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Stocker L, Zervou SK, Papageorgiou SN, Karakousoglou S, Triantis T, Hiskia A, Eliades G, Eliades T. Salivary levels of eluents during Invisalign™ treatment with attachments: an in vivo investigation. Prog Orthod 2024; 25:22. [PMID: 38825612 PMCID: PMC11144685 DOI: 10.1186/s40510-024-00522-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/10/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND The aim of the present study was to investigate qualitatively and quantitatively the elution of substances from polyester-urethane (Invisalign™) aligners and resin composite attachments (Tetric EvoFlow) in vivo. METHODS Patients (n = 11) treated with the aligners and attachments (16 per patient, without other composite restorations) for an average of 20 months, who were planned for attachment removed were enrolled in the study. Patients were instructed to rinse with 50 mL of distilled water upon entry and the rinsing solution was collected (before removal). Then, the attachments were removed with low-speed tungsten carbide burs for adhesive residue removal, a thorough water rinsing was performed immediately after the grinding process to discard grinding particle residues, and subsequently, after a second water-rinsing the solution was collected for analysis (after removal). The rinsing solutions were analyzed for targeted (LC-MS/MS: Bis-GMA, DCDMA, UDMA, BPA) and untargeted (LC-HRMS: screening of leached species and their degradation products) compounds. RESULTS Targeted analysis revealed a significant reduction in BPA after attachment removal (4 times lower). Bis-GMA, DCDMA, UDMA were below the detection limit before removal but were all detectable after removal with Bis-GMA and UDMA at quantifiable levels. Untargeted analysis reviled the presence of mono-methacrylate transformation products of Bis-GMA (Bis-GMA-M1) and UDMA (UDMA-M1), UDMA without methacrylate moieties (UDMA-M2), and 4-(dimethylamino) benzoic acid (DMAB), the degradation product of the photo-initiator ethyl-4-(dimethylamino) benzoate (EDMAB), all after attachment removal. Several amino acids and endogenous metabolites were also found both before and after removal. CONCLUSIONS Elevated levels of BPA were traced instantaneously in patients treated with Invisalign™ and flowable resin composite attachments for the testing period. BPA was reduced after attachment removal, but residual monomers and resin degradation products were found after removal. Alternative resin formulations and attachment materials may be utilized to reduce eluents.
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Affiliation(s)
- Larissa Stocker
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, 8032, Switzerland
| | - Sevasti-Kiriaki Zervou
- Laboratory for Photo-Catalytic Processes and Environmental Chemistry, Institute of Nanoscience and Nanotechology, National Center for Scientific Research "Demokritos", Agia Paraskevi, Greece
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, 8032, Switzerland
| | | | - Theodoros Triantis
- Laboratory for Photo-Catalytic Processes and Environmental Chemistry, Institute of Nanoscience and Nanotechology, National Center for Scientific Research "Demokritos", Agia Paraskevi, Greece
| | - Anastasia Hiskia
- Laboratory for Photo-Catalytic Processes and Environmental Chemistry, Institute of Nanoscience and Nanotechology, National Center for Scientific Research "Demokritos", Agia Paraskevi, Greece
| | - George Eliades
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, 8032, Switzerland.
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Cintora-López P, Arrieta-Blanco P, Martin-Vacas A, Paz-Cortés MM, Gil J, Aragoneses JM. In vitro analysis of the influence of the thermocycling and the applied force on orthodontic clear aligners. Front Bioeng Biotechnol 2023; 11:1321495. [PMID: 38173871 PMCID: PMC10761475 DOI: 10.3389/fbioe.2023.1321495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
The mechanical properties of polyurethane dental aligners have been studied in an oral environment at 37°C and subjected to thermal cycling between 5°C and 55°C for long periods of time at different mechanical stresses. The aim is to determine the efficacy of the orthodontic aligner at different stress levels, the effect of thermal cycling with therapy time on tooth position correction. Sixty aligners with the same design were studied applying tensions of 0, 3 and 30 N and determining the deformation at different times from 1 to 760 h. Half of these aligners were subjected to stresses submerged in artificial saliva at 37°C and the other half were subjected to thermal cycles between 2°C and 55°C in salivary medium. Deformation was determined using a high-resolution stereo magnifier and ImageJ image analysis software. Water adsorption by the polyurethane was determined at the different test times. The results showed that in the unloaded aligners there is no appreciable deformation, but with thermal cycling there is a light shrinkage of the aligner due to the semi-crystallization process (ordering of polymeric chains) of the polyurethane. When applying loads of 3 and 30 N, creep curves with constant deformation transition zones can be seen. The transition zones decrease as the applied mechanical load increases. In addition, the significant effect of thermal cycling on the reduction of the transition zone of the aligners has been demonstrated. The transition zones are optimal for dental correction as constant stresses are exerted for tooth movement. The effect of thermal cycling shortens the constant deformation zone and reduces tooth alignment time. It was observed that the absorption of water in the aligner is constant after 1 h of immersion and does not exceed 0.4% by weight of absorbed water.
