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PubMed1999

Ion release from orthodontic appliances.

OBJECTIVE: The microbiological and enzymatic characteristics of the oral cavity would seem to provide a suitable environment for the corrosion of metals. We assayed the release of metal ions from one orthodontic appliance which included two 304 and 316 steel molar bands, ten 316 steel brackets, one nickel-titanium archwire and a brazing alloy to connect the elements of molar bands and brackets. METHODS: The orthodontic appliance was dipped in both inorganic (pH 3.5-6.5) and organic acid solutions (w/v 1% each of tartaric, citric and ascorbic acid at pH 2.2 or 1.5% each of lactic and acetic acid at pH 2.5). The release of nickel (Ni), chromium (Cr), copper (Cu), silver (Ag) and palladium (Pd) was determined using an atomic absorption spectrophotometer Varian AA 10. RESULTS: The release of Ni, Cr and Cu was markedly less at pH 6.5 than at pH 3.5 at all time points in acid solution. Daily release/single appliance after the first day decreased. Contrary to expectations, appliances immersed in organic acid solutions at pH 2.2 or 2.5 after 28 days generally released an amount of ions similar to that observed in inorganic acid solution at pH 3.5, with the exception of Cu. Release of silver and palladium, two metals present in the brazing alloy, proved to be very low (approximately 0.2 microgram after 28 days). CONCLUSIONS: The daily release of Ni, Cu and Cr by an orthodontic appliance in acid pH, particularly favourable to corrosion, was well below that ingested with a normal daily diet. It is therefore concluded that the quantities of metal ions released in our experimental conditions should not be cause for concern in utilising the appliance.

Chromium↗
PubMed2003

Congenitally missing mandibular second premolar: treatment outcome with orthodontic space closure.

Orthodontic treatment for patients with congenitally missing mandibular second premolars can be challenging. Treatment options include keeping the deciduous second molar, extracting the molars and allowing the space to close spontaneously, autotransplantation, prosthetic replacement, and orthodontic space closure. Space closure with orthodontic appliances is demonstrated in this case report.

Anodontia↗
PubMed2003

Surface changes induced by fluoride prophylactic agents on titanium-based orthodontic wires.

This study investigated the effect of fluoride prophylactic agents on the surfaces of titanium-based orthodontic wires. Four types of titanium-based orthodontic wires (2 nickel-titanium alloy wires [nickel-titanium and copper-nickel-titanium] and 2 beta-titanium alloy wires [titanium-molybdenum and titanium-niobium], all from Ormco, Glendora, Calif) with similar sizes were prepared and immersed in 5 fluoride prophylactic agents (2 acidulated phosphate fluoride agents [Nupro APF (Dentsply International, York, Pa) and Florentine III (Confi-Dental, Louisville, Colo)], 1 neutral agent [Neupro Neutral (Dentsply International)] and 2 stannous fluoride agents [Florentine II (Confi-Dental) and Perio-Med (Omni International, Warrenton, Va)]) for 5 minutes, 1 hour, and 24 hours. After immersion, average surface roughness and color changes were evaluated. The surface changes were observed with a scanning electron microscope. The average surface roughness data were statistically analyzed by analysis of variance and Tukey post hoc test at a significance level of alpha = 0.05. There were no significant differences in average surface roughness value among fluoride solutions or orthodontic wires, except for the titanium-molybdenum wire, which showed significantly (P <.05) higher average surface roughness values after immersion in Nupro APF for 24 hours. The results suggested that a few applications of acidulated phosphate fluoride agents might change the surface color of the beta-titanium alloy wires, particularly the titanium-molybdenum wire, which contains a large amount (about 80%) of titanium.

Acidulated Phosphate Fluoride↗
PubMed2003

Evaluation of immunologic profile in patients with nickel sensitivity due to use of fixed orthodontic appliances.

The aim of this study was to develop a new approach to testing the impact of nickel antigen on in vitro cell-proliferation assay, to identify adverse reactions to casting alloys among orthodontic patients. Cell-proliferation assay in vitro was used as the basic methodology to assess the influence of such variables as source of nickel antigen, type of serum used to supplement the culture medium, and number of cells in the culture. We selected 35 orthodontic patients who were classified as nickel sensitive and non-nickel sensitive, based on their clinical records. Our results showed that hexahydrated nickel sulfate at 10 microg/mL, 10% of autologous sera, and 2 x 10(5) cells was the best condition for inducing the most marked nickel proliferation response in vitro. This optimized method was able to distinguish nickel-sensitive from non-nickel-sensitive dental patients and also to discriminate those with positive skin tests. Our data suggest that continuous exposure to nickel casting alloys might lead to oral tolerance mechanisms that modulate nickel sensitivity, as evidenced by the lower cell proliferation index in patients undergoing orthodontic treatment over 24 months. Finally, our findings demonstrated a known nickel-induced type 2 immune response and a marked lack of type 1 immunity (interferon gamma) as the hallmarks of nickel-sensitive patients. Further studies are needed to clarify the major cell phenotype associated with this type 2 immune response and the lack of type 1 immunity observed in nickel-sensitive people.

