Surface characterizations and corrosion resistance of nickel-titanium orthodontic archwires in artificial saliva of various degrees of acidity

Quantitative and qualitative analysis of metallic ion release of orthodontic brackets in three different pH conditions - An invitro study

Background

Fluoridated mouth rinses improve anti-cariogenic environment but decrease oral pH below critical value, affecting orthodontic bracket surface topography and causing corrosive changes over prolonged use. This invitro study aimed to quantitatively and qualitatively assess the surface topography and metallic ion release of the stainless steel (SS) brackets at varying acidic and alkaline pH.

Materials and methods

Forty unused SS brackets were divided into four groups (Group A, B, C, D) and immersed for 48- hours in solutions of artificial saliva and sodium fluoride (0.2 %) mouth rinse at varying pH of 5.5,6.7,7 and 8. The surface morphologic changes were analyzed under scanning electron microscope (SEM) at 50×, 150×, and 500× magnification. The changes in slot area were scored using the customized scale. The Energy Dispersive Xray Spectroscopy Analysis (EDAX) was used to estimate the probed elements' atomic and weight percentage.

Results

The mean score of the scale was 3.4 for the brackets immersed in the acidic solution which was statistically significant (p = 0.00)and for alkaline and neutral solutions (p = 0.00). Chromium was found to be significantly higher in the alkaline solution (p = 0.016) followed by the neutral solution. Carbon was found excess in acidic solution than the neutral and alkaline solution.

Conclusion

Quantitative and qualitative analysis of the ion release in stainless steel brackets using SEM and EDAX revealed the corrosive effect of fluoride ion causing maximum surface changes in acidic medium and chromium release in alkaline pH.

Biocompatible antibiotic-coupled nickel-titanium nanoparticles as a potential coating material for biomedical devices

The challenges facing metallic implants for reconstructive surgery include the leaching of toxic metal ions, a mismatch in elastic modulus between the implant and the treated tissue, and the risk of infection. These problems can be addressed by passivating the metal surface with an organic substrate and incorporating antibiotic molecules. Nitinol (NiTi), a nickel-titanium alloy, is used in devices for biomedical applications due to its shape memory and superelasticity. However, unmodified NiTi carries a risk of localized nickel toxicity and inadequately supports angiogenesis or neuroregeneration due to limited cell adhesion, poor biomineralization, and little antibacterial activity. To address these challenges, NiTi nanoparticles were modified using self-assembled phosphonic acid monolayers and functionalized with the antibiotics ceftriaxone and vancomycin via the formation of an amide. Surface modifications were monitored to confirm that phosphonic acid modifications were present on NiTi nanoparticles and 100% of the samples formed ordered films. Modifications were stable for more than a year. Elemental composition showed the presence of nickel, titanium, and phosphorus (1.9% for each sample) after surface modifications. Dynamic light scattering analysis suggested some agglomeration in solution. However, scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy confirmed a particle size distribution of <100 nm, the even distribution of nanoparticles on coverslips, and elemental composition before and after cell culture. B35 neuroblastoma cells exhibited no inhibition of survival and extended neurites of approximately 100 μm in total length when cultured on coverslips coated with only poly-l-lysine or with phosphonic acid-modified NiTi, indicating high biocompatibility. The ability to support neural cell growth and differentiation makes modified NiTi nanoparticles a promising coating for surfaces in metallic bone and nerve implants. NiTi nanoparticles functionalized with ceftriaxone inhibited Escherichia coli and Serratia marcescens (SM6) at doses of 375 and 750 μg whereas the growth of Bacillus subtilis was inhibited by a dose of only 37.5 μg. NiTi-vancomycin was effective against B. subtilis at all doses even after mammalian cell culture. These are common bacteria associated with infected implants, further supporting the potential use of functionalized NiTi in coating reconstructive implants.

Assessing color stability of orthodontic esthetic wires in different staining solutions

BACKGROUND

Esthetic orthodontic wires are preferred for their ease to fit in with natural tooth color, but their susceptibility to staining in the oral environment poses a concern. Various Coatings such as Teflon and Epoxy aim to enhance appearance and biocompatibility but may still result in discoloration. Understanding the color stability of these wires under different staining conditions is crucial for a better and enhanced treatment plan.

OBJECTIVE

This study intended to assess the color stability of esthetic orthodontic wires under various staining solutions that are often used in daily life.

METHOD

Color changes of Teflon and Epoxy-coated esthetic orthodontic wires were meticulously measured at baseline, 7, 14, and 21-day intervals utilizing the precise CIE Lab* color measurement system. A total of thirty-two samples of wires from each brand were prepared (n= 8/group) and immersed in staining solutions (coffee, tea, cola, and saffron). The color change within and between the groups was statistically evaluated (p< 0.05).

RESULTS

Significant variations in color stability were observed across different staining solutions. Saffron emerged as the most potent agent, inducing the most pronounced color changes, whereas cola demonstrated the least impact. Furthermore, Epoxy-coated wires consistently exhibited superior color stability compared to their Teflon-coated counterparts across all staining solutions and time intervals.

CONCLUSION

This study underlines the significance for orthodontists to consider staining agents' possible effects on orthodontic wires into account when selecting the orthodontic wires. The findings suggest that Epoxy-coated wires hold promise in mitigating discoloration issues during orthodontic therapy.