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Affiliation(s)
| | | | - Andrea Martin-Vacas
- Faculty of Dentistry, Alfonso X El Sabio University, Villanueva de la Cañada, Spain
| | | | - Javier Gil
- Faculty of Medicine and Health Sciences, Bionegineering Institute of Technology, International University of Catalunya, Barcelona, Spain
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Çifçi Özkan E, Dumanlı Gök G. Evaluation of bisphenol release of different clear aligner materials using the liquid chromatography-mass spectrometry/mass spectrometry method. Angle Orthod 2023; 93:721-726. [PMID: 37539687 PMCID: PMC10633800 DOI: 10.2319/010923-17.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 06/01/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVES To evaluate the bisphenol release of different brands of clear aligner materials. MATERIALS AND METHODS Six different clear aligner materials were used in this study: Duran (Scheu-Dental GmbH, Iserlohn, Germany), Zendura Flx (Bay Materials LLC, Fremont, CA, USA), Zendura A (Bay Materials), Essix (Raintree Essix Inc., Metairie, LA, USA), Taglus Premium (Laxmi Dental Export Pvt. Ltd, Mumbai, India), and Smart Track (Align Technology, San Jose, CA, USA). The samples were kept in saline solution for 8 weeks in airtight test tubes at 37°C. The ratio between the weights of the samples and the volumes of the dilutions was prepared as 0.1 g/mL as suggested by International Standards Organization parameters. To evaluate the bisphenol release of materials, liquid chromatography-mass spectrometry/mass spectrometry analysis was performed. Data were analyzed with the Kruskal-Wallis test (α = 0.05). RESULTS Bisphenol A (BPA) values in Smart Track were found to be significantly higher than the Zendura A and Zendura Flx groups (P = .02, P = .03, respectively). There was no statistically significant difference among the samples in terms of Bisphenol F (BPF) values (P = .108). In terms of Bisphenol S (BPS) values, a statistically significant difference was found (P = .002) indicating that Smart Track released significantly more BPS than Zendura A (P = .001). CONCLUSIONS Under the test conditions, the amounts of leached BPA, BPF, and BPS were less than the reference dose for daily intake. However, the cumulative effect of these appliances should not be underestimated.
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Affiliation(s)
- Esra Çifçi Özkan
- Corresponding author: Dr Esra Çifçi Özkan, Department of Orthodontics, Biruni University Faculty of Dentistry, Kazlıçeşme, Cinoğlu Çk. No:2, 34020 Zeytinburnu/İstanbul, Turkey (e-mail: )
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Peter E, J M, George SA. Bisphenol-A release from thermoplastic clear aligner materials: A systematic review. J Orthod 2023; 50:276-286. [PMID: 36922722 DOI: 10.1177/14653125231160570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
AIM The aim of the present study was to undertake a systematic review of the available evidence on the release of bisphenol-A (BPA) from thermoplastic materials used in the fabrication of clear aligners (CA). METHODS Electronic databases, such as MEDLINE (via PubMed), Google Scholar, Scopus, Cochrane Library, Web of Science, OpenGrey, and the U.S. National Institute of Heath-Clinical Trials, were searched up to 27 October 2022. In vivo/in vitro studies that assessed the release of BPA from different thermoplastic CA materials, with or without a control group, were selected. The risk of bias (RoB) in the randomised controlled trials (RCT) and in vitro studies was assessed using the Cochrane RoB tool and the guidelines for the reporting of pre-clinical studies, respectively. The quality of evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Pro tool. RESULTS Six studies were considered for review from a total of 1926 records. This included one RCT and five in vitro studies. Only two studies found leaching of BPA, while four did not report any traces. The RoB was found to be moderate to high. The GRADE evidence level ranged from low to very low. Five of the included studies were conducted in vitro. Significant heterogeneity among the included studies prevented a quantitative synthesis. CONCLUSION In light of the available conflicting evidence, BPA release from CAs can neither be confirmed nor denied. Safety remains questionable until high-quality in vivo trials prove otherwise. REGISTRATION PROSPERO CRD42022310434.
