Search Results (75)

Objectives: This study investigated the use of artificial intelligence (AI) in the design of lingual bracket indirect bonding trays and its association with bracket transfer accuracy using three-dimensional (3D) printing. Methods: Digital impressions of patient’s dental arches were captured using an intraoral scanner, and orthodontic setups were virtually constructed. Brackets were virtually positioned in their ideal locations using the digital setups guided by virtual archwire templates. Indirect bonding trays were automatically generated using the AI-powered Auto Creation function of the Medit Splints application, which analyzes anatomical features to streamline design. Bracket transfer accuracy was evaluated in vivo by comparing planned and actual bracket positions across grouped and individual tray configurations. Linear and angular deviations were measured using conventional 3D inspection software. Results: Most bracket transfer errors were within clinically acceptable thresholds, although torque accuracy remained suboptimal. Grouped trays generally exhibited greater precision than individual trays in several dimensions. Conclusions: These findings support the application of AI-assisted design tools to enhance digital workflows and improve consistency in appliance fabrication. Full article

Fluoride mouthwashes are often recommended by dental professionals due to their proven benefits for oral hygiene. However, it is vital to acknowledge that these products may have undesirable effects on orthodontic treatment outcomes, particularly by altering the biomechanical properties of orthodontic devices and their components. To gain a comprehensive understanding of this potential issue, an extensive and systematic search was conducted across seven distinct databases. PRISMA extension for scoping reviews (PRISMA ScR) guidelines were followed. Following a detailed evaluation and careful scrutiny of the available evidence, a total of seven relevant studies met the inclusion criteria and were incorporated into the current scoping review. Findings indicated that regular intraoral use of fluoride-containing mouthwashes could lead to heightened corrosion and greater release of metal ions from stainless-steel brackets and nickel–titanium (NiTi) archwires. Additionally, the mechanical properties and structural integrity of titanium–molybdenum alloy (TMA) wires were negatively influenced by exposure to fluoride mouthwashes. Although existing evidence highlights these potential drawbacks, there remains a clear necessity for additional comprehensive research. Given the possibility that fluoride mouthwashes could adversely influence orthodontic treatment effectiveness, orthodontists and dental clinicians must exercise cautious judgment and deliberate consideration when prescribing fluoride-based mouthwashes for patients undergoing orthodontic therapy. Full article

Nickel-containing orthodontic archwires, particularly those made of nickel-titanium (NiTi) and stainless steel (SS), play a crucial role in orthodontic treatment using the fixed technique due to their mechanical properties. However, concerns regarding nickel-induced allergic reactions, cytotoxicity, and metal ion release, especially nickel-related ones, persist. This narrative review aims to explore recent findings on nickel release from orthodontic appliances, building upon prior systematic reviews by analyzing both in vitro and in vivo studies under various environmental conditions. The databases Web of Science, Scopus, and PubMed were searched for relevant studies that examined the relationship between nickel ion release from nickel-containing archwires and various environmental conditions. The studies found indicate that while metal ion release occurs during short-term treatment, the levels are lower than harmful thresholds, with factors such as pH, corrosion, length of treatment, and environmental influences affecting release rates. Despite this, long-term studies are few and are usually conducted only in an in vitro or in vivo environment, but not both. To establish causal relationships regarding metal ion release, in vivo monitoring of ions like Ni is critical, with further research needed to assess its prolonged effects. Furthermore, collaborative efforts among practitioners, researchers, and regulatory bodies are vital for developing evidence-based guidelines for orthodontic material selection, prioritizing patient safety and addressing metal ion release risks. Full article

Background/Objectives: Orthodontic treatment offers significant functional and aesthetic benefits, but it often causes discomfort, impacting patients’ daily activities, including diet and medication use. The primary aim of this observational study was to assess the influence of orthodontic patients’ age, gender, and living environment on pain duration, diet impairment, and analgesic use one week after their first adjustment visit to the orthodontist. Methods: This observational study included a sample of 194 orthodontic patients who completed a questionnaire consisting of six single-choice questions. The questions addressed the following variables: age, gender, living environment, pain duration, diet impairment, and analgesic use. The main inclusion criteria encompassed undergoing fixed orthodontic treatment on the upper arch for one week using a 0.0016-inch superelastic NiTi archwire (American Orthodontics, Sheboygan, WI, USA) and presenting moderate to severe crowding of the upper and lower anterior teeth. Results: Female patients were significantly more likely to experience diet impairment than males (51.9% vs. 33.3%, p = 0.013). Among female patients reporting pain lasting approximately one week, a higher proportion resided in rural areas (25% vs. 6.8%, p = 0.045), whereas male patients reporting the same pain duration predominantly lived in urban areas (12.5% vs. 0%, p = 0.028). Overall, 55.7% of participants used analgesics, with females in rural areas being the most frequent users. Additionally, patients who used analgesics were significantly more likely to experience diet impairment than those who did not (64.3% vs. 49.1%, p = 0.041). Conclusions: Female patients residing in rural areas reported a longer duration of pain, which led to a greater likelihood of experiencing diet impairment and increased consumption of analgesics compared to their counterparts. These findings highlight the need for personalized pain management strategies in orthodontic treatment, especially for patients with increased vulnerability to discomfort. Full article

