Corrosion of metal orthodontic brackets and archwires caused by fluoride-containing products: Cytotoxicity, metal ion release and surface roughness

Metal Release and Cytotoxicity of Different Orthodontic Bracket-Wire Combinations: An In Vitro Study

Aim

To quantify and compare the metal ions released from different bracket-wire combinations and to assess their cytotoxicity.

Materials and Methods

A total of 360 fabricated sectional fixed orthodontic appliances were divided into 6 groups. The first three groups consisted of stainless-steel brackets with stainless-steel, snickel-titanium (NiTi), and titanium-molybdenum alloy (TMA) archwires, and the other three groups were fabricated using ceramic brackets (polycrystalline alumina) with stainless-steel, NiTi, and TMA archwires. These appliances were immersed in artificial saliva (pH 6.5 ± 0.5, 37°C), for 1 week, 2 weeks, and 1 month. The nickel and chromium ions released in the artificial saliva were quantified using a flame atomic absorption spectrometer, and cytotoxicity assessment was performed using a 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay on human cervical cancer cell line.

Results

The stainless-steel bracket groups displayed a significantly greater release of nickel and chromium ions compared to the ceramic bracket groups (P < 0.05). However, no significant differences were identified when comparing the three archwire types within the stainless-steel/ceramic bracket groups. At the end of 1 month, the % cell viability demonstrated by the appliances was in the decreasing order of stainless-steel-TMA > ceramic-stainless steel > stainless-steel-NiTi > ceramic-NiTi > stainless-steel-stainless steel > ceramic-TMA.

Conclusion

Considerably greater release of nickel and chromium ions was observed from the appliances utilizing stainless-steel brackets compared to those employing ceramic brackets. However, no remarkable difference in the levels of nickel and chromium ions was observed when comparing the three archwires: stainless steel, NiTi, and TMA. In the cytotoxicity assessment, the ceramic-TMA combination displayed the highest level of cytotoxicity, while the stainless-steel-TMA combination displayed the least cytotoxicity.

Cytotoxicity, genotoxicity, and cellular metal accumulation caused by professionally applied fluoride products in patients with fixed orthodontic appliances: A randomized clinical trial

BACKGROUD

Corrosion of metal orthodontic appliances caused by professional fluoride products has been recently concerned. Therefore, the objective of this study was to evaluate the cytotoxic and genotoxic effect of these products on buccal mucosal cells from patients wearing fixed orthodontic appliances.

METHODS

A total of 44 patients, aged 12 to 35 years, who began orthodontic treatment with fixed appliances were included in this single-center, prospective, randomized clinical trial. Patients were randomly allocated into 4 parallel groups according to the type of professional fluoride treatment applied after placing the appliances: acidulated phosphate fluoride gel (APF); neutral fluoride gel (NGel); fluoride varnish (FVa); and without fluoride treatment (control). Buccal cells were collected before treatment (T1) and 3 months after appliance placement (T2). The cells were assayed for cell viability and underwent Papanicolaou staining. Cells with micronuclei and degenerative nuclear alterations were scored using a light microscope. Cell metal content was quantified by inductively coupled plasma-mass spectrometry. The data were analyzed with the Kruskal-Wallis test.

RESULTS

The intracellular nickel content in the APF group significantly increased (P < 0.05), whereas that of the control, NGel, and FVa groups did not. The changes in chromium concentration in all groups were not significantly different compared with control. Use of APF resulted in a significantly higher decrease in cell viability and increase in morphologic signs of cell death compared with control (P < 0.05). The change in frequency of micronucleated cells was not significantly different from that in the control group.

CONCLUSIONS

Applying APF gel on fixed orthodontic appliances increased the cell metal content and decreased cell viability; however, genotoxic effects were absent. FVa and NGel are suggested as the products of choice to use during orthodontic treatment.

Exposure to the oral environment enhances the corrosion of metal orthodontic appliances caused by fluoride-containing products: Cytotoxicity, metal ion release, and surface roughness

INTRODUCTION

This study aimed to evaluate the metal ion release, cytotoxicity, and surface roughness of clinically used metal orthodontic appliances after immersion in different fluoride product solutions compared with those of new appliances.

