Corrosion and permanent fracture resistance of coated and conventional orthodontic wires

Advancing Nitinol: From heat treatment to surface functionalization for nickel–titanium (NiTi) instruments in endodontics

Nickel-titanium (NiTi) alloy has been extensively researched in endodontics, particularly in cleaning and shaping the root canal system. Research advances have primarily focused on the design, shape, and geometry of the NiTi files as well as metallurgy and mechanical properties. So far, extensive investigations have been made surrounding surface and thermomechanical treatments, however, limited work has been done in the realm of surface functionalization to augment its performance in endodontics. This review summarizes the unique characteristics, current use, and latest developments in thermomechanically treated NiTi endodontic files. It discusses recent improvements in nano-engineering and the possibility of customizing the NiTi file surface for added functionalization. Whilst clinical translation of this technology has yet to be fully realized, future research direction will lie in the use of nanotechnology.

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Nitinol (Nickel Titanium alloy) is widely used to clean/shape root canal system in endodontics.

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To enhance its performance, various thermo-mechanical and nano-engineering modifications have been performed.

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This comprehensive review summarizes the latest advances and future trends relating to functionalized NiTi endodontic files.

Present and Theoretical Applications of Poly-Ether-Ether-Ketone (PEEK) in Orthodontics: A Scoping Review

Background: During the last decade, there has been an increased demand for non-metallic materials in orthodontics due to allergies, compatibility with medical imaging devices such as MRI, and aesthetic reasons. Monolithic poly-ether-ether-ketone material could address medical issues such as allergies and MRI compatibility. Moreover, nickel-titanium (NiTi) archwires covered in PEEK, either by a tube or electrophoretic deposition, could address esthetic concerns. This scoping review aims to summarize the available evidence in the literature to provide an overview of the applications and material properties of PEEK in orthodontics. Methods: This scoping review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis for scoping reviews and the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols extension for Scoping Reviews (PRISMA-ScR). We searched for relevant publications in MEDLINE (via PubMed), Embase, Web of Science, Cochrane Library, CENTRAL, ProQuest, and SCOPUS. A gray literature search was conducted on Google Scholar. Results: Six studies were included. In three studies, the authors investigated the feasibility of developing a composite PEEK-NiTi wire, while in two other studies, the authors investigated the feasibility of monolithic PEEK wires. In the final study, the authors investigated the feasibility of PEEK as a bonded retainer. Conclusions: The included studies show promising results in developing monolithic and composite (PEEK-NiTi) materials. Further research on the robustness of PEEK composites in the oral cavity, the status of cytotoxicity and roughness values, and the (bio)-mechanical behavior of the composites is needed. A homogenously set up comparative study of clinically relevant, evenly sized, monolithic PEEK wires versus conventional orthodontic wires for their biomechanical, mechanical, and material properties would clarify the possibilities of developing monolithic PEEK wires. Missing data in the retainer study suggest more research on the mechanical properties and points of failure of PEEK-bonded retainers, and a comparative study comparing the failure and mechanical properties of PEEK-bonded retainers to flat braided metallic bonded retainers is needed.

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.

Effectiveness of medical coating materials in decreasing friction between orthodontic brackets and archwires

Objective

The aim of this in vitro study was to evaluate the changes in friction between orthodontic brackets and archwires coated with aluminum oxide (Al₂O₃), titanium nitride (TiN), or chromium nitride (CrN). In addition, the resistance of the coatings to intraoral conditions was evaluated.

Methods

Stainless steel canine brackets, 0.016-inch round nickel–titanium archwires, and 0.019 × 0.025-inch stainless steel archwires were coated with Al₂O₃, TiN, and CrN using radio frequency magnetron sputtering. The coated materials were examined using scanning electron microscopy, an X-ray diffractometer, atomic force microscopy, and surface profilometry. In addition, the samples were subjected to thermal cycling and in vitro brushing tests, and the effects of the simulated intraoral conditions on the coating structure were evaluated.

Results

Coating of the metal bracket as well as nickel–titanium archwire with Al₂O₃ reduced the coefficients of friction (CoFs) for the bracket–archwire combination (p < 0.01). When the bracket and stainless steel archwire were coated with Al₂O₃ and TiN, the CoFs were significantly lower (0.207 and 0.372, respectively) than that recorded when this bracket–archwire combination was left uncoated (0.552; p < 0.01). The friction, thermal, and brushing tests did not deteriorate the overall quality of the Al₂O₃ coatings; however, some small areas of peeling were evident for the TiN coatings, whereas comparatively larger areas of peeling were observed for the CrN coatings.

Conclusions

Our findings suggest that the CoFs for metal bracket–archwire combinations used in orthodontic treatment can be decreased by coating with Al₂O₃ and TiN thin films.

Comparison of surface topography of low-friction and conventional TMA orthodontic arch wires using atomic force microscopy

OBJECTIVE:

To evaluate the surface topography and roughness of orthodontic arch wire materials, including low-friction titanium molybdenum alloy (TMA), conventional TMA, and stainless-steel arch wires.

MATERIALS AND METHODS:

The surface topography was evaluated using atomic force microscopy (AFM). A total of 24 wire specimens were used for the AFM scans {8 low-friction TMA (TMA-Low), 8 conventional TMA (TMA-C), and 8 stainless steel (SS)} (Ormco, Orange, CA, USA), measuring 0.016 × 0.022 inches. The conventional and low-friction TMA arch wires served as the test groups, while the stainless-steel arch wire served as the control group.