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Affiliation(s)
- Elbe Peter
- Department of Orthodontics & Dentofacial Orthopedics, Government Dental College, Kottayam, Kerala, India
| | - Monisha J
- Department of Orthodontics & Dentofacial Orthopedics, Annoor Dental College, Kerala, India
| | - Suja Ani George
- Department of Orthodontics & Dentofacial Orthopedics, Government Dental College, Kottayam, Kerala, India
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Seifi S, Mirzakouchaki B, Rafighi A, Aghanejad A, Hamidi AA, Shahrbaf S. Evaluation of the bisphenol released in the saliva after residual adhesive removal in orthodontic patients by using ultrasonic scaling and rotary system: A single-center randomized clinical trial. Am J Orthod Dentofacial Orthop 2023; 163:148-153. [PMID: 36396531 DOI: 10.1016/j.ajodo.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Bisphenol A (BPA) is a substance commonly used in dental materials with noxious properties. Monomers of this substance may be dissolved in the saliva and cause adverse effects. This study aimed to evaluate the amount of BPA released in the saliva after residual adhesive removal in orthodontic patients using an ultrasonic scaler (US) and tungsten carbide bur (TCB). METHODS This single-center randomized clinical trial was conducted on 40 subjects whose stainless-steel brackets were bonded directly with light-cured bonding and composite. The subjects were randomly divided into 2 equal groups (n = 20) of TCB or US according to the adhesive removal method. The salivary BPA level was determined using high-performance liquid chromatography-mass spectrometry. And adhesive cleaning time was measured by a stopwatch. Data were analyzed by SPSS using an independent t test and paired-samples t test (P <0.05). RESULTS The mean salivary BPA level was significantly lower in the TCB method than in the US method. (1.008 ± 0.061 μg/mL and 2.83 ± 0.24 μg/mL, respectively) (P <0.001). The mean adhesive cleanup time was significantly shorter in the TCB method than in the US method (8.86 ± 0.83 minutes and 13.20±1.02 minutes, respectively) (P <0.001). CONCLUSIONS According to the results, residual adhesive removal with TCB released less BPA in saliva and shortened the adhesive cleaning time than the US method. TRIAL REGISTRATION The trial was registered at the Iranian Registry of Clinical Trials (IRCT20200702047988N1). PROTOCOL The protocol was not published before trial commencement.
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Affiliation(s)
- Sara Seifi
- Department of Orthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behnam Mirzakouchaki
- Department of Orthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Ali Rafighi
- Department of Orthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ayuob Aghanejad
- Research Centre for Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Asghar Hamidi
- Research Centre for Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Shahrbaf
- Academic Unit of Restorative Dentistry, the University of Sheffield, Sheffield, United Kingdom
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Moradinejad M, Yazdi M, Daryanavard H, Ashtiani A, Rakhshan V. A systematic review of biocompatibility and safety of orthodontic clear aligners and transparent vacuum-formed thermoplastic retainers: Bisphenol-A release, adverse effects, cytotoxicity, and estrogenic effects. Dent Res J (Isfahan) 2023. [DOI: 10.4103/1735-3327.372658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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Panayi N, Cha JY, Kim KB. 3D Printed Aligners : Material science, Workflow and Clinical applications. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Willi A, Patcas R, Zervou SK, Panayi N, Schätzle M, Eliades G, Hiskia A, Eliades T. Leaching from a 3D-printed aligner resin. Eur J Orthod 2022; 45:244-249. [PMID: 36130120 DOI: 10.1093/ejo/cjac056] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
AIM To quantitatively assess the degree of conversion and the water-leaching targeted compound from 3D-printed aligners. MATERIALS AND METHODS 3D-printed aligners were made of photopolymerized resin (Tera Harz TC85A). The molecular structure and degree of conversion of the set resin were investigated by ATR-FTIR spectroscopy (n = 5). The aligners (n = 10) were immersed in double distilled water for 1 week at 37°C and the eluents were analysed using liquid chromatography/mass spectrometry methods (LC-ESI-MS/MS for urethane dimethacrylate [UDMA] and LC-APCI-MS/MS for bispenol-A [BPA]). RESULTS The resin was composed of aliphatic vinyl ester-urethane monomers, with acrylate and/or methacrylate functionalization. The degree of conversion was estimated as to 83%. There was no detection of BPA in any of the assessed samples (0.25 µg/l). Quantifiable amounts of UDMA were detected in all the exposed samples, ranging from 29 to 96 µg/l. CONCLUSIONS Although efficiently polymerized and BPA free, the great variability in the amount of UDMA monomer leached from the examined samples may raise concerns on potential health hazards after repeated intraoral exposure, which is indicated for this class of materials.