METHODS

Used fixed appliances were debonded from 36 patients after their treatment was done. New appliances were as-received. Each used and new group comprised 36 sets of 20 brackets and 4 tubes that were divided into 3 groups by archwire type; stainless steel, nickel-titanium, and beta-titanium. The samples in each group were divided into 3 subgroups and immersed in solutions of fluoride toothpaste, 1.23% acidulated phosphate fluoride, or artificial saliva without fluoride as a control group. The immersion times were estimated from the recommended time for using each fluoride product for 3 months. The samples were then immersed in Dulbecco's Modified Eagle's Medium for 7 days. The cytotoxicity test was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay using primary gingival fibroblasts. Chromium, nickel, and iron ion release were detected using inductively coupled plasma mass spectroscopy. The surface roughness of the brackets and wires was measured by a scanning electron microscope and a noncontact optical 3-dimensional surface characterization and roughness measuring device. The data were analyzed using the paired t test and 2-way analysis of variance.

RESULTS

Used brackets demonstrated a significantly higher ion release, surface roughness, and cytotoxicity than the new brackets. Acidulated phosphate fluoride significantly increased the ion release and surface roughness; however, it significantly decreased cell viability, especially in the titanium molybdenum subgroup.

CONCLUSIONS

Used brackets were significantly prone to further corrosion. Acidulated phosphate fluoride gel should not be used in orthodontic patients with fixed metal appliances.

Tribocorrosion Evaluation of Nb2O5, TiO2, and Nb2O5 + TiO2 Coatings for Medical Applications

Materials used in biomedicine for purposes of long-time stay inside the body presents diverse sort of problems like cytotoxicity, wear, biocompatibility, and ion liberation along time. This paper presents the characterization of corrosion-wear combined phenomena on Nb2O5, TiO2, and Nb2O5 + TiO2 coatings with future applications as biomaterials. After the films’ production process using magnetron sputtering technique, they were characterized through an optic, scanning electron, and atomic force microscopy to evaluate their morphology, structure, and surface damage suffered by the synergy between wear and corrosion phenomena. The life in service of the implant was evaluated in terms of the coating behavior against inside body conditions like charge, wear, and electrochemical degradation. This test was made with electrochemical measurements in simulated biological fluid combined with the wear characterization implementing a potentiostat and a tribometer in a linear wear configuration with a bone pin. As a result, the different electrochemical responses of the films were evidenced by polarization curves and equivalent circuits of the systems. The coefficient of friction and surface degradation were also obtained and evaluated. Comparing the properties of the systems, we conclude that TiO2 coatings have better behavior in terms of the wear-corrosion synergy phenomena while the systems with Nb present pitting corrosion.

Effect of fluoride agents on surface characteristics of NiTi wires. An ex vivo investigation

Aim

To analyze the degree of corrosion of nickel titanium arch wires in patients with and without exposure to fluorides.

Material and methods

This was an ex vivo study comprising of 60 subjects undergoing fixed orthodontic treatment. Group 1(controls) comprised of 30 sets of new unused NiTi wires and unused 11, 15 brackets, Group 2(patients) comprised of 30 sets of non fluoridated NiTi wires and 11, 15 brackets and Group 3(patients) had 30 sets of fluoridated NiTi wires and 11, 15 brackets. NiTi wires were used over 6 months of treatment(0.014″,0.016″, 16 × 22", each wire was used for 2 months and replaced with the next size). All wires were retrieved, stored and analyzed. At 6 months, brackets from 11 to 15 were debonded in both treatment groups. Archwires and brackets in 3 groups were subjected to SEM analysis at 500 and 1000X to observe differences. Additionally, EDX Spectroscopy was undertaken to evaluate surface elemental compositional differences in groups.

Results

Significant differences among groups were evident in brackets and archwires tested. Maximum degradation, cracks and dark spots were seen in wires and brackets exposed to fluoride agents. EDX spectroscopy revealed least Ni% in fluoridated wires and brackets.

Conclusions

Increased leaching of metal ions was evident when wires and brackets are exposed to fluoride agents during treatment. Use of non fluoridated mouthwash and toothpastes may be considered in orthodontic patients without risk of caries to mitigate such effects.