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Wu C, Mangal U, Seo JY, Kim H, Bai N, Cha JY, Lee KJ, Kwon JS, Choi SH. Enhancing biofilm resistance and preserving optical translucency of 3D printed clear aligners through carboxybetaine-copolymer surface treatment. Dent Mater 2024; 40:1575-1583. [PMID: 39068090 DOI: 10.1016/j.dental.2024.07.009] [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: 02/27/2024] [Revised: 06/30/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES This study aimed to use a carboxybetaine methacrylate (CBMA) copolymer solution to surface treat 3D printed clear aligners at different fabrication stages, to impart antifouling properties, and assess the surface treatment at various fabrication stages' impact on physico-mechanical characteristics. METHODS Surface treatments using a blend of 2-hydroxyethyl methacrylate (HEMA) and CBMA, termed CCS, were performed at various stages of 3D printed clear aligner fabrication. Experimental groups, CB1, CB2, and CB3, were determined by the stage of surface treatment during post-processing. CB1, CB2, and CB3 received treatment before post-curing, after post-curing, and after post-processing, respectively. Untreated samples served as controls. Physical and mechanical properties were assessed through tensile testing, Fourier-transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), and UV-Vis spectroscopy. The surface was further characterized through scanning electron microscopy and contact angle measurements. The cytotoxicity was assessed with 7-day elution and agar diffusion assays. Lastly, bacterial biofilm resistance was evaluated using confocal laser scanning microscopy. Crystal violet assay was performed using Streptococcus mutans. RESULTS Surface treatment during CB1 stage exerted the most significantly unfavorable influence on properties of the 3D printed aligner resin. CB2 samples showed the maximum preservation of translucency even after 7-day aging. CB2 and CB3 phases showed enhanced hydrophilicity of sample surfaces with reduced adhesion of multispecies biofilm and S. mutans. SIGNIFICANCE Application of CCS surface treatment immediately after post-curing (CB2) can enhance the biofilm resistance of 3D printed clear aligners while maintaining high fidelity to optical translucency and constituent mechanical properties.
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Affiliation(s)
- Chengzan Wu
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Utkarsh Mangal
- BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Ji-Young Seo
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Hoon Kim
- Research Institute of Agriculture and Life Sciences, College of Agriculture and Life Sciences, Seoul National University, Seoul, Republic of Korea
| | - Na Bai
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao University, School of Stomatology of Qingdao University, Qingdao 266000, Shandong, China
| | - Jung-Yul Cha
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Jae-Sung Kwon
- BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea; Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
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Moradinezhad M, Abbasi Montazeri E, Hashemi Ashtiani A, Pourlotfi R, Rakhshan V. Biofilm formation of Streptococcus mutans, Streptococcus sanguinis, Staphylococcus epidermidis, Staphylococcus aureus, Lactobacillus casei, and Candida Albicans on 5 thermoform and 3D printed orthodontic clear aligner and retainer materials at 3 time points: an in vitro study. BMC Oral Health 2024; 24:1107. [PMID: 39294648 PMCID: PMC11412017 DOI: 10.1186/s12903-024-04893-4] [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: 05/02/2024] [Accepted: 09/10/2024] [Indexed: 09/21/2024] Open
Abstract
INTRODUCTION Orthodontic clear aligners and retainers have numerous advantages that is making them ever increasingly popular. However, they might, similar to any other oral appliance, contribute to biofilm formation and finally dental caries or white spot lesions or gingival inflammations. The literature on biofilm formation on orthodontic clear appliances is very scarce and limited to a few microorganisms and materials. Therefore, this experimental study evaluated the biofilm formation on 5 thermoformed and 3D printed CAD/CAM orthodontic retainers in 3 intervals. METHODS In this in vitro study, 345 specimens (270 test discs and 45 negative controls) were created from fabricated retainers. Retainers included a 3D printed CAD/CAM material (Detax) and four thermoformed retainers [Erkodent (polyethylene terephthalate glycol [PETG]); EasyVac (polyethylene); DB (polyester based on terephthalic acid); and Clear Tech]. They were all 1 mm thick, and all completely fabricated, i.e., heated or printed. The discs were placed in 96-well plates. Microorganisms were cultured on 270 discs for 24 h (90 discs), 72 h (90 other discs), and 5 days or 120 h (90 other discs). Biofilm formation of the strains and negative controls was measured using the microtiter plate assay by ELISA reading. The microbes' ability to produce biofilm was categorized based on the comparison of average optical density (OD) of tests versus a cut-off point OD (ODc) calculated as the average of the OD of corresponding negative controls plus 3× its standard deviation: non-biofilm former [OD ≤ ODc], weak biofilm former [ODc < OD ≤ (2 × ODc)], moderate biofilm former [(2 × ODc) < OD ≤ (4 × ODc)], and strong biofilm former [(4 × ODc) < OD]. These were also converted to ranked scores between zero (no biofilm) and 3. The difference between ODs with control ODs were calculated. These were analyzed using 3-way ANOVA, 2-way ANOVA, and Tukey tests (α = 0.05, α = 0.008). RESULTS The 3-way ANOVA showed that the overall difference among the ΔODs of 5 retainers (all microorganisms and all intervals combined, n = 270) was not significant (F = 1.860, P = 0.119). Nevertheless, the difference among 3 intervals (F = 31.607, P = 0.0000) and the difference among the 6 microorganisms (F = 24.044, P = 0.0000) were significant. According to the Tukey test, the differences between the 1st interval with either of the other two intervals was significant (both P values = 0.000). There were significant differences between Candida albicans with all other organisms (all 5 P values = 0.0000). All other pairwise comparisons were insignificant (all 10 P values ≥ 0.1). After taking the averages of the 3 intervals, the order of the biofilm generation for different materials were as follows: Detax (average score: 1.56), Easyvac (1.67), Erkodent (1.78), Clear Tech (1.83), BD (2.28). CONCLUSIONS As far as these 6 microorganisms are of concern, there might not be a significant overall difference among the clear retainer materials tested in this study. A significant overall increase was observed between the first and third days, which later did not significantly increase more until day 5. The Candida albicans biofilm was more intense than the tested 5 bacteria, which themselves showed rather similar growth patterns to each other.
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Affiliation(s)
- Mehrnaz Moradinezhad
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Effat Abbasi Montazeri
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Hashemi Ashtiani
- Department of Prosthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Pourlotfi
- School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Vahid Rakhshan
- Department of Dental Anatomy, Azad University of Medical Sciences, Tehran, Iran
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Mundada R, Tanpure SB, Mapare S, Karra A, Yannawar V, Gilani R. The Effect of Nanoparticles Against Streptococcus mutans in the Orthodontic Primer Used for Aligner Attachment: An In Vitro Study. Cureus 2024; 16:e68359. [PMID: 39355471 PMCID: PMC11443300 DOI: 10.7759/cureus.68359] [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: 07/27/2024] [Accepted: 08/28/2024] [Indexed: 10/03/2024] Open
Abstract
Objective This study investigates the antimicrobial properties of silver (1%) and chitosan (1%) nanoparticles against Streptococcus mutans (S. mutans) when added to an orthodontic primer used for aligner attachments. While aligner treatments are becoming increasingly popular for their aesthetics and convenience, their attachments can create retention sites for bacteria, potentially leading to white spot lesions (WSLs). This in vitro study aims to address this issue by enhancing the antimicrobial efficacy of aligner primers. Methodology Thirty freshly extracted teeth were classified into the following three groups: Group A with the standard primer, Group B with chitosan nanoparticles mixed in the primer, and Group C with silver nanoparticles mixed in the primer. The samples were incubated with S. mutans and bacterial colonies were counted at 12, 24, 48, and 72 hours. Results The results showed a significant reduction in colony-forming units (CFUs) in the groups with nanoparticles compared to the control group, with silver nanoparticles exhibiting a higher antimicrobial effect than chitosan. Conclusions This study suggests that incorporating silver nanoparticles into orthodontic primers can effectively reduce bacterial growth, potentially improving oral hygiene and reducing the risk of WSLs in patients undergoing aligner treatment.
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Affiliation(s)
- Ram Mundada
- Department of Orthodontics and Dentofacial Orthopedics, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Saurabh B Tanpure
- Department of Orthodontics and Dentofacial Orthopedics, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Sagar Mapare
- Department of Orthodontics and Dentofacial Orthopedics, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Arjun Karra
- Department of Orthodontics and Dentofacial Orthopedics, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Vijay Yannawar
- Department of Orthodontics and Dentofacial Orthopedics, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Rizwan Gilani
- Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Cen X, Pan X, Wang R, Huang X, Zhao Z. The complex of tannic acid and cetylpyridinium chloride: An antibacterial and stain-removal cleaner for aligners. Am J Orthod Dentofacial Orthop 2024; 165:173-185. [PMID: 37906245 DOI: 10.1016/j.ajodo.2023.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 11/02/2023]
Abstract
INTRODUCTION Effective aligner hygiene is recognized as an important part of orthodontic treatments and oral hygiene. However, there is no effective cleansing method for removable aligners. METHODS In this study, we incorporated tannic acid (TA) with cetylpyridinium chloride (CPC) to develop the TA-CPC complex. The antibacterial properties of 15.8 mg/mL TA-CPC against Escherichia coli and Staphylococcus aureus were evaluated in vitro, which were compared with 5.1 mg/mL TA, 10.7 mg/mL CPC, a commercial denture cleansing solution (YA; 15 mg/mL), and water. As for the assessment of stain-removal ability, the aligners stained by coffee were soaked in cleansing solutions, and the color changes (ΔE∗) were calculated on the basis of the CIE L∗a∗b∗ color system, and the National Bureau of Standards system was used for the clinical interpretation of the color change. Atomic force microscope examination, tensile property assessment, and wavelength dispersive x-ray fluorescence analysis were performed to investigate the material compatibility of TA-CPC, and Cell Counting Kit-8 assay and live/dead assay were used to test the cytotoxicity of TA-CPC. RESULTS The results showed that TA-CPC had a positive zeta-potential, and cation-π interaction changed the chemical environments of the phenyl group in TA-CPC, resulting in greater inhibition zones of S. aureus and E. coli than other cleaners. The quantification of the biofilm biomass and the fluorescent intensities also reflected that the TA-CPC solution exhibited better antibacterial ability. As for the ability of stain removal, ΔE∗ value of group TA-CPC was 2.84 ± 0.55, whereas those of stained aligners immersed with deionized distilled water, TA, YA, and CPC were 10.26 ± 0.04, 9.54 ± 0.24, 5.93 ± 0.36, and 4.69 ± 0.35, respectively. The visual inspection and National Bureau of Standards ratings also showed that the color of stained aligners cleansed by TA-CPC was much lighter than those of the other groups. Meanwhile, TA-CPC had good compatibility with the aligner material and cells. CONCLUSIONS TA-CPC is a promising strategy to inhibit the formation of biofilms and remove the stains on the aligners safely, which may disinfect the aligners to improve oral health and help keep the transparent appearances of aligners without impacting the morphology and mechanical properties.