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Affiliation(s)
- Andreas Willi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Raphael Patcas
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Sevasti-Kiriaki Zervou
- Photo-Catalytic Processes and Environmental Chemistry, Institute of Nanoscience and Nanotechnology, National Centre for Scientific Research Demokritos, Athens, Greece
| | - Nearchos Panayi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland.,Department of Dentistry, European University Cyrpus, Nicosia, Cyprus
| | - Marc Schätzle
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - George Eliades
- Photo-Catalytic Processes and Environmental Chemistry, Institute of Nanoscience and Nanotechnology, National Centre for Scientific Research Demokritos, Athens, Greece.,Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Anastasia Hiskia
- Photo-Catalytic Processes and Environmental Chemistry, Institute of Nanoscience and Nanotechnology, National Centre for Scientific Research Demokritos, Athens, Greece
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
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Hamran T, Čirgić E, Aiyar A, Vandevska-Radunovic V. Survey on retention procedures and use of thermoplastic retainers among orthodontists in Norway, Sweden, and Denmark. J World Fed Orthod 2022; 11:114-119. [DOI: 10.1016/j.ejwf.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 11/30/2022]
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Pratsinis H, Papageorgiou SN, Panayi N, Iliadi A, Eliades T, Kletsas D. Cytotoxicity and estrogenicity of a novel 3-dimensional printed orthodontic aligner. Am J Orthod Dentofacial Orthop 2022; 162:e116-e122. [PMID: 35842359 DOI: 10.1016/j.ajodo.2022.06.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Orthodontic aligners printed with in-office 3-dimensional (3D) procedures have been described, but no data on their biocompatibility exist. This study investigates the cytotoxicity and estrogenicity of a 3D-printed orthodontic aligner by assessing its biological and behavioral effects. METHODS Ten sets of 1 type of aligner were immersed in sterile deionized water for 14 days, and the cytotoxicity and estrogenicity of released factors were assessed via MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assays on human gingival fibroblasts and the estrogen-sensitive MCF-7 and the estrogen-insensitive MDA-MB-231 breast cancer cell lines. 17β-Estradiol and bisphenol-A were used as positive controls. The statistical analysis of data was performed with generalized linear models at a 0.05 level of significance. RESULTS No signs of cytotoxicity were seen for the aligner samples for concentrations (v/v) of 20% (P = 0.32), 10% (P = 0.79), or 5% (P = 0.76). The antioxidant activity expressed as the capacity to reduce intracellular levels of reactive oxygen species was not affected in the aligner samples (P = 0.08). No significant estrogenicity was induced by the aligner samples compared with eluents from the negative control for both MCF-7 (P = 0.65) and MDA-MB-231 (P = 0.78). As expected, 17β-Estradiol and bisphenol-A stimulated MCF-7 cell proliferation, whereas no effect was observed on MDA-MB-231 cells. CONCLUSIONS In conclusion, if any factors were released during the 14-day aging of 3D-printed aligners in water, these were not found to be cytotoxic for human gingival fibroblasts and did not affect their intracellular reactive oxygen species levels. Moreover, no estrogenic effects of these putative eluates were observed based on an E-screen assay.
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Affiliation(s)
- Harris Pratsinis
- Laboratory of Cell Proliferation and Ageing, Institute of Biosciences and Applications, National Center for Scientific Research "Demokritos," Athens, Greece
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nearchos Panayi
- Department of Dentistry, European University Cyprus, Nicosia, Cyprus; Private practice, Limassol, Cyprus
| | - Anna Iliadi
- Department of Dental Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - Dimitris Kletsas
- Laboratory of Cell Proliferation and Ageing, Institute of Biosciences and Applications, National Center for Scientific Research "Demokritos," Athens, Greece
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Alhendi A, Khounganian R, Almudhi A, Ahamad SR. Leaching of Different Clear Aligner Systems: An In Vitro Study. Dent J (Basel) 2022; 10:dj10020027. [PMID: 35200252 PMCID: PMC8871144 DOI: 10.3390/dj10020027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to investigate and compare the leaching of four different clear aligner systems (Invisalign®, Eon®, SureSmile®, and Clarity®). Three sets of aligners as obtained from the four manufacturers were cut and immersed in glass vials containing ethanol with different solutions. The first was 100% ethanol, the second was 75% ethanol to 25% water, the third was 50% ethanol to water, the fourth was 25% ethanol to 75% water, and the last was 100% water. The samples were incubated for two weeks at 37 °C. Leached substances were detected by the gas chromatography–mass spectrometry (GC-MS). Eleven different chemical compounds were detected and confirmed. Benzene1,3-bis(1,1-dimethylethyl) was the only compound detected in all four systems at levels of 100% and 75% ethanol. Statistically, insignificant differences were detected among the different systems where leaching was confirmed. Eon® system was the only material to show statistically significant differences when comparing the number of leached substances among the immersion solution concentrations. The four included systems showed variable degrees of leaching. The lowest amount of leached chemicals was observed in relation to the Invisalign® system, while the highest number was found in the Eon® system. None of the included clear aligner systems leached detectable amounts of bisphenol-A (BPA).