Adolescent↗
PubMed2003

Airborne particles produced during enamel cleanup after removal of orthodontic appliances.

Airborne particles can be produced during enamel cleanup after the removal of fixed orthodontic appliances. Particles with an aerodynamic diameter of less than 2.5 microm, known as PM2.5, can reach the alveoli of the lungs. The aim of this experiment was to qualitatively determine whether such particles are produced during enamel cleanup at the end of orthodontic treatment. Particles were collected and examined under a scanning electron microscope. Aerodynamic diameters of the particles ranged from approximately 2 to 30 microm. X-ray analysis confirmed not only the presence of components of the adhesives being removed, but also tungsten from the bur and tooth enamel. In conclusion, inhalable particles can be produced during enamel cleanup at the completion of orthodontic treatment. Further investigation is required to determine the clinical significance of such particles, how their production can be minimized, and whether even smaller, fine or ultrafine, particles are produced.

Aerosols↗
PubMed1993

Cytotoxicity of orthodontic elastics.

The neon-colored orthodontic rubber bands have recently become remarkably popular to wear among the young patients. In this study we examined if the dyes used in the manufacture of these elastics might exhibit any toxic effects. Gingival fibroblasts were exposed to extracts of colored and plain elastics in vitro. Cytotoxicity was examined by cellular proliferation rate and viability. Results showed that both the plain and the colored elastics display identical toxic effects. This ex vivo cytotoxicity, however, could not be observed in orthodontic patients: gingival fibroblast viability is no different in patients with and without rubber band wear. We conclude that in in vitro conditions, all orthodontic rubber bands are cytotoxic. Clinically, however, this effect is not demonstrable.

Adolescent↗
PubMed1992

Shear peel bond strengths of esthetic orthodontic brackets.

Anecdotal reports of bracket fracture and tooth damage associated with the use of certain esthetic orthodontic brackets have been reported in the literature. With the advent of new esthetic orthodontic brackets, the need has arisen to test the claims of the manufacturers. The objectives of this study were to determine: (1) shear peel bond strengths (SPBS) of various debonded orthodontic brackets, (2) SPBS of these rebonded esthetic brackets with and without use of silane, and (3) fracture sites of all groups examined. Seventy-five noncarious human premolar teeth were randomly divided into five groups (A through E). The teeth were cleaned, stored in 70% ethyl alcohol, and mounted for testing in the Instron machine. The following brackets were bonded to the teeth with Ortho-Concise bonding resin: (A) metal brackets, (B) Silkon brackets, (C) Transcend 2000 brackets, (D) debonded Transcend 2000 brackets, and (E) debonded silanized Transcend 2000 brackets. After wet storage at 37 degrees C for 7 days, the SPBS of brackets were recorded, and fracture sites observed. There were statistically significant differences between the SPBS of metal brackets when compared with the Transcend 2000 and the Silkon brackets. These groups exhibited clinically acceptable SPBS. Debonded silanized Transcend 2000 brackets showed clinically unacceptable SPBS. Fracture sites of metal and Transcend 2000 brackets were resin-bracket, whereas Silkon brackets fracture sites were predominantly resin-enamel.

Bicuspid↗
PubMed1991

The effects of ion implantation on the beaks of orthodontic pliers.

The surface of stainless steel may be hardened by bombarding the material with a stream of nitrogen ions generated by a nuclear accelerator. In the present study this technique was used to determine the hardening effect of ion implantation on the beaks of stainless steel orthodontic pliers. Ten orthodontic pliers (Dentarum 003 094) were divided into two equal groups, designated control and experimental. The beaks of the experimental pliers were subjected to ion implantation, after which the tips of the beaks of all the pliers were stressed in an apparatus attached to an Instron testing machine. A cyclical load of 500 N was applied to the handles of the pliers, while a 0.9 mm (0.036 inch) round, stainless steel wire was held between the tips of the beaks. The effect of the stress was assessed by measurement with a traveling microscope of the gap produced between the tips of the beaks. Measurements were taken before loading and after 20, 40, 60, and 80 cycles. Statistical analysis of variance and the two-sample t tests indicated that there was a significant increase in the size of the gap as the pliers were stressed from 0 to 80 cycles (p less than 0.001). Furthermore, the mean gap was significantly greater in the control group than in the experimental group (p less than 0.001). This study suggests that ion implantation increases the hardness of the tips of the beaks of orthodontic pliers.