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Affiliation(s)
- Xiao Cen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuefeng Pan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rong Wang
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China.
| | - Xinqi Huang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Blochberger BL, Symmank J, Nitzsche Á, Nietzsche S, Steiniger F, Guellmar A, Reise M, Sigusch B, Jacobs C, Hennig CL. Influence of the orthodontic bonding procedure on biofilm formation. Orthod Craniofac Res 2024; 27:95-101. [PMID: 37470303 DOI: 10.1111/ocr.12692] [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: 04/05/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION In orthodontics, white spot lesions are a persistent and widespread problem caused by the demineralization of buccal tooth surfaces around bonded brackets. The remaining adhesive around the brackets leads to surface roughness, which might contribute to demineralization. The present in vitro study aimed to compare a conventional and a modern adhesive system (APC Flash-Free technology) for orthodontic brackets with regard to the adhesion of Streptococcus sobrinus, a leading caries pathogen. METHODS This in vitro study included 20 premolar teeth and compared 10 APC Flash-Free adhesive-coated ceramic brackets (FF)with 10 conventionally bonded (CB) ceramic clarity brackets. Specimens were incubated in an S. sobrinus suspension for 3 h. To evaluate the bacterial formation, samples were analysed with a scanning electron microscope (SEM). Imaging software was used to quantify and statistically compare percentage values of colonization (PVC) in both groups' adhesion and transition areas. RESULTS We found a significant difference in biofilm formation between the groups for the adhesive and transition areas. PVC in the adhesive area was approximately 10.3-fold greater for the CB group compared with the FF group (median: 3.2 vs 0.31; P < 0.0001). For the transition area, median PVC was approximately 2.4-fold greater for the CB group compared with the FF group (median: 53.17 vs 22.11; P < 0.01). CONCLUSIONS There was a significantly lower level of S. sobrinus formation around the FF bracket system than there was surrounding the conventionally bonded group. This study suggests that the FF adhesive bracket system can help reduce the occurrence of bacterial growth around orthodontic brackets.
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Affiliation(s)
| | - Judit Symmank
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Ánn Nitzsche
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Sandor Nietzsche
- Electron Microscopy Center, University Hospital Jena, Jena, Germany
| | - Frank Steiniger
- Electron Microscopy Center, University Hospital Jena, Jena, Germany
| | - André Guellmar
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Markus Reise
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Bernd Sigusch
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Collin Jacobs
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Christoph-Ludwig Hennig
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, Jena, Germany
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Wang M, Chen J, Wang Z, Wang Y, Zhang Y, Feng Q, Wei F. Salivary microbiomes vary among orthodontic appliances and associate with clinical periodontal parameters. Orthod Craniofac Res 2024; 27:174-184. [PMID: 37985447 DOI: 10.1111/ocr.12733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE To investigate the salivary bacterial communities during the first 6-month orthodontic treatment with Clear Aligners (CA) and Fixed Appliances (FA), and its correlation with clinical periodontal parameters. MATERIALS AND METHODS Saliva and periodontal parameters were sampled from individuals wearing CA or FA before treatment (T0), and after 3- (T3) and 6-month (T6) treatments. Salivary bacterial communities characterized based on the 16S rRNA V3-V4 region were compared between FA and CA and correlated with clinical periodontal parameters. RESULTS Probing Depth (PD) significantly increased at T6 in the FA group versus T0, whereas it remained stable in the CA group. The Shannon and Pielou indices were significantly higher in the FA group and significantly positively correlated with periodontal inflammation parameters. β-diversity analysis revealed distinct communities between the FA group and CA group at T6. The relative abundances of 3 genera and 15 species were significantly higher in the FA group. Among the above appliance-type related taxa, bacterial genera Selenomonas, Stomatobaculum, Olsenella and Faecalicoccus and bacterial species Selenomonas_sputigena, Dialister_invisus, Olsenella_profus, Prevotella_buccae, Cryptobacterium_curtum and Clostridium_spiroforme were significantly positively associated with periodontal parameters. CONCLUSIONS Orthodontic treatments trigger appliance-related salivary bacterial communities, highlighting the importance of developing appliance-orientated periodontal strategies during orthodontic treatments. Salivary bacterial communities harboured by patients wearing FA possess higher bacterial parameters which were associated with increasing PD, PI and Gingival Index.
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Affiliation(s)
- Mengqiao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Jitian Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Ziyao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Yihua Wang
- Department of Microbiome, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Yue Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Qiang Feng
- Department of Microbiome, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Fulan Wei
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
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Eslami S, Kopp S, Goteni M, Dahmer I, Sayahpour B. Alterations in the surface roughness and porosity parameters of directly printed and Invisalign aligners after 1 week of intraoral usage: An in vivo prospective investigation. Am J Orthod Dentofacial Orthop 2024; 165:73-79. [PMID: 37665312 DOI: 10.1016/j.ajodo.2023.07.013] [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: 03/01/2023] [Revised: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 09/05/2023]
Abstract
INTRODUCTION Direct printing of clear aligners could be the next paradigm shift in modern orthodontics and can potentially overcome the limitation of the indirect production method. This study investigated the effects of 1 week of intraoral usage on the surface roughness parameters of directly printed aligners (DPAs) and commercially produced Invisalign aligners compared with their unused control counterparts using confocal laser scanning microscopy. METHODS The study consisted of 4 groups with 34 samples per group. Unused control aligners were allocated to the control groups (DP-Ctr and INV-Ctr). Sixty-eight patients undergoing clear aligner therapy were allocated to group DP-Clin (patients in therapy using DPAs made from TC-85 DAC resin) and group INV-Clin (patients provided with Invisalign aligners). After 1 week of intraoral usage, the aligners were retrieved from the patients in groups DP-Clin and INV-Clin. Samples were made from the buccal surface of the maxillary right central incisor of each aligner and underwent surface roughness and porosity measuring using confocal laser scanning microscopy. The arithmetic mean deviation of the profile, root mean square deviation, maximum peak height, maximum valley depth, maximum height difference among the highest peak and deepest valley, void volume, and void count were measured. Descriptive analysis and median (quantile) regression models were used for data analysis of this experiment. RESULTS One week of intraoral usage significantly increased the surface roughness and porosity of DPAs. In contrast, a significant reduction in the surface roughness and porosity parameters of Invisalign aligners was recorded after intraoral service. CONCLUSIONS This study suggests an increase in the surface roughness and surface porosity of DPAs following 1 week of intraoral usage, which might lead to an increase in bacterial adhesion and biofilm formation in these aligners.
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Affiliation(s)
- Sara Eslami
- Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt, Germany.
| | - Stefan Kopp
- Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt, Germany
| | | | - Iulia Dahmer
- Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt, Germany
| | - Babak Sayahpour
- Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt, Germany
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Rouzi M, Zhang X, Jiang Q, Long H, Lai W, Li X. Impact of Clear Aligners on Oral Health and Oral Microbiome During Orthodontic Treatment. Int Dent J 2023; 73:603-611. [PMID: 37105789 PMCID: PMC10509397 DOI: 10.1016/j.identj.2023.03.012] [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: 12/23/2022] [Revised: 03/19/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
The demand for clear aligners has risen over the past decade because they satisfy patients' desire for less noticeable and more comfortable orthodontic appliances. Because clear aligners are increasingly used in orthodontics, there is a big push to learn more about the physiologic and microbial changes that occur during treatment. The present work highlighted further links between clear aligners and changes in oral health and the oral microbiome and provided plaque control methods for clear aligner trays. Existing literature revealed that clear aligners have no significant influence on the structure of the oral microbiome during orthodontic therapy. Clear aligner treatment demonstrated promising results in terms of controlling plaque index, gingival health, and the prevalence of white spot lesions. Nevertheless, grooves, ridges, microcracks, and abrasions on the aligner surface would provide a prime environment for bacterial adherence and the development of plaque biofilms. A combination of mechanical and chemical methods seems to be a successful approach for removing plaque biofilm from aligners whilst also preventing pigment adsorption.
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Affiliation(s)
- Maierdanjiang Rouzi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoqi Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Qingsong Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Hu Long
- Department of Orthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- Department of Orthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Xiaolong Li
- Department of Orthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Vas NV, Jain RK, Ramachandran SK. Gingerol and Chitosan-Based Coating of Thermoformed Orthodontic Aligners: Characterization, Assessment of Anti-Microbial Activity, and Scratch Resistance: An In Vitro Study. Cureus 2023; 15:e42933. [PMID: 37674946 PMCID: PMC10477816 DOI: 10.7759/cureus.42933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023] Open
Abstract
Aim To prepare and characterize a 6-gingerol-incorporated chitosan biopolymer for coating on thermoformed aligners and evaluate its scratch resistance and antimicrobial activity. Material and methods In this in vitro study, 6-gingerol extract was prepared, incorporated with chitosan biopolymer into a coating solution and characterized using nuclear magnetic resonance imaging spectroscopy (NMR). Twenty thermoformed aligner samples were exposed to UV radiation for surface activation, then coated with a crosslinking agent. These were divided into four groups of five. The control group consisted of samples dip-coated in a chitosan solution for 15 minutes. The three test groups consisted of samples dip coated in a gingerol-chitosan coating solution, with each group representing the following time periods of dip coating: five, 10, and 15 minutes. The crosslinking of the coating with the aligner material was confirmed by a Fourier transform infrared spectroscopy (FTIR) test. A scratch test was carried out to evaluate the wear resistance of the coating, and the antibacterial properties of the coating were tested using a Disc Diffusion test. Results The NMR analysis confirmed the presence of 6-gingerol in the extract. The coating of 6-Gingerol on aligners was confirmed by FTIR spectroscopy. The wear resistance of aligners coated for 5 minutes, 10 minutes, and 15 minutes was 1.8 ± 0.09 N, 2.3 ± 0.021 N, and 3.06 ± 0.17 N, respectively, and the difference was statistically significant (p<0.05). The aligner coated for 15 minutes exhibited the widest zone of inhibition of up to 2.38 ± 0.44 mm against Streptococcus mutans, and the difference was statistically significant (p<0.05). No antibacterial effect was found against E. Coli. Conclusion A novel coating material with 6-gingerol extract incorporated in chitosan biopolymer was prepared and characterized, followed by coating on thermoformed aligners. The coating showed antibacterial activity against Streptococcus mutans, and both the antimicrobial activity and wear resistance increased with coating duration.