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Affiliation(s)
- Aseel Alhendi
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia;
- Correspondence: ; Tel.: +96-654-141-9097
| | - Rita Khounganian
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Abdullazez Almudhi
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia;
| | - Syed Rizwan Ahamad
- Central Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
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Francisco I, Paula AB, Ribeiro M, Marques F, Travassos R, Nunes C, Pereira F, Marto CM, Carrilho E, Vale F. The Biological Effects of 3D Resins Used in Orthodontics: A Systematic Review. Bioengineering (Basel) 2022; 9:bioengineering9010015. [PMID: 35049724 PMCID: PMC8773237 DOI: 10.3390/bioengineering9010015] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 11/16/2022] Open
Abstract
Three-dimensional (3D) resin medical-dental devices have been increasingly used in recent years after the emergence of digital technologies. In Orthodontics, therapies with aligners have gained popularity, mainly due to the aggressive promotion policies developed by the industry. However, their systemic effects are largely unknown, with few studies evaluating the systemic toxicity of these materials. The release of bisphenol A and other residual monomers have cytotoxic, genotoxic, and estrogenic effects. This systematic review aims to analyze the release of toxic substances from 3D resins used in Orthodontics and their toxic systemic effects systematically. The PICO question asked was, "Does the use of 3D resins in orthodontic devices induce cytotoxic effects or changes in estrogen levels?". The search was carried out in several databases and according to PRISMA guidelines. In vitro, in vivo, and clinical studies were included. The in vitro studies' risk of bias was assessed using the guidelines for the reporting of pre-clinical studies on dental materials by Faggion Jr. For the in vivo studies, the SYRCLE risk of bias tool was used, and for the clinical studies, the Cochrane tool. A total of 400 articles retrieved from the databases were initially scrutinized. Fourteen articles were included for qualitative analysis. The risk of bias was considered medium to high. Cytotoxic effects or estrogen levels cannot be confirmed based on the limited preliminary evidence given by in vitro studies. Evidence of the release of bisphenol A and other monomers from 3D resin devices, either in vitro or clinical studies, remains ambiguous. The few robust results in the current literature demonstrate the absolute need for further studies, especially given the possible implications for the young patient's fertility, which constitutes one of the largest groups of patients using these orthodontic devices.
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Affiliation(s)
- Inês Francisco
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
- Correspondence:
| | - Anabela Baptista Paula
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, 3004-531 Coimbra, Portugal; (C.M.M.); (E.C.)
- Faculty of Medicine, Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3004-531 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-531 Coimbra, Portugal
| | - Madalena Ribeiro
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Filipa Marques
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Raquel Travassos
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Catarina Nunes
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Flávia Pereira
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Carlos Miguel Marto
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, 3004-531 Coimbra, Portugal; (C.M.M.); (E.C.)
- Faculty of Medicine, Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3004-531 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-531 Coimbra, Portugal
- Faculty of Medicine, Institute of Experimental Pathology, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Eunice Carrilho
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, 3004-531 Coimbra, Portugal; (C.M.M.); (E.C.)
- Faculty of Medicine, Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3004-531 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-531 Coimbra, Portugal
| | - Francisco Vale
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
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Lite C, Raja GL, Juliet M, Sridhar VV, Subhashree KD, Kumar P, Chakraborty P, Arockiaraj J. In utero exposure to endocrine-disrupting chemicals, maternal factors and alterations in the epigenetic landscape underlying later-life health effects. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2022; 89:103779. [PMID: 34843942 DOI: 10.1016/j.etap.2021.103779] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 06/13/2023]
Abstract
Widespread persistence of endocrine-disrupting chemicals (EDCs) in the environment has mandated the need to study their potential effects on an individual's long-term health after both acute and chronic exposure periods. In this review article a particular focus is given on in utero exposure to EDCs in rodent models which resulted in altered epigenetic programming and transgenerational effects in the offspring causing disrupted reproductive and metabolic phenotypes. The literature to date establishes the impact of transgenerational effects of EDCs potentially associated with epigenetic mediated mechanisms. Therefore, this review aims to provide a comprehensive overview of epigenetic programming and it's regulation in mammals, primarily focusing on the epigenetic plasticity and susceptibility to exogenous hormone active chemicals during the early developmental period. Further, we have also in depth discussed the epigenetic alterations associated with the exposure to selected EDCs such as Bisphenol A (BPA), di-2-ethylhexyl phthalate (DEHP) and vinclozlin upon in utero exposure especially in rodent models.
