of diode-pumped solid-state lasers for dental materials

Material structure-property relationship is strongly related to the employed process technology. Over the past years, laser processing of engineering materials has been proposed in many fields and different uses for diode lasers have been found in dentistry. In this contest, the potential of GaN- and InGaN-based laser diodes to cure dental materials was analysed. Two wavelengths of 405 nm and 445 nm were used as heat or light sources for warm condensation of gutta-percha, light transmission in dental posts and brackets or light curing of dental composites. Additive manufacturing approach was considered to fabricate 3D root analogues, suitable supports, positioning systems and moulds for optical measurements. A three-axis CAD/CAM system was implemented for positioning and aligning the laser beam. The ability of diode-pumped solid-state lasers to cure dental materials or to transmit light was compared to that of a traditional instrument. Temperature profile at the apex of an additive manufactured root canal sealed with gutta-percha, light transmission through translucent quartz fiber post or through aesthetic ceramic bracket, bending properties and morphological features of light cured dental composites (Gradia Direct - GC Corporation and Venus Diamond - Heraeus Kulzer) were measured. Results showed a very high potential of diode-pumped solid-state lasers to be used in endodontics, orthodontics and restorative dentistry.

Evaluation of force released by deflection of orthodontic wires in conventional and self-ligating brackets

Introduction:

The aim of the study was to evaluate deflection forces of rectangular orthodontic wires in conventional (Morelli^TM), active (In-Ovation R^TM) and passive (Damon 3MX^TM) self-ligating brackets.

Material and Methods:

Two brands of stainless steel and nickel-titanium (NiTi) wires (Morelli^TM and GAC^TM), in addition to Ormco^TM copper-nickel-titanium wires were used. Specimens were assembled in a clinical simulation device especially designed for this study and tested in an Instron universal testing machine. For the testing procedures, an acrylic structure representative of the maxillary right central incisor was lingually moved in activations of 0 to 1 mm, with readings of the force released by deflection in unloading of 0.5, 0.8 and 1 mm at a constant speed of 2 mm/min. Inter-bracket forces with stainless steel, NiTi and CuNiTi were individually compared by two-way ANOVA, followed by Tukey’s tests.

Results:

Results showed that there were lower forces in conventional brackets, followed by active and passive self-ligating brackets. Within the brands, only for NiTi wires, the Morelli^TM brand presented higher forces than GAC^TM wires.

Conclusions:

Bracket systems provide different degrees of deflection force, with self-ligating brackets showing the highest forces.

Effect of Intraoral Aging on Debris Accumulation and Friction of First Molar Tubes

AIM

The aim of this article was to evaluate the impact of intraoral aging and site specificity on debris accumulation and friction in molar tubes after intraoral use.

MATERIALS AND METHODS

A total of 80 intraorally used first molar convertible tubes were provided by 20 orthodontic adolescent patients after 6 months of treatment. The specimens were divided into eight groups (n = 10) according to the mouth quadrant and the type of examination [four groups of ten tubes for scanning electron microscope (SEM) and four groups of ten tubes for friction test]. Scanning electron microscope examination was performed after opening the convertible caps and friction test was executed using a 0.019'' × 0.025'' stainless steel wire, which was inserted in the tubes belonging to each group. The Mann-Whitney test, analysis of variance (ANOVA), and Bonferroni tests were performed for statistical analysis at 0.01 level of significance.

RESULTS

There was a significant increase in the amount of debris and frictional force after 6 months of intraoral exposure (p < 0.0001). Debris scores were higher (10% increase) on the upper tubes when compared with the lower ones, with no statistical difference. Mean frictional force ranged from 0.22 to 0.26 N according to the mouth quadrant, but the difference between groups was also not significant.

CONCLUSION

After 6 months of intraoral exposure, there was a significant increase in the amount of debris in the first molar tube slots, leading to significantly higher frictional forces during sliding mechanics. The influence of site specificity on the amount of debris and on frictional forces of the first molar tubes could not be demonstrated.

CLINICAL SIGNIFICANCE

Molar tubes should be cleaned, before and during sliding mechanics, in order to minimize friction.

Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets

OBJECTIVE

The aim of the present study was to evaluate, comparatively, the periodontal response during orthodontic treatment performed with self-ligating and conventional brackets.