RESULTS:

Surface roughness evaluation using AFM revealed that the highest mean of all three roughness parameters was found in the TMA-C group followed by the TMA-Low and SS arch wires in descending order. Pairwise comparison of the mean values showed that the mean value of the SS arch wire material is statistically significantly lower than the mean values of the other two arch wire materials (TMA-C and TMA-Low). However, there was no statistically significant difference in the mean values of TMA-C and TMA-Low arch wires.

CONCLUSION:

The SS arch wire showed the smoothest surface topography among the alloys and had statistically significantly lower roughness values than the TMA-C and TMA-Low groups. Low-friction TMA arch wire is still considered to be inferior to stainless steel arch wire.

Comparison of force loss during sliding of low friction and conventional TMA orthodontic archwires : An in vitro study

Objective

The goal was to measure and compare the amount of force loss during tooth movement guided by archwires, including a newly introduced low-friction titanium molybdenum alloy (TMA), conventional TMA, and stainless steel archwires.

Methods

The force loss was measured using a specialized biomechanical set-up, the orthodontic measurement and simulation system (OMSS). A total of 30 specimen were used (10 low-friction TMA (TMA-Low), 10 conventional TMA (TMA-C), and 10 stainless steel (SS) archwires, each having a dimension of 0.016 × 0.022 inches). The conventional and low friction TMA archwires served as test groups, while the SS archwires served as the control group.

Results

The mean values of force loss between the three types of wires (TMA‑C, TMA-Low, and SS) were significantly different (p < 0.0001). The highest mean force loss during sliding movement was found in the conventional TMA group (72.1%), followed by low friction TMA (48.8%) and stainless steel wires (33.7%) in a descending order.

Conclusion

The friction property of the low friction TMA archwire was superior to the conventional TMA archwire but was still inferior to the stainless steel archwire.

Evolution, clinical applications, and prospects of nickel-titanium alloys for orthodontic purposes

This review article presents an evolution of the nickel-titanium wires for orthodontics, following their introduction by the pioneering studies of Andreasen. The original nonsuperelastic wires were followed by the introduction of superelastic Japanese NiTi wire by Miura and colleagues and Chinese NiTi wire by Burstone and colleagues. Subsequently, new nickel-titanium wires with true shape memory in the oral environment were introduced. Manufacturers have marketed special heat-treated wires with variable force delivery at different positions along the archwire. Ion implantation and other surface modification techniques have been used by manufacturers to reduce in vivo nickel release from the nickel-titanium wires, provide a more esthetic appearance, decrease friction, and improve corrosion resistance. The use of several research techniques to provide supporting information about the structures and transformations, mechanical properties, and clinical failure for the different types of the nickel-titanium wires are summarized. The evolution of the ADA/ISO standard for evaluation of these wires is also described. The closing section focuses on the use of surface modification and special coatings for the nickel-titanium wires, a major recent and ongoing area of active research.

Evaluation of Nanomechanical Properties, Surface Roughness, and Color Stability of Esthetic Nickel-Titanium Orthodontic Archwires

Objectives:

The objective of the study is to evaluate the surface roughness, nanomechancial properties the color stability of three brands of coated (rhodium, epoxy, and Teflon) nickel-titanium (NiTi) esthetic archwires.

Materials and Methods:

Three brands of coated (rhodium, epoxy, and Teflon) esthetic NiTi archwires and three brands of uncoated (NiTi) archwires from the same manufactures were evaluated for the surface roughness, nanomechanical properties, and color stability. The specimens with 20 mm length (n = 5) were cut from the straight buccal segments of the coated and uncoated archwires. The specimens with 20 mm length (n = 10) were subjected to color measurement after immersion in a coffee staining solution. The color measurement was evaluated after 7, 14, 21, and 28 days after immersion in staining solution using color eye 7000 spectrophotometer. The experimental data were analyzed using descriptive statistics, analyses of variance, and Tukey's post hoc test.

Results:

Epoxy (1.517 ± 0.071) and rhodium (0.297 ± 0.015) coated archwires showed the highest and lower value of surface roughness. All the intergroup comparisons showed a significant difference (P < 0.05) in surface roughness except between rhodium and control group (P = 0.998). There were significant differences between control and the experimental groups for both nanohardness and elastic modulus was observed. All the three NiTi-coated esthetic archwires demonstrated trace” (extremely slight change) color changes as measured by the National Bureau of Standards units after 4 weeks of immersion.

Conclusion:

Surface roughness of rhodium-coated archwires was almost similar to that of uncoated wires. Whereas Teflon and epoxy coated archwires showed a significant difference in surface roughness compared to uncoated archwires. Uncoated archwires showed higher nanohardness values compared to the coated archwires. Teflon-coated archwires demonstrated significantly slight color change after 4 weeks of immersion in staining solution.

Surface topography of plain nickel-titanium (NiTi), as-received aesthetic (coated) NiTi, and aesthetic NiTi archwires sterilized by autoclaving or glutaraldehyde immersion: A profilometry/SEM/AFM study

BACKGROUND AND AIM

Surface topography is a crucial factor in bracket sliding mechanics. Literature on surface roughness of aesthetic archwires is scarce, and there is no study on surface topography of such archwires affected by any sterilization methods. The aim of this study was to compare the surface topography of plain nickel-titanium (NiTi) versus as-received aesthetic coated NiTi wires versus aesthetic wires sterilized by autoclaving or glutaraldehyde immersion.