Background/Objectives: The nature, diameter, and cross-section of orthodontic archwires affect tooth movement and the surrounding alveolar bone. Researchers have explored different features of archwires to optimize treatment outcomes. In this context, this study aimed to evaluate the properties of the I-arch for its effects on alveolar bone height, dehiscence, fenestration, and treatment duration. Methods: Forty patients (eight males, and thirty-two females; mean age: 20.97 ± 2.41 years) with dental crowding ≤ 6 mm and Class I malocclusion were treated without extractions. They were randomly divided into two groups: the experimental group (EG, n = 20), treated with the I-arch, and the control group (CG, n = 20), treated with traditional archwires of the MBT technique. Two CBCT scans were taken for each patient, one before treatment (T0) and one after leveling (T2). The studied teeth were upper and lower centrals, canines, and second premolars. The treatment duration was measured across three periods: T0–T1, T1–T2, and T0–T2. Results: Alveolar bone resorption, dehiscence, and fenestration were lower in the EG. Total treatment duration (T0–T2) was similar between groups, but the first period (T0–T1) was significantly shorter in the EG (p < 0.05). Conclusions: The I-arch resulted in fewer side effects on alveolar bone height during leveling and alignment. Full article

Rationale: Orthodontic archwires undergo chemical and structural changes in the complex intraoral environment. The present work aims to investigate the safe duration for intraoral use (related to the nickel release hypothesis) of different types of nickel-containing wires. By analyzing how the nickel content (NC) varies over time, we aim to provide practical recommendations for the optimal use of said archwires. Materials and Methods: Our analysis focuses on the following nickel-containing archwires: stainless steel, Ni-Ti superelastic, heat-activated NiTi and CuNiTi, and multi-force archwires. The studied archwires of each type were divided into three groups: group 1, as received; group 2, retrieved after intraoral exposure for less than 6 weeks; group 3, used for more than 8 weeks. To assess NC, measurements using scanning electron microscopy (SEM), energy-dispersive X-ray (EDX), and laser-induced breakdown spectroscopy (LIBS) were performed in multiple regions of each wire. Statistical analysis of the measured values using one-way ANOVA and multiple group comparisons showed significant differences in nickel content between groups. The dynamic behavior of the statistical results for NC was then modeled using logistic regression and fitted with cubic splines. Conclusions: The proposed behavior model, with further refinement, could enable orthodontists to make informed, patient-specific decisions regarding the safe and effective use of orthodontic floss. The overall conclusion of the study is that due to stability, SS-CrNi, HA-Ni-Ti with Cu, and TriTanium^TM are suitable for long-term use, and due to higher nickel release, Ni-Ti-Superelastic, HA-Ni-Ti without Cu, and Bio-Active^TM are better for short- to medium-term use. Full article

Backgrounds/Objectives: The finite element method (FEM) is an advanced numerical technique that can be applied in orthodontics to study tooth movements, stresses, and deformations that occur during orthodontic treatment. It is also useful for simulating and visualizing the biomechanical behavior of teeth, tissues, and orthodontic appliances in various clinical scenarios. The objective of this research was to analyze the mechanical behavior of teeth, tissues, and orthodontic appliances in various clinical scenarios. Materials and Methods: For this study, we utilized a model derived from a set of CBCT scans of a 26-year-old female patient who underwent fixed orthodontic treatment using the lingual technique. Through a series of programs based on reverse engineering, we constructed a three-dimensional reconstruction of the teeth and their internal structures. Using the finite element method (FEM), we obtained six simulations of an orthodontic system utilizing the fixed lingual technique, in which we employed brackets made of chrome–nickel or gold, and archwires made of nitinol, gold, or stainless steel. Results: The study reveals that although the deformation of the archwires during orthodontic treatment is the same, the forces generated by the three types of archwires on brackets differ. The variation in forces applied to the brackets in the fixed lingual orthodontic technique is essential for customizing orthodontic treatment, as these forces must be precisely controlled to ensure effective tooth movement and prevent overloading of the dental structures. Conclusions: The FEM analysis allows for the identification of ideal combinations between the materials used for orthodontic archwires and the materials used for brackets. This ensures that the optimal intensity of forces applied during the fixed lingual orthodontic technique results in desired tooth movements without causing damage to the enamel, dentin, or pulp of the teeth. Full article