METHODS

Sixteen Caucasian individuals of both sexes, aged between 12 and 16 years old and in permanent dentition were selected. Eight individuals were treated with conventional brackets installed on the lower dental arch and self-ligating brackets on the upper arch. Another eight individuals received self-ligating brackets in the lower arch and conventional brackets in the upper arch. The subjects received material and instructions for oral hygiene. Visible plaque index (VPI), gingival bleeding index (GBI) and clinical attachment level (CAL) were evaluated just after installation of orthodontic appliances, and 30, 60 and 180 days later. Mann-Whitney test was used to compare differences between groups (self-ligating and conventional), two-way ANOVA followed by Tukey's test was used to assess CAL at each site of each tooth. Significance level was set at 5%.

RESULTS

No significant changes were found with regard to the assessed parameters (VPI, GBI and CAL) in either one of the systems.

CONCLUSION

No significant changes were found with regard to the periodontal response to orthodontic treatment for the variables assessed and between subjects receiving passive self-ligating and conventional brackets. All individuals had received oral hygiene instructions and had their periodontal conditions monitored.

A comparison of lower canine retraction and loss of anchorage between conventional and self-ligating brackets: a single-center randomized split-mouth controlled trial

OBJECTIVE

To evaluate the rate of lower canine retraction, anchorage loss, and changes on lower canines and first molars axial inclination using self-ligating and conventional brackets.

MATERIALS AND METHODS

Twenty-five adult patients with a treatment plan involving extractions of four first premolars were selected for this split-mouth trial and had either conventional or self-ligating brackets bonded to lower canines in a block randomization. Retraction was accomplished using 100-g nickel titanium closed-coil springs, which were reactivated each 4 weeks. Oblique radiographs were taken before and after total canine retraction and the cephalograms were superimposed on stable structures of the mandible. Cephalometric points were digitized twice by a single-blinded operator for error control and the average of the points were used to determine the following variables: canine cusp horizontal changes, molar cusp horizontal changes, and angulation changes in canines and molars. Paired t tests were used to analyze the blinded data for group differences.

RESULTS

All patients reached final phase without bracket debonds. No differences were found between the two groups for all variables tested. No serious harm was observed.

CONCLUSION

Both brackets showed the same rate of canine retraction and loss of anteroposterior anchorage of the molars. No changes were found between brackets regarding the inclination of canines and first molars.

CLINICAL RELEVANCE

Using self-ligating brackets to retract lower canines will not increase the velocity of tooth movement, does not increase anchorage, and does not decrease tipping.

Archwire diameter effect on tooth alignment with different bracket-archwire combinations

INTRODUCTION

Our objective was to evaluate the effect of the diameter of the archwire on tooth alignment with different bracket-archwire combinations.

METHODS

The materials included 2 categories of orthodontic brackets (1) conventional ligating brackets (Victory Series [3M Unitek, Monrovia, Calif], Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo], and Synergy [Rocky Mountain Orthodontics]) and (2) self-ligating brackets (SmartClip [3M Unitek], a passive self-ligating bracket; Time3 [American Orthodontics, Sheboygan, Wis], an active self-ligating bracket; and SPEED [Strite Industries, Cambridge, Ontario, Canada], an active self-ligating bracket). All brackets had a nominal 0.022-in slot size. The brackets were combined with Therma-Ti 0.014-in and Therma-Ti 0.016-in titanium memory archwires (American Orthodontics). The archwires were tied to the conventional brackets with both stainless steel ligatures (0.010 in) and elastomeric rings. Each bracket-archwire combination was tested 20 times with the orthodontic measurement and simulation system built in a temperature-controlled chamber where the temperature was kept at 37°C (±1°C) during testing. The malocclusion simulated in the study represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis).

RESULTS

The incisogingival corrections achieved by the 0.014-in archwire combined with the brackets used ranged from 40% to 95%; the corrections by the 0.016-in wire were 55% to 95%. The labiolingual corrections achieved by the 0.014-in archwire combined with the brackets used ranged from 10% to 100%, and the corrections of the 0.016-in archwires ranged from 15% to 100%.

CONCLUSIONS

Increasing the diameter from 0.014 to 0.016 in increased the correction achieved by up to 15% in certain bracket-archwire combinations, but it decreased the correction by up to 25% in other combinations.