MATERIALS AND METHODS

This in vitro study was performed on 80 atomic force microscopy (AFM) observations, 160 profilometry observations, and 40 scanning electron microscopy (SEM) images from rectangular wires of the brands 'American Orthodontics, Ortho Organizers, SIA, and Gestenco'. AFM consisted of 8 subgroups of NiTi orthodontic wires, consisting of 4 subgroups of 4 brands of coated orthodontic wires and 4 subgroups of 4 brands of uncoated wires from the same brands. Profilometry consisted of 16 subgroups of NiTi orthodontic wires, consisting of 4 subgroups of 4 brands of coated orthodontic wires and 12 subgroups of 4 brands of uncoated wires from the same brands (4 as-received wire subgroups, 4 autoclaved, and 4 cold-sterilized subgroups). Scanning electron microscopy (SEM) and AFM images were subjectively evaluated. AFM and profilometry data were analysed statistically (α=0.05).

RESULTS

Overall, the difference between surface roughness parameters of coated versus uncoated archwires was not significant (P>0.05). However, surface roughness of brands differed significantly. Mann-Whitney did not show any significant differences between sterilized wires (both sterilization methods together as one group) and unsterilized wires (both unsterilized coated and uncoated as one group) (P>0.460). After excluding plain uncoated NiTi group, the coated wires in 3 sterilization groups (no sterilization, autoclaving, glutaraldehyde) were not significantly different in terms of average overall surface roughness (Ra) and maximum roughness depths (Rq) of different sterilization groups (P>0.1) but the average maximum peak to valley heights (Rz) values of 3 sterilization groups were significantly different (P=0.0415). Dunn test showed that among three post-hoc pairwise comparisons of Rz values, only the comparison of "no sterilization versus autoclaving" was significant (P<0.05) and the other two were non-significant.

CONCLUSION

Coating might not affect the surface roughness considerably. Brands have different surface roughnesses. Autoclaving but not cold sterilization might affect the surface roughness of coated archwires.

Comparison of deflection forces of esthetic archwires combined with ceramic brackets

Coated archwires and ceramic brackets have been developed to improve facial esthetics during orthodontic treatment. However, their mechanical behavior has been shown to be different from metallic archwires and brackets. Therefore, the aim of this study was to compare the deflection forces in coated nickel-titanium (NiTi) and esthetic archwires combined with ceramic brackets. Material and Methods Non-coated NiTi (NC), rhodium coated NiTi (RC), teflon coated NiTi (TC), epoxy coated NiTi (EC), fiber-reinforced polymer (FRP), and the three different conventional brackets metal-insert polycrystalline ceramic (MI-PC), polycrystalline ceramic (PC) and monocrystalline ceramic (MC) were used. The specimens were set up on a clinical simulation device and evaluated in a Universal Testing Machine (Instron). An acrylic device, representative of the right maxillary central incisor was buccolingually activated and the unloading forces generated were recorded at 3, 2, 1 and 0.5 mm. The speed of the testing machine was 2 mm/min. ANOVA and Tukey tests were used to compare the different archwires and brackets. Results The brackets presented the following decreasing force ranking: monocrystalline, polycrystalline and polycrystalline metal-insert. The decreasing force ranking of the archwires was: rhodium coated NiTi (RC), non-coated NiTi (NC), teflon coated NiTi (TC), epoxy coated NiTi (EC) and fiber-reinforced polymer (FRP). At 3 mm of unloading the FRP archwire had a plastic deformation and produced an extremely low force in 2; 1 and 0.5 mm of unloading. Conclusion Combinations of the evaluated archwires and brackets will produce a force ranking proportional to the combination of their individual force rankings.

Static and kinetic frictional forces of silica-insert ceramic brackets with coated archwires in artificial saliva

Background:

During sliding mechanics, the frictional force (FF) is an important counterforce to orthodontic tooth movement. The purpose of this in vitro study was to investigate the static and kinetic FFs of S silica-insert ceramic (SIC) brackets with Teflon-coated (TC) and conventional S stainless steel (SS) archwires.

Materials and Methods:

The target group of this study included 80 maxillary canine 0.022 inch slot SIC brackets. Forty SS brackets were used as the control. TC and conventional uncoated SS archwires of different dimensions (0.016, 0.018, 0.016 × 0.022, and 0.018 × 0.025 inch) were examined. All tests were carried out under artificial saliva injected condition. Scanning Electron Micrographs were prepared for two samples of coated and uncoated archwires. Analysis of variance and Tukey post hoc tests were used for statistical purposes (level of significance P < 0.05).

Results:

SIC brackets showed significantly lower levels of FFs than SS brackets. TC archwires had greater frictional values than conventional uncoated ones. They also exhibited an unusual behavior of increasing kinetic FFs with time. Indentation and delamination of coating were obvious under scanning electron microscopy observations.

Conclusion:

From the standpoint of friction, SIC brackets may serve well, even better than SS brackets, in sliding mechanics. The coating layer of the archwires may delaminate and lost, causing an impediment to tooth movement.

Influence of long-term in vivo exposure, debris accumulation and archwire material on friction force among different types of brackets and archwires couples

Objective

The aim was to assess the influence of long-term in vivo exposure, debris accumulation and archwire material on static and kinetic friction force among different types of brackets and archwires couples.

Material and Methods

Friction testing was performed among four lower incisors' brackets, conventional and self-ligating (SL), coupled with either nickel-titanium or stainless steel archwires, as-received and in vivo exposed in 18 subjects. The friction testing was performed for a sliding distance of 14 mm at a speed of 10 mm/min, with a starting force of 0.2 N. Wear and quantitative assessment of debris accumulation was performed on pictures of brackets obtained using a scanning electron microscope. Non parametric tests were used for statistical analysis.