Cytotoxicity of Metal Ions Released from NiTi and Stainless Steel Orthodontic Appliances, Part 1: Surface Morphology and Ion Release Variations

Despite numerous studies on ion release from orthodontic appliances, no clear conclusions can be drawn due to complex interrelations of multiple factors. Therefore, as the first part of a comprehensive investigation of cytotoxicity of eluted ions, the objective of this study was to analyze four parts of a fixed orthodontic appliance. Specifically, NiTi archwires and stainless steel (SS) brackets, bands, and ligatures were immersed in artificial saliva and studied for morphological and chemical changes after 3-, 7-, and 14-day immersion, using the SEM/EDX technique. Ion release profiles were analyzed for all eluted ions using inductively coupled plasma mass spectrometry (ICP-MS). The results demonstrated dissimilar surface morphologies among parts of the fixed appliance, due to variations in manufacturing processes. The onset of pitting corrosion was observed for the SS brackets and bands in the as-received state. Protective oxide layers were not observed on any of the parts, but adherent layers developed on SS brackets and ligatures during immersion. Salt precipitation, mainly KCl, was also observed. ICP-MS proved to be more sensitive than SEM/EDX and exhibited results undetected by SEM/EDX. Ion release was an order-of-magnitude higher for SS bands compared to other parts, which was attributed to manufacturing procedure (welding). Ion release did not correlate with surface roughness.

Evaluation of the Corrosion Resistance of Different Types of Orthodontic Fixed Retention Appliances: A Preliminary Laboratory Study

(i) Objective: The present study aimed to compare the electrochemical corrosion resistance of six different types of fixed lingual retainer wires used as fixed retention appliances in an in vitro study. (ii) Methods: In the study, two different Ringer solutions, with pH 7 and pH 3.5, were used. Six groups were formed with five retainer wires in each group. In addition, 3-braided stainless steel, 6-braided stainless steel, Titanium Grade 1, Titanium Grade 5, Gold, and Dead Soft retainer wires were used. The corrosion current density (i_corr), corrosion rate (CR), and polarization resistance (R_p) were determined from the Tafel polarization curves. (iii) Results: The corrosion current density of the Gold retainer group was statistically higher than the other retainer groups in both solutions (p < 0.05). The corrosion rate of the Dead Soft retainer group was statistically higher than the other retainer groups in both solutions (p < 0.05). The polarization resistance of the Titanium Grade 5 retainer group was statistically higher than the other retainer groups in both solutions (p < 0.05). As a result of Scanning Electron Microscope (SEM) images, pitting corrosion was not observed in the Titanium Grade 1, Titanium Grade 5 and Gold retainer groups, while pitting corrosion was observed in the other groups. (iv) Conclusion: From a corrosion perspective, although the study needs to be evaluated in vivo, the Titanium Grade 5 retainer group included is in this in vitro study may be more suitable for clinical use due to its high electrochemical corrosion resistance and the lack of pitting corrosion observed in the SEM images.

Nanotopography Evaluation of NiTi Alloy Exposed to Artificial Saliva and Different Mouthwashes

Nitinol (NiTi) alloy is a widely used material for the production of orthodontic archwires. Its corrosion behavior in conditions that exist in the oral cavity still remains a great characterization challenge. The motivation behind this work is to reveal the influence of commercially available mouthwashes on NiTi orthodontic archwires by performing non-electrochemical corrosion tests and quantifying the changes in the nanotopography of commercially available NiTi orthodontic wires. In this study, we examined the behavior of NiTi alloy archwires exposed for 21.5 days to different corrosive media: artificial saliva, Eludril^®, Aquafresh^®, and Listerine^®. The corrosion was characterized by contact mode atomic force microscopy (AFM) before and after the corrosion tests. A novel analysis methodology was developed to obtain insight into locations of material gain or material loss based on standard surface roughness parameters Sa, Sdr, Ssk, and S10z. The developed methodology revealed that fluoride-containing mouthwashes (Aquafresh^® and Listerine^®) dominantly cause material loss, while chloride-containing mouthwash (Eludril^®) can cause both material loss and material gain. The sample exposed to artificial saliva did not display significant changes in any parameter.

A Critical Appraisal of the Use and Properties of Nickel-Titanium Dental Alloys

Nickel-titanium (NiTi) archwires are used in dentistry for orthodontic treatment. NiTi alloys have favourable mechanical characteristics, such as superelasticity and shape memory, and are also known as a corrosion-resistant alloy. In specific cases, an archwire could be attacked by certain types of corrosion or wear degradation, which can cause the leaching of metal ions and a hypersensitive response due to increased concentrations of Ni in the human body. A systematic search of the literature retrieved 102 relevant studies. The review paper focuses on three main fields: (i) electrochemical properties of NiTi wires and the effect of different environments on the properties of NiTi wires (fluoride and low pH); (ii) tribocorrosion, a combination of chemical and mechanical wear of the material, and (iii) the biocompatibility of NiTi alloy and its subsequent effect on the human body. The review showed that corrosion properties are affected by microstructure, pH of saliva and the presence of fluorides. A high variation in published results should be, therefore, interpreted with care. The release of nickel ions was assessed using the same unit, showing that the vast majority of metal ions were released in the first few days of exposure, then a stable, steady state was reached. In tribocorrosion studies, the increased concentrations of Ni ions were reported.

Improvement of Properties of Stainless Steel Orthodontic Archwire Using TiO2:Ag Coating

Orthodontic treatment carries the risk of major complications such as enamel demineralization, tooth decay, gingivitis, and periodontal damage. A large number of elements of fixed orthodontic appliance results in the creation of additional plaque retention sites which increase the risk of biofilm creation. Modification of the surface of orthodontic elements may prevent the formation of bacterial biofilm. In this paper, surface modification of stainless steel orthodontic wires with TiO2: Ag was carried out by the sol-gel thin film dip-coating method. To obtain the anatase crystal structure, substrates were calcined for 2 h at 500 °C. The properties of the obtained coatings were investigated using scanning electron microscopy, X-ray diffraction, and electrochemical tests. Corrosion studies were performed in a Ringer’s solution, which simulated physiological solution. SEM and XRD analyses of the coated surface confirmed the presence of Ag nanoparticles which may have antimicrobial potential.