Ceramic brackets and low friction : A possible synergy in patients requiring multiple MRI scanning

AIM

To investigate any advantages of low friction biomechanics in orthodontic patients with fixed appliances without producing metal artifacts during magnetic resonance imaging (MRI).

MATERIALS AND METHODS

Frictional resistance generated by bracket-wire-ligature systems was analyzed via an experimental model that reproduced upper canine misalignment. Each sample was tested 10 consecutive times in a dry state; a total of 160 tests were carried out. We documented the frictional forces generated by a 0.012- and 0.014-inch superelastic nickel-titanium wire (SENT) with ceramic self-ligating brackets (SLB) with metal insert and ceramic monocrystalline brackets with nonconventional elastic ligatures (NCEL) in conjunction with various degrees of canine misalignment (1.5, 3.0, 4.5, and 6.0 mm). Comparisons between the frictional forces released by the two different bracket-wire-ligature systems were made by conducting 3-way analysis of variance (ANOVA) with Tukey HSD pairwise test (P < 0.005).

RESULTS

We observed no clinically relevant difference between the frictional forces released by ceramic SLB and ceramic brackets in conjunction with a 0.012- and 0.014-inch SENT. Statistically significant differences were apparent with a 0.012-inch SENT at 4.5 and 6.0 mm of canine misalignment, where the SLB revealed higher frictional forces.

CONCLUSIONS

Ceramic brackets with NCEL revealed frictional forces similar to those generated in conjunction with ceramic SLB, thereby helping to avoid metal artifacts in case of expected necessary MRI during orthodontic treatment with fixed appliances.

Effect of passive self-ligating bracket placement on the posterior teeth on reduction of frictional force in sliding mechanics

Objective

The purpose of this study was to investigate the static (SFF) and kinetic frictional forces (KFF) in sliding mechanics of hybrid bracket systems that involve placing a conventional bracket (CB) or active self-ligating bracket (ASLB) on the maxillary anterior teeth (MXAT) and a passive SLB (PSLB) on the maxillary posterior teeth (MXPT).

Methods

The samples consisted of two thoroughbred types (group 1, anterior-CB + posterior-CB; group 2, anterior-ASLB + posterior-ASLB) and four hybrid types (group 3, anterior-CB + posterior-PSLB-type 1; group 4, anterior-CB + posterior-PSLB-type 2; group 5, anterior-ASLB + posterior-PSLB-type 1; group 6, anterior-ASLB + posterior-PSLB-type 2) (n = 13 per group). After maxillary dentition alignment and maxillary first premolars removal in the stereolithographically-made typodont system, a 0.019 × 0.025-inch stainless steel wire was drawn through the right quadrant of the maxillary arch at 0.5 mm/min for 5 min. The SFF and KFF were measured with a mechanical testing machine and statistical analyses were performed.

Results

Four different categories of SFF and KFF were observed among all groups (all p < 0.001). Group 1 demonstrated the highest SFF and KFF; groups 4 and 3 were second and third highest, respectively. The fourth category included groups 2, 5, and 6. Placing PSLBs on the MXPT resulted in significant SFF and KFF reductions in cases with CBs on the MXAT, but not in cases with ASLBs on the MXAT.

Conclusions

These data might aid in the development of a hybrid bracket system that enables low-friction sliding of an archwire through the MXPT.

Comparative evaluation of anchorage loss between self-ligating appliance and Conventional pre-adjusted edgewise appliance using sliding mechanics - A retrospective study

BACKGROUND

Although a number of studies have been undertaken to evaluate the friction characteristics of self-ligating brackets, there have been only few studies which have actually evaluated the clinical efficiency of these self-ligating brackets. This study was done to evaluate the clinical efficiency of Passive SLB (Smart Clip) in terms of anchorage loss and total treatment duration by comparing it with a Conventional pre-adjusted edgewise (M.B.T.) bracket system.

METHODS

This was a retrospective study in which the study sample comprised of ten patients treated with Passive SLB (Smart Clip, 0.022″) and ten patients treated with Conventional pre-adjusted edgewise (M.B.T.) bracket system (0.022″) who required therapeutic extraction of U/L first premolars as a part of their orthodontic treatment plan. Pretreatment and post treatment lateral cephalograms were taken to evaluate the amount of anchorage loss. The total time required to complete the treatment was also recorded.