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Affiliation(s)
- Nazleen Valerie Vas
- Department of Orthodontics, Saveetha Dental College and Hospitals, Chennai, IND
| | - Ravindra Kumar Jain
- Department of Orthodontics, Saveetha Dental College and Hospitals, Chennai, IND
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Lira LF, Otero Amaral Vargas E, Moreira da Silva E, Nunes da Silva Meirelles Dória Maia J, Elzubair A, Siqueira de Morais L, Alvaro de Souza Camargo S, Serra G, Gomes de Souza MM. Effect of oral exposure on chemical, physical, mechanical, and morphologic properties of clear orthodontic aligners. Am J Orthod Dentofacial Orthop 2023; 164:e51-e63. [PMID: 37330727 DOI: 10.1016/j.ajodo.2023.05.015] [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: 11/01/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION The dental industry is heavily committed to developing more esthetic solutions for orthodontic treatments. Invisalign is a system of transparent orthodontic aligners introduced as an alternative to conventional orthodontic fittings with brackets and metal wires. This study aimed to assess the chemical, physical, mechanical and morphologic changes in these polymeric aligners after exposure to the oral environment. METHODS Twenty-four Invisalign orthodontic aligners were equally divided into 2 groups: an in vivo aged group in which patients used aligners for 14 days and the reference group, unexposed to the oral environment. Different experimental techniques were used to study the chemical structure, the color changes and translucency, the density and subsequent volume of the aligners, mechanical properties, surface roughness, morphology and elemental composition. The data were subjected to several statistical analyses. RESULTS Clear orthodontic aligners exhibit chemical stability but undergo a statistically significant optical change in color and translucency. There was a gradual increase in the water absorption rate and the dimensional variation of the polymer, indicating a strong correlation among these factors. The mechanical properties of the polymer showed a statistically significant decrease in its elastic modulus and hardness. There was a slight tendency toward increased surface roughness of the material, but no statistical differences were found between reference and aged groups. The surface morphology of the used aligners demonstrates microcracks, distortions and biofilm formation. CONCLUSION Intraoral aging adversely affected the physical, mechanical, and morphologic properties of the Invisalign appliance.
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Affiliation(s)
- Larine Ferreira Lira
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eduardo Otero Amaral Vargas
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eduardo Moreira da Silva
- Analytical Laboratory of Restorative Biomaterials-LABiom-R, School of Dentistry, Federal Fluminense University, Niterói, Brazil
| | | | - Amal Elzubair
- Metallurgical and Materials Engineering Program, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering (COPPE), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Liliane Siqueira de Morais
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sérgio Alvaro de Souza Camargo
- Metallurgical and Materials Engineering Program, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering (COPPE), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Nanotechnology Engineering Program, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Glaucio Serra
- Department of Specific Formation, Federal Fluminense University, Nova Friburgo, Brazil
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11
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Belayutham S, Wan Hassan WN, Razak FA, Mohd Tahir NNZ. Microbial adherence on vacuum-formed retainers with different surface roughness as constructed from conventional stone models and 3D printed models: a randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04940-4. [PMID: 36947263 PMCID: PMC10031723 DOI: 10.1007/s00784-023-04940-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This single center parallel, randomized controlled trial aimed to determine the propensity of microbial adherence on vacuum-formed retainers (VFRs) with different surface roughness imprints. MATERIALS AND METHODS Thirty-six patients debonded from fixed appliances at a teaching institution were allocated by block randomization stratified for gender to three groups [VFRs fabricated on conventional, fused deposition modeling (FDM) or stereolithography apparatus (SLA) working models]. Participants wore the VFRs for three months full-time followed by three months part-time. VFRs were collected after each follow-up for Streptococcus and yeast counts. Surface roughness was measured indirectly on the working models using a 3D optical surface texture analyzer. Blinding was not feasible due to appliance appearance. The trial was registered [NCT03844425 ( ClinicalTrials.gov )] and funded by the Universiti Malaya Dental Postgraduate Research Grant (DPRG/14/19). RESULTS Thirty participants (eleven conventional, ten FDM, and nine SLA) were analyzed after six dropped out. No harms were reported. Microbial counts between the groups were not significantly different. There were more microbes in the lower VFRs than upper VFRs (total count: p<0.05; effect size, 0.5 during full-time wear and 0.4 during part-time wear). SLA had significantly (p<0.05) smoother surface than FDM (effect size, 0.3) and conventional models (effect size, 0.5). Microbial adherence was not associated with working model surface roughness. CONCLUSION Microbial adherence on VFRs was not influenced by degree of surface roughness imprints from working models. CLINICAL RELEVANCE 3D printed models can be used to make VFRs. Lower VFRs tended to accumulate oral microbes, potentially increasing the oral health risk in the lower arch.
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Affiliation(s)
- Sonia Belayutham
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Wan Nurazreena Wan Hassan
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Fathilah Abdul Razak
- Department of Oral and Craniofacial Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
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12
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Cao L, Yan J, Luo T, Yan H, Hua F, He H. Antibacterial and fluorescent clear aligner attachment resin modified with chlorhexidine loaded mesoporous silica nanoparticles and zinc oxide quantum dots. J Mech Behav Biomed Mater 2023; 141:105817. [PMID: 37015147 DOI: 10.1016/j.jmbbm.2023.105817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES To develop an antibacterial and fluorescent clear aligner attachment resin via the incorporation of chlorhexidine loaded pore-expanded mesoporous silica nanoparticles (CHX@pMSN) and amino-silane functionalized zinc oxide quantum dots (aZnOQDs), and to evaluate its antibacterial activity, fluorescence capability, esthetic properties, mechanical performance and biocompatibility. METHODS CHX@pMSN and aZnOQDs were incorporated into the commercial resin composites (Filtek Z350 XT, 3M) at different mass fractions, control group: Filtek; fluorescent attachment resin (FAR): Filtek + 3 wt% aZnOQDs; antibacterial and fluorescent attachment resin (AFAR)-1: Filtek + 3 wt% aZnOQDs + 1 wt% CHX@pMSN; AFAR-2: Filtek + 3 wt% aZnOQDs + 3 wt% CHX@pMSN; AFAR-3: Filtek + 3 wt% aZnOQDs + 5 wt% CHX@pMSN. CHX release, antibacterial activity, fluorescence capability, color change, stain resistance, degree of conversion, depth of cure, polymerization shrinkage, water sorption and solubility, softening in solvent, flexural strength, flexural modulus, shear bond strength, and cytotoxicity were evaluated comprehensively. RESULTS CHX could be continuously released from the AFAR groups for up to 30 days. CFU, MTT, lactic acid production, SEM and CLSM evaluation showed AFAR-2 and AFAR-3 could effectively inhibit S. mutans biofilms even after 1-month aging. Only AFAR-3 showed clinically perceptible color change and all the experimental groups were not more susceptible to staining. AFAR-1 and AFAR-2 could suppress polymerization shrinkage and enhance the resistance to degradation without compromising other properties, including degree of conversion, water sorption and solubility, flexural strength, flexural modulus, and shear bond strength. Depth of cure of all the four experimental groups was significantly decreased (p < 0.05) but still within the ISO standard. CCK-8 assay and live/dead cell staining denied the cytotoxicity of experimental resins. Fluorescence intensity tests showed that FAR and AFAR-2 could emit strong yellowish fluorescence under the excitation of ultraviolet for up to six months. CONCLUSIONS AFRA-2 possessed long-term antibiofilm activity, strong fluorescence capability and satisfying biocompatibility without compromising esthetic and mechanical properties. This study proposed a new strategy for reducing bacteria accumulation around the attachment, which is also promising in helping orthodontists to remove the attachment thoroughly and precisely.
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Baybekov O, Stanishevskiy Y, Sachivkina N, Bobunova A, Zhabo N, Avdonina M. Isolation of Clinical Microbial Isolates during Orthodontic Aligner Therapy and Their Ability to Form Biofilm. Dent J (Basel) 2023; 11:dj11010013. [PMID: 36661550 PMCID: PMC9858208 DOI: 10.3390/dj11010013] [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: 11/21/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 01/04/2023] Open
Abstract
The purpose of this study is to calculate microbiological composition of aligners after a day of wearing them. To date, the dental market for orthodontists offers many ways to correct bites. Aligners are transparent and almost invisible from the teeth. They are used for everyday wear to correct the incorrect position of the teeth, which was once considered the prerogative of braces. Scientists worldwide have repeatedly considered questions regarding the interaction between aligners and the oral cavity's microflora; however, the emphasis has mainly shifted toward species composition and antibiotic resistance. The various properties of these microorganisms, including biofilm formation, adhesion to various cells, and the ability to phagocytize, have not been studied so widely. In addition, these characteristics, as well as the microorganisms themselves, have properties that change over time, location, and in certain conditions. In this regard, the problem of biofilm formation in dental practice is always relevant. It requires constant monitoring since high contamination of orthodontic materials can reduce the effectiveness of local anti-inflammatory therapy and cause relapses in caries and inflammatory diseases of the oral cavity. Adhesive properties, one of the key factors in forming the architectonics of biofilms, provide the virulence factors of microorganisms and are characterized by an increase in optical density, determining the duration and retrospectivity of diagnostic studies. This paper focuses on the isolation of clinical microbial isolates during aligner therapy and their ability to form biofilms. In the future, we plan to use the obtained strains of microorganisms to create an effective and safe biofilm-destroying agent. We aimed to study morphometric and densitometric indicators of biofilms of microorganisms persisting on aligners.