Influence of intraoral application of antiseptics and fluorides during orthodontic treatment on corrosion and mechanical characteristics of nickel-titanium alloy in orthodontic appliances

OBJECTIVES

To explore whether the commercial agents recommended for controlling dental biofilm formation had a significant effect in vivo on mechanical and corrosion properties of nickel-titanium (NiTi) alloy.

MATERIALS AND METHODS

NiTi archwires (dimensions 0.508 × 0.508 mm) were collected from 36 orthodontic patients aged 13-42 years after a 3-month intraoral exposure. Three experimental groups were formed: (1) subjects conducting regular oral hygiene, (2) subjects who used fluorides for intensive prophylaxis for the first month, and (3) subjects who used chlorhexidine in the same manner. Corrosion behavior, surface characteristics, stiffness, hardness, and friction were analyzed.

RESULTS

Exposure to intraoral conditions significantly reduced the stiffness and hardness of the NiTi alloy (P ≤ .015). Fluoride tended to reduce stiffness and hardness more than did saliva or antiseptic, but not significantly. Roughness and friction were not significantly influenced by oral exposure. Intraoral aging predominantly produced general corrosion independent of the adjuvant prophylactic agent, although localized corrosion may also have occurred.

CONCLUSIONS

Fluorides and the antiseptic chlorhexidine do not increase corrosion more than saliva itself, nor do they further modify the mechanical properties of the NiTi alloy.

In Vitro Ion Release of Wires in Removable Orthodontic Appliances

Various orthodontic wire compositions and configurations are present on the market for removable appliances; however, there have still been only few studies focusing on the effect of resin color and additives such as glitter on corrosion of metallic wires under different conditions. Thus, the aim of the study was to compare concentrations of released ions (aluminium, chromium, nickel) in a corrosive medium under three different conditions: non-loaded wires, loaded wires, and non-loaded wires treated with Kukis^® cleaning tablets. Six different wires made of three types of steel alloy were embedded in PMMA resin leaving one centimetre of each wire emerging from the resin to come into contact with the corrosive medium. Glitter particles were added to half of the produced test specimens. For the unloaded test series, five specimens of each group were covered in a petri dish with 50 mL of corrosive medium (pH 2.3) following EN-ISO 10271 for seven days at 37 °C. The wires for the mechanically loaded test specimens overlapped the resin by 5 cm and were clamped into a time-switched electric drive for a defined period of time before the samples were taken after a testing time of 7 days. In the third group, unloaded test specimens were transferred from their petri dishes into the prepared Kukis^® solution every 24 h before being stored in the corrosive medium. Inductively coupled plasma mass spectrometry (ICP-MS) was used to quantify the specific ions in the corrosive solution. Statistical analysis showed that the mechanical loading of all wires could significantly raise the diffusion of ions into the corrosive medium. The colour of the resin did not affect the concentration of the released ions. The Kukis^® cleaning tabs could not lower the corrosion of the tested metals, as some of the wires were corroded even more using the brace cleanser. Glitter-containing test specimens showed significantly higher amounts of aluminium. Mechanical loading as well as the presence of glitter particles in the resin significantly affected ion concentrations.

Effects of salivary pH on coating durability of two different aesthetic archwire coatings under a simulated intraoral environment

Objectives

This study compared the effects of normal salivary pH, and acidic pH found in patients with poor oral hygiene, on the durability of aesthetic archwire coated with epoxy resin and polytetrafluoroethylene (PTFE).

Methods

The posterior parts of the archwires were sectioned into 20 mm segments (N = 102) and divided among six groups. Four groups were treated with different pH levels and two served as controls. The specimens were immersed in individual test tubes containing 10 ml of artificial saliva adjusted to a pH of 6.75 or 3.5. The tubes were sealed and stored in a 37 °C water bath for 28 days. After 28 days, the specimens were ligated to brackets embedded in an acrylic block and subjected to mechanical stress using an electronic toothbrush for 210 s. The specimens were photographed, and images were measured for coating loss using AutoCAD® software. Surface morphology was observed using a scanning electron microscope (SEM).

Results

Significant coating loss (p < 0.001) was found in the epoxy resin groups, regardless of pH value, but not in the PTFE groups. The acidic pH caused epoxy resin layer coating loss by twice as much as normal pH. SEM revealed existing manufacturing defects on the as-received epoxy resin coating, whereas the retrieved epoxy resin demonstrated rupture, roughness, and coating loss in multiple locations.

Significance

Epoxy resin coatings demonstrate poor durability in acidic environments. This condition is worsened by the existing manufacturing defects found on as-received archwires. Hence, archwires coated with epoxy resin are not recommended in patients with poor oral hygiene.

The effect of electro-thermal treatment of stainless steel arch wire on mechanical properties and cell proliferation

Background

Electric resistance heat treatment may be performed on orthodontic arch wires, but it remains unclear whether this procedure reliably provides better mechanical properties or whether an austenite phase transition affords less cytotoxicity and less arch wire width change.

Methods

Stainless steel (SS) arch wires of 0.017 × 0.025 and 0.019 × 0.025 inches in size were heat-treated using a spot welder for eight seconds at power settings of 2, 4, 6 and 8. The surface morphology, coefficient of friction (COF), flexural modulus, cytotoxicity, austenitic content, colour change and arch width of the samples were subsequently analysed.

Results

The COF, flexural modulus and austenitic content of the orthodontic SS arch wires increased after heat treatment. SS wires appearing brownish-yellow and blue exhibited higher flexural moduli. The heat treatment of the SS wires did not significantly increase arch wire width or cause cytotoxicity.