RESULTS

Anchorage loss observed with Passive SLB (Smart Clip) sagittally was 1.90 ± 0.68 mm in the maxilla and 1.90 ± 0.43 mm in the mandible and vertically was 0.52 ± 0.53 mm in the maxilla and 0.70 ± 0.69 mm in the mandible. Anchorage loss observed with Conventional pre-adjusted edgewise (M.B.T.) bracket system sagittally was 2.08 ± 0.43 mm in the maxilla and 1.95 ± 0.44 mm in the mandible and vertically was 0.50 ± 0.49 mm in the maxilla and 0.68 ± 0.53 mm in the mandible. The average time taken for the completion of treatment in Passive SLB (Smart Clip) and Conventional pre-adjusted edgewise (M.B.T.) bracket system was 14.0 ± 2.4 and 17.2 ± 2.6 months respectively.

CONCLUSION

There was no statistically significant difference in the quantum of anchor loss between Smart Clip self-ligating bracket system and Conventional pre-adjusted edgewise (M.B.T.) bracket system although Smart Clip self-ligating bracket system is efficient in reducing the overall treatment time.

Evaluation of friction produced by self-ligating, conventional and Barbosa Versatile brackets

Abstract Introduction The Barbosa Versatile bracket design may provide lower frictional force and greater sliding. However, no in vitro studies have shown its sliding mechanisms and frictional resistance, particularly in comparison with other self-ligating or conventional brackets. Objective To compare the frictional resistance among self-ligating brackets (EasyClip/ Aditek, Damon MX/ Ormco and In Ovation R/ GAC); conventional brackets (Balance Roth/ GAC, and Roth Monobloc/ Morelli); and Barbosa Versatile bracket (Barbosa Versatile/ GAC) with different angles and arch wires. Material and method Brackets were tested with the 0.014", 0.018", 0.019"×0.025" and 0.021"×0.025" stainless steel wires, with 0, 5, 10, 15 and 20 degree angulations. Tying was performed with elastomeric ligature for conventional and Barbosa Versatile brackets, or with a built-in clip system of the self-ligating brackets. A universal testing machine was used to obtain sliding strength and friction value readouts between brackets and wires. Result Three-way factorial ANOVA 4×5×6 (brackets × angulation × wire) and Tukey tests showed statistically significant differences for all factors and all interactions (p<0.0001). Static frictional resistance showed a lower rate for Barbosa Versatile bracket and higher rates for Roth Monobloc and Balance brackets. Conclusion The lowest frictional resistance was obtained with the Barbosa Versatile bracket and self-ligating brackets in comparison with the conventional type. Increasing the diameter of the wires increased the frictional resistance. Smaller angles produced less frictional resistance.

Influence of bio-lubricants on the orthodontic friction

The Friction force of Stainless Steel (SS) and Nickel-Titanium (Ni-Ti) rectangular archwires against stainless steel brackets was investigated. Two types of brackets were used namely: Self-ligating brackets (SLB) and conventional brackets (CB). The friction tests were conducted on an adequate developed device under dry and lubricated conditions. Human saliva, olive oil, Aloe Vera oil, sesame oil and sunflower oil were used as bio-lubricants. The friction force was examined as a function of the ligation method and oil temperature. It is found that under oil lubrication, the friction behavior in the archwire/bracket assembly were the best. The SLB ligation was better than the conventional ligation system. The enhancement of the frictional behavior with natural oils was linked to their main components: fatty acids.

Development of a standardized testing system for orthodontic sliding mechanics

Background

The primary objective of this study was to develop a computer-controlled three-dimensional friction measuring system, the orthodontic friction simulator (OFS). A clinically-based in vitro experiment considering wet and dry friction for conventionally and self-ligated brackets is presented to elucidate debate surrounding sliding mechanics and illustrate capabilities of the OFS.

Methods

The OFS was designed and manufactured using sound engineering principles and with the primary concern of being able to measure all forces and moments generated during sliding mechanics. This required the implementation of a six-axis load cell. A variety of translation and rotation stages were also incorporated to allow for precise positioning of the bracket relative to the archwire. Once designed and built, the OFS was then used to compare conventional and self-ligation methods in both the wet and dry state. Damon Q brackets and 0.018″ × 0.025″ stainless steel wires were used for all tests with a sample size of n = 65 for each ligation method. Archwires were pulled at a speed of 0.1 mm/s in 11 increments of 0.1 mm. At each increment, the bracket would be rotated 0.5° resulting in a total archwire travel of 1.1 mm and a second-order bracket angle range of 0°–5°. A repeated measures ANOVA was conducted to determine if ligation method and/or addition of moisture effected resulting orthodontic loads.