Good oral hygiene is crucial during treatment with fixed appliances, emphasising the need for additional or alternative oral health methods during orthodontic treatment. This study investigates the effect of essential oil (EO)-based preparations on biofilm adhesion to orthodontic archwires. Five identical-sized orthodontic archwires of different materials were tested using therapeutic and preventive applications of essential oils. This study also used molecular docking to explore how essential oil compounds interact with key proteins of common oral pathogens like Staphylococcus aureus and Streptococcus mutans. We found that the constituent materials heavily influence the antimicrobial effects of essential oils on different orthodontic archwires. Stainless steel-based orthodontic archwires demonstrated the highest efficacy in antimicrobial protection against S. mutans strains (maximum BIP = 28.82% on the epoxy-coated SS). Conversely, inhibition effects in preventive applications against S. aureus were observed exclusively with titanium–molybdenum alloy orthodontic archwires across all tested emulsions (maximum BIP = 29.44%). CuNiTi alloys showed ineffectiveness in preventive treatments, as none of the EO mixtures inhibited biofilm development on this material. After biofilm contamination with S. mutans and S. aureuss strains, the ternary emulsion was most effective for four out of five orthodontic archwires. Computational analysis revealed strong binding interactions between essential oil compounds and key proteins of S. aureus and S. mutans, highlighting specific amino acid residues that are critical for these interactions. Based on the results, stainless steel with epoxy coating or TMA archwires, combined with BEO/CEO/OEO ternary mixture, are recommended for optimal antibacterial protection against biofilm formation on orthodontic archwires. Full article

This study investigates the release of metal ions from commonly used orthodontic archwires, specifically, stainless steel (SS), nickel–titanium (NiTi), chromium–cobalt (CrCo), and titanium–molybdenum (TMA) alloys. To simulate oral conditions, each type of wire was immersed in artificial saliva at body temperature for a four-week period. Ion release levels were analyzed through ICP-OES mass spectrometry. The findings indicate that NiTi and CrCo wires released significantly higher amounts of nickel (Ni) and chromium (Cr) ions compared to SS wires. These findings underscore the potential risk of allergic reactions, particularly to nickel, and emphasize the need for careful consideration of biocompatibility in orthodontic material selection. This research also provides valuable insights aimed at minimizing adverse reactions in patients, especially those with metal allergies. Full article

This study investigates the cytotoxicity of various orthodontic archwires, which are essential in directing tooth movement through biomechanical forces. With advancements in material science, different archwire materials have been developed to balance mechanical performance with aesthetic and biological considerations. The study focuses on evaluating the biocompatibility and mechanical properties of stainless steel, nickel–titanium, and chromium–cobalt archwires, particularly their cytotoxic effects on oral cavity cells. In vitro cell culture experiments with fibroblasts, combined with scanning electron microscopy (SEM) analysis, were conducted to assess cell viability and morphology. The results revealed significant differences in cytotoxicity, with copper wires showing high toxicity and causing extensive cell death, while nickel–titanium and chromium–cobalt wires supported better cell viability and healthier cell morphology. These findings highlight the importance of selecting archwire materials that ensure mechanical efficiency without compromising cellular health, emphasizing the need for ongoing assessment of material biocompatibility in the oral environment. Full article

Aims: It was the scope of this study to explore the biomechanical implications of retraction force application point modifications in lingual orthodontics, aiming to mitigate the bowing effect and enhance anchorage stability in the anterior teeth. Methods: Using the FE method on an idealized maxillary model, en masse retraction was simulated using a modified lingual fixed appliance including edgewise lingual brackets, a 0.017″ × 0.025″ mushroom-shaped archwire, and power arms between lateral incisors and canines, with a transpalatal arch (TPA) connecting the first molars. Applying bilateral retraction forces of 1.5 N at twelve positions, initial tooth displacements during space closure were evaluated. Results: Shifting power arms gingivally did not effectively counteract palatal tipping of incisors but reduced posterior and palatal tipping of canines with a power arm length of 11.3 mm preventing posterior tipping. Apically displacing the TPA retraction force increased mesiobuccal rotation while preventing mesial molar tipping for retraction forces applied 12.6 mm from the archwire. Conclusions: Apically shifting retraction forces can mitigate vertical bowing effects in lingual orthodontics, yet it also highlights the challenges in maintaining torque in the anterior teeth. Further research and clinical validation are essential in order to confirm these results, emphasizing the complexity and need for advanced biomechanical strategies in personalized lingual orthodontic treatments. Full article

