The Orthodontic Mini-Implants Failures Based on Patient Outcomes: Systematic Review

Anchorage is a challenge and essential issue for an orthodontist in determining the success of orthodontic treatment. Orthodontic anchorage is defined as resistance to unwanted tooth movement. Mini-implant is one of the devices that can be used as an anchor in orthodontic treatment. Many cases have reported successful treatment using mini-implant, but there are cases where mini-implants may fail. Failure of mini-implants can affect orthodontic treatment, and it is known that several factors may lead to mini-implant loss in orthodontic treatment. This systematic review aimed to determine the factors influencing mini-implant failure in orthodontic treatment. Articles were selected from electronic databases (PubMed, Google Scholar, The Cochrane Library, ScienceDirect) from January 2015 until 2023 according to the PRISMA method (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) under the PEOS (Population-Exposure-Outcome-StudyType) framework questions for systematic review. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022337684). All data collected were in English, and filtering was done by eliminating duplicate data, meta-analysis, case reports, case series, mini-reviews, and animal studies. The analysis was further divided into three groups, that is, patient-related, implant-related, and operator-related and operator-related (A graphical abstract provided as a Supplementary information [available in the online version]). Twenty-one articles were identified according to the inclusion criteria in the form of retrospective, prospective, in vivo, and randomized controlled trial studies. Mini-implant failures due to patient-related showed six etiological factors, failures due to implant-related had eight etiological factors, and only one factor was operator-related, which may lead to mini-implant failure. The data was extracted without a computerized system and only in English. Mini-implant failure can be caused by many factors; we could not accuse one major factor as a cause. However, the quality or condition of the bones and oral hygiene are factors that play a significant role in obtaining the stability of implants. Mini-implant failure is highly influenced by poor oral hygiene and peri-implant inflammation. Comprehensive diagnostic prior to mini-implant insertion should be appropriately considered. This systematic review describes several factors that can influence mini-implant failure, divided into three groups: patient-related, implant-related, and operator-related (A graphical abstract provided as a Supplementary information [available in the online version]).

Nickel and copper ion release, deflection and the surface roughness of copper-nickel-titanium orthodontic archwire in sodium fluoride solution

OBJECTIVE

Sodium fluoride (NaF) is commonly used in oral hygiene products, leading to corrosion and reduced archwire properties. In addition, ion release can cause allergies and become toxic to the oral environment. This research aimed to observe the Nickel (Ni) and Copper (Cu) ions released that affected initial corrosion as deflection and surface roughness changed in the Copper-Nickel-Titanium (CuNiTi) archwire.

MATERIAL AND METHODS

The total samples were 54 copper-nickel-titanium (CuNiTi-Tanzo, American orthodontic®) archwires immersed in three solutions. Artificial saliva was used in the control group NaF 0.05%, and a NaF 0.15% solution was used in the intervention groups (n = 6). The groups were divided into three observation times (two, four, and six weeks). Cu and Ni ions released, deflection, the surface roughness of the archwires, and solution acidities were recorded and analyzed.

RESULTS

Ni and Cu ion release and surface roughness of the CuNiTi archwires significantly increased as the NaF concentration increased. The Ni ion release improved along the immersion period; the opposite was true for the Cu ion release. The solutions became more alkaline after the CuNiTi archwires were immersed. The pH and the archwires' deflections of the three solutions did not show significant differences.

CONCLUSION

The NaF increased Cu-Ni ion release and surface roughness but not the deflection force of the CuNiTi. The increase was affected by the concentration and duration of immersion.

Corrosion of copper nickel titanium archwire in chlorhexidine, sodium fluoride, and chitosan mouthwashes

Background: Copper (Cu), nickel (Ni), chromium (Cr) ion release, and surface topography change from the orthodontic wire are the initial processes of corrosion that may affect the mechanical properties of the archwire. In this study, we aim to evaluate the effect of CHX, NaF, and chitosan on the corrosion of CuNiTi wire nickel and copper ions released, surface roughness change, and archwire deflection. Methods: Ninety samples of CuNiTi Tanzo™ archwires were divided into five groups according to their immersion solution: Artificial Saliva, CHX, NaF, CHX-NaF, and chitosan group. Each group was further divided into three subgroups (n=6) corresponding immersion time, i.e., two, four, and six weeks. The corrosion of the samples was analyzed with an atomic absorption spectrophotometer (AAS), scanning electron microscope (SEM), and universal testing machine (UTM). Results: The amount of nickel ion releases was increasing, but the copper ion releases were reduced by the time of observations. The highest nickel ion was released in the CHX-NaF group and the lowest in the chitosan group for six-week immersion. It also corresponded to the surface topography by SEM analysis which showed the most extended cracks and deep pits in the CHX-NaF group and a smoother surface in the chitosan group. Copper ion release showed the highest ion release in the NaF group and the lowest release in the chitosan group. The unloading force of CuNiTi archwire deflection remains the same at week two and week four for all mouthwashes. Conclusion: The use of mouthwashes that contained CHX, NaF, and chitosan could further alter the passive layer and cause higher nickel and copper ion release and increased CuNiTi archwire surface structure porosity. But there is no distinction between mouthwashes to release the unloading force within two until four weeks.