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Affiliation(s)
- Oleg Baybekov
- Institute of Biochemical Technology and Nanotechnology, Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Yaroslav Stanishevskiy
- Institute of Biochemical Technology and Nanotechnology, Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Nadezhda Sachivkina
- Department of Microbiology V.S. Kiktenko, Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- Correspondence:
| | - Anna Bobunova
- Department of Foreign Languages, Institute of Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Natallia Zhabo
- Department of Foreign Languages, Institute of Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Marina Avdonina
- Department of Linguistics and Intercultural Communication, Moscow State Linguistic University, 119034 Moscow, Russia
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Comparison of Various Antimicrobial Agents for Thermoplastic Polymeric Retainers. Polymers (Basel) 2022; 14:polym14183753. [PMID: 36145897 PMCID: PMC9502766 DOI: 10.3390/polym14183753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/21/2022] [Accepted: 09/02/2022] [Indexed: 11/26/2022] Open
Abstract
The thermoplastic retainers indicated a rising incidence of cariogenic bacteria such as Streptococcus mutans. A report suggested the case of a patient with severe gingival inflammation and dental caries as a result of inadequate appliance cleaning. This study aims to compare the various antimicrobial agents for thermoplastic polymeric retainers. A minimum bactericidal concentration (MBC) of acetic acid was determined. Streptococcus mutans biofilm was formed on punched 4-mm copolyester (Essix ACE®) and polyurethane (Vivera®) retainers after they were submerged in 0.12% chlorhexidine (CHX group), acetic acid (AA group), Polident Denture Cleanser® (PD group), and Polident Pro Guard & Retainer® (PR group). A crystal violet (CV) test was performed. The biofilm imaging was assessed by confocal laser scanning microscopy (CLSM). The results showed that all chemical disinfectants exhibited statistically significant differences (p < 0.05) compared to the positive control. This novel finding elucidated that 0.625% acetic acid is effective for antimicrobial in both copolyester and polyurethane retainers. However, only the CHX, PD, and PR groups could reduce biofilm mass. In addition, the CV assay cannot provide information about the actual number of living and dead bacteria. Furthermore, the LIVE/DEAD BacLight assay was able to show the bacterial viability.
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15
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Sun F, Hu W, Zhao Y, Li Y, Xu X, Li Y, Zhang H, Luo J, Guo B, Ding C, Li J. Invisible assassin coated on dental appliances for on-demand capturing and killing of cariogenic bacteria. Colloids Surf B Biointerfaces 2022; 217:112696. [PMID: 35834998 DOI: 10.1016/j.colsurfb.2022.112696] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 02/08/2023]
Abstract
The accumulation of microbes on long-wear artificial dental materials creates a great risk for oral diseases and causes deterioration of material properties. Therefore, smart antibacterial materials capable of resisting the colonization of microorganisms and simultaneously eliminating pathogenic bacteria as needed show outstanding superiority for the recovery of dental health, which are scarcely reported until now. Here, we present a responsive hydrogel coating as invisible assassin on clear overlay appliances target for dental caries. Taking advantage of pH-responsive carboxybetaine methacrylate-dimethylaminoethyl methacrylate copolymer P(CBMA-co-DMAEMA) and antibacterial peptides, the surface potential of hydrogel shifts positively, accompanied with the release of antibacterial peptides when pH gets lower. The hybrid hydrogel layer hence exerts antifouling property and resists bacterial adhesion in normal physiological, while captures and kills cariogenic bacteria in acidic condition. This biocompatible, transparent and stable hydrogel coating has little influence for the aesthetics and mechanical properties of bulk materials. The strategy developed here can provide reference for the design of biomedical devices in other areas.
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Affiliation(s)
- Fan Sun
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Wei Hu
- Medical School of Chinese People's Liberation Army (PLA), Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yao Zhao
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Yike Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Xiaoyang Xu
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Yanyan Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Hongbo Zhang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Jun Luo
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Bin Guo
- Medical School of Chinese People's Liberation Army (PLA), Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Chunmei Ding
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China.
| | - Jianshu Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Med-X Center for Materials, Sichuan University, China.
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16
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Park SH, Kim K, Cho S, Chung DH, Ahn SJ. Variation in adhesion of Streptococcus mutans and Porphyromonas gingivalis in saliva-derived biofilms on raw materials of orthodontic brackets. Korean J Orthod 2022; 52:278-286. [PMID: 35678009 PMCID: PMC9314218 DOI: 10.4041/kjod21.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
Objective To evaluate differences in the adhesion levels of the most common oral pathogens, Streptococcus mutans and Porphyromonas gingivalis, in human saliva-derived microcosm biofilms with respect to time and raw materials of orthodontic brackets. Methods The samples were classified into three groups of bracket materials 1) monocrystalline alumina ceramic (CR), 2) stainless steel metal (SS), and 3) polycarbonate plastic (PL), and a hydroxyapatite (HA) group was used to mimic the enamel surface. Saliva was collected from a healthy donor, and saliva-derived biofilms were grown on each sample. A real-time polymerase chain reaction was performed to quantitatively evaluate differences in the attachment levels of total bacteria, S. mutans and P. gingivalis at days 1 and 4. Results Adhesion of S. mutans and P. gingivalis to CR and HA was higher than the other bracket materials (SS = PL < CR = HA). Total bacteria demonstrated higher adhesion to HA than to bracket materials, but no significant differences in adhesion were observed among the bracket materials (CR = SS = PL < HA). From days 1 to 4, the adhesion of P. gingivalis decreased, while that of S. mutans and total bacteria increased, regardless of material type. Conclusions The higher adhesion of oral pathogens, such as S. mutans and P. gingivalis to CR suggests that the use of CR brackets possibly facilitates gingival inflammation and enamel decalcification during orthodontic treatment.
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Affiliation(s)
- So-Hyun Park
- Department of Orthodontics, Dankook University Jukjeon Dental Hospital, Yongin, Korea
| | - Kyungsun Kim
- Dental Research Institute and Department of Oral Microbiology and Immunology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Soha Cho
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Dong-Hwa Chung
- Department of Orthodontics, Dankook University Jukjeon Dental Hospital, Yongin, Korea
| | - Sug-Joon Ahn
- Dental Research Institute and Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
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Kiatwarawut K, Rokaya D, Sirisoontorn I. Antimicrobial Activity of Various Disinfectants to Clean Thermoplastic Polymeric Appliances in Orthodontics. Polymers (Basel) 2022; 14:polym14112256. [PMID: 35683929 PMCID: PMC9183154 DOI: 10.3390/polym14112256] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022] Open
Abstract
There is a lack of research evidence on the risk–benefits of the various disinfectants in cleaning products and cleansing regimens. This systematic review compared the antimicrobial activity of various chemical disinfectants to disinfect the thermoplastic polymeric appliances in orthodontics. The study was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane Handbook of Systematic Reviews of Interventions. An electronic search was conducted on Pubmed, Google Scholar, Scopus, ScienceDirect, and Springer. Two authors independently investigated the risk of bias in duplication. A total of 225 articles were collected. After removing duplicates, 221 articles remained, and after filtering their titles and abstracts, 11 articles met eligibility qualifications remained. Finally, nine articles that met the criteria were selected. It showed that both over-the-counter orthodontic appliance cleaners and applied-chemical disinfectants were effective against bacteria. The duration and frequency of usage guidelines cannot be concluded.
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18
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Lee SY, Kim H, Kim HJ, Chung CJ, Choi YJ, Kim SJ, Cha JY. Thermo-mechanical properties of 3D printed photocurable shape memory resin for clear aligners. Sci Rep 2022; 12:6246. [PMID: 35428796 PMCID: PMC9012852 DOI: 10.1038/s41598-022-09831-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/14/2022] [Indexed: 11/22/2022] Open
Abstract
To overcome the limitations of the conventional vacuum thermoforming manufacturing method, direct 3D printing of clear aligners has been developed. The present study investigated the thermo-mechanical and viscoelastic properties of a photocurable resin TC-85, which is a new material for the direct 3D printed clear aligners, comparing to a conventional thermoplastic material polyethylene terephthalate glycol. Dynamic mechanical analysis was performed to analyse the mechanical behaviours of the two materials at 37 °C and 80 °C, respectively. Furthermore, the shape memory property of the two materials was evaluated using a U-shape bending test, and the shape recovery ratio for 60 min at 37 °C was calculated. The results indicate that TC-85 can constantly apply a light force to the teeth when used for the 3D printed clear aligners, owing to its flexibility and viscoelastic properties. In addition, it is expected that the force decay induced by repeated insertion of the clear aligners will be reduced and a constant orthodontic force will be maintained. Furthermore, its geometric stability at high temperatures and the shape memory properties provide advantages for the clinical application.
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Affiliation(s)
- Se Yeon Lee
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hoon Kim
- Research Institute of Agriculture and Life Sciences, College of Agriculture and Life Sciences, Seoul National University, Seoul, Korea.,Graphy Inc., Graphy R&D Center, Seoul, Korea
| | - Hyun-Joong Kim
- Research Institute of Agriculture and Life Sciences, College of Agriculture and Life Sciences, Seoul National University, Seoul, Korea.,Laboratory of Adhesion and Bio-Composites, Department of Agriculture, Forestry and Bioresources, Seoul National University, Seoul, Korea
| | - Chooryung J Chung
- Department of Orthodontics, Gangnam Severance Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Su-Jung Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Jung-Yul Cha
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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Charavet C, Gourdain Z, Graveline L, Lupi L. Cleaning and Disinfection Protocols for Clear Orthodontic Aligners: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10020340. [PMID: 35206954 PMCID: PMC8871989 DOI: 10.3390/healthcare10020340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 01/25/2023] Open
Abstract
(1) Background: Clear orthodontic aligners support the development of oral biofilms, which could lead to interferences with the oral microbiota already existing and the deterioration of oral health, with the development of dental caries, periodontal disease and even systemic infections. Therefore, preventive oral health care requires a cleaning and disinfection procedure for aligners. (2) Methods: A systematic review of the literature was conducted across four databases following the PRISMA guidelines up to May 2021, combining an electronic and a manual search. Prospective studies, including randomized controlled trials (RCTs), crossover studies (COSs) and controlled clinical trials (CCTs), published in the English language without time restrictions, evaluating the efficacy of cleaning and disinfection protocols for clear orthodontic aligners by comparing them with a placebo or a negative control, were included. The article selection, data extraction and risk of bias assessment were performed by two independent blinded review authors. In case of disagreement, a third author was solicited throughout the selection process. (3) Results: Among the 221 articles screened in the search process, 4 studies were included in the review, all designed as crossover studies (single arm without randomization with the same sequence of different cleaning and disinfection protocols for each participant). Different cleaning and disinfection methods were studied such as mechanical methods (brushing with toothpaste or vibration), chemical methods/pharmaceutical products (chlorhexidine antibacterial substance, anionic or cationic detergents or effervescent tablets) or combinations of both. (4) Conclusion: Although the determination of the most remarkable method of cleaning and disinfection was impossible because no direct comparison was conducted between all these methods, a multi-step protocol, including the combination of a mechanical and a chemical method, seems to be the most effective approach. Further research is needed to define the most preventive oral health care protocol. Registration: PROSPERO CRD 42021278498.