Electropolishing is a common treatment in the industry; however, how it behaves in the mouth and what benefits it can bring over metal dental attachments have not yet been established. Thus, the aim of this study was to determine the levels of corrosion, the released metal ions, and the changes in structural composition in metallic orthodontic appliances following electropolishing treatment. This study included 56 orthodontic brackets and 28 archwires. The samples were subjected to a pH cycle to simulate an oral environment. Using UV–Vis spectrophotometry, the release of metallic particles was evaluated, and using scanning electron microscopy, the structural and composition changes were evaluated. Groups were compared using Student’s t-tests with a value of p ≤ 0.05. The cyclical pH solutions showed variations between groups and days (1, 3, 5, 7 and 15), reaching the highest acidification in the self-ligating brackets; the absorbance between solutions did not differ significantly. As seen from the SEM results, the experimental group showed minor irregularities compared with the control groups. The experimental brackets decreased in iron and increased in chromium after electropolishing, while for the NiTi archwires, they decreased in nickel. Therefore, electropolishing treatments in metallic orthodontic attachments improve their surface structure and corrosion resistance could reduce the risk of metal hypersensitivity, mainly from nickel. Full article

The manufacturing of orthodontic archwires made from NiTi alloy has undergone numerous changes from the second half of the last century to modern times. Initially, superelastic-active austenitic NiTi alloys were predominant, followed by thermodynamic-active martensitic NiTi alloys, and, finally, the most recent development was graded thermodynamic alloys. These advancements have been the subject of extensive investigation in numerous studies, as they necessitated a deeper understanding of their properties. Furthermore, it is imperative that we validate the information provided by manufacturers regarding these archwires through independent studies. This review evaluates existing studies on the subject with a specific focus on the Bio-active multi-force NiTi archwire, by examining its mechanical, thermal, and physicochemical properties before and after clinical use. This archwire consists primarily of Ni and Ti, with traces of Fe and Cr, which release graduated, biologically tolerable forces which increase in a front-to-back direction and are affected by the temperature of the environment they are in. The review provides information to practicing orthodontists, facilitating informed decisions regarding the selection and use of Bio-active™ archwires for individual patient treatments. Full article

(1) Background: The most important part of an orthodontic attachment (bracket or tube) is the tube or slot for the insertion of the orthodontic wire. Aligning teeth along the archwire according to angular values preadjusted in the bracket slots (or tubes) requires a very precise size accordance between the archwires and slots. The aim of this study was to perform a nanotomographic analysis of the geometric features of molar tubes for direct bonding in terms of their dimensions and angles of their inner walls and analyze the presence of metallurgic imperfections. (2) Methods: Orthodontic tubes (n = 100) for upper right first molars from five different manufacturers (3M-Victory Series, Adenta-Bond Sing, Dentaurum-Ortho Cast M, GC-L LP, and ORMCO-Accent), 20 tubes each, were subjected to nanotomographic analysis. Measurements of the inner channel of the tubes, angles between the walls, and analysis of metallurgic imperfections were performed using high-resolution computed tomography. (3) Results: height measurements differed by 4–14% from ideal values declared by manufacturers, whereas the angles ranged from reducing by a maximum 1% comparing to values declared (hypodivergent walls) to increasing by a maximum 4.5% (divergent walls). (4) Conclusions: 1. The sizes of channels measured were slightly larger than those declared by manufacturers. 2. Slight deviations in wall parallelism and angles between the walls were found. 3. Some tubes were characterized by manufacturing defects of the metal. 4. Efforts should be made to further improve the production process of orthodontic attachments. Full article

Polyetheretherketone (PEEK), an organic thermoplastic polymer, has gained interest in dentistry due to its excellent mechanical strength, flexibility, and biocompatibility. Furthermore, the ability to utilize CAD/CAM in the fabrication of PEEK enhances accuracy, reliability, and efficiency while also saving time. Hence, several orthodontic studies have explored the utilization of PEEK in various applications, such as archwires, brackets, fixed lingual retainers, palatal expansion devices, transpalatal arches, Tübingen palatal plates, different types of space maintainers, mini-implant insertion guides, and more. However, a complete systematic review of the available data comparing the performance of PEEK with traditional orthodontic materials has not yet been conducted. Therefore, this systematic review seeks to assess if PEEK material meets the required mechanical criteria to serve as an alternative to conventional orthodontic appliances. To ensure clarity and precision, this review will specifically concentrate on fixed appliances. This systemic review followed the PRISMA guidelines and utilized databases including PubMed/MEDLINE, Embase, Springer, Web of Science, and Wiley. Searches were restricted to English language articles from January 2013 to February 2024. Keywords such as “Polyetheretherketone” or “PEEK” and “Orthodontic” or “Orthodontic device” or “Orthodontic materials” were employed across all databases. Nine studies were incorporated, covering orthodontic archwires, brackets, and fixed lingual retainers. Based on the reviewed literature, PEEK demonstrates promising potential in orthodontic fixed appliances, offering advantages in force delivery, friction reduction, and aesthetic appeal. Further research is needed to fully explore its capabilities and optimize its application in clinical practice. Full article