Conclusions

Electric resistance heat treatment of SS arch wires is a feasible method to improve the flexural modulus without widening the arch wire and increasing cytotoxicity. The colour of the wire helps determine the heating status, and the maximum flexural modulus of the wires is obtained when the colour changes to brownish-yellow.

Cytotoxicity and oxidative stress induced by nickel and titanium ions from dental alloys on cells of gastrointestinal tract

The aim was to explore the biological effect of nickel (Ni) and titanium (Ti) ions released from dental alloys. NiTi alloy were exposed to 40 mL of artificial saliva (pH = 4.8, t = 37 °C). The dynamics of Ni and Ti ions release during corrosion were recorded on the 3th, 7th and 14th day. Biological effect of Ni and Ti ions released from alloy was explored on cell lines of human tongue CAL 27, liver Hep G2 and colon Caco-2. Neutral Red uptake assay for the estimation of cell viability/cytotoxicity and 2',7'-dichlorofluorescein diacetate fluorimetric assay for reactive oxygen species were used. Cells were exposed to the following concentration of corrosion products: 5.0×, 1.0×, 0.5 and 0.1× during the period of 24, 48 and 72 h. To check the effect of each metal separately, cells were exposed to nickel-chloride and titanium-dioxide of corresponding concentration. The release of Ni is higher than of Ti (15.1-30.4 μg/L for Ni and 9.0-17.3 μg/L for Ti, respectively) and 5× higher concentrations are needed to induce cytotoxic effect. Ni and Ti ions alone do not induce a major cytotoxic effect, but their combination does indicating their synergistic effect. Increase in concentration of Ni and Ti tends to increase cytotoxicity, Ti more than Ni. Cytotoxicity and induction of free radicals are in strong positive linear correlation. Ions released from NiTi alloy during 14 days do not induce significant cytotoxic effect and would not have a clinically important impact. Cytotoxic effect is largely the result of the induction of free radicals.

Ion Release and Surface Characterization of Nanostructured Nitinol during Long-Term Testing

The corrosion resistance of nanostructured nitinol (NiTi) was investigated using long-term tests in solutions simulating physiological fluids at static conditions, reflecting the material structure and metal concentration in the solutions. Mechanical polishing reduced the ion release by a factor of two to three, whereas annealing deteriorated the corrosion resistance. The depassivation and repassivation of nitinol surfaces were considered. We found that nanostructured nitinol might increase the corrosion leaching of titanium into solutions, although the nickel release decreased. Metal dissolution did not occur in the alkaline environment or artificial plasma. A Ni-free surface with a protective 25 nm-thick titanium oxide film resulted from soaking mechanically treated samples of the NiTi wire in a saline solution for two years under static conditions. Hence, the medical application of nanostructured NiTi, such as for the production of medical devices and implants such as stents, shows potential compared with microstructured NiTi.

Optimization of clinically applied orthodontic archwire electrothermal treatment conditions by heat tint and mechanical properties: An experimental study

OBJECTIVE

Electric resistance heat treatment procedures are performed by most orthodontists; however, the effects of electrothermal treatment on the mechanical properties, surface morphology, phase transition, colour and arch width of stainless steel archwires remain controversial and are worthy of investigation.

MATERIALS AND METHODS

Stainless steel archwires (0.017×0.025 and 0.019×0.025 inches) were heat-treated using a spot-welder machine at a power setting of 3 for 5, 10, 15 or 20s and were then cooled in air. After the heat treatment, we analysed the surface morphology of the samples by scanning electron microscopy (SEM) and the flexural modulus with a universal testing machine. The changes in phase and the austenite content after heat treatment were determined by X-ray diffraction (XRD). The changes in the colour of the sample were analysed by a digital single-lens reflex (DSLR) camera, and the arch width changes were measured with Vernier calippers.

RESULTS

The flexural modulus and austenite content of the orthodontic stainless steel archwires increased after heat treatment (P<0.05). The colour changed from silver to yellow-brown-blue. Heat treatment of the stainless steel wires increased the inter-canine and inter-molar widths only when the amount of heat received was low.

CONCLUSION

Heat treatment of stainless steel orthodontic archwires using an electric resistance device is an effective and convenient method to improve their flexural modulus. The colour of the wire surface after heat treatment can help determine the heating conditions, and the maximum flexural modulus of the stainless steel wires was obtained when the colour changed to brownish yellow.

Galvanic coupling of steel and gold alloy lingual brackets with orthodontic wires: Is corrosion a concern?

OBJECTIVES

The aim of this research was to assess galvanic behavior of lingual orthodontic brackets coupled with representative types of orthodontic wires.

MATERIALS AND METHODS

Three types of lingual brackets: Incognito (INC), In-Ovation L (IOV), and STb (STB) were combined with a stainless steel (SS) and a nickel-titanium (NiTi) orthodontic archwire. All materials were initially investigated by scanning electron microscopy / x-ray energy dispersive spectroscopy (SEM/EDX) while wires were also tested by x-ray diffraction spectroscopy (XRD). All bracket-wire combinations were immersed in acidic 0.1M NaCl 0.1M lactic acid and neutral NaF 0.3% (wt) electrolyte, and the potential differences were continuously recorded for 48 hours.

RESULTS

The SEM/EDX analysis revealed that INC is a single-unit bracket made of a high gold (Au) alloy while IOV and STB are two-piece appliances in which the base and wing are made of SS alloys. The SS wire demonstrated austenite and martensite iron phase, while NiTi wire illustrated an intense austenite crystallographic structure with limited martensite. All bracket wire combinations showed potential differences below the threshold of galvanic corrosion (200 mV) except for INC and STB coupled with NiTi wire in NaF media.