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Affiliation(s)
- Christy Lite
- Department of Medical Biotechnology and Integrative Physiology, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, India.
| | - Glancis Luzeena Raja
- Department of Biotechnology, School of Bioengineering, SRM Institute of Science and Technology, Kattankulatur, Chennai 603203, Tamil Nadu, India
| | - Melita Juliet
- Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Kattankulatur, Chennai 603203, Tamil Nadu, India
| | - Vasisht Varsh Sridhar
- Department of Biotechnology, School of Bioengineering, SRM Institute of Science and Technology, Kattankulatur, Chennai 603203, Tamil Nadu, India
| | - K Divya Subhashree
- Department of Biotechnology, School of Bioengineering, SRM Institute of Science and Technology, Kattankulatur, Chennai 603203, Tamil Nadu, India
| | - Praveen Kumar
- Department of Medical Biotechnology and Integrative Physiology, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, India
| | - Paromita Chakraborty
- Environmental Science and Technology Laboratory, Department of Chemical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai 603203, Tamil Nadu, India.
| | - Jesu Arockiaraj
- Department of Biotechnology, College of Science and Humanities, SRM Institute of Science and Technology, Kattankulatur, Chennai 603203, Tamil Nadu, India.
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De Nys S, Duca RC, Vervliet P, Covaci A, Boonen I, Elskens M, Vanoirbeek J, Godderis L, Van Meerbeek B, Van Landuyt KL. Bisphenol A release from short-term degraded resin-based dental materials. J Dent 2021; 116:103894. [PMID: 34798152 DOI: 10.1016/j.jdent.2021.103894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/10/2021] [Accepted: 11/14/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES There is still much debate about the release of bisphenol A (BPA) from resin-based dental materials. Therefore, this study aimed to quantify BPA present as an impurity and to evaluate whether their degradation by salivary, bacterial, and chemical challenges could increase its release. METHODS BPA was determined in three different amounts (300, 400, and 500 µg) of eight unpolymerized resin-based materials (four composites, one fissure sealant, two adhesives and one root canal sealer). Next, polymerized samples (n = 5) of each material were immersed in 1 mL of whole human pooled saliva collected from adults, Streptococcus mutans (2 × 107 CFU/mL), and acidic (0.1 M HCl), alkaline (0.1 M NaOH), and control media, respectively. The amount of BPA was quantified using an UPLC-MS/MS method including derivatization of BPA by pyridine-3-sulfonyl chloride. RESULTS Only the composites contained trace amounts of BPA above the limit of quantification (ranging from 301±32 pg PBA/mg to 1534±62 pg BPA/mg), most likely as impurity from the synthesis of the monomers. The amounts of BPA released from polymerized materials upon salivary and bacterial degradation were too low for accurate quantification, but in water, quantifiable amounts of BPA were released from all materials. In alkaline media, the BPA release from two composites was significantly decreased, while the release from one adhesive was significantly increased, compared to water. CONCLUSIONS BPA already present in unpolymerized resin-based materials may account for the release of BPA after polymerization. There was no clear indication that short-term material degradation leads to increased release of BPA.
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Affiliation(s)
- Siemon De Nys
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & University Hospitals Leuven (UZ Leuven), Dentistry, Leuven, Belgium; IDEWE, External service for prevention and protection at work, Heverlee, Belgium
| | - Radu Corneliu Duca
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium; Unit Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, National Health Laboratory (LNS), 3555 Dudelange, Luxembourg; IDEWE, External service for prevention and protection at work, Heverlee, Belgium
| | - Philippe Vervliet
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, D.S.551, 2610 Wilrijk, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, D.S.551, 2610 Wilrijk, Belgium
| | - Imke Boonen
- Laboratory of Analytical, Environmental and GeoChemistry, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Ixelles, Belgium
| | - Marc Elskens
- Laboratory of Analytical, Environmental and GeoChemistry, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Ixelles, Belgium
| | - Jeroen Vanoirbeek
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium; IDEWE, External service for prevention and protection at work, Heverlee, Belgium
| | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium; Laboratory of Analytical, Environmental and GeoChemistry, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Ixelles, Belgium; IDEWE, External service for prevention and protection at work, Heverlee, Belgium
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & University Hospitals Leuven (UZ Leuven), Dentistry, Leuven, Belgium; IDEWE, External service for prevention and protection at work, Heverlee, Belgium
| | - Kirsten L Van Landuyt
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & University Hospitals Leuven (UZ Leuven), Dentistry, Leuven, Belgium; IDEWE, External service for prevention and protection at work, Heverlee, Belgium.
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16
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Removable orthodontic retainers: practical considerations. Br Dent J 2021; 230:723-730. [PMID: 34117427 DOI: 10.1038/s41415-021-2893-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 10/27/2020] [Indexed: 12/15/2022]
Abstract
This article provides an overview of removable orthodontic retainers, discussing their history and the different types available, and compares the two most popular removable retainers. Practical information on consent and the clinical steps involved in the provision of removable retainers, as well as suggested wear and care instructions, are also presented.
