In vitro cytotoxic effects of orthodontic appliances

Toxicological Profile of Biological Environment of Two Elastodontic Devices

Malocclusion and teething problems are common health problems globally, affecting people of all ages, especially children and adolescents. In addition to the pathophysiological complications associated with orthodontic problems, they also affect the well-being of the individual. Orthodontic appliances are frequently used, even from an early age, and their activity in different biological environments is very varied and incompletely described. Due to these considerations, the purpose of the study was to evaluate the toxicological profile of the biological environment (saliva at three pH values: 3, 7, and 10) of two elastodontic orthodontic appliances: Myobrace (MB) and LM TrainerTM 2 (LMD). In vitro techniques applied were conducted on human keratinocytes to evaluate cell viability (Alamar blue assay) and gene expression real-time reverse transcription–polymerase chain reaction (RT-PCR technique). In addition, it was assessed the irritating effect on the vascular plexus using as a biological model the chorioallantoic membrane of the hen’s egg by applying the hen’s egg-chorioallantoic membrane (HET-CAM) method. The obtained results showed a decrease in cell viability up to 82% in the case of LMD at pH = 3, a slight increase in mRNA expression for the anti-apoptotic marker (Bcl-2 and Bcl-xL), and a decrease in mRNA expression for the pro-apoptotic marker (Bad), and any type of toxic change at the capillary level (irritation score being below 0.9). Based on the data obtained, it can be stated that MB and LMD biological environments, at different pH values, present a safe toxicological profile.

Biocompatibility evaluation of sputtered zirconium-based thin film metallic glass-coated steels

Thin film metallic glasses comprised of Zr48Cu36Al8Ag8 (at.%) of approximately 1.5 μm and 3 μm in thickness were prepared using magnetron sputtering onto medical grade 316L stainless steel. Their structural and mechanical properties, in vitro corrosion, and antimicrobial activity were analyzed. The amorphous thin film metallic glasses consisted of a single glassy phase, with an absence of any detectable peaks corresponding to crystalline phases. Elemental composition close to the target alloy was noted from EDAX analysis of the thin film. The surface morphology of the film showed a smooth surface on scanning electron microscopy and atomic force microscopy. In vitro electrochemical corrosion studies indicated that the zirconium-based metallic glass could withstand body fluid, showing superior resistance to corrosion and electrochemical stability. Interactions between the coated surface and bacteria were investigated by agar diffusion, solution suspension, and wet interfacial contact methods. The results indicated a clear zone of inhibition against the growth of microorganisms such as Escherichia coli and Staphylococcus aureus, confirming the antimicrobial activity of the thin film metallic glasses. Cytotoxicity studies using L929 fibroblast cells showed these coatings to be noncytotoxic in nature.

In vitro cytotoxicity of metallic ions released from dental alloys

The cytotoxicity of a dental alloy depends on, but is not limited to, the extent of its corrosion behavior. Individual ions may have effects on cell viability that are different from metals interacting within the alloy structure. We aimed to investigate the cytotoxicity of individual metal ions in concentrations similar to those reported to be released from Pd-based dental alloys on mouse fibroblast cells. Metal salts were used to prepare seven solutions (concentration range 100 ppm-1 ppb) of the transition metals, such as Ni(II), Pd(II), Cu(II), and Ag(I), and the metals, such as Ga(III), In(III), and Sn(II). Cytotoxicity on mouse fibroblasts L929 was evaluated using the MTT assay. Ni, Cu, and Ag are cytotoxic at 10 ppm, Pd and Ga at 100 ppm. Sn and In were not able to induce cytotoxicity at the tested concentrations. Transition metals were able to induce cytotoxic effects in concentrations similar to those reported to be released from Pd-based dental alloys. Ni, Cu, and Ag were the most cytotoxic followed by Pd and Ga; Sn and In were not cytotoxic. Cytotoxic reactions might be considered in the etiopathogenesis of clinically observed local adverse reactions.