CONCLUSIONS

The electrochemical results indicate that all brackets tested demonstrated galvanic compatibility with SS wire, but fluoride treatment should be used cautiously with NiTi wires coupled with Au and SS brackets.

An in vitro assessment of the mechanical characteristics of nickel-titanium orthodontic wires in Fluoride solutions with different acidities

Objectives:

The aim was to evaluate the in vitro effects of fluoride solutions with different acidities on load-deflection characteristics of nickel-titanium (NiTi) orthodontic wires.

Materials and Methods:

In this study, which lasted 30 days, 36 (3 cm long, 0.016 × 0.022 inches, SENT 1622, G & H wire Company, Greenwood, Indiana, USA) NiTi wires, were divided into three experimental groups of 12 each. Two groups were subjected to 0.05 topical fluoride mouthwash with different acidities (G1, pH 4; G2, pH 6.6) for 90 s, twice a day, and kept in normal saline after that. The third group (G3, the control group) was kept in normal saline only. Load and unload forces were measured with three bracket bending test in a universal testing machine (Testometric Co, Rochdale, UK). Loading and unloading plateaus and hysteresis were also recorded. Data were then analyzed using analysis of variance and honestly significant difference Tukey at P < 0.05.

Results:

During the loading phase, there was a significant difference between deflections (P < 0.001); but there was no interaction effect (P = 0.191) and no significant difference among three groups (P = 0.268). In the unloading phase, there was a significant difference between deflections (P < 0.001) and an interaction effect was also observed (P = 0.008). Further, significant differences noted among three groups (P = 0.037). Only in the unloading phase, at deflections of 2.2 through 0.2 mm, significant differences between the mean force values of the G1 and G3 groups were observed (P = 0.037).

Conclusion:

Based on this in-vitro study, compared to neutral fluoride solution, daily mouthwash with a fluoride solution with more acidic pH of 4 affected the NiTi wires load-deflection characteristics during the unloading phase. This finding may have clinical implications and can be further validated by in-vivo studies.

Degradation of orthodontic wires under simulated cariogenic and erosive conditions

This study examined the effect of cariogenic and erosive challenges (CCs and ECs, respectively) on the degradation of copper-nickel-titanium (CuNiTi) orthodontic wires. Sixty wire segments were divided into four treatment groups and exposed to CCs, ECs, artificial saliva, or dry storage (no-treatment control). CC and EC were simulated using a demineralizing solution (pH 4.3) and a citric acid solution (pH 2.3), respectively. Following treatment, the average surface roughness (Ra) of the wires was assessed, and friction between the wires and a passive self-ligating bracket was measured. CuNiTi wires subjected to ECs exhibited significantly higher Ra values than did those that were stored in artificial saliva. In contrast, surface roughness was not affected by CCs. Finally, friction between the treated wires and brackets was not affected by ECs or CCs. Our results indicate that CuNiTi orthodontic wires may suffer degradation within the oral cavity, as ECs increased the surface roughness of these wires. However, rougher surfaces did not increase friction between the wire and the passive self-ligating bracket.

Influence of surface layer on mechanical and corrosion properties of nickel-titanium orthodontic wires

OBJECTIVE

To analyze the effect of various coating formulations on the mechanical and corrosion properties of nickel-titanium (NiTi) orthodontic wires.

MATERIALS AND METHODS

Uncoated, rhodium-coated, and nitrified NiTi wires were observed with a three-point-bend test, surface roughness (Ra) measurement, scanning electron microscopy, energy dispersive spectroscopy, and electrochemical testing (open circuit potential, electrochemical impedance spectroscopy, and cyclic polarization scan). Differences in the properties of tested wire types were analyzed with analysis of variance and Tukey post hoc test.

RESULTS

Uncoated and nitrified NiTi wires showed similar mechanical and anticorrosive properties, while rhodium-coated NiTi wires showed the highest Ra and significantly higher modulus of elasticity, yield strength, and delivery of forces during loading but not in unloading. Rhodium-coated NiTi wires also had the highest corrosion current density and corrosion potential, lowest impedance modulus, and two time constants on Bode plot, one related to the Rh/Au coating and the other to underlying NiTi.

CONCLUSION

Working properties of NiTi wires were unaffected by various coatings in unloading. Nitrification improved corrosion resistance. Rhodium coating reduced corrosion resistance and pronounced susceptibility to pitting corrosion in artificial saliva because of galvanic coupling between the noble coating and the base alloy.

An in vivo study on the incidence and location of fracture in round orthodontic archwires

OBJECTIVE

The main objective of this in vivo study was to determine the incidence and location of fracture in round nickel-titanium (NiTi) and round stainless steel orthodontic archwires, both commonly used in orthodontics. Secondarily, this study sought to determine if there is any correlation between archwire fracture and gender, diameter of the archwire, arch type (maxillary/mandibular) or bracket used.

DESIGN

In vivo study.

MATERIALS AND METHODS

One thousand orthodontic patients (1434 archwires) were evaluated during regular treatment visits to assess archwire fracture and location. The patient's gender, age, type of archwire (round NiTi and round stainless steel), diameter of the archwire, arch type, location of fracture (anterior or posterior) and period of service before fracture were recorded.

STATISTICAL ANALYSIS

Chi-square statistical test was utilized to address the frequency and the correlation between the different variables. Level of statistical significance (α) was set at 0.05.

RESULTS

Twenty-five archwire failures were reported (1.7%) of the total sample size. All fractured archwires were NiTi, and 76% of the fractures were located in the posterior region. No statistical significance was found between archwire fracture and gender, arch type (maxillary/mandibular), archwire diameter or bracket type.