Analysis of Variance↗
PubMed1990

The duration of orthodontic treatment with and without extractions: a pilot study of five selected practices.

Contemporary orthodontic practice is diverse, both in the variety of clinical problems treated and in the methods used. Practices differ with respect to their patient composition as well as in many variables relative to treatment protocols. Such heterogeneity makes it difficult to make valid generalizations concerning the characteristics of orthodontic treatment procedures or outcomes; yet data and methods are required for assessment of issues of efficacy and utility. The frequency of orthodontic extractions is an objective criterion that distinguishes practices and may also be related to differences in treatment outcome variables, such as duration. Following a telephone survey to estimate extraction rates in the practices of 238 Michigan orthodontists, five practices with very high or low reported rates were chosen for this pilot study. Our primary aim was to determine whether a systematic relationship existed between the relative frequency of extraction treatments and the duration of active appliance therapy. Records of 438 patients from these practices were examined. The extraction rates of the practices ranged from a low of 25% to a high of 84%. Treatment duration was affected by several variables, such as the number of arches treated, the number of treatment phases, and the practice selected. When the data for all five practices were pooled, and all of the extraction versus nonextraction treatments were compared, the mean durations of treatment were 31.2 and 31.3 months, respectively. Data from individual practices, however, indicated that extraction treatment in each of the practices was of longer duration than nonextraction therapy. These differences in duration were 3.0, 6.6, 2.4, 3.0, and 7.3 months in the five practices.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Root resorption after orthodontic treatment: Part 2. Literature review.

All permanent teeth may show microscopic amounts of root resorption that are clinically insignificant and radiographically undetected. Root resorption of permanent teeth is a probable consequence of orthodontic treatment and active tooth movement. The incidence of reported root resorption during orthodontic treatment varies widely among investigators. Usually, extensive resorption does not affect the functional capacity or the effective life of the tooth. Most studies agree that the root resorption process ceases once the active treatment is terminated. Root resorption of the deciduous dentition is a normal, essential, and physiologic process. Permanent teeth have the potential to clinically undergo significant external root resorption when affected by several stimuli. This resorptive potential varies in persons and between different teeth in the same person. This throws doubt on the role of systemic factors as a primary cause of root resorption during orthodontic treatment. Tooth structure, alveolar bone structure at various locations, and types of movement may explain these variations. The extent of treatment duration and mechanical factors definitely influence root resorption. In most root resorption studies, it is not possible to compare the results and conclusions because of their different methods. Further research in this field is necessary to advance the service of the specialty. The question of whether there is an optimal force to move teeth without resorption or whether root resorption may be predictable remain unanswered. This review indicates the unpredictability and widespread incidence of the root resorption phenomenon.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1994

A two-month study of the effects of oral irrigation and automatic toothbrush use in an adult orthodontic population with fixed appliances.

Forty-seven adult orthodontic patients with fixed orthodontic appliances were divided into three study groups: (1) oral irrigation with automatic toothbrush, (n = 16); (2) oral irrigation with manual toothbrushing, (n = 16); (3) control group with continued normal toothbrushing only, (n = 15). Gingival and plaque indices, bleeding after probing, and gingival sulcus depths were assessed at baseline, 1-month, and 2-month periods. Marked and significant gingival and plaque improvements from baseline were measured in all three study groups. After 1 to 2 months use of the automatic toothbrush and/or the oral irrigation device, there was a significant reduction in plaque when compared with the control group who used only the manual toothbrush (p = 0.026). Also, there was a significant reduction in gingival inflammation (p = 0.045) and evidence for reducing bleeding after probing (p = 0.037). No significant differences were found in probe depths among the three study groups, however, use of both devices reduced the pocket depth significantly from baseline by 0.5 mm (p < 0.0002). For this population of orthodontic patients, significant reductions in plaque, gingival inflammation, and a tendency for reduced bleeding after probing occurred in both groups with the power device. These improvements were most attributable to the effect of the oral irrigation device.

Adult↗
PubMed1994

Reduction of caries and of demineralization around orthodontic brackets: effect of a fluoride-releasing resin in the rat model.