Results

Only bracket type, but not exposure duration, amount of debris accumulation, archwire material or their manufacturer, was significantly correlated with both static (rho = 0.602, P < 0.001) and kinetic (rho = 0.584, P < 0.001) friction force. Within each bracket type no significant difference was observed between as-received and in vivo exposed brackets for any friction parameter except for the SL brackets in which significantly higher static and kinetic (P = 0.001, at least) friction forces were seen in in vivo exposed SL brackets (164.9 cN and 217.63 cN, respectively) in comparison with as-received SL brackets (19.69 cN and 55.72 cN, respectively).

Limitation

The frictional testing was performed in the dry condition which might have influenced the results.

Conclusion

A significant correlation was seen between friction force and bracket type, while treatment duration, amount of debris accumulation, archwire material or their manufacturer was not significantly correlated to it. Nevertheless, higher friction forces were measured among in vivo aged SL brackets in comparison with as-received ones.

Characterization and coating stability evaluation of nickel-titanium orthodontic esthetic wires: an in vivo study

The objective of this study was to compare coating dimensions and surface characteristics of two different esthetic covered nickel-titanium orthodontic rectangular archwires, as-received from the manufacturer and after oral exposure. The study was designed for comparative purposes. Both archwires, as-received from the manufacturer, were observed using a stereomicroscope to measure coating thickness and inner metallic dimensions. The wires were also exposed to oral environment in 11 orthodontic active patients for 21 days. After removing the samples, stereomicroscopy images were captured, coating loss was measured and its percentage was calculated. Three segments of each wire (one as-received and two after oral exposure) were observed using scanning electron microscopy for a qualitative analysis of the labial surface of the wires. The Lilliefors test and independent t-test were applied to verify normality of data and statistical differences between wires, respectively. The significance level adopted was 0.05. The results showed that the differences between the wires while comparing inner height and thickness were statistically significant (p < 0.0001). In average, the most recently launched wire presented a coating thickness twice that of the control wire, which was also a statistically significant difference. The coating loss percentage was also statistically different (p = 0.0346) when the latest launched wire (13.27%) was compared to the control (29.63%). In conclusion, the coating of the most recent wire was thicker and more uniform, whereas the control had a thinner coating on the edges. After oral exposure, both tested wires presented coating loss, but the most recently launched wire exhibited better results.

Effect of esthetic coating on surface roughness of orthodontic archwires

BACKGROUND AND AIM

Esthetic wires are commonly used in orthodontic treatments. Surface roughness is an important factor in the friction and bacterial adhesion in these wires. Surface roughness of esthetic wires has not been assessed, except in a few recent (mostly qualitative esthetics) studies. The aim of this study was to quantitatively compare the surface roughness of 4 coated esthetic wires with that of a conventional orthodontic wire.

MATERIALS AND METHODS

In this in vitro trial, 25 coated and uncoated orthodontic archwires were studied, including: NiTi Memory wire (American Orthodontics, USA) as a control group; Orthocosmetic Elastinol (Ortho Organizers, USA); Perfect (Hubit, Korea); Imagination (Gestenco, Sweden); EverWhite (American Orthodontics, USA). All were .016×.022" rectangular maxillary wires. Fifteen millimeters of wire was cut off at the posterior end and a surface area of 2000×2000nm was probed using a Scanning Probe Microscope (DS95-50E/DME, Denmark) to determine the surface roughness values. The roughness parameters of Sa, Sdq, Sv and Sy were measured and statistically compared by Kruskal-Wallis and Mann-Whitney U tests.

RESULTS

The average range of the 4 parameters was the highest for the uncoated Ni-Ti Memory wire (control group) while the Perfect coated wire showed the lowest values. The differences were significant for parameters Sa and Sy (P<0.02 and P<0.023) and non-significant for Sv and Sdq. Significant differences existed between uncoated and coated wires regarding Sa and Sy values (P<0.01), being higher for the uncoated wires.

CONCLUSION

Taking into account the study limitations, the surface roughness values of NiTi uncoated archwires were significantly higher than those of the coated wires.

Friction behavior of self-ligating and conventional brackets with different ligature systems

OBJECTIVES

Self-ligating brackets are widely believed to offer better clinical efficiency and, in particular, less friction. Thus, the goal of this in vitro investigation was to assess the friction behavior of different bracket/archwire/ligature combinations during simulated canine retraction. An important aspect of this work was to determine whether conventional bracket systems behave differently in passive or active self-ligating brackets used with a Slide™ ligature, an elastic ligature, or a steel ligature.

METHODS

Three conventional (Contour, Class One; Discovery(®), Dentaurum; Mystique MB, GAC) and six self-ligating (Carriere SL, Class One; Clarity™ SL, 3M Unitek; Damon3, Ormco; In-Ovation(®) C, GAC; Speed Appliance, Speed System™; QuicKlear(®), Forestadent(®)) bracket systems were analyzed. All brackets featured a 0.022″ slot (0.56 mm). Each conventional system was tested with a steel ligature (0.25 mm; Remanium(®), Dentaurum), an elastic ligature (1.3 mm in diameter; Dentalastics, Dentaurum), and a modified elastic ligature (Slide™; Leone(®)). Each combination was used with four archwires, including rectangular stainless steel (0.46 × 0.64 mm, 0.018 × 0.025″, Dentaurum), rectangular nickel-titanium with Teflon coating (0.46 × 0.64 mm, 0.018 × 0.025″, Forestadent(®)), round coaxial nickel-titanium (0.46 mm, 0.018″, Speed), and half-round/half-square (D-profile) stainless steel (0.46 mm, 0.018″, Speed). In the orthodontic measurement and simulation system (OMSS), retraction of a canine was simulated on a Frasaco model replicated in resin. Based on the force systems, the respective friction values were determined. For each combination of materials, five brackets of the same type were tested and five single measurements performed.