CONCLUSION

The frequency of archwire fracture during regular orthodontic visits is very low. The most common archwire fracture site is the posterior region. NiTi wires are the most commonly fractured archwire. No statistically significant correlation exists between archwire fracture and gender, arch type, bracket type or diameter of archwire.

Effect of temperature on the orthodontic clinical applications of NiTi closed-coil springs

NiTi spring coils were used to obtain large deformation under a constant force. The device consists on a NiTi coil spring, superelastic at body temperature, in order to have a stress plateau during the austenitic retransformation during the unloading. The temperature variations induced changes in the spring force. Objectives: The aim of this study is to investigate the effect of the temperature variations in the spring forces and corrosion behaviour simulating the ingestion hot/cold drinks and food. Study Design: The springs were subjected to a tensile force using universal testing machine MTS-Adamel (100 N load cell). All tests were performed in artificial saliva maintained at different temperatures. The corrosion tests were performed according to the ISO-standard 10993-15:2000. Results: The increase in temperature of 18oC induced an increase in the spring force of 30%. However, when the temperature returns to 37oC the distraction force recovers near the initial level. After cooling down the spring to 15oC, the force decreased by 46%. This investigation show as the temperature increase, the corrosion potential shifts towards negative values and the corrosion density is rising. Conclusions: The changes of the temperatures do not modify the superelastic behaviour of the NiTi closed-coil springs. The corrosion potential of NiTi in artificial saliva is decreasing by the rise of the temperatures.

Key words:Superelasticity, NiTi, springs, orthodontic, coils, recovery, temperature.

In vitro effect of a corrosive hostile ocular surface on candidate biomaterials for keratoprosthesis skirt

Aim

Keratoprosthesis (KPro) devices are prone to long-term corrosion and microbiological assault. The authors aimed to compare the inflammatory response and material dissolution properties of two candidate KPro skirt materials, hydroxyapatite (HA) and titania (TiO₂) in a simulated in vitro cornea inflammation environment.

Methods

Lipopolysaccharide-stimulated cytokine secretions were evaluated with human corneal fibroblasts on both HA and TiO₂. Material specimens were subjected to electrochemical and long-term incubation test with artificial tear fluid (ATF) of various acidities. Topography and surface roughness of material discs were analysed by scanning electron microscopy and atomic force microscopy.

Results

There were less cytokines secreted from human corneal fibroblasts seeded on TiO₂ substrates as compared with HA. TiO₂ was more resistant to the corrosion effect caused by acidic ATF in contrast to HA. Moreover, the elemental composition of TiO₂ was more stable than HA after long-term incubation with ATF.

Conclusions

TiO₂ is more resistant to inflammatory degradation and has a higher corrosion resistance as compared with HA, and in this regard may be a suitable material to replace HA as an osteo-odonto-keratoprosthesis skirt. This would reduce resorption rates for KPro surgery.

In vivo evaluation of titanium oxide and hydroxyapatite as an artificial cornea skirt

Keratoprosthetic devices are subject to chronic inflammatory, pathological processes and the external environment that affect their stability and biocompatibility with the ocular surface and adjacent ocular tissues. We compared the corrosion resistance property and tissue-implant reaction of titanium oxide (TiO(2)) with hydroxyapatite (HA) in artificial tear fluid and a rabbit skin implantation model. The dissolution properties of the implant surfaces were evaluated with scanning electronic microscope (SEM) and atomic force microscope (AFM). Tissue inflammatory reactions were evaluated by Hematoxylin & Eosin staining, avidin biotin peroxidase complex (ABC) immunoassay and immunofluorescence. SEM and AFM images showed that there was less pitting corrosion on the surface of TiO(2) implants compared with HA. TiO(2) and HA exhibited a similar pattern of foreign body capsule formation and inflammatory cellular responses. The Collagen I/Collagen III ratio of the TiO(2) capsule was higher than that of the HA capsule. TiO(2) implants possess a high corrosion resistance property both in vitro and in vivo and the inflammatory cellular response to TiO(2) is similar to HA. With regards to corrosion resistance and inflammatory tissue responses, TiO(2) appears to be a promising material for keratoprosthetic skirt devices.

Effect of soft drinks on the physical and chemical features of nickel-titanium-based orthodontic wires

OBJECTIVE

The purpose of this study was to evaluate the effect of three popular soft drinks on the Young's modulus, hardness, surface topography and chemical composition of widely used nickel-titanium-based orthodontic wires.

MATERIALS AND METHODS

Thirty-two specimens (20 mm in length) were cut from the straight portion of pre-formed 0.019 × 0.025 inch Nitinol Heat-Activated archwires and randomly divided into four groups of eight specimens each: Group A1 (Coca Cola(®) regular); Group A2 (Santal(®) orange juice); Group A3 (Gatorade(®)); Group B (distilled, deionized water; dH(2)O). Each specimen was immersed in 10 ml of one of the soft drinks or dH(2)O, control, for 60 min, at 37°C. At the end of the soaking time, the Young's modulus and hardness were determined using a nanoindenter. Scanning Electron Microscope-Energy Dispersive Spectroscopy (SEM-EDS) was used to characterize the effects on the topography and chemical composition of the wires.

RESULTS

No statistically significant differences were found between the groups either in the Young's modulus or in hardness after the selected soaking protocol. Besides some surface colour changes, the topography and the chemical composition of the wires were not affected by the immersion in any of the chosen soft drinks.

CONCLUSIONS

These in-vitro results suggest that the consumption of soft drinks cannot be acknowledged as one possible reason for the degradation of the physical and chemical properties of heat activated nickel titanium orthodontic wires in patients undergoing fixed orthodontic treatment.

