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Porwal A, Al Moaleem MM, Adawi HA, Nandalur KR, Satpathy A, Mehta V, Cicciù M, Minervini G. Bibliographic analysis and evaluation of the mesh keywords in the journal of prosthodontics: Implant, esthetic, and reconstructive dentistry. Technol Health Care 2024; 32:343-359. [PMID: 37125591 DOI: 10.3233/thc-230204] [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] [Indexed: 05/02/2023]
Abstract
BACKGROUND Various studies have been conducted to analyze data via bibliometric analysis in different dentistry, including prosthetic dentistry. However, these studies evaluated the most cited published articles in dentistry. OBJECTIVE To analyze and evaluate the characteristic development of several mesh keywords in the Journal of Prosthodontics - Implant, Esthetic, and Reconstructive Dentistry between 1992 and 2022. METHODS The Scopus databases was searched to retrieve the data related to 8 categories, including published articles, most cited documents, authors and organizations, and maximum articles cited during the evaluation period. The data retrieved were exported to a Microsoft Excel sheet and were analyzed using the bibliometrix package. The data were first analyzed for ten years and then for 30 years. The highest of 10 were reported for each category, and co-authorship, reoccurrence, and linked data were also reported. RESULTS 2603 published documents were recorded from the Scopus databases. Articles comprised 87.9% of the total published work, followed by review articles at 5.46%. The most productive decade was between 2013 and 2022. 3793 terms were used during the evaluation period, with the maximum number in 2003-2012 (2481). A total of 5392 keywords were used during 1992-2022, with the highest number (3232) from 2013 to 2022. A total of 6108 authors were acknowledged, with the maximum number (3964) from 2013 to 2022 and the fewest (767) from 1992 to 2002. Authors from different countries increased from 17 countries in 1992-2002 to 52 countries in 2013-2022 (total = 63 countries). Similarly, the number of organizations increased from 312 organizations in 1992-2002 to 1315 organizations in 2013-2022 (total = 1976 organizations). CONCLUSION The current bibliometric analysis delivered a comprehensive overview about more spread research topics and its impactful role in contemporary dentistry, especially prosthetic dentistry.
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Affiliation(s)
- Amit Porwal
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
- Department of Prosthodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, India
| | - Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Hafiz Ahmed Adawi
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Kulashekar Reddy Nandalur
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, India
| | - Vini Mehta
- Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidhyapeeth, Pimpri, India
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Chepelova N, Antoshin A, Voloshin S, Usanova A, Efremov Y, Makeeva M, Evlashin S, Stepanov M, Turkina A, Timashev P. Oral Galvanism Side Effects: Comparing Alloy Ions and Galvanic Current Effects on the Mucosa-like Model. J Funct Biomater 2023; 14:564. [PMID: 38132818 PMCID: PMC10744021 DOI: 10.3390/jfb14120564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
The interaction of different dental alloys with the oral environment may cause severe side effects (e.g., burning sensation, inflammatory reactions, carcinogenesis) as a result of oral galvanism. However, the pathogenesis of side effects associated with oral galvanism is still unclear, and the effects of direct current and alloy corrosion ions are considered potentially contributing factors. Therefore, the aim of this study was to systemically compare the damaging effects of (1) galvanism as a synergistic process (direct current + corrosion ions), (2) direct current separately, and (3) corrosion ions separately on an in vitro mucosa-like model based on a cell line of immortalized human keratinocytes (HaCaTs) to reveal the factors playing a pivotal role in dental alloys side effects. For this, we chose and compared the dental alloys with the highest risk of oral galvanism: Ti64-AgPd and NiCr-AgPd. We showed that galvanic current may be the leading damaging factor in the cytotoxic processes associated with galvanic coupling of metallic intraoral appliances in the oral cavity, especially in the short-term period (28 days). However, the contribution of corrosion ions (Ni2+) to the synergistic toxicity was also shown, and quite possibly, in the long term, it could be no less dangerous.