Surface characterization of nickel titanium orthodontic arch wires

BACKGROUND

Surface roughness of nickel titanium orthodontic arch wires poses several clinical challenges. Surface modification with aesthetic/metallic/non metallic materials is therefore a recent innovation, with clinical efficacy yet to be comprehensively evaluated.

METHODS

One conventional and five types of surface modified nickel titanium arch wires were surface characterized with scanning electron microscopy, energy dispersive analysis, Raman spectroscopy, Atomic force microscopy and 3D profilometry. Root mean square roughness values were analyzed by one way analysis of variance and post hoc Duncan's multiple range tests.

RESULTS

Study groups demonstrated considerable reduction in roughness values from conventional in a material specific pattern: Group I; conventional (578.56 nm) > Group V; Teflon (365.33 nm) > Group III; nitride (301.51 nm) > Group VI (i); rhodium (290.64 nm) > Group VI (ii); silver (252.22 nm) > Group IV; titanium (229.51 nm) > Group II; resin (158.60 nm). It also showed the defects with aesthetic (resin/Teflon) and nitride surfaces and smooth topography achieved with metals; titanium/silver/rhodium.

CONCLUSIONS

Resin, Teflon, titanium, silver, rhodium and nitrides were effective in decreasing surface roughness of nickel titanium arch wires albeit; certain flaws. Findings have clinical implications, considering their potential in lessening biofilm adhesion, reducing friction, improving corrosion resistance and preventing nickel leach and allergic reactions.

Corrosion resistance of surface modified nickel titanium archwires

OBJECTIVE

To compare the corrosion behavior of commercially available surface modified nickel titanium (NiTi) arch wires with respect to a conventional NiTi and to evaluate its association with surface characteristics.

MATERIALS AND METHODS

Five types of surface modified arch wires and a conventional NiTi arch wire, all from different manufacturers, were evaluated for their corrosion resistance from breakdown potential in an anodic polarization scan in Ringer's solution. Surface characteristics were determined from scanning electron microscopy, atomic force microscopy, and energy dispersive analysis. One-way analysis of variance and post hoc Duncan's multiple range tests were used to evaluate statistical significance.

RESULTS

Surface modified NiTi wires showed significant improvement in corrosion resistance and reduction in surface roughness values. Breakdown potentials increased in the order of group 6 (conventional; 204 mV) < group 1 (nitride; 333 mV) < group 5 (epoxy resin; 346mV) < group 3 (oxide; 523 mV) < group 2 (gold; 872 mV) < group 4 (Teflon; 1181 mV), but root mean square (RMS) roughness values, which indicated surface roughness, followed a different pattern: group 3 (oxide; 74.12 nm) < group 1 (nitride; 221.651 nm) < group 4 (Teflon; 278.523 nm) < group 2 (gold; 317.894 nm) < group 5 (epoxy resin; 344.236 nm) < group 6 (conventional; 578.555 nm).

CONCLUSIONS

Surface modification of NiTi wires proved to be effective in improving its corrosion resistance and decreasing surface roughness. However, neither factor could maintain a direct, one-to-one relationship. It meant that the type and nature of coating material can effectively influence the anticorrosive features of NiTi wires, compared with its surface roughness values.

Metallic ions released from stainless steel, nickel-free, and titanium orthodontic alloys: toxicity and DNA damage

INTRODUCTION

The aims of this study were to determine the amounts of metallic ions that stainless steel, nickel-free, and titanium alloys release to a culture medium, and to evaluate the cellular viability and DNA damage of cultivated human fibroblasts with those mediums.

METHODS

The metals were extracted from 10 samples (each consisting of 4 buccal tubes and 20 brackets) of the 3 orthodontic alloys that were submerged for 30 days in minimum essential medium. Next, the determination of metals was performed by using inductively coupled plasma mass spectrometry, cellular viability was assessed by using the tetrazolium reduction assay (MTT assay) (3-[4,5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide), and DNA damage was determined with the Comet assay. The metals measured in all the samples were Ti(47), Cr(52), Mn(55), Co(59), Ni(60), Mo(92), Fe(56), Cu(63), Zn(66), As(75), Se(78), Cd(111), and Pb(208).