RESULTS

Friction values were found to vary distinctly with the different combinations, modifiers being the ligature systems and the archwire types. Any significant friction differences between the steel-ligated, Slide™-ligated, and self-ligated brackets were sporadic. All three systems were associated with average friction values of 40 %. Active self-ligating brackets and elastic-ligated conventional brackets, by contrast, generally differed significantly from the three above-mentioned bracket systems and showed distinctly higher friction values averaging 59 and 67 %, respectively.

CONCLUSIONS

While passive self-ligating bracket systems have frequently been touted as advantageous in the literature, they should not be regarded as the only favorable system. Steel-ligated and Slide™-ligated conventional bracket systems are capable of offering similar friction performance.

Surface ultrastructure and mechanical properties of three different white-coated NiTi archwires

The recent trend in orthodontic treatment is to apply esthetic materials to orthodontic appliances with adequate clinical performance. The aim of this study was to investigate the ultrastructure (surface roughness) and mechanical properties (load-deflection curve) of three as-received, white-coated superelastic nickel-titanium (NiTi) archwires using atomic force microscopy (AFM) and modified three-point bending test assessments, respectively. Three representative esthetic NiTi archwires were used, silver-platinum- and polymer-coated NiTi Natural Dany (Dany group), epoxy resin-coated Orthoforce Ultraesthetic™ (Ultra group), and Teflon®-coated Perfect (Perfect group). Uncoated metallic areas of each wire were used as controls. The diameter of the Perfect archwire was significantly larger than that of other archwires. The Dany and Ultra groups showed more deflection than the Perfect group. The hysteresis area of the Dany and Ultra groups showed approximately two- and fourfold increases compared to the control and the Perfect group. The Dany group (2037.5 ± 527.3 nm) had the highest peak-to-peak surface roughness in the coated areas, followed by the Ultra group (811.1 ± 407.5 nm) and the Perfect group (362.7 ± 195.8 nm). However, reverse nanostructural changes in the surface roughness were observed in the uncoated metallic areas. The results suggested that the load-deflection properties and the surface roughness of superelastic NiTi archwires were affected directly by the coating materials. Although the efficiency of orthodontic treatment was affected by various factors, when only considering the frictional force and mechanostructural properties, the epoxy resin-coated Orthoforce Ultraesthetic™ archwires were the most effective for orthodontic treatment.

Mechanical properties of orthodontic wires made of super engineering plastic

Most orthodontic equipment is fabricated from alloys such as stainless steel, Co-Cr and Ni-Ti because of their excellent elastic properties. In recent years, increasing esthetic demands, metal allergy and interference of metals with magnetic resonance imaging have driven the development of non-metallic orthodontic materials. In this study, we assessed the feasibility of using three super engineering plastics (PEEK, PES and PVDF) as orthodontic wires. PES and PVDF demonstrated excellent esthetics, although PEEK showed the highest bending strength and creep resistance. PEEK and PVDF showed quite low water absorption. Because of recent developments in coloration of PEEK, we conclude that PEEK has many advantageous properties that make it a suitable candidate for use as an esthetic metal-free orthodontic wire.

Comparison of frictional forces between aesthetic orthodontic coated wires and self-ligation brackets

OBJECTIVE

The purpose of this study was to evaluate the clinical efficacy of polymer- and rhodium-coated wires compared to uncoated wires by measuring the frictional forces using self-ligation brackets.

METHODS

0.016-inch nickel titanium (NiTi) wires and 0.017 × 0.025-inch stainless steel (SS) wires were used, and the angulations between the brackets and wires were set to 0°, 5°, and 10°. Upper maxillary premolar brackets (Clippy-C®) with a 0.022-inch slot were selected for the study and a tensile test was performed with a crosshead speed of 5 mm/min. The maximum static frictional forces and kinetic frictional forces were recorded and compared.

RESULTS

The maximum static frictional forces and the kinetic frictional forces of coated wires were equal to or higher than those of the uncoated wires (p < 0.05). The maximum static frictional forces of rhodium-coated wires were significantly higher than those of polymer-coated wires when the angulations between the brackets and wires were set to (i) 5° in the 0.016-inch NiTi wires and (ii) all angulations in the 0.017 × 0.025-inch SS wires (p < 0.05). The kinetic frictional forces of rhodium-coated wires were higher than those of polymer-coated wires, except when the angulations were set to 0° in the 0.016-inch NiTi wires (p < 0.05).

CONCLUSIONS

Although the frictional forces of the coated wires with regards to aesthetics were equal to or greater than those of the uncoated wires, a study under similar conditions regarding the oral cavity is needed in order to establish the clinical implications.

A systematic review and meta-analysis of experimental clinical evidence on initial aligning archwires and archwire sequences

The aim of the study was to assess treatment effects and potential side effects of different archwires used on patients receiving orthodontic therapy. Electronic and manual unrestricted searches were conducted in 19 databases including MEDLINE, Cochrane Library, and Google Scholar until April 2012 to identify randomized controlled trials (RCTs) and quasi-RCTs. After duplicate study selection, data extraction, risk of bias assessment with the Cochrane risk of bias tool, and narrative analysis, mean differences (MDs) with confidence intervals (CIs) of similar studies were pooled using a random-effects model and evaluated with GRADE. A total of 16 RCTs were included assessing different archwire characteristics on 1108 patients. Regarding initial archwires, meta-analysis of two trials found slightly greater irregularity correction with an austenitic-active nickel-titanium (NiTi) compared with an martensitic-stabilized NiTi archwire (corresponding to MD: 1.11 mm, 95% CI: -0.38 to 2.61). Regarding archwire sequences, meta-analysis of two trials found it took patient treated with a sequence of martensitic-active copper-nickel-titanium (CuNiTi) slightly longer to reach the working archwire (MD: 0.54 months, 95% CI: -0.87 to 1.95) compared with a martensitic-stabilized NiTi sequence. However, patients treated with a sequence of martensitic-active CuNiTi archwires reported general greater pain intensity on the Likert scale 4 h and 1 day after placement of each archwire, compared with a martensitic-stabilized NiTi sequence. Although confidence in effect estimates ranged from moderate to high, meta-analyses could be performed only for limited comparisons, while inconsistency might pose a threat to some of them. At this point, there is insufficient data to make recommendations about the majority of initial archwires or for a specific archwire sequence.