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Affiliation(s)
- Carole Charavet
- Université Côte d’Azur, Faculté de Chirurgie Dentaire, Département d’Orthodontie, 06800 Nice, France
- Centre Hospitalier Universitaire de Nice, Pôle Odontologie, 06000 Nice, France; (Z.G.); (L.G.)
- Laboratoire MICORALIS UPR 7354, Université Côte d’Azur, 06800 Nice, France
- Correspondence: or
| | - Zoé Gourdain
- Centre Hospitalier Universitaire de Nice, Pôle Odontologie, 06000 Nice, France; (Z.G.); (L.G.)
- Université Côte d’Azur, Faculté de Chirurgie Dentaire, 06800 Nice, France
| | - Léa Graveline
- Centre Hospitalier Universitaire de Nice, Pôle Odontologie, 06000 Nice, France; (Z.G.); (L.G.)
- Université Côte d’Azur, Faculté de Chirurgie Dentaire, 06800 Nice, France
| | - Laurence Lupi
- Centre Hospitalier Universitaire de Nice, Pôle Odontologie, 06000 Nice, France; (Z.G.); (L.G.)
- Laboratoire MICORALIS UPR 7354, Université Côte d’Azur, 06800 Nice, France
- Université Côte d’Azur, Faculté de Chirurgie Dentaire, Département de Santé Publique, 06800 Nice, France;
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AlSamak S, Hamdoon S, Ahmed M, Gasgoos S. Evaluation of biofilm formation on different clear orthodontic retainer materials. J Orthod Sci 2022; 11:34. [PMID: 36188210 PMCID: PMC9515562 DOI: 10.4103/jos.jos_7_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/11/2022] Open
Abstract
Aim: To assess the chemical composition and oral biofilm formation on different types of commercially available clear orthodontic retainer materials (CORM). Materials and Methods: Four types of CORM commercially available were used (Clear advantage series I (CAS1), Clear advantage series II (CAS2), Endure (ES), and CENTRI FORM-clear rigid material (CFCRM)). Circular samples (12 mm diameter) of each CORM were prepared for (n = 40). Unstimulated saliva from twenty volunteers was collected. Fourier Transformation Infrared Spectroscopy (FTIR) was used for the evaluation of the chemical composition of CORM. For the quantitative assessment of oral biofilm formation, samples of each CORM were incubated for twenty-four hours, and crystal violet assay (CVA) was utilized. The degree of absorbance was measured using a spectrophotometer at 570 nm. For qualitative evaluation of oral formation, the samples of each CORM were incubated for 24 hours, and viable biofilm cells stained by acridine orange were examined under a fluorescent microscope. Results: FTIR findings showed that CAS2 was made of polypropylene and ES is made of polyvinyl chloride, while others were made of co-polyester. CVA results confirmed that CAS2 showed the lowest biofilm formation, which differs significantly compared to CAS1, CFCRM, and ES. No significant difference in biofilm formation was detected between CAS1, CFCRM, and ES. Viable biofilm cells staining by acridine orange showed that CAS2 demonstrated smaller microcolonies of viable biofilm cells compared with CAS1, CFCRM, and ES, which confirmed the result obtained by CVA. Conclusions: CAS2 showed anti-microbial activities with a decrease the in vitro biofilm formation, which may be related to its chemical composition.
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Da Jason CS, Seneviratne CJ, Wong HC, Yow M. Effects of Hawley, Essix, and Vivera ® retainers on salivary properties, oral hygiene, and Streptococcus mutans levels: A prospective clinical pilot study. APOS TRENDS IN ORTHODONTICS 2021. [DOI: 10.25259/apos_5_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
The objectives of the study were to investigate the in vitro and in vivo effects of various removable orthodontic retainer materials on clinical and microbiological parameters, specifically on saliva characteristics, oral hygiene, and salivary levels of Streptococcus mutans (S. mutans).
Materials and Methods:
This study consists of two parts: An in vitro study and in vivo prospective clinical pilot study. The in vitro study measures surface roughness and S. mutans adhesion of three orthodontic retainer materials: Polymethylmethacrylate (PMMA) used in traditional Hawley removable retainers, polypropylene (PP), and polyurethane (PU) used in vacuum-formed retainers. In the clinical pilot study, 20 subjects, on completion of orthodontic treatment were randomized into three groups to receive PMMA, PP, or PU removable orthodontic retainers. They were compared with control subjects with no orthodontic treatment and retainers. Quantitative analysis of salivary S. mutans using real-time polymerase chain reaction was performed to screen for differences during retainer issue (T0) and 8–15 weeks later (T1). Salivary flow rate, pH, buffering capacity, and plaque scores were also recorded at these two periods for comparison.
Results:
PMMA had significantly greater surface roughness and S. mutans adhesion than PP and PU (P = 0.027). The PMMA group displayed significantly greater amounts of salivary S. mutans count when compared to the PP (0.001) and PU (P = 0.011) groups.
Conclusion:
PMMA retainers showed increased S. mutans adhesion and intra-oral colonization of S. mutans compared to PP and PU retainers. The results validate further clinical testing for a relationship between caries risk and type of retainer prescribed.
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Affiliation(s)
| | | | - Hung Chew Wong
- Research Support Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,
| | - Mimi Yow
- Department of Orthodontics, National Dental Centre, Singapore,
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22
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Yan D, Liu Y, Che X, Mi S, Jiao Y, Guo L, Li S. Changes in the Microbiome of the Inner Surface of Clear Aligners After Different Usage Periods. Curr Microbiol 2021; 78:566-575. [PMID: 33392671 DOI: 10.1007/s00284-020-02308-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
Clear aligners are removable orthodontic appliances that cover the tooth surface. The microbial composition and pH of the inner surface of aligners directly affect the enamel health. In this study, eight subjects who used the same type of clear aligners were instructed to brush their teeth normally and to not clean their aligners until sampling. Saliva and the contents of the inner surface of the aligners (liquid and plaque) were collected at 0 h (T0), 4 h (T4), 8 h (T8), 12 h (T12), and 24 h (T24) after usage, and pH values and microbial compositions were measured. The microbial composition was analyzed with 16S rRNA gene sequencing, and changes were assessed based on operational taxonomic unit abundance. The pH, alpha diversity values, and abundance of specific microbes on the inner surface of the aligners gradually decreased from T0 to T24 (P < 0.05). An insignificant increase in microbial community beta diversity was observed from T0 to T24. Principal component analysis revealed that the microbial composition at T0 was different from at T12 and T24. The relative abundances of phylum Firmicutes (P < 0.01), orders Lactobacillales and Bacteroidales (P < 0.05), and genus Streptococcus and species Streptococcus infantis increased significantly, while those of genera Actinomyces and Rothia and species Rothia aeria decreased significantly at T24 (P < 0.05). These findings reveal that uncleaned aligners might lead to enamel damage, especially after continuous usage for 12 h. Thus, clear aligners should be cleaned after 12 h of usage or at least within 24 h of usage.
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Affiliation(s)
- Dong Yan
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yi Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiaoxia Che
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Sicong Mi
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yao Jiao
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Lijia Guo
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China.
| | - Song Li
- Department of Orthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, People's Republic of China.
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Tektas S, Thurnheer T, Eliades T, Attin T, Karygianni L. Initial Bacterial Adhesion and Biofilm Formation on Aligner Materials. Antibiotics (Basel) 2020; 9:antibiotics9120908. [PMID: 33333723 PMCID: PMC7765154 DOI: 10.3390/antibiotics9120908] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/17/2022] Open
Abstract
The present study aims to assess the initial bacterial adhesion and biofilm formation on different aligner materials. A total of four different aligner materials, CA-medium (CAM), copolyester (COP), Duran (DUR), Erkodur (ERK), were tested. Stimulated human saliva was obtained from six healthy volunteers. Salivary bacteria were harvested by centrifugation, and 1 mL of the salivary suspension was injected onto each sample surface for 2 h and 3 days, respectively. The samples were then washed twice with 5 mL 0.9% NaCl solution, and non-adherent bacteria were removed. The adherent microorganisms were dislodged from the sample surfaces after ultrasonication for 4 min in 1 mL 0.9% NaCl on ice. After the incubation of the adherent salivary bacteria under both aerobic and anaerobic conditions on Columbia blood agar plates at 37 °C and 5% CO2 and in anaerobic jars overnight, several dilutions thereof were used for the determination of CFUs. This protocol was applied three times, obtaining an average of nine independent measurements for each material group. Overall, the differences between the tested aligner materials as well as between the materials and controls were not of statistical significance (p > 0.05). Regarding initial bacterial attachment and biofilm formation, the tested aligner materials are comparable to enamel and metal orthodontic brackets and can be therefore considered for clinical use. The four tested aligner materials CAM, COP, DUR, ERK showed no significant differences in initial microbial attachment and biofilm formation of aerobic and anaerobic species compared to enamel and conventional brackets.
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Affiliation(s)
- Sibel Tektas
- Clinic of Orthodontics and Paediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (S.T.); (T.E.)
| | - Thomas Thurnheer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (T.T.); (T.A.)
| | - Theodore Eliades
- Clinic of Orthodontics and Paediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (S.T.); (T.E.)
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (T.T.); (T.A.)
| | - Lamprini Karygianni
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (T.T.); (T.A.)