RESULTS

The cellular viability of the cultured fibroblasts incubated for 7 days with minimum essential medium, with the stainless steel alloy submerged, was close to 0%. Moreover, high concentrations of titanium, chromium, manganese, cobalt, nickel, molybdenum, iron, copper, and zinc were detected. The nickel-free alloy released lower amounts of ions to the medium. The greatest damage in the cellular DNA, measured as the olive moment, was also produced by the stainless steel alloy followed by the nickel-free alloy. Conversely, the titanium alloy had an increased cellular viability and did not damage the cellular DNA, as compared with the control values.

CONCLUSIONS

The titanium brackets and tubes are the most biocompatible of the 3 alloys studied.

Biocompatibility of orthodontic bands following exposure to dental plaque

OBJECTIVE

The aim of this study was to assess the biocompatibility of orthodontic bands following exposure to the human oral environment.

METHODS

Cell adherence and cell morphology of gingival fibroblasts grown on 32 orthodontic bands were tested. The bands were in place intraorally for 6 to 37 months.

RESULTS

We observed cell adherence in 76% of the previously plaque-free surfaces. Cell morphology was 50% spherical and 50% elongated. The surfaces that had had plaque attached demonstrated cell adherence in 84% of the given areas; those cells were spherical in 42% and elongated in 58%.

CONCLUSION

We conclude that individual oral hygiene habits during orthodontic treatment seem to have no effect on the biocompatibility of orthodontic bands, as we failed to discern a difference in either cell adherence or cell morphology in areas with and without prior plaque attachment.

Variations in surface characteristics and corrosion behaviour of metal brackets and wires in different electrolyte solutions

The aim of this study was to assess the surface characteristics and to compare the corrosion potential of metal brackets and wires in environments containing different media. Four brands of metal brackets and two types of orthodontic wires [stainless steel and nickel-titanium (NiTi)] were investigated. An electrochemical assay was used to compare the corrosion potential (V) of the brackets and wires in different electrolyte media at 37°C. The test media were acidulated sodium fluoride (NaF) and pH 4 and pH 6 artificial saliva solutions. The data were analysed using analysis of variance with a predetermined significance level of α = 0.05. Scanning electron microscopy (SEM) was used to observe surface defects and corrosion. The results of the potentiodynamic curve showed that most brands of metal brackets were easily corroded in the NaF and pH 4 environments, while the NiTi and stainless steel wires were easily corroded in the pH 4 artificial saliva. SEM observations showed that defects or pitting corrosion occurred on the surfaces of the brackets and wires in all tested media.

Nickel concentration in the saliva of patients with nickel-titanium orthodontic appliances

INTRODUCTION

The purpose of this study was to examine whether nickel-titanium (Ni-Ti) archwires cause an increase of nickel concentration in the saliva of 18 orthodontic patients to estimate the possible risk of these archwires in patients who have nickel hypersensitivity.

METHODS

Saliva samples were collected before orthodontic treatment, after placement of the bands and brackets, 2 weeks later and before placing the Ni-Ti archwires, immediately after placing the Ni-Ti archwires, 4 weeks after placing the wires, and 8 weeks after placing the wires.

RESULTS

By using mass spectrometry, no statistically significant differences were found in the nickel concentrations in the samples taken without appliances, in those obtained 2 weeks after placement of the bands and brackets, and 4 and 8 weeks after placement of the archwires. Samples taken immediately after placement of the bands and brackets and the Ni-Ti archwires showed slight but significant increases in nickel concentration of 78 and 56 microg per liter, respectively, compared with the pretreatment value of 34 microg per liter.