Effects of intraoral aging on surface properties of coated nickel-titanium archwires

OBJECTIVE

To evaluate the effects of intraoral aging on surface properties of esthetic and conventional nickel-titanium (NiTi) archwires.

MATERIALS AND METHODS

Five NiTi wires were considered for this study (Sentalloy, Sentalloy High Aesthetic, Superelastic Titanium Memory Wire, Esthetic Superelastic Titanium Memory Wire, and EverWhite). For each type of wire, four samples were analyzed as received and after 1 month of clinical use by an atomic force microscope (AFM) and a scanning electronic microscope (SEM). To evaluate sliding resistance, two stainless steel plates with three metallic or three monocrystalline brackets, bonded in passive configuration, were manufactured; four as-received and retrieved samples for every wire were pulled five times at 5 mm/min for 1 minute by means of an Instron 5566, recording the greatest friction value (N). Data were analyzed by one-way analysis of variance and by Student's t-test.

RESULTS

After clinical use, surface roughness increased considerably. The SEM images showed homogeneity for the as-received control wires; however, after clinical use esthetic wires exhibited a heterogeneous surface with craters and bumps. The lowest levels of friction were observed with the as-received Superelastic Titanium Memory Wire on metallic brackets. When tested on ceramic brackets, all the wires exhibited an increase in friction (t-test; P < .05). Furthermore, all the wires, except Sentalloy, showed a statistically significant increase in friction between the as-received and retrieved groups (t-test; P < .05).

CONCLUSION

Clinical use of the orthodontic wires increases their surface roughness and the level of friction.

An investigation into the mechanical and aesthetic properties of new generation coated nickel-titanium wires in the as-received state and after clinical use

BACKGROUND/OBJECTIVES

The purpose of this study was to compare the mechanical, structural, and aesthetic properties of two types of aesthetic coated nickel-titanium (NiTi) wires compared with comparable regular NiTi wires in the as-received state and after clinical use.

MATERIALS/METHODS

Sixty one subjects were randomly assigned to four groups (N = 61), two groups of coated wires and two groups of comparable, non-coated controls (n = 15/group). The period in the mouth ranged from 4 to 12 weeks after insertion. In total, 121 wires (61 retrieved and 60 as-received) were used in the study. The percentages of coating retention and loss were extrapolated from scans. A brief survey of five questions with three choices was given to all patients. Differential scanning calorimetry (DSC) and three-point bending tests were done on as-received and used wires.

RESULTS

The surface characterization by the percentage of resin remaining indicated that most wires in both test groups lost a significant amount of coating. A patient survey indicated that this was a noticeable feature for patients. DSC analysis of the wires indicated that the metallurgical properties of the coated wires were not similar to the uncoated wires in the as-received condition. Three-point bending results indicate a wide variation in test results with large standard deviations among all the groups.

LIMITATIONS

The extent of coating loss requires investigating, as do the biological properties of the detached coating.

CONCLUSIONS

Both wires lost a significant amount of aesthetic coating after varying periods in the mouth. The metallurgical testing of these findings may indicate that these wires perform differently in the mouth.

Evaluation of surface roughness of orthodontic wires by means of atomic force microscopy

OBJECTIVE

To compare the surface roughness of different orthodontic archwires.

MATERIALS AND METHODS

Four nickel-titanium wires (Sentalloy(®), Sentalloy(®) High Aesthetic, Titanium Memory ThermaTi Lite(®), and Titanium Memory Esthetic(®)), three β-titanium wires (TMA(®), Colored TMA(®), and Beta Titanium(®)), and one stainless-steel wire (Stainless Steel(®)) were considered for this study. Three samples for each wire were analyzed by atomic force microscopy (AFM). Three-dimensional images were processed using Gwiddion software, and the roughness average (Ra), the root mean square (Rms), and the maximum height (Mh) values of the scanned surface profile were recorded. Statistical analysis was performed by one-way analysis of variance (ANOVA) followed by Tukey's post hoc test (P < .05).

RESULTS

The Ra, Rms, and Mh values were expressed as the mean ± standard deviation. Among as-received archwires, the Stainless Steel (Ra  =  36.6 ± 5.8; Rms  =  48 ± 7.7; Mh  =  328.1 ± 64) archwire was less rough than the others (ANOVA, P < .05). The Sentalloy High Aesthetic was the roughest (Ra  =  133.5 ± 10.8; Rms  =  165.8 ± 9.8; Mh  =  949.6 ± 192.1) of the archwires.

CONCLUSIONS

The surface quality of the wires investigated differed significantly. Ion implantation effectively reduced the roughness of TMA. Moreover, Teflon(®)-coated Titanium Memory Esthetic was less rough than was ion-implanted Sentalloy High Aesthetic.