Results

The developed equipment for studying orthodontic sliding mechanics was able to measure forces and moments in all three directions; a capability not previously realized in the literature. Additionally, it was found that passive ligation significantly reduced resistance to sliding, P ≤ 0.05, while the dry/wet state did not.

Conclusions

The OFS certainly proved to be an adequate instrument for the scientific evaluation of orthodontic sliding mechanics. It is capable of measuring loads generated in all directions and is a fully automated apparatus allowing for simple and repeatable friction tests to be conducted. Furthermore, the addition of saliva was not found to significantly influence the loads generated during sliding mechanics regardless of ligation method.

In vitro evaluation of frictional forces of two ceramic orthodontic brackets versus a stainless steel bracket in combination with two types of archwires

Purpose:

The aim of this study was to compare frictional forces between monocrystalline alumina (MA), polycrystalline alumina (PA), and stainless steel (SS) brackets with two SS wires: Rectangular and round.

Materials and Methods:

In this in vitro study, 60 0.022 brackets [20 PA (0° torque, Forestadent, Germany) and 20 MA (0° torque, Ormco, California, USA)] brackets plus 20 SS brackets (0° torque, Foretadent, Germany) and 60 SS archwires (30 rectangular 0.019 ×0.025 archwires and 30 round 0.018 archwires, Ortho Technology, USA) were used in subgroups of 10 from the combination of all brackets and all archwires. A universal testing machine (Instron, Model STM 250, Germany) was used to investigate the static frictional resistance. The angulation between the bracket and wire was 0°, and the wires were pulled through the slots at a crosshead speed of 10 mm/min. Two-way and one-way analyses of variance (ANOVA) and Tukey tests were used to analyze the data.

Results:

Mean (SD) static frictional force for each group was as follows: MA + round: 3.47 (0.38); MA + rectangular: 4.05 (0.47); PA + round: 4.14 (0.37); PA + rectangular: 4.45 (0.65); SS + round: 3.28 (0.22); and SS + rectangular: 4.22 (0.61). Significant effects of bracket types (P = 0.001) and archwire types (P = 0.000) on the friction force were detected using ANOVA. Tukey test indicated significant differences between PA brackets with both SS and MA brackets (P < 0.05), but not between SS and MA brackets. The two archwires as well had significantly different effects (Tukey P = 0.000).

Conclusions:

Based on the present in-vitro study, the PA brackets might create higher frictional forces compared to both SS and MA brackets. The rectangular 0.019 ×0.025 archwire might create greater forces than round 0.018 archwire.

A comparative experimental investigation of torque capabilities induced by conventional and active, passive self-ligating brackets

INTRODUCTION

A proper selected bracket-archwire combination displays a determining factor in the efficacy of torque applied to a tooth at the final stages of an orthodontic treatment. The objective of the current study was to assess the torque capabilities of various bracket systems combined with diverse archwire materials and cross-sections.

METHODS

The study comprised of four different 0.018-inch slot orthodontic brackets: the passive and the active self-ligating 1. Swiss Nonligating Bracket (SNB) and 2. SPEED and the metallic and the plastic conventional ligating 3. Mini Mono and 4. Brilliant, respectively, and four different archwire types: stainless steel and Nitinol: 0.016×0.016 inch and 0.016×0.022 inch. A 20 degrees labial crown torque (+20 degrees) and then a 20 degrees palatal crown torque (-20 degrees) were applied gradually on the upper right central incisor. Maximum torquing moments and torque play were registered.

RESULTS

Highest torquing moments were expressed by combining SPEED® with 0.016×0.022 inch stainless steel archwire. Lowest moments, but highest torque loss were registered by inserting a 0.016×0.016 inch Nitinol archwire in conventional ligating brackets.

CONCLUSIONS

Active self-ligating system manifests the best torque effectiveness. An evident dependence of the torque expression is displayed both on the type of ligation and on the material of the archwire.