Effect of sodium fluoride in chlorhexidine mouthwashes on force decay and permanent deformation of orthodontic elastomeric chain

Introduction: Orthodontic elastomeric chain is polyurethane elastomer that is widely used among orthodontists due to its functions. Chlorhexidine (CHX) and sodium fluoride (NaF) are listed in mouthwash composition which could affect the mechanical properties of the elastomeric chain. This study was aimed to analyze the effect of sodium fluoride in chlorhexidine mouthwashes on force decay and permanent deformation of orthodontic elastomeric chains. Methods: This research is an experimental analytic laboratory with pretest-posttest control group design. 150 samples of orthodontic chains were divided into three groups. Group 1: artificial saliva (control group); Group 2: 0,1% chlorhexidine gluconate solution (CHX); Group 3: 0,1% chlorhexidine digluconate with sodium fluoride solution (CHX-NaF). The orthodontic elastomeric chain was stretched and maintained at a standardized distance equivalent to a force of 300 g. The measurement of force decay and permanent deformation were performed with digital force gauge and digital caliper (0.01mm) at intervals of the first, seventh, fourteenth, twenty-first, and twenty-eighth days, respectively. Results: The force decay and permanent deformation of the elastomeric chain compared between three groups (control, CHX mouthwash and CHX+NaF mouthwash) showed did not have any significantly different (p-value>0,05) at the first, seventh, fourteenth, twenty-first, and twenty-eighth days, respectively. Conclusion: Sodium fluoride in chlorhexidine mouthwash showing no significant difference among saliva, CHX mouthwash and CHX+NaF mouthwash on force decay and permanent deformation of elastomeric chain.

Effect of vitamin E supplementation on orthodontic tooth movement in Wistar rats

Background: Tooth movement induced by the application of orthodontic force is facilitated by bone remodelling cells and chemical mediators. Vitamin E has anti-inflammatory properties, which helps in suppressing the damaging effects of oxygen free radicals in cells during bone formation. This study aimed to evaluate the effect of vitamin E supplementation on orthodontic tooth movement in Wistar rats. Methods: Wistar rats (n=56) were divided into two groups. Group 1 served as the control groups, while group 2 was given vitamin E for 14 days before application of orthodontic force. Each group was divided into four subgroups (n=7), corresponding to the number of days orthodontic force lasted, i.e. 0, 1, 3, 7 days. At each of these four time points, distance measurements and quantity of osteoblasts-osteoclasts were measured in each rat. Results: Tooth movement distance was increased for group 2 than group 1 for all time intervals, but this difference was only statistically different on day 3 ( p=0.001). For both groups, tooth movement was significantly different between each time interval in each group ( p=0.041). The mean number of osteoblast cells was increased for group 2 compared to group 1 for all time intervals (p<0.05), but was not significant different between time intervals ( p=0.897). The number of osteoclasts was not significantly different between groups, but it was statistically different between time intervals (p=0.004). Conclusion: Present outcomes demonstrate that vitamin E contributes to faster tooth movement compared to control group.  It also stimulates more bone formation without reducing the bone resorption.

Effect of vitamin E supplementation on orthodontic tooth movement in Wistar rats: a prelimary study

Background: Tooth movement induced by the application of orthodontic force was initiated by inflammatory process. Studies have shown that vitamin E has an anti-inflammatory and antioxidant properties which perhaps could inhibit the tooth to move. This study aimed to evaluate the effect of vitamin E supplementation on orthodontic tooth movement in Wistar rats. Methods: Wistar rats (n=56) were divided into two groups. Group 1 served as the control groups, while group 2 was given vitamin E for 14 days before application of orthodontic force. Each group was divided into four subgroups (n=7), corresponding to the number of days orthodontic force lasted, i.e. 0, 1, 3, 7 days. At each of these four time points, distance measurements and quantity of osteoblasts-osteoclasts were measured in each rat. Results: Tooth movement distance was increased for group 2 than group 1 for all time intervals, but this difference was only statistically different on day 3 ( p=0.001). For both groups, tooth movement was significantly different between each time interval in each group ( p=0.041). The mean number of osteoblast cells was increased for group 2 compared to group 1 for all time intervals (p<0.05), but was not significant different between time intervals ( p=0.897). The number of osteoclasts was not significantly different between groups, but it was statistically different between time intervals (p=0.004). Conclusion: The outcome of this study demonstrated that group 2  resulted a better tooth movement compared to group 1 and significantly found on day 3, based on the distance measurement. The osteoclast cell numbers were the same within both control groups, whilst  the number of osteoblast cells in group 2 was significantly higher than those in group 1.

Effect of vitamin E supplementation on orthodontic tooth movement in Wistar rats: a prelimary study

Background: Tooth movement induced by the application of orthodontic force was initiated by inflammatory process. Studies have shown that vitamin E has an anti-inflammatory and antioxidant properties which perhaps could inhibit the tooth to move. This study aimed to evaluate the effect of vitamin E supplementation on orthodontic tooth movement in Wistar rats. Methods: Wistar rats (n=56) were divided into two groups. Group 1 served as the control groups, while group 2 was given vitamin E for 14 days before application of orthodontic force. Each group was divided into four subgroups (n=7), corresponding to the number of days orthodontic force lasted, i.e. 0, 1, 3, 7 days. At each of these four time points, distance measurements and quantity of osteoblasts-osteoclasts were measured in each rat. Results: Tooth movement distance was increased for group 2 than group 1 for all time intervals, but this difference was only statistically different on day 3 ( p=0.001). For both groups, tooth movement was significantly different between each time interval in each group ( p=0.041). The mean number of osteoblast cells was increased for group 2 compared to group 1 for all time intervals (p<0.05), but was not significant different between time intervals ( p=0.897). The number of osteoclasts was not significantly different between groups, but it was statistically different between time intervals (p=0.004). Conclusion: The outcome of this study demonstrated that group 2  resulted a better tooth movement compared to group 1 on day 3, based on the distance measurement. The osteoclast cell numbers were the same within control groups, whilst  the number of osteoblast cells in group 2 was significantly higher than those in group 1.