CONCLUSIONS

Nickel leaching occurred after placement of the bands and brackets and after placement of the Ni-Ti archwires, associated with an increase of the nickel ion concentration in the patient's saliva. This effect decreased within 10 weeks.

Corrosion resistance and biocompatibility of a new porous surface for titanium implants

Alterations of the commercially pure titanium (cpTi) surface may be undertaken to improve its biological properties. The aim of this study was to investigate the biocompatibility of cpTi when submitted to a new, porous titanium, surface treatment (porous Ti). Five types of surface treatments, namely sintered microspheres porous titanium (porous Ti), titanium plasma spray (TPS), hydroxyapatite (HA), sandblasted and acid etched (SBAE), and resorbable blast medium, sandblasted with hydroxyapatite (RBM) were made. In the experimental methods, the corrosion potentials were measured over time, and then a linear sweep voltammetric analysis measured the polarization resistances and corrosion currents. For biocompatibility evaluation, MG63 osteoblast-like cells were used. Cell morphology, cell proliferation, total protein content, and alkaline phosphatase (ALP) activity were evaluated after 2 h, and after 2, 4 and 7 d. Porous Ti and SBAE showed a better corrosion resistance, with a weak corrosion current and a high polarization resistance, than the other surfaces. Cell attachment, cell morphology, cell proliferation, and ALP synthesis were influenced by the surface treatments, with a significant increase observed of the activity of osteoblast cells on the porous coating (porous Ti). Based on these results, it is suggested that the porous Ti surface has a significantly better biocompatibility than the other surface treatments and an excellent electrochemical performance.

Cytotoxicity of Two Bonding Adhesives Assessed by Three-Dimensional Cell Culture

Objective: To determine the toxicity of orthodontic adhesives assessed on in vitro three-dimensional reconstructed human oral epithelium (RHOE).

Materials and Methods: Two adhesive primers, Transbond XT (3M, Monrovia, Calif) and Excite (Vivadent, Schaan, Liechtenstein), were tested. After topical exposure, the cell cultures were fixed, cut, and stained for light microscopy (LM) and transmission electron microscopy (TEM). Detection of cytotoxicity by measuring lactate dehydrogenase (LDH) activity was performed. Toxicity was assessed by evaluating the morphological changes with LM and TEM. Copper wires and Triton X-100 served as positive controls, and native cell cultures as negative control.

Results: Morphological evaluation of the native cell cultures revealed no toxic reactions. The LDH assay revealed the following mean values for viability: native cell line (negative control), 1.51; Triton X-100 (positive control), 3.06; Transbond XT polymerized, 1.15; Excite polymerized, 1.11; Transbond XT primer, 2.67; and Excite primer, 0.04. Acute toxicity was observed for Triton X-100 and Transbond XT primer (P &lt; .001). Histological evaluation of the RHOE showed toxicity for both primers and mild changes after topical application of polymerized adhesives. The biocompatibility ranking of the adhesive primers was the same after histological analysis and LDH assay except for Excite™ noncured.

Conclusions: RHOE proved to be a valuable model for topical exposure. The toxicity of both uncured primers was demonstrated.

Cytotoxicity of Orthodontic Wire Corroded in Fluoride Solution In Vitro

OBJECTIVE

To investigate the toxicity of fluoride corrosion extracts of stainless steel (SS) and nickel-titanium (NiTi) wires on a human osteosarcoma cell line (U2OS).

MATERIALS AND METHODS

The SS and NiTi wires were corroded by an electrochemical method with the application of three kinds of electrolytes: 0.2% pH 3.5 acidulated phosphate fluoride (NaF) in artificial saliva, and pH 4 and pH 6.75 artificial saliva solutions. The extracts were analyzed for nickel, chromium, and titanium ions by the atomic absorption method. The extracts were diluted with medium to different concentrations (1, 0.1, and 0.01 microL/mL). The cell survival rate was determined by the ability of test cells to cleave the tetrazolium salt to form a formazan dye.