The effectiveness of fluoride in reduction of caries is well known. This study examined the ability of a fluoride-releasing resin to reduce caries, as well as demineralization around orthodontic brackets, by using the Sprague-Dawley rat as a model. Eighteen-day-old rats were infected with cariogenic Streptococcus sobrinus 6715. After infection was confirmed, standard orthodontic techniques were used to bond miniature orthodontic brackets to the lingual surfaces of maxillary first molars, with either a fluoride-releasing resin (group I) or a conventional resin (group II). A control group was infected but not bonded (group III). Bonding was done at age 34 days. Rats were fed a cariogenic diet and were killed at age 72 days. Lingual surfaces of maxillary first molars were evaluated for area of demineralization, and mandibular molars were scored for caries. Mean percent area of demineralization for group I was 4.7%, for group II 35.7%, and for group III 0%. The difference between groups I and II was statistically significant (p < 0.01). Mean mandibular molar enamel carious lesion unit count for group I was 9.8, for group II 16.3, and for group III 13.7. Group I had significantly fewer lesions than groups II and III (p < 0.01), and group II had significantly more lesions than group III (p < 0.01). These results indicate that a fluoride-releasing resin reduces demineralization at the site of application and reduces caries at distant sites in the experimental rat model.

Animals↗
PubMed1994

Elastic energy/stiffness ratios for selected orthodontic wires.

This investigation determined the ratio of the energy available for orthodontic tooth movement to the stiffness and flexibility of a given wire. Twenty-five specimens each of five brands of orthodontic wire were tested in tension in the as-received condition. Force versus elongation diagrams were obtained and then converted into stress-strain data. Mean values were determined for the yield strength and yield strain for each brand of wire. The modulus of elasticity (E), modulus of resilience (R), and elastic compliance (C) were then calculated. Two ratios were established by using the three mechanical properties: (1) the modulus of resilience/modulus of elasticity (R/E) ratio and (2) the modulus of resilience/elastic compliance (R/C) ratio. The results confirmed that the use of these two ratios in combination permitted one to differentiate among the various types of orthodontic wires, with respect to stored energy and its relationship to the stiffness or flexibility of the wire.

Analysis of Variance↗
PubMed1994

Eighteen-month evaluation of the effects of a 0.4% stannous fluoride gel on gingivitis in orthodontic patients.

The purpose of this study was to determine whether conventional toothbrushing and twice daily use of a brush-on 0.4% stannous fluoride (SnF2) gel containing more than 90% available Sn2+ would be more effective for controlling plaque accumulation and gingivitis in the presence of orthodontic appliances than conventional toothbrushing alone. Consecutively treated adolescents who were to receive full-mouth fixed orthodontic appliances were assigned to one of two groups according to age and sex criteria. The first group (control, n = 35) used toothbrushing with a standard fluoride toothpaste, whereas the second group (treatment, n = 30) used toothbrushing supplemented with a 0.4% SnF2 gel used twice daily for the entire 18-month study period. Clinical assessments (Plaque Index, Gingival Index, bleeding tendency, and coronal staining) were made single blind before appliances were placed and 1, 3, 6, 9, 12, and 18 months after appliances were placed. Complete data were obtained for 32 control and 23 SnF2 gel subjects. The results indicated that the SnF2 gel group had significantly lower scores for plaque index (p < 0.01), gingival index (p < 0.001), and bleeding tendency (p < 0.001) at all examinations than did the control group. In the SnF2 group, one subject developed mild coronal staining, and two subjects developed moderate staining. We conclude that the use of a 0.4% SnF2 gel containing more than 90% available Sn2+ is an effective adjunct to mechanical tooth cleaning in preventing gingivitis in adolescents undergoing orthodontic treatment with fixed appliances.

Adolescent↗
PubMed1995

Fluoride release from four visible light-cured orthodontic adhesive resins.

Decalcification of enamel during fixed orthodontic appliance treatment remains a problem. This study determined the in vitro fluoride (F) release from four light-cured orthodontic adhesives since cariostatic potential of such adhesives is related to their F releasing ability. Two nonfluoride and two fluoride-containing adhesives were tested. By means of the potentiometric analytical method, the F release of each resin was determined daily for 7 days and thereafter weekly for a month and then monthly until week 85. The data were analyzed with Kruskal-Wallis, Mann-Whitney, and Wilcoxon matched-pairs tests. The F release of all the resins were characterized by an initial burst of F release during the first day, followed by a tapering down in magnitude. FluorEver (MacroChem, Billerica, Mass.) outperformed the other adhesives in all aspects of F release and continued to release F for up to 85 weeks. Fluorapatite formation resulting from F release from orthodontic adhesives could be more advantageous in reducing decalcification during fixed appliance treatment than other preventive modalities.