Influence of topographical features on the fluoride corrosion of Ni-Ti orthodontic archwires

Different manufacturing processes of Ni-Ti archwires respond differently to corrosion due to the surface conditions involved. In this study, several topographical features and their influence upon fluoride corrosion were studied. Four topographies (smooth, dimple, scratch, and crack) according to the main surface defect were characterized (n = 40). Static corrosion tests were performed in artificial saliva with fluorated prophylactic gel (12500 ppm) for 28 days. The surface was characterized by SEM and laser confocal microscopy. Standard electrochemical corrosion (open circuit potential, corrosion potential and corrosion current density) was performed. Statistical analysis was carried out using the ANOVA test (α ≤ 0.05). An increase was observed in the surface defects and/or roughness of the cracked and scratched surfaces. These defects produced an important increase in corrosion behavior. The best surfaces for the orthodontic archwires were the smooth and dimpled surfaces, respectively. The increase in defects was independent of roughness. Manufacturing processes that produce surface cracks should be avoided in orthodontic applications.

Comparison of some dietary habits on corrosion behavior of stainless steel brackets: an in vitro study

BACKGROUND AND OBJECTIVE

Resistance to corrosion is an advantageous property of orthodontic brackets; however, due to low levels of pH found in the mouth of a patient, localized corrosion may occur This can affect tooth movement by increasing friction between the arch wire and bracket slot and initiate enamel discoloration. Additionally, corrosion causes the release of elements that may lead to cytotoxic and biological side effects. The aim of this study was to compare the amount of corrosion caused by lemon juice, vinegar and Coca-Cola on orthodontic brackets in vitro and then to recommend the most suitable diet during orthodontic treatment.

METHOD

Sixty orthodontic brackets in three groups of twenty were immersed in a test solution (Fusamaya-Meyer artificial saliva plus lemon juice, vinegar or Coca-Cola) at a temperature of 37 degrees C +/- 1. Moreover, a negative control consisting of twenty brackets were put in pure artificial saliva. After 6 weeks the amount of corrosion was determined by measuring delta W of mean weights of brackets and the results were analyzed by general linear models (repeated measurement).

RESULTS

Significant differences were seen during different weeks of the study (P < 0.001) and different solutions (P < 0.001). This study showed the amount of corrosion in orthodontic brackets was the most for cola followed by vinegar and then lemon juice. In addition, mean differences for cola versus lemon juice was -0.010 (sig. <0.001), vinegar versus lemon juice was -0.006 (sig. = 0.001) and cola versus vinegar was -0.004 (sig. = 0.013).

CONCLUSION

Acidic effervescent soft drinks such as cola have to be eliminated or minimized in the nutritional diet of orthodontic patients because of their harmful effects on their brackets.

Vertical distraction osteogenesis using a titanium nitride-coated distractor

OBJECTIVES

The purpose of this study was to examine the effect of using a titanium nitride (TiN)-coated vertical distractor on osseointegration after implantation.

STUDY DESIGN

Four adult mongrel dogs, weighing 9-10 kg, were used in this study. The lower premolars were extracted, and vertical distraction was performed after 10 weeks using 8 distraction devices (left, 4 titanium; right, 4 nitrified). A 7-day latency period was allowed before distraction began. The distraction device was activated at a rate of 0.5 mm twice a day for 5 days. After completing distraction, the device was removed after a consolidation period of 6 weeks and 24 implants were installed. The dogs were killed after 4 or 8 weeks. Histologic examinations were performed.

RESULTS

The implant success rate was 100% in all of the study groups. Direct bone contact was achieved, and there were no significant differences between the control and experimental groups in the implantation area.

CONCLUSION

The results suggested that the nitrified distraction device does not negatively affect osseointegration in the vertical distraction osteogenesis; therefore, it has the advantageous potential to substitute for the conventional distractor.

Polystyrene formation on monolayer-modified nitinol effectively controls corrosion

A surface-initiated polymerization of styrene on carboxylic acid terminated phosphonic monolayers was utilized to increase the corrosion resistance of nitinol and nickel oxide surfaces. Alkyl chain ordering, organic reactions, wettability, and film quality of the monolayers and polymers were determined by infrared spectroscopy, atomic force microscopy, matrix-assisted laser desorption ionization spectrometry, and water contact angles. The polystyrene film proved to be a better corrosion barrier than phosphonic acid monolayers by analysis with cyclic voltammetry and electrochemical impedance spectroscopy. The protection efficiency of the polystyrene film on nitinol was 99.4% and the monolayer was 42%.

Critical overview of Nitinol surfaces and their modifications for medical applications

Nitinol, a group of nearly equiatomic shape memory and superelastic NiTi alloys, is being extensively explored for medical applications. Release of Ni in the human body, a potential problem with Nitinol implant devices, has stimulated a great deal of research on its surface modifications and coatings. In order to use any of the developed surfaces in implant designs, it is important to understand whether they really have advantages over bare Nitinol. This paper overviews the current situation, discusses the advantages and disadvantages of new surfaces as well as the limitations of the studies performed. It presents a comprehensive analysis of surface topography, chemistry, corrosion behavior, nickel release and biological responses to Nitinol surfaces modified mechanically or using such methods as etching in acids and alkaline solutions, electropolishing, heat and ion beam treatments, boiling in water and autoclaving, conventional and ion plasma implantations, laser melting and bioactive coating deposition. The analysis demonstrates that the presently developed surfaces vary in thickness from a few nanometers to micrometers, and that they can effectively prevent Ni release if the surface integrity is maintained under strain and if no Ni-enriched sub-layers are present. Whether it is appropriate to use various low temperature pre-treatment protocols (< or = 160 degrees C) developed originally for pure titanium for Nitinol surface modifications and coatings is also discussed. The importance of selection of original Nitinol surfaces with regard to the performance of coatings and comparative performance of controls in the studies is emphasized. Considering the obvious advantages of bare Nitinol surfaces for superelastic implants, details of their preparation are also outlined.