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Sabour A, El Helou M, Roger-Leroi V, Bauer C. Release and toxicity of bisphenol-A (BPA) contained in orthodontic adhesives: A systematic review. Int Orthod 2020; 19:1-14. [PMID: 33308954 DOI: 10.1016/j.ortho.2020.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/26/2020] [Accepted: 11/07/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The objectives of this systematic review of the literature are to search for BPA release from biomaterials used in orthodontics and to highlight their possible impact on human health. MATERIALS AND METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model, digital and manual searches were conducted in February 2020 in the database of CENTRAL, MEDLINE and EMBASE. Thirteen parameters relating to the release and biological effects of BPA were identified and analysed. RESULTS Thirty-one non-randomized clinical trials were included. In general, the level of evidence was low, and the risk of bias ranged from moderate to high. Furthermore, although at different concentrations, most of in vitro and in vivo studies found BPA release from orthodontic adhesives. The lack of standardized protocols and the clinical and methodological heterogeneity of the studies prevented a valid interpretation of the actual results. Concerning the possible toxicity of BPA, no conclusive scientific evidence could be drawn, but it seems that orthodontic biomaterials containing BPA have potential adverse biological effects in humans. DISCUSSION AND CONCLUSION Until we have solid evidence from clinical trials, clinicians should consider that orthodontic adhesives containing BPA have potential short- and long-term adverse biological effects in humans. Careful consideration should therefore be given to bonding, polymerization and debonding protocols in orthodontics.
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Affiliation(s)
- Anas Sabour
- Université Clermont - Auvergne, UFR d'Odontologie, 2, rue de Braga, 63100 Clermont-Ferrand, France.
| | - Marwan El Helou
- Université Clermont - Auvergne, UFR d'Odontologie, 2, rue de Braga, 63100 Clermont-Ferrand, France
| | - Valérie Roger-Leroi
- Université Clermont - Auvergne, UFR d'Odontologie, 2, rue de Braga, 63100 Clermont-Ferrand, France
| | - Cynthia Bauer
- Université Clermont - Auvergne, UFR d'Odontologie, 2, rue de Braga, 63100 Clermont-Ferrand, France
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The use of attachments in aligner treatment: Analyzing the “innovation” of expanding the use of acid etching–mediated bonding of composites to enamel and its consequences. Am J Orthod Dentofacial Orthop 2020; 158:166-174. [DOI: 10.1016/j.ajodo.2020.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/22/2020] [Indexed: 11/23/2022]
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Iliadi A, Koletsi D, Papageorgiou SN, Eliades T. Safety Considerations for Thermoplastic-Type Appliances Used as Orthodontic Aligners or Retainers. A Systematic Review and Meta-Analysis of Clinical and In-Vitro Research. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E1843. [PMID: 32295303 PMCID: PMC7215465 DOI: 10.3390/ma13081843] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/10/2020] [Accepted: 04/11/2020] [Indexed: 12/19/2022]
Abstract
Use of thermoplastic material in orthodontics, either as aligner or as retainer appliances, is common practice and is likely to increase in the years to come. However, no systematic assessment on safety considerations of these adjuncts has been implemented up to date. The aim of this systematic review was to collectively appraise the existing evidence from both clinical and laboratory studies, on whether these appliances are associated with any estrogenic/cytotoxic effects or bisphenol-A (BPA) and monomer leaching. Eight electronic databases were searched with no limits in December 22, 2019, for published and unpublished research. Eligibility criteria comprised of studies of any design, describing use of any type of thermoplastic aligner. Study selection, data extraction and risk of bias (RoB) assessment was done independently, either in duplicate or confirmed by a second reviewer. Random effects meta-analyses of weighted mean differences (WMD) with associated 95% Confidence Intervals (CIs) were planned. Quality of the evidence was evaluated with Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of 58 articles were initially identified, while 5 were included in qualitative synthesis and 2 of those contributed to the quantitative syntheses. Four studies were in-vitro, while one was a randomized controlled trial; all assessed some type of orthodontic aligner or retainer, either as-received or retrieved. Risk of bias recordings ranged between unclear and high for all studies. Proliferation induction capacity of thermoplastic appliances' eluents on MCF-7 cells failed to be confirmed compared to beta-estradiol (2 studies: 5% v/v, WMD: -182.08; 95% CI: -198.83, -165.33; p-value < 0.001; and 20% v/v, WMD: -184.53; 95% CI: -206.17, -162.88; p-value < 0.001). No cytotoxic activity was detected as well. In addition, although evidence from in-vitro studies was indicative of no traceable detection of BPA or other monomers, the findings from a single clinical trial were allied to increased levels of BPA in whole stimulated saliva, after up to 30 days of thermoplastic retainer usage, compared to standard Hawley retainer. The quality of the evidence overall was low to medium. Current data from in-vitro research are indicative of an absence of an estrogenic or cytotoxic effect of thermoplastic aligners or retainers. Regarding BPA or monomer release, evidence from clinical and laboratory studies appear inconsistent.
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Affiliation(s)
- Anna Iliadi
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (D.K.); (S.N.P.)
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (D.K.); (S.N.P.)