Adhesives↗
PubMed1995

Polymerization efficiency of chemically cured and visible light-cured orthodontic adhesives: degree of cure.

The use of light-cured orthodontic adhesives in combination with the new generation of ceramic brackets has become popular from an esthetic standpoint. The purpose of this article was to evaluate the degree of cure (DC) of selected light-cured and chemically cured adhesives bonded to ceramic and stainless steel brackets. The optical properties of eight types of brackets (single-crystal alumina, polycrystalline alumina, polycrystalline allumina with polycarbonate base, and stainless steel) were evaluated by diffuse visible light transmittance spectroscopic analysis. The degree of cure (DC) of a visible light-cured orthodontic adhesive bonded to these brackets under direct (20 seconds through the bracket) and indirect (2 x 10 seconds from the incisal and cervical edges of the bracket) irradiation was measured by micro-MIR FTIR spectroscopy. Brackets bonded to a chemically cured, two-paste orthodontic adhesive were used as a control group. According to the results the single-crystal alumina brackets showed the highest diffuse transmittance values at 468 nm followed by polycrystalline alumina and polycarbonate-base alumina types. Direct irradiation resulted in low DC values that were strongly correlated to the diffuse transmittance measurements at 468 nm (r = 0.73, p < 0.05). Indirect irradiation manifested significantly higher DC values than direct irradiation in the stainless steel bracket group, which yielded values comparable to those found in some indirectly irradiated polycrystalline bracket groups.

Acrylic Resins↗
PubMed1995

24-hour shear bond strength of metal orthodontic brackets bonded to porcelain using various adhesion promoters.

Clinically, orthodontists are often faced with the difficulties of bonding to porcelain crowns, veneers, or bridges. Traditional methods of dealing with this are often time-consuming and generally esthetically unacceptable to patients. Current interest involves the use of organosilane primers with or without NTG-GMA and BPDM resins to aid in chemically bonding porcelain with traditional orthodontic adhesives. This study compared the bond strength of three types of adhesion promoters: Ormco Porcelain Primer (OR) (Ormco Corp., Glendora, Calif.), All-Bond2 (AB2) (Bisco Dental Products, Inc., Itasca, Ill.), and Scotchprime Ceramic Primer (SP) (3M, St. Paul, Minn.) with two orthodontic adhesives: Phase II (Reliance, Inc., Itasca, Ill.) and Rely-a-bond (Reliance, Inc., Itasca, Ill.). Eighty ceramometal samples were fabricated and hydrated for 1 week in distilled water before bonding. Next, the samples were etched with 2.5 % HF acid for 90 seconds, rinsed and upper central incisor metal orthodontic brackets were bonded with the various primers and adhesives. After 24 hours they were sheared off with an MTS machine at at rate of 0.5 mm/min, and the bond strength was measured. The mean shear bond strengths (MPa) with Phase II were as follows; Control 0.44 (sigma = 0.22), AB2 8.40 (sigma = 3.61), OR 13.31 (sigma = 5.79), SP 13.53 (sigma = 3.34). With Rely-a-bond, the shear bond strengths were Control 0.41 (sigma = 0.67), AB2 4.34 (sigma = 1.88), OR 9.73 (sigma = 4.58), and SP 12.40 (sigma = 3.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Acid Etching, Dental↗
PubMed1995

Orthodontic forces increase tumor necrosis factor alpha in the human gingival sulcus.

The production of cytokines has been associated with the biology of tooth movement in animal populations. The purpose of this study was to measure tumor necrosis factor-alpha (TNF) directly in the human gingival sulcus before and after the application of an orthodontic force. To recover TNF from the sulcus, paramagnetic beads, coated with monoclonal antibodies for TNF, were introduced into the gingival sulcus of 50 teeth undergoing orthodontic tooth movement (by two force systems) in 20 patients. Retrieval was performed by a permanent magnetic device designed to fit the periodontal sulcus. The samples were taken before force application (controls), and at a fixed time after force application. The amount of immunoabsorbed TNF was quantified with an immunochemical assay. There was a greater than twofold increase in TNF recoverable from the gingival sulcus after application of orthodontic forces (mean of 12.9 ng vs 30.5 ng). A Student's t test for paired samples demonstrated statistical significance at p < 0.01. We conclude that the quantity of paradental TNF, found in human gingival sulcus, is elevated during tooth movement. The source may be from the adjacent gingiva, but more likely the compressed periodontal ligament and the resorbing bone adjacent to the root surface.

Adolescent↗