- Correspondence: ; Tel.: +41-44-634-3275
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24
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Jeon DM, An JS, Lim BS, Ahn SJ. Orthodontic bonding procedures significantly influence biofilm composition. Prog Orthod 2020; 21:14. [PMID: 32476070 PMCID: PMC7261716 DOI: 10.1186/s40510-020-00314-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Because changes in surface properties affect bacterial adhesion, orthodontic bonding procedures may significantly influence biofilm formation and composition around orthodontic appliances. However, most studies used a mono-species biofilm model under static conditions, which does not simulate the intraoral environment and complex interactions of oral microflora because the oral cavity is a diverse and changeable environment. In this study, a multi-species biofilm model was used under dynamic culture conditions to assess the effects of the orthodontic bonding procedure on biofilm formation and compositional changes in two main oral pathogens, Streptococcus mutans and Porphyromonas gingivalis. METHODS Four specimens were prepared with bovine incisors and bonding adhesive: untreated enamel surface (BI), enamel surface etched with 37% phosphoric acid (ET), primed enamel surface after etching (PR), and adhesive surface (AD). Surface roughness (SR), surface wettability (SW), and surface texture were evaluated. A multi-species biofilm was developed on each surface and adhesion amounts of Streptococcus mutans, Porphyromonas gingivalis, and total bacteria were analyzed at day 1 and day 4 using real-time polymerase chain reaction. After determining the differences in biofilm formation, SR, and SW between the four surfaces, relationships between bacteria levels and surface properties were analyzed. RESULTS The order of SR was AD < PR < BI < ET, as BI and ET showed more irregular surface texture than PR and AD. For SW, ET had the greatest value followed by PR, BI, and AD. S. mutans and P. gingivalis showed greater adhesion to BI and ET with rougher and more wettable surfaces than to AD with smoother and less wettable surfaces. The adhesion of total bacteria and S. mutans significantly increased over time, but the amount of P. gingivalis decreased. The adhesion amounts of all bacteria were positively correlated with SR and SW, irrespective of incubation time. CONCLUSIONS Within the limitations of this study, changes in SR and SW associated with orthodontic bonding had significant effects on biofilm formation and composition of S. mutans and P. gingivalis.
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Affiliation(s)
- Da-Mi Jeon
- Department of Orthodontics, School of Dentistry, Seoul National University, 101 Deahak-ro, Jongro-Gu, Seoul, 03080, Republic of Korea
| | - Jung-Sub An
- Department of Orthodontics, Seoul National University Dental Hospital, Jongro-Gu, Seoul, 03080, Republic of Korea
| | - Bum-Soon Lim
- Dental Research Institute and Department of Dental Biomaterials, Seoul National University Dental Hospital, Jongro-Gu, Seoul, 03080, Republic of Korea
| | - Sug-Joon Ahn
- Dental Research Institute and Department of Orthodontics, Seoul National University School of Dentistry, 101 Daehakro, Jongro-Gu, Seoul, 03080, Republic of Korea.
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Zhao R, Huang R, Long H, Li Y, Gao M, Lai W. The dynamics of the oral microbiome and oral health among patients receiving clear aligner orthodontic treatment. Oral Dis 2020; 26:473-483. [PMID: 31418980 DOI: 10.1111/odi.13175] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVES This 6-month prospective clinical study assessed the impacts of Invisalign appliances on the oral bacterial community and oral health of patients. METHODS Salivary samples were obtained from twenty-five adult patients receiving Invisalign aligner treatment before the treatment (Group B) and at a 6-month follow-up (Group P). The bacterial composition of each sample was determined using Illumina MiSeq sequencing of the bacterial 16S rRNA. Intra- and intergroup biodiversity was analyzed. Clinical periodontal parameters and daily oral hygiene habits were recorded. RESULTS Reduction in plaque, increased daily brushing frequency, and decreased dessert intake were observed in Group P compared with that in Group B. A total of 1,853,952 valid reads were obtained from the 50 salivary samples, with 37,904 sequences per sample. No significant differences were detected in the intra- and intergroup biodiversity comparisons between the two groups. By clustering, 8,885 OTUs were identified and categorized into six major phyla: Firmicutes, Proteobacteria, Bacteroidetes, Fusobacteria, Actinobacteria, and Candidate_division_TM7_norank. At the genus level, compared with Group B, Group P demonstrated significantly increased Bacillus abundance and decreased Prevotella abundance. CONCLUSIONS Our results suggested that the general biodiversity and salivary microbial community structure did not change significantly and that patients had increased beneficial oral hygiene habits and awareness during the first six months of Invisalign treatment. Hence, on the basis of this study, it appears that Invisalign aligner treatment did not induce deterioration of oral health nor significant biodiversity changes in oral bacterial communities, assuming that detailed oral hygiene instructions for both teeth and aligners were provided.
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Affiliation(s)
- Rui Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Renhuan Huang
- Department of Orthodontics, Tenth People's Hospital, Shanghai, China
| | - Hu Long
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Meiya Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Meto A, Colombari B, Castagnoli A, Sarti M, Denti L, Blasi E. Efficacy of a Copper-Calcium-Hydroxide Solution in Reducing Microbial Plaque on Orthodontic Clear Aligners: A Case Report. Eur J Dent 2019; 13:478-484. [PMID: 31494917 PMCID: PMC6890510 DOI: 10.1055/s-0039-1695653] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to investigate the ability of a copper–calcium–hydroxide-based compound to remove microbial plaque naturally produced onto orthodontic clear aligners. A commercially available dental paste, named Cupral, based on copper–calcium–hydroxide, was used. A healthy volunteer (female, 32 years old), undergoing orthodontic treatment with thermoplastic clear aligners was enrolled. By conventional/confocal microscopy and colony-forming unit (CFU) assay, 2-week used aligners were examined for microbial plaque, prior and following exposure to Cupral. Confocal microscopy revealed abundant plaque irregularly distributed onto the aligner surface. Following Cupral treatment, a drastic decrease occurred in plaque thickness and matrix presence. As assessed by the CFU assay, total microbial load approached 10
9
CFUs/aligner, with slight differences in aerobiosis and anaerobiosis culture conditions; six macroscopically different types of colonies were detected and identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Following Cupral treatment, microbial load dropped to undetectable levels, irrespectively of the conditions considered. Exposure of clear aligners to Cupral results in the elimination of contaminating microorganisms; the antimicrobial activity is retained up to 1.25% concentration. Overall, our data describe a novel use of Cupral, a copper–calcium–hydroxide-based compound, in daily hygiene practices with promising results.
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Affiliation(s)
- Aida Meto
- School of Doctorate in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Bruna Colombari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, Laboratory of Microbiology and Virology, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Castagnoli
- School of Specialization in Microbiology and Virology, University of Modena and Reggio Emilia, Modena, Italy
| | - Mario Sarti
- Medical Doctor, Clinical Microbiology Laboratory, S. Agostino-Estense Hospital, Baggiovara, Modena, Italy
| | - Lucia Denti
- Enzo Ferrari Engineering Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisabetta Blasi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with interest in Transplant, Oncological and Regenerative Medicine, Laboratory of Microbiology and Virology, University of Modena and Reggio Emilia, Modena, Italy
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27
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Sifakakis I, Papaioannou W, Papadimitriou A, Kloukos D, Papageorgiou SN, Eliades T. Salivary levels of cariogenic bacterial species during orthodontic treatment with thermoplastic aligners or fixed appliances: a prospective cohort study. Prog Orthod 2018; 19:25. [PMID: 30066184 PMCID: PMC6068060 DOI: 10.1186/s40510-018-0230-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fixed orthodontic appliances might be associated with intraoral adverse effects on enamel, due to plaque accumulation and their colonization by oral microbes. At the same time, the demand for esthetic alternatives to orthodontic treatment, like thermoplastic aligners, is growing. However, thermoplastic aligners may behave differently intraorally than fixed appliances in terms of bacterial colonization and biofilm formation. Therefore, the aim of this prospective cohort study was to assess the salivary prevalence of the cariogenic bacteria Streptococcus mutans, Lactobacillus acidophilus, and Streptococcus sanguinis among adolescents treated orthodontically with thermoplastic aligners or fixed appliances. METHODS Thirty adolescent patients (17 girls/13 boys; mean age 13.8 years old) were assigned to treatment with either (i) self-ligating fixed appliances with nickel-titanium archwires or (ii) aligners constructed from clear transparent polyethylenterephthalat-glycol copolyester (PET-G) thermoplastic sheets. Whole stimulated saliva was collected from each patient at three time points: at baseline (before bonding and initiation of orthodontic therapy or before insertion of the thermoplastic aligners), after 2 weeks, and after 1 month. A simplified plaque index, a simplified gingival index, and the decayed, missing, and filled teeth (DMFT) index were assessed from the clinical examination of the patients. Microbiological analysis of salivary bacteria was performed by quantitative polymerase chain reaction, followed by descriptive and inferential statistics at the 5% level. RESULTS Although patients treated with aligners had significantly lower plaque and gingivitis scores throughout treatment compared to patients treated with fixed appliances, no significant difference could be found between the S. mutans counts of the two groups at any time through treatment (P > 0.05). On the other hand, patients treated with aligners had significantly lower salivary S. sanguinis counts at all time points than patients treated with fixed appliances (P < 0.05). Finally, almost no L. acidophilus were identified in the collected saliva samples in either of the treated samples. CONCLUSIONS Within the limitations of this study, there were no differences in the salivary counts of S. mutans or L. acidophilus among adolescent patients treated for 1 month with thermoplastic aligners or self-ligating appliances. On the other hand, patients treated with aligners had lower salivary levels of S. sanguinis compared to those treated with self-ligating appliances.
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Affiliation(s)
- Iosif Sifakakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - William Papaioannou
- Department of Preventive and Community Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Papadimitriou
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, Faculty of Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, Faculty of Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
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Jiang Q, Li J, Mei L, Du J, Levrini L, Abbate GM, Li H. Periodontal health during orthodontic treatment with clear aligners and fixed appliances: A meta-analysis. J Am Dent Assoc 2018; 149:712-720.e12. [PMID: 29921415 DOI: 10.1016/j.adaj.2018.04.010] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 04/01/2018] [Accepted: 04/06/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Clear aligners have become increasingly popular because of their esthetics and comfort. The authors' aim in this systematic review was to compare periodontal health in patients undergoing orthodontic treatment with clear aligners with that of those undergoing orthodontic treatment with fixed appliances. TYPES OF STUDIES REVIEWED The authors systematically searched the PubMed, Web of Science, Cochrane Library, and Embase databases to collect related studies. After extracting data and assessing quality, the authors performed a meta-analysis and trial sequential analysis. The authors used the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of the evidence. RESULTS The authors included 9 studies in the quantitative synthesis analysis. Clear aligners were better for periodontal health, including plaque index (mean difference [MD], -0.53; 95% confidence interval [CI], -0.85 to -0.20; P = .001), gingival index (MD, -0.27; 95% CI, -0.37 to -0.17; P < .001), and probing depth (MD, -0.35; 95% CI, -0.67 to -0.03; P = .03), than were fixed appliances. However, the trial sequential analysis outcome indicated a false-positive meta-analysis result for probing depth. The authors downgraded the level of the evidence because of the risk of bias and inconsistency. CONCLUSIONS AND PRACTICAL IMPLICATIONS Clear aligners were better for periodontal health than fixed appliances and might be recommended for patients at high risk of developing gingivitis. However, high-quality studies still are required.