Variations in surface roughness of seven orthodontic archwires: an SEM-profilometry study

OBJECTIVE

The purpose of this study was to evaluate the surface roughness (SR) of 2 types of orthodontic archwires made by 4 different manufacturers.

METHODS

This in vitro experimental study was conducted on 35 specimens of 7 different orthodontic archwires, namely, 1 nickel-titanium (NiTi) archwire each from the manufacturers American Orthodontics, OrthoTechnology, All-Star Orthodontics, and Smart Technology, and 1 stainless steel (SS) archwire each from the manufacturers American Orthodontics, OrthoTechnology, and All-Star Orthodontics. After analyzing the composition of each wire by energy-dispersive X-ray analysis, the SR of each wire was determined by scanning electron microscopy (SEM) and surface profilometry. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests (α < 0.05).

RESULTS

The average SR of NiTi wires manufactured by Smart Technology, American Orthodontics, OrthoTechnology, and All-Star Orthodontics were 1,289 ± 915 A°, 1,378 ± 372 A°, 2,444 ± 369 A°, and 5,242 ± 2,832 A°, respectively. The average SR of SS wires manufactured by All-Star Orthodontics, OrthoTechnology, and American Orthodontics were 710 ± 210 A°, 1,831 ± 1,156 A°, and 4,018 ± 2,214 A°, respectively. Similar to the results of profilometry, the SEM images showed more defects and cracks on the SS wire made by American Orthodontics and the NiTi wire made by All-Star Orthodontics than others.

CONCLUSIONS

The NiTi wire manufactured by All-Star Orthodontics and the SS wire made by American Orthodontics were the roughest wires.

Load-deflection and surface properties of coated and conventional superelastic orthodontic archwires in conventional and metal-insert ceramic brackets

Background:

Properties of coated archwires, which have been introduced for esthetic demands during orthodontic treatments, along with the use of tooth-colored brackets, are not clear. The aim of this study is to compare the load-deflection and surface properties of coated superelastic archwires with conventional superelastic archwires in conventional and metal-insert ceramic brackets.

Materials and Methods:

In this experimental study, 3 types of archwires including ultraesthetic polycoated, ultraesthetic epoxyresin coated and conventional (uncoated) superelastic nickel-titanium (NiTi) archwires were used in each of 2 types of brackets including conventional and metal-insert ceramic. To simulate oral environment, all specimens were incubated in artificial saliva using thermocycling model and then were tested in three-bracket bending test machine. Loading and unloading forces, plateau gap and end load deflection point (ELDP) were recorded. Archwires were investigated with a stereomicroscope before and after the experiment. Two-way ANOVA and Tukey tests were used at P<0.05.

Results:

Epoxyresin archwires produced lower forces (19 to 310 gr) compared to polycoated (61 to 359 gr) and NiTi (61 to 415 gr) (P<0.0001). The maximum ELDP (0.43 mm) was observed in epoxyresin archwires (P<0.001). Coatings of some epoxyresin wires were torn and of polycoated wires peeled off. Conventional ceramic bracket produced higher loading forces with polycoated and NiTi archwires and lower unloading forces with all 3 types of archwires compared to metal-insert type (P<0.05).

Conclusion:

Epoxyresin-coated archwire had the lowest force and highest ELDP. Coatings were not durable in these experimental conditions. Conventional ceramic bracket produced higher frictional force compared to metal-insert type.

Effect of monomer composition of polymer matrix on flexural properties of glass fibre-reinforced orthodontic archwire

To compare force levels obtained from glass fibre-reinforced composite (FRC) archwires. Specifically, FRC wires were compared with polymer matrices having different dimethacrylate monomer compositions. FRC material (E-glass provided by Stick Tech Ltd, Turku, Finland) with continuous unidirectional glass fibres and four different types of dimethacrylate monomer compositions for the resin matrix were tested. Cross-sectionally round FRC archwires fitting into the 0.3 mm slot of a bracket were divided into 16 groups with six specimens in each group. Glass fibres were impregnated by the manufacturer, and they were initially light-cured by hand light-curing unit or additionally post-cured in light-curing oven. The FRC archwire specimens were tested at 37°C according to a three-point bending test in dry and wet conditions using a span length of 10 mm and a crosshead speed of 1.0 mm/minute. The wires were loaded until final failure. The data were statistically analysed using analysis of variance (ANOVA). The dry FRC archwire specimens revealed higher load values than water stored ones, regardless of the polymer matrix. A majority of the FRC archwires showed higher load values after being post-cured. ANOVA revealed that the polymer matrix, curing method, and water storage had a significant effect (P < 0.05) on the flexural behaviour of the FRC archwire. Polymer matrix composition, curing method, and water storage affected the flexural properties and thus, force level and working range which could be obtained from the FRC archwire.

Polyphenylene polymers as esthetic orthodontic archwires

INTRODUCTION

There is continuing interest in an esthetic, effective labial archwire. In this study, we evaluated the potential of new, high-strength polyphenylene polymers to fill this need.

METHODS

Polyphenylene (Primospire, Solvay Advanced Polymers, Alpharetta, Ga) polymer was extruded into wires with clinically relevant round and rectangular cross sections. Tensile, flexure, spring-back, stress-relaxation, and formability characteristics were assessed. Arch forms and secondary shapes were formed.

RESULTS

Smooth wires with consistent cross-sectional dimensions, high spring-back, and good ductility were produced. Forces delivered were generally similar to typical beta-titanium and nickel-titanium wires of somewhat smaller cross sections. The polyphenylene wire did experience stress relaxation for up to 75 hours. The force magnitudes place polyphenylene wires in the category of an alignment or leveling wire. High formability allowed shape bending similar to that associated with stainless steel wires.