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (D.K.); (S.N.P.)
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Chagas AS, Freitas KMS, Cançado RH, Valarelli FP, Canuto LFG, Oliveira RCGD, Oliveira RCGD. Level of satisfaction in the use of the wraparound Hawley and thermoplastic maxillary retainers. Angle Orthod 2020; 90:63-68. [PMID: 31335161 PMCID: PMC8087063 DOI: 10.2319/031319-197.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/01/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the level of satisfaction in the use of wraparound Hawley and thermoplastic maxillary retainers. MATERIALS AND METHODS The study sample included 70 orthodontic patients (24 males and 46 females), who were in the retention stage (mean age = 20.80 years). All patients wore the two types of maxillary retainer for 1 month each, along with a 3×3 fixed mandibular retainer. After the use of each retainer, the patients responded to a questionnaire evaluating the level of satisfaction with their use of the maxillary retainer. Intergroup comparison was performed by independent t tests. Chi-square test was used to evaluate preference for the type of retainer by gender. RESULTS The thermoplastic retainer was better for swallowing and the wraparound Hawley appliance was better for hygiene and durability. The other factors evaluated (adaptation, speech, comfort, esthetics, satisfaction, and fitting) did not show significant differences between the retainers. There was also no significant difference in preference for the appliances. CONCLUSIONS Regarding the overall satisfaction and the preference, there was no difference between the wraparound Hawley and thermoplastic retainers. The wraparound Hawley appliance was better in hygiene and resistance than the thermoplastic retainer; and the thermoplastic appliance was better than the wraparound Hawley for swallowing fluids and saliva.
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Once Resin Composites and Dental Sealants Release Bisphenol-A, How Might This Affect Our Clinical Management?-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091627. [PMID: 31075949 PMCID: PMC6539392 DOI: 10.3390/ijerph16091627] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/22/2019] [Accepted: 05/03/2019] [Indexed: 12/12/2022]
Abstract
(1) Background: Bisphenol A (BPA) based dental resins are commonly used in preventive and reparative dentistry. Since some monomers may remain unpolymerized in the application of dental resin, they dissolve in the saliva. (2) Methods: The literature search was carried out in Pubmed, Cochrane and Embase databases. Randomized controlled trials, cohort studies and case-control studies that evaluated BPA levels in human urine, saliva and/or blood were included. (3) Results: The initial search had 5111 results. A total of 20 studies were included in the systematic review. Most studies showed an increase of the levels of bisphenol A 1 h after treatments with composite resins and dental sealants. One week after treatments the levels were decreased. (4) Conclusions: Some clinical precautions should be taken to decrease the release of BPA, namely the use of rubber dam, the immediate polishing of all resins used, or the use of glycerin gel to avoid non-polymerization of the last resin layer, and mouthwash after treatment. Another preventive measure in addition to the above-mentioned is the use of the smallest possible number of restorations or sealants, a maximum of four per appointment. These measures are even more important in children, adolescents and pregnant women.
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Bisphenol A and orthodontics: An update of evidence-based measures to minimize exposure for the orthodontic team and patients. Am J Orthod Dentofacial Orthop 2018; 152:435-441. [PMID: 28962717 DOI: 10.1016/j.ajodo.2017.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 08/14/2017] [Accepted: 08/14/2017] [Indexed: 12/24/2022]
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A novel high sensitivity UPLC-MS/MS method for the evaluation of bisphenol A leaching from dental materials. Sci Rep 2018; 8:6981. [PMID: 29725047 PMCID: PMC5934439 DOI: 10.1038/s41598-018-24815-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/10/2018] [Indexed: 11/12/2022] Open
Abstract
There is a growing necessity to acquire more profound knowledge on the quantity of eluates from resin-based dental materials, especially with regard to bisphenol A (BPA). The aim of the present study was to develop a highly sensitive method to characterize the short-term release of BPA in saliva with ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), using an extraction step and additional derivatization of BPA with pyridine-3-sulfonyl chloride. Light-cured resin-based composites were incubated at 37 °C in 1 mL artificial saliva, which was refreshed daily for one week. The final protocol allows accurate quantification of very low levels of BPA in samples of artificial saliva (i.e. 1.10 pmol BPA/mL or 250 pg/mL). The daily BPA-release from dental composites, ranging from 1.10 to 7.46 pmol BPA/mL, was characterized over a period of 7 days. The highest total amount of BPA was released from Solitaire 2 (24.72 ± 2.86 pmol), followed by G-ænial Posterior (15.51 ± 0.88 pmol) and Filtek Supreme XTE (12.00 ± 1.31 pmol). In contrast, only trace amounts of BPA were released from Ceram.x Universal. This UPLC-MS/MS method might be used for clinical research focusing on the evaluation of the clinical relevance of BPA release from dental materials.
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