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Guo R, Zheng Y, Liu H, Li X, Jia L, Li W. Profiling of subgingival plaque biofilm microbiota in female adult patients with clear aligners: a three-month prospective study. PeerJ 2018; 6:e4207. [PMID: 29312828 PMCID: PMC5755484 DOI: 10.7717/peerj.4207] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 12/08/2017] [Indexed: 12/18/2022] Open
Abstract
Background Clear aligners are well known for facilitating oral hygiene maintenance and decreasing susceptibility to periodontal diseases as compared to conventional fixed appliances. However, few research studies focus on the subgingival microbial community during clear aligner treatment (CAT). Hence, this study investigates changes of the subgingival microbial community and its association with clinical characteristics during the first three months of CAT. Methods Ten female patients with clear aligners were enrolled in this study. Subgingival plaque samples were obtained at three time points: before orthodontic treatment (T0), one month after orthodontic treatment (T1) and three months after orthodontic treatment (T2). DNA was then extracted from plaque samples and analyzed by 16S rRNA gene sequencing. Periodontal examinations, including plaque index (PI) and gingival bleeding index (GBI) measurements were also recorded. Results The plaque indices (PIs) and gingival bleeding indices (GBIs) were slightly increased at T1 and T2, but no statistically significant difference was found. The alpha diversity indices, including the ACE, Chao1, Shannon indices, all showed a declining trend without significance, and a rising trend in the Simpson diversity index was observed. The weighted UniFrac distance was significantly higher at T1 and T2 compared with T0. Principal Coordinates Analysis (PCoA) demonstrated that the communities at T0 tended to cluster apart from the communities at T1 and T2. The relative abundance of the phylum Firmicutes and genus Mycoplasma was significantly increased at T0 compared with T2. There was no significant difference in the relative abundance of periodontal pathogens at the genus and species levels or core microorganisms at the genus level. Conclusion A slightly decreasing microbial diversity with a significant change of microbial structure was found during the first three-month clear aligner treatment (CAT). However, subjects receiving clear aligner treatment were free from periodontal diseases with relatively stable levels of periodontal microorganisms and core microorganisms. Thus, our preliminary findings indicated that clear aligners induced nonpathogenic changes of the subgingival microbiome in the first three-month treatment.
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Affiliation(s)
- Runzhi Guo
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yunfei Zheng
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hao Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaobei Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Lingfei Jia
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.,Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Weiran Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
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30
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Azeem M, Ul Hamid W. Incidence of white spot lesions during orthodontic clear aligner therapy. J World Fed Orthod 2017. [DOI: 10.1016/j.ejwf.2017.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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31
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Dutta Sinha S, Das S, Tarafdar S, Dutta T. Monitoring of Wild Pseudomonas Biofilm Strain Conditions Using Statistical Characterization of Scanning Electron Microscopy Images. Ind Eng Chem Res 2017. [DOI: 10.1021/acs.iecr.7b01106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Suparna Dutta Sinha
- Condensed Matter Physics Research Centre, Department of Physics, Jadavpur University, Kolkata−700032, India
| | - Saptarshi Das
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, U.K
- Department of Power
Engineering, Jadavpur University, Salt Lake Campus, LB-8, Sector 3, Kolkata−700098, India
| | - Sujata Tarafdar
- Condensed Matter Physics Research Centre, Department of Physics, Jadavpur University, Kolkata−700032, India
| | - Tapati Dutta
- Physics Department, St. Xavier’s College, Kolkata−700016, India
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Albanna RH, Farawanah HM, Aldrees AM. Microbial evaluation of the effectiveness of different methods for cleansing clear orthodontic retainers: A randomized clinical trial. Angle Orthod 2017; 87:460-465. [PMID: 27845562 PMCID: PMC8381989 DOI: 10.2319/072916-585.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/01/2016] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare effectiveness of brushing an Essix retainer with water only and brushing followed by soaking in one of three commercial cleansing tablets. MATERIALS AND METHODS A double-blind, parallel, randomized clinical trial with a split-mouth design was completed with 60 volunteers with specific eligibility criteria assigned to three groups to compare the cleansing effectiveness of brushing an Essix retainer with water only, followed by soaking in one of three alkaline peroxide-based commercial cleansing tablets (Retainer Brite®, Kukis®, and Corega®). Each participant wore an upper Essix retainer (with an electronic microsensor) on a full-time basis for 14 days and used one of the three products on one side of the retainer for 15 min/d. The effectiveness of the cleansing tablets was tested by the scanning electron microscopy, bacterial identification, bacterial quantification, and disk diffusion methods. RESULTS Bacterial quantification tests demonstrated nonsignificant statistical differences between the control and test sides of the three cleansing tablets: Retainer Brite®, Kukis®, and Corega® (Mann-Whitney test P-values were .6, .37, and .5, respectively). A Kruskal-Wallis test also showed nonstatistical difference in the bacterial counts between the three groups (P-value = .5). In vitro tests showed a minimal inhibition zone of Staphylococcus epidermidis only with Corega® tablets. CONCLUSIONS Using chemical cleansing tablets after mechanical cleansing did not significantly reduce the bacterial count in Essix retainers when compared to use of mechanical cleansing alone. However, the tablets seem to be effective against "cocci" bacterial species.
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Compositional differences in multi-species biofilms formed on various orthodontic adhesives. Eur J Orthod 2017; 39:528-533. [DOI: 10.1093/ejo/cjw089] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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ATP Bioluminometers Analysis on the Surfaces of Removable Orthodontic Aligners after the Use of Different Cleaning Methods. Int J Dent 2016; 2016:5926941. [PMID: 27242901 PMCID: PMC4875988 DOI: 10.1155/2016/5926941] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 04/14/2016] [Indexed: 01/14/2023] Open
Abstract
Purpose. The aim was to quantify the bacteria concentration on the surface of orthodontic clear aligners using three different cleaning methods. Furthermore the objective was to validate the efficacy of the bioluminometer in assessing the bacteria concentration. Materials and Methods. Twenty subjects (six males and fourteen females) undergoing orthodontic therapy with clear aligners (Invisalign® Align Technology, Santa Clara, California) were enrolled in this study. The observation time was of six weeks. The patients were instructed to use different cleaning methods (water, brushing with toothpaste, and brushing with toothpaste and use of sodium carbonate and sulphate tablet). At the end of each phase a microbiological analysis was performed using the bioluminometer. Results. The highest bacteria concentration was found on aligners cleaned using only water (583 relative light units); a value of 189 relative light units was found on aligners cleaned with brushing and toothpaste. The lowest bacteria concentration was recorded on aligners cleaned with brushing and toothpaste and the use of sodium carbonate and sulfate tablet. Conclusions. The mechanical removal of the bacterial biofilm proved to be effective with brushing and toothpaste. The best results in terms of bacteria concentration were achieved adding the use of sodium carbonate and sulfate tablet.
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Levrini L, Novara F, Margherini S, Tenconi C, Raspanti M. Scanning electron microscopy analysis of the growth of dental plaque on the surfaces of removable orthodontic aligners after the use of different cleaning methods. Clin Cosmet Investig Dent 2015; 7:125-31. [PMID: 26719726 PMCID: PMC4687621 DOI: 10.2147/ccide.s95814] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Advances in orthodontics are leading to the use of minimally invasive technologies, such as transparent removable aligners, and are able to meet high demands in terms of performance and esthetics. However, the most correct method of cleaning these appliances, in order to minimize the effects of microbial colonization, remains to be determined. Purpose The aim of the present study was to identify the most effective method of cleaning removable orthodontic aligners, analyzing the growth of dental plaque as observed under scanning electron microscopy. Methods Twelve subjects were selected for the study. All were free from caries and periodontal disease and were candidates for orthodontic therapy with invisible orthodontic aligners. The trial had a duration of 6 weeks, divided into three 2-week stages, during which three sets of aligners were used. In each stage, the subjects were asked to use a different method of cleaning their aligners: 1) running water (control condition); 2) effervescent tablets containing sodium carbonate and sulfate crystals followed by brushing with a toothbrush; and 3) brushing alone (with a toothbrush and toothpaste). At the end of each 2-week stage, the surfaces of the aligners were analyzed under scanning electron microscopy. Results The best results were obtained with brushing combined with the use of sodium carbonate and sulfate crystals; brushing alone gave slightly inferior results. Conclusion On the basis of previous literature results relating to devices in resin, studies evaluating the reliability of domestic ultrasonic baths for domestic use should be encouraged. At present, pending the availability of experimental evidence, it can be suggested that dental hygienists should strongly advise patients wearing orthodontic aligners to clean them using a combination of brushing and commercially available tablets for cleaning oral appliances.
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Affiliation(s)
- Luca Levrini
- Department of Surgical and Morphological Sciences, Dental Hygiene School, Research Centre Cranio Facial Disease and Medicine, University of Insubria, Varese, Italy
| | - Francesca Novara
- Department of Surgical and Morphological Sciences, Dental Hygiene School, Research Centre Cranio Facial Disease and Medicine, University of Insubria, Varese, Italy
| | - Silvia Margherini
- Department of Surgical and Morphological Sciences, Dental Hygiene School, Research Centre Cranio Facial Disease and Medicine, University of Insubria, Varese, Italy
| | - Camilla Tenconi
- Department of Surgical and Morphological Sciences, Dental Hygiene School, Research Centre Cranio Facial Disease and Medicine, University of Insubria, Varese, Italy
| | - Mario Raspanti
- Department of Surgical and Morphological Sciences, Dental Hygiene School, Research Centre Cranio Facial Disease and Medicine, University of Insubria, Varese, Italy
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Finite element method analysis of the periodontal ligament in mandibular canine movement with transparent tooth correction treatment. BMC Oral Health 2015; 15:106. [PMID: 26337291 PMCID: PMC4559922 DOI: 10.1186/s12903-015-0091-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 08/28/2015] [Indexed: 11/10/2022] Open
Abstract
Background This study used the 3D finite element method to investigate canine’s displacements and stresses in the canine’s periodontal ligament (PDL) during canine’s translation, inclination, and rotation with transparent tooth correction treatment. Methods Finite element models were developed to simulate dynamic orthodontic treatments of the translation, inclination, and rotation of the left mandibular canine with transparent tooth correction system. Piecewise static simulations were performed to replicate the dynamic process of orthodontic treatments. The distribution and change trends of canine’s displacements and stresses in the canine’s PDL during the three types of tooth movements were obtained. Results Maximum displacements were observed at the crown and middle part in the translation case, at the crown in the inclination case, and at the crown and root part in the rotation case. The relative maximum von Mises and principal stresses were mainly found at the cervix of the PDL in the translation and inclination cases. In the translation case, tensile stress was mainly observed on the mesial and distal surfaces near the lingual side and compressive stress was located at the bottom of the labial surface. In the inclination case, tensile stress was mainly observed at the labial cervix and lingual apex and compressive stress was located at the lingual cervix and labial apex. In the rotation case, von Mises stress was mainly located at the cervix and inside the lingual surface, tensile stress was located on the distal surface, and compressive stress was detected on the mesial surface. The stress and displacement value rapidly decreased in the first few steps and then reached a plateau. Conclusions Canine’s movement type significantly influences the distribution of canine’s displacement and stresses in the canine’s PDL. Changes in canine’s displacement and stresses in the canine’s PDL were exponential in transparent tooth correction treatment.