RESULTS

The results were compared using one-way analysis of variance. Differences between the treatment means were analyzed using a Student-Newman-Keuls (SNK) test and were considered significant at P < .05. The release of ionic nickel was different in different extract groups (P < .05). The SS and NiTi wires in the 0.2% pH 3.5 NaF artificial saliva group caused a dose-dependent decrease in the survival rate (P < .05). Survival rates of cells in the groups exposed to extracts of SS and NiTi wires in pH 4 and pH 6.75 artificial saliva solutions showed no statistical differences (P >.05).

CONCLUSIONS

Orthodontic wires in acidulated fluoride saliva solution can cause U2OS cell toxicity.

Toxicity of used orthodontic archwires assessed by three-dimensional cell culture

The aim of the present study was to determine whether used orthodontic wires made of different materials cause toxicity and loss of viability on three-dimensional (3D) cell cultures. Three types of orthodontic wires, stainless steel, Nitinol, and TMA (n = 9) which had been used clinically in fixed appliances for a period of 1 month, were retrieved at random from five patients. Both upper and lower archwires were collected and subjected to two different protocols: to assess toxicity, two pieces of each wire were placed on 3D cell cultures (reconstituted human epithelium); to investigate the possibility of cell damage, the 3-(4,5-dimethylthiazol-2-yl)2,5-diphenyl tetrazolium bromide (MTT) assay was used and haematoxylin and eosin staining was performed to evaluate morphological changes. Copper wire served as the control to determine the morphology of severe toxicity, and native cell cultures and silk were used as the negative controls. Morphological evaluation of the native cell cultures revealed no toxic reactions. The ranking, from mild to severe toxicity was as follows: stainless steel < Nitinol = TMA. There were no significant differences between TMA and Nitinol. The MTT assay revealed the following mean percentage values for viability: native cell line (negative control), 100; stainless steel, 102.25; TMA, 87.4; Nitinol, 85.3; and copper wire (positive control) 57.2. Histological evaluation of the 3D cell cultures showed no severe toxicity or loss of viability for any of the wires. However, relative comparison between the different wires revealed that stainless steel induced less toxicity/loss of viability compared with TMA and Nitinol wire.

In vitro corrosion behavior of bioceramic, metallic, and bioceramic-metallic coated stainless steel dental implants

OBJECTIVES

The most common metals and alloys used in dentistry may be exposed to a process of corrosion in vivo that make them cytotoxic. The biocompatibility of dental alloys is primarily related to their corrosion behavior. The aim of this work was to evaluate the corrosion behavior and thus the biocompatibility of the uncoated and coated stainless steels and compare the effect of type of coatings on corrosion behavior.

METHODS

Three types of coatings, hydroxyapatite (HA), titanium (Ti), and a double-layer HA/Ti on AISI 316L stainless steel were made. HA coating was produced using plasma-spraying technique and Ti coating was made using physical vapor deposition process. In order to perform a novel double-layer composite coating, a top layer of HA was plasma-sprayed over a physical vapor deposited Ti layer on AISI 316L stainless steel. Structural characterization techniques including XRD, SEM and EDX were used to investigate the microstructure, morphology and crystallinity of the coatings. Electrochemical potentiodynamic tests were performed in physiological solutions in order to determine and compare the corrosion behavior of the coated and uncoated specimens as an indication of biocompatibility.

RESULTS

Double-layer HA/Ti coating on AISI 316L SS had a positive effect on improvement of corrosion behavior. The decrease in corrosion current densities was significant for these coated specimens and was much lower than the values obtained for uncoated and single HA coated specimens. Ti coating on AISI 316L SS also has a beneficial effect on corrosion behavior. The results were compared with the results of corrosion behavior of HA coated commercially pure titanium (cpTi) and uncoated cpTi.

SIGNIFICANCE

These results demonstrated that the double-layer HA/Ti coated 316L SS can be used as an endodontic implant and two goals including improvement of corrosion resistance and bone osteointegration can be obtained simultaneously.