CONCLUSIONS

Polyphenylene polymers could serve as esthetic orthodontic archwires; further study is warranted.

Degradation of 316L stainless steel sternal wire by steam sterilization

Sterilization is an important step prior to the implantation of medical devices inside the human body. In this work we studied the influence of steam sterilization cycles on the oxide film properties of stainless steel sternal wire. Characterization techniques such as open- circuit potential, potentiodynamic measurement, electrochemical impedance spectroscopy, cathodic stripping, transmission electron microscopy, atomic force microscopy and scanning electron microscopy were employed to investigate the cycles of steam sterilization on the corrosion behavior of sternal wire. The results showed that the oxide properties are a function of the number of steam sterilization cycles and deteriorate as the number of cycles increases. Steam sterilization might damage the implant integrity and heavy metals could be released to the surrounding tissues due to deterioration of the oxide film.

Morphological characterization of as-received and in vivo orthodontic stainless steel archwires

This study was undertaken to evaluate the material degradation of clinical bracket-archwire-contacting surfaces after in vivo orthodontic use. Twenty-four stainless steel multiloop edgewise archwires with two different cross sections (0.016 x 0.016 and 0.016 x 0.022 inches) were used for at least 6 months in the mouths of 14 patients. The surfaces of both as-received (cross-section of 0.016 x 0.016, 0.016 x 0.022, and 0.017 x 0.025 inches) and the in vivo wires were examined using scanning electron microscopy. The as-received wires exhibited an inhomogeneous surface with different surface irregularities resulting from the manufacturing process. For the in vivo archwires, an increase in the variety, type, and number of surface irregularities were observed. Crevice corrosion occurred not only at surface irregularities formed during manufacturing and orthodontic handling but also at the bracket-archwire-contacting surfaces and at the archwire surfaces coated with plaque and food remnants. This corrosion may be linked to the formation of a micro-environment at these locations. In addition, a limited number of signs of degradation induced during in vivo testing due to wear and friction were observed.

Stability of passivated 316L stainless steel oxide films for cardiovascular stents

Passivated 316L stainless steel is used extensively in cardiovascular stents. The degree of chloride ion attack might increase as the oxide film on the implant degrades from exposure to physiological fluid. Stability of 316L stainless steel stent is a function of the concentration of hydrated and hydrolyated oxide concentration inside the passivated film. A high concentration of hydrated and hydrolyated oxide inside the passivated oxide film is required to maintain the integrity of the passivated oxide film, reduce the chance of chloride ion attack, and prevent any possible leaching of positively charged ions into the surrounding tissue that accelerate the inflammatory process. Leaching of metallic ions from corroded implant surface into surrounding tissue was confirmed by the X-ray mapping technique. The degree of thrombi weight percentage [W(ao): (2.1 +/- 0.9)%; W(ep): (12.5 +/- 4.9)%, p < 0.01] between the amorphous oxide (AO) and the electropolishing (EP) treatment groups was statistically significant in ex-vivo extracorporeal thrombosis experiment of mongrel dog. The thickness of neointima (T(ao): 100 +/- 20 microm; T(ep): 500 +/- 150 microm, p < 0.01) and the area ratio of intimal response at 4 weeks (AR(ao): 0.62 +/- 0.22; AR(ep): 1.15 +/- 0.42, p < 0.001) on the implanted iliac stents of New Zealand rabbit could be a function of the oxide properties.

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

This study investigated the surface characterizations and corrosion resistance of as-received commercial nickel-titanium (NiTi) dental orthodontic archwires from different manufacturers using a cyclic potentiodynamic test in artificial saliva with various acidities. An atomic force microscope was used to evaluate the surface topography of the NiTi wires. The surface chemical analysis of the passive film on the NiTi wires was characterized using X-ray photoelectron spectroscopy and Auger electron spectroscopy. A scanning electron microscope, together with an energy-dispersive spectrometer, was used to analyze the surface characterizations of the NiTi wires before and after the corrosion tests. Two-way analysis of variance was used to analyze the corrosion-resistance parameters with the factors of wire manufacturer and solution pH. The results showed that the surface structure of the passive film on the tested NiTi wires were identical, containing mainly TiO2, with small amounts of NiO. A different surface topography was observed on the NiTi wires from various manufacturers. The corrosion tests showed that both the wire manufacturer and solution pH had a statistically significant influence on the corrosion potential, corrosion rate, passive current, breakdown potential, and crevice-corrosion susceptibility. The difference in the corrosion resistance among these NiTi dental orthodontic archwires did not correspond with the surface roughness and pre-existing defects.

Influence of fluoridated mouthwashes on corrosion resistance of orthodontics wires

The aim of the present study was to classify the different alloys commonly used to make orthodontic wire according to their corrosion resistance in different media. The four materials analysed were titanium-based alloys: TMA, TiNb, NiTi and CuNiTi, which were tested in three fluoride mouthwashes: Elmex, Meridol and Acorea as well as in Fusayama Meyer artificial saliva. The electrochemical study showed that the alloys could be divided into two groups. In one group were the NiTi-based alloys which were subject to strong corrosion in the presence of monofluorophosphate found in Acorea solution. In the other group were TiNb, which was the most resistant to corrosion, and TMA, which corroded strongly with the stannous fluoride found in Meridol mouthwash. The results obtained in the present study will enable us to provide attending practitioners with advice concerning fluoride mouthwash to recommend, depending on the treatment phase and the alloy used. So we can advise Elmex mouthwash for patients with TMA and NiTi-based orthodontics wires but we suggest Acorea or Meridol mouthwashes for patients with TiNb orthodontics wires.