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CAI YONGQING, YANG XIAOXIANG, HE BINGWEI. INFLUENCE OF FRICTION IN TRANSPARENT TOOTH CORRECTION TREATMENT: FINITE ELEMENT METHOD. J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415500529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: The objective was to evaluate the effect of frictional forces on the canine's translation and rotation in transparent tooth correction treatment. Materials and Methods: Based on computed tomography (CT) images of the teeth and their supporting tissues, solid models were used to build finite-element models. One canine was simulated translation and rotation in the buccolingual direction by aligners with different friction coefficients. Results: The change of the canine's rotation centers and periodontal ligament (PDL) stress with an increase of the friction coefficient in the two movement types were obtained. Conclusions: Friction coefficient has little effect on the canine's translation movement. While in rotation cases, the small friction coefficient seems to be helpful to gain the body movement type.
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Affiliation(s)
- YONGQING CAI
- Department of Chemical Engineering, Fuzhou University, Fuzhou 350116, P. R. China
| | - XIAOXIANG YANG
- Department of Mechanical Engineering, Fuzhou University, Fuzhou 350116, P. R. China
| | - BINGWEI HE
- Department of Mechanical Engineering, Fuzhou University, Fuzhou 350116, P. R. China
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Levrini L, Mangano A, Montanari P, Margherini S, Caprioglio A, Abbate GM. Periodontal health status in patients treated with the Invisalign(®) system and fixed orthodontic appliances: A 3 months clinical and microbiological evaluation. Eur J Dent 2015; 9:404-410. [PMID: 26430371 PMCID: PMC4569994 DOI: 10.4103/1305-7456.163218] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The aim of this prospective study was to compare the periodontal health and the microbiological changes via real-time polymerase chain reaction (PCR) in patients treated with fixed orthodontic appliances and Invisalign(®) system (Align Technology, Santa Clara, California). MATERIALS AND METHODS Seventy-seven patients were enrolled in this study and divided into three groups (Invisalign(®) group, fixed orthodontic appliances group and control group). Plaque index, probing depth, bleeding on probing were assessed. Total biofilm mass and periodontal pathogens were analyzed and detected via real-time PCR. All these data were analyzed at the T0 (beginning of the treatment) T1 (1-month) and T2 (3 months); and statistically compared using the Mann-Whitney test for independent groups. RESULTS After 1-month and after 3 months of treatment there was only one sample with periodontopathic anaerobes found in patient treated using fixed orthodontic appliances. The Invisalign(®) group showed better results in terms of periodontal health and total biofilm mass compared to the fixed orthodontic appliance group. A statistical significant difference (P < 0.05) at the T2 in the total biofilm mass was found between the two groups. CONCLUSION Patients undergoing orthodontic treatment with the Invisalign(®) System show a superior periodontal health in the short-term when compared to patients in treatment with fixed orthodontic appliances. Invisalign(®) should be considered as a first treatment option in patients with risk of developing periodontal disease.
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Affiliation(s)
- Luca Levrini
- Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy
| | - Alessandro Mangano
- Oro Cranio Facial Disease and Medicine Research Centre, University of Insubria, Varese, Italy
| | - Paola Montanari
- Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy
| | - Silvia Margherini
- Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy
| | - Alberto Caprioglio
- Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy
| | - Gian Marco Abbate
- Department of Morphological and Surgical Sciences, University of Insubria, Varese, Italy
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Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Periodontal health during clear aligners treatment: a systematic review. Eur J Orthod 2014; 37:539-43. [PMID: 25548145 DOI: 10.1093/ejo/cju083] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 11/11/2014] [Indexed: 11/13/2022]
Abstract
BACKGROUND Clear aligner treatment (CAT) has been cited as a safe and comfortable orthodontic procedure for adult patients. However, the available evidence is scarce. OBJECTIVE To perform a systematic review of the existing literature in order to assess periodontal health during CAT. SEARCH METHODS AND SELECTION CRITERIA Pubmed, Pubmed Central, National Library of Medicine's Medline, Embase, Cochrane Central Register of Controlled Clinical trials, Web of Knowledge, Scopus, Google Scholar, and LILACS were searched from January 1945 to September 2014 to identify all peer-reviewed papers potentially relevant to the review. DATA COLLECTION AND ANALYSIS After duplicate selection and extraction procedures, the risk of bias was assessed according to the Centre for Reviews and Dissemination criteria, and a 3-point grading system, as described by the Swedish Council on Technology Assessment in Health Care (SBU), was used to rate the methodological quality of the selected papers. A PICOS table was used for data extraction. RESULTS Five relevant articles were selected from the 1247 identified articles. The level of evidence was moderate for all the studies. A significant improvement of the periodontal health indexes was revealed, in particular when CAT was compared to fixed appliances. No periodontal CAT adverse effects were observed in the selected studies. CONCLUSIONS Periodontal health indexes were significantly improved during CAT. The results of this review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies.
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Affiliation(s)
- Gabriele Rossini
- Department of Orthodontics, Dental School, University of Turin, Italy
| | - Simone Parrini
- Department of Orthodontics, Dental School, University of Turin, Italy
| | | | - Andrea Deregibus
- Department of Orthodontics, Dental School, University of Turin, Italy
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Kumar V, Sachan TK, Sharma P, Rawat KD. Ultrastructural Morphologic Changes in Mycobacterial Biofilm in Different Extreme Condition. Ultrastruct Pathol 2014; 39:38-48. [DOI: 10.3109/01913123.2014.950780] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Shpack N, Greenstein RBN, Gazit D, Sarig R, Vardimon AD. Efficacy of three hygienic protocols in reducing biofilm adherence to removable thermoplastic appliance. Angle Orthod 2014; 84:161-170. [PMID: 23786595 PMCID: PMC8683063 DOI: 10.2319/012413-75.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 05/01/2013] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES To examine the ability of a removable thermoplastic appliance (RTA) to adsorb hygienic solutions and inhibit bacterial growth and to examine the efficacy of three hygiene protocols in reducing bacterial biofilm adherence to RTA. MATERIALS AND METHODS Solution adsorption and bacterial growth inhibition were examined in vitro using paper vs RTA discs. Subsequently, 11 patients treated with RTA (mean age, 29.1 ± 4.7 years) were assigned into a sequence of three hygiene protocols: regular RTA brushing (baseline), immersion RTAs in chlorhexidine mouthwash (CHX), and using a vibrating bath with cleaning solution (VBC). For each patient, 12 upper RTAs were examined (2 baseline RTAs, 5 CHX RTAs, and 5 VBC RTAs), for a total of 132 RTAs. All RTAs were stained with gentian violet, and biofilm presence was measured using a photodensitometer. RESULTS The RTA discs did not adsorb CHX or cleaning solution. The later agent did not show antibacterial features. Baseline RTAs showed significant biofilm adherence (P < .001) on the posterior palatal side of the aligner and on the anterior incisal edge. CHX and VBC hygienic protocols significantly (P < .001) reduced baseline biofilm adherence by 16% and 50%, respectively. Hygienic improvement was maintained over 140 days when CHX and VBC were used. However, VBC was three times more efficient than CHX. CONCLUSIONS This study highly recommends the use of a VBC protocol. Biofilm deposits on the RTA, especially on incisal edges and attachment dimples, could lead to inadequate tooth/RTA and attachment/RTA overlap and consequently impair tooth alignment.
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Affiliation(s)
- Nir Shpack
- Lecturer, Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Bar-Ness Greenstein
- Senior Lecturer, Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Gazit
- Postgraduate student, Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rachel Sarig
- Instructor, Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alexander Dan Vardimon
- Professor and Head, Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Krieger E, Seiferth J, Marinello I, Jung B, Wriedt S, Jacobs C, Wehrbein H. Invisalign® treatment in the anterior region. J Orofac Orthop 2012; 73:365-76. [DOI: 10.1007/s00056-012-0097-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 03/20/2012] [Indexed: 10/28/2022]
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Influence of thermoplastic retainers on Streptococcus mutans and Lactobacillus adhesion. Am J Orthod Dentofacial Orthop 2012; 141:598-603. [PMID: 22554754 DOI: 10.1016/j.ajodo.2011.11.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 11/01/2011] [Accepted: 11/01/2011] [Indexed: 11/22/2022]
Abstract
INTRODUCTION This study was designed to test the hypothesis that thermoplastic retainers influence oral microbial flora during the retention period because they prevent the flushing effect of saliva on dental and mucous tissues. METHODS Twenty-four orthodontic patients finished the study. After debonding, the patients were given thermoplastic retainers (Essix ACE 0.040-in plastic, Dentsply International, York, Pa) for both jaws and instructed to wear them all day. Plaque samples from tooth surfaces and saliva samples were collected from each patient just after debonding (T0), and on day 15 (T1), day 30 (T2), and day 60 (T3) of retention. The jaws were divided into 6 regions, and the data for each region were evaluated separately. Total viable Lactobacillus and Streptococcus mutans colonies were counted, and the numbers of the viable microorganisms were calculated. RESULTS The numbers of Lactobacillus colonies at T3 were higher than at T0, T1, and T2, and the difference between T0 and T3 was statistically significant (P <0.05). The numbers of S mutans colonies at T3 were higher than at T0, T1, and T2, and the differences between T0 and T1, and T1 and T2 were statistically significant (P <0.05). CONCLUSIONS Retention with thermoplastic retainers might create oral conditions conducive to S mutans and Lactobacillus colonization on dental surfaces.
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