The effect of perturbations on resistance to sliding in second-order moments comparing two different bracket types

Orthodontic literature has shown all ligation methods to behave similarly in the clinical situation; however, the reasoning behind this still requires further investigation. A novel frictional device able to measure forces at the level of the bracket along with a custom perturbation device was used to investigate the effect of perturbations on resistance to sliding (RS) using conventional and passive ligated brackets. 150 3M Victory Series twins (0.022 slot) and 150 Damon Q brackets (0.022 slot) were tested using an 0.018 x 0.025 stainless steel wire for RS. There were 5 test groups consisting of equal numbers (n=30) representing combinations of high and low amplitude and frequency of perturbations along with a control. Second order angulation tested ranged from 0 to 6 degrees. Results for conventional brackets in the presence of perturbations at 0 degrees showed there was a statistically significant reduction (P<0.001) in RS when compared to controls. At 6 degrees, this difference (P<0.001) was seen in both high perturbation groups and one of the low perturbation groups. For passive ligated brackets, no statistically significant difference between groups was seen at 0 degrees. However, at 6 degrees high perturbation groups both resulted in statistically significant (P<0.001) reductions in RS when compared to controls. From this study it was concluded that passive ligated brackets have a lower RS when compared to conventional ligated brackets under all test conditions and angulations. Also, amplitude of perturbations has a larger role than frequency in reduction of RS values.

Frictional resistance of self-ligating versus conventional brackets in different bracket-archwire-angle combinations

Objective

To compare the influence of archwire material (NiTi, beta-Ti and stainless steel) and brackets design (self-ligating and conventional) on the frictional force resistance.

Material and Methods

Two types of brackets (self-ligating brackets - Smartclip, 3M/Unitek - and conventional brackets - Gemini, 3M/Unitek) with three (0, 5, and 10 degrees) slot angulation attached with elastomeric ligatures (TP Orthodontics) were tested. All brackets were tested with archwire 0.019"x0.025" nickel-titanium, beta-titanium, and stainless steel (Unitek/3M). The mechanical testing was performed with a universal testing machine eMIC DL 10000 (eMIC Co, Brazil). The wires were pulled from the bracket slots at a cross-head speed of 3 mm/min until 2 mm displacement.

Results

Self-ligating brackets produced significantly lower friction values compared with those of conventional brackets. Frictional force resistance values were directly proportional to the increase in the bracket/ wire angulation. With regard to conventional brackets, stainless steel wires had the lowest friction force values, followed by nickel-titanium and beta-titanium ones. With regard to self-ligating brackets, the nickel-titanium wires had the lowest friction values, significantly lower than those of other materials.

Conclusion

even at different angulations, the self-ligating brackets showed significantly lower friction force values than the conventional brackets. Combined with nickel-titanium wires, the self-ligating brackets exhibit much lower friction, possibly due to the contact between nickel-titanium clips and wires of the same material.

Comparison of the frictional resistance between archwire and different bracket system: An in vitro study

BACKGROUND AND OBJECTIVES

The purpose of this study is to evaluate the frictional resistance generated by conventional stainless steel, radiance ceramic bracket, self-ligating and composite brackets using a 0.019 × 0.025 stainless steel straight length wires in a 022 slot and to select brackets based on their frictional characteristic.

METHODOLOGY

In order to conduct this study, four different types of bracket system were selected of the mclaughlin-bennet-trevesi (MBT) discipline. They are Group 1 - stainless steel, Group 2 - composite bracket Group 3 - (American Orthodontics) radiance ceramic bracket Group 4 - self-ligating bracket (SLB) (Empower). In this study, five maxillary brackets of an arch of each type were used. All brackets are 0.022 × 0.028 in preadjusted edgewise appliance which simulates the dental arch. Five brackets were bonded to a stainless steel bar of dimension 150 mm × 25 mm × 3 mm. The bracket-arch wire units were submitted to mechanical test with an Instron universal testing machine 3365. A testing apparatus or holding jig was designed to hold the bracket during the mechanical test. Each sample was pulled at a speed of 6 mm for 1 min. Descriptive statistical information including mean and standard deviation of maximum friction force was calculated for each bracket wire combination.

INTERPRETATION AND CONCLUSION

The SLB has the least friction among the four groups. The ceramic bracket showed the highest friction followed by stainless steel bracket, composite bracket, and SLB.