Influence of fluoride and chloride on corrosion behavior of NiTi orthodontic wires

The influence of fluoride and chloride ions on the corrosion behavior of nearly equiatomic nickel-titanium orthodontic wires was studied using conventional electrochemical measurement methods, including corrosion potential, potentiodynamic and cyclic potentiodynamic polarization measurements. In addition, scanning electron microscopy was employed to observe the surface morphology before and after the test. All the electrochemical parameters are analyzed based on the sample standard deviations. The results indicated that NiTi alloy is primarily susceptible to localized corrosion when exposed to a solution containing chloride, while it is susceptible to general corrosion when subjected to a solution containing fluoride. Furthermore, the synergistic interaction of fluoride and chloride on corrosion of NiTi alloy is associated with their respective molar concentrations.

The release of nickel from orthodontic NiTi wires is increased by dynamic mechanical loading but not constrained by surface nitridation

The influence of dynamic mechanical loading and of surface nitridation on the nickel release from superelastic nickel-titanium orthodontic wires was investigated under ultrapure conditions. Commercially available superelastic NiTi arch wires (size 0.018 x 0.025'') without surface modification (Neo Sentalloy) and with nitrogen ion implantation surface treatment (Neo Sentalloy Ionguard) were analyzed. Mechanical loading of wire segments with a force similar to the physiological situation was performed with a frequency of 5 Hz in ultrapure water and saline solution, respectively. The release of nickel was monitored by atomic absorption spectroscopy for up to 36 days. The mechanically loaded wires released significantly more nickel ( approximately 45 ng cm(-2) d(-1)) than did nonloaded wires (<1 ng cm(-2) d(-1)). There was no statistically significant effect of the testing solution (water or NaCl) or of the surface nitridation. The total amount of released nickel was small in all cases, but may nevertheless account for the occasional clinical observations of adverse reactions during application of NiTi-based orthodontic appliances. The surface nitridation did not constrain the release of nickel from NiTi under continuous mechanical stress.

Metallurgical characterization, galvanic corrosion, and ionic release of orthodontic brackets coupled with Ni-Ti archwires

In orthodontics, a combination of metallic alloys is placed into the oral cavity during medical treatment and thus the corrosion resistance and ionic release of these appliances is of vital importance. The aim of this study is to investigate the elemental composition, microstructure, hardness, corrosion properties, and ionic release of commercially available orthodontic brackets and Copper Ni-Ti archwires. Following the assessment of the elemental composition of the orthodontic wire (Copper Ni-Ti) and the six different brackets (Micro Loc, Equilibrium, OptiMESH(XRT), Gemini, Orthos2, and Rematitan), cyclic polarization curves were obtained for each material to estimate the susceptibility of each alloy to pitting corrosion in 1M lactic acid. Galvanic corrosion between the orthodontic wire and each bracket took place in 1M lactic acid for 28 days at 37 degrees C and then the ionic concentration of Nickel and Chromium was studied. The orthodontic wire is made up from a Ni-Ti alloy with copper additions, while the orthodontic brackets are manufactured by different stainless steel grades or titanium alloys. All tested wires and brackets with the exception of Gemini are not susceptible to pitting corrosion. In galvanic corrosion, following exposure for 28 days, the lowest potential difference (approximately 250 mV) appears for the orthodontic wire Copper Ni-Ti and the bracket made up from pure titanium (Rematitan) or from the stainless steel AISI 316 grade (Micro Loc). Following completion of the galvanic corrosion experiments, measurable quantities of chromium and nickel ions were found in the residual lactic acid solution.

Variation in surface topography of different NiTi orthodontic archwires in various commercial fluoride-containing environments

OBJECTIVES

The surface topography can affect the friction behavior between an orthodontic wire and brackets during clinical applications. The purpose of this study was to investigate the influence of a fluoride-containing environment on the surface topography variations of different nickel-titanium (NiTi) orthodontic archwires.

METHODS

Four different NiTi commercial orthodontic archwires were immersed in fluoride mouthwashes and in artificial saliva with the addition of commercial fluoride toothpastes or prophylactic gels for a 28-day period. Atomic force microscopy (AFM) was used to measure the three-dimensional surface topography of NiTi archwires before and after the immersion tests. Two-way analysis of variance (ANOVA) was used to analyze the surface roughness variance (including DeltaR(a), DeltaR(ms), and DeltaR(z)) with the archwire manufacturer and immersion test environment as the factors.

RESULTS

Both the archwire manufacturer and immersion environment had a significant influence on DeltaR(a), DeltaR(ms), and DeltaR(z) (manufacturer: P<0.05; environment: P<0.0001). Regardless of the archwire manufacturer, no statistically significant difference in DeltaR(a) (<70 nm), DeltaR(ms) (<90 nm), and DeltaR(z) (<450 nm) was observed on the tested NiTi archwires in lower fluoride-containing (<2500 ppm) environments, including the various fluoride mouthwashes and the artificial saliva added with fluoride toothpastes. In artificial saliva added with high fluoride prophylactic gel (around 17,000 ppm), a significant increase in DeltaR(a) (around 120-250 nm), DeltaR(ms) (around 140-320 nm), and DeltaR(z) (around 770-1410 nm), i.e. increasing the surface roughness, was observed on the tested NiTi archwires.

SIGNIFICANCE

The variation in the surface topography of the NiTi orthodontic archwires in the commercial fluoride-containing environments should be taken into consideration when the friction between the archwire and bracket is a clinical concern.