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Affiliation(s)
- Natalia Chepelova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 8-2 Trubetskaya St., Moscow 119048, Russia; (N.C.); (S.V.); (A.U.); (Y.E.); (P.T.)
| | - Artem Antoshin
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 8-2 Trubetskaya St., Moscow 119048, Russia; (N.C.); (S.V.); (A.U.); (Y.E.); (P.T.)
| | - Sergei Voloshin
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 8-2 Trubetskaya St., Moscow 119048, Russia; (N.C.); (S.V.); (A.U.); (Y.E.); (P.T.)
| | - Anna Usanova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 8-2 Trubetskaya St., Moscow 119048, Russia; (N.C.); (S.V.); (A.U.); (Y.E.); (P.T.)
| | - Yuri Efremov
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 8-2 Trubetskaya St., Moscow 119048, Russia; (N.C.); (S.V.); (A.U.); (Y.E.); (P.T.)
| | - Maria Makeeva
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov First Moscow State Medical University, 8-2 Trubetskaya Str., Moscow 119048, Russia; (M.M.); (A.T.)
- Conservative Dentistry Department, RUDN University, 6 Miklukho-Maklaya Street, Moscow 117198, Russia
| | - Stanislav Evlashin
- Center for Materials Technologies, Skolkovo Institute of Science and Technology, Moscow 121205, Russia;
| | - Mikhail Stepanov
- Department of Dental Surgery, Sechenov First Moscow State Medical University, 8-2 Trubetskaya Str., Moscow 119048, Russia;
| | - Anna Turkina
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov First Moscow State Medical University, 8-2 Trubetskaya Str., Moscow 119048, Russia; (M.M.); (A.T.)
| | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 8-2 Trubetskaya St., Moscow 119048, Russia; (N.C.); (S.V.); (A.U.); (Y.E.); (P.T.)
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3
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Yassaei S, Aghili HA, Behrouzirad A. Effect of Erbium:YAG Laser Recycling on Mechanical Characteristics of Retrieved Orthodontic Mini-screws. J Lasers Med Sci 2023; 14:e42. [PMID: 38028875 PMCID: PMC10658111 DOI: 10.34172/jlms.2023.42] [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: 11/13/2022] [Accepted: 03/12/2023] [Indexed: 12/01/2023]
Abstract
Introduction: This study aimed to evaluate the influence of two recycling methods on the mechanical and surface characteristics of orthodontic mini-screws. Methods: Thirty-six retrieved mini-screws were randomly classified into two equal groups. In the first group (laser recycled group (LG)), the Er:YAG laser (2940 nm, 5.5 W, 275 mJ, perpendicular to the mini-screws at a distance of 7-10 mm, 25 s) was used to recycle mini-screws. In the second group (phosphoric acid and sodium hypochlorite recycled group (ASG)), the mini-screws were kept in 37% phosphoric acid gel (10 minutes) and then placed in 5.25% sodium hypochlorite for 30 minutes. Eighteen new mini-screws were selected as the control group (CG). Maximum insertion torque (MIT), maximum removal torque (MRT), and fracture torque (FT) of all mini-screws were measured. A sample from each group was examined for the surface changes of the mini-screw and tissue remnants under a scanning electron microscope (SEM). Results: The mean MIT was significantly higher in both LG and ASG groups than the CG (P<0.001 and P=0.002, respectively). However, no significant difference was shown between the LG and ASG groups. The mean values of MRT and FT showed no significant difference between the groups. The amount of tissue remnants in the ASG group was significantly higher than that in the LG group. The evidence of porosity and corrosion was observed on the ASG mini-screw surface, and there was an increase in roughness on the LG mini-screw surface. Conclusion: The Er:YAG laser recycling of mini-screws is a proper method causing minimum damage to the screw surface.
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Affiliation(s)
- Soghra Yassaei
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossien Agha Aghili
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Atie Behrouzirad
- Department of Orthodontics, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
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Alhamoudi FH, Aldosari LIN, Alshadidi AAF, Hassan SAB, Alwadi MAM, Vaddamanu SK, Cicciù M, Minervini G. An Investigation of the Fracture Loads Involved in the Framework of Removable Partial Dentures Using Two Types of All-Ceramic Restorations. Biomimetics (Basel) 2023; 8:biomimetics8010113. [PMID: 36975343 PMCID: PMC10046878 DOI: 10.3390/biomimetics8010113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/21/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
Retention and support are needed for removable partial denture stability. The stability can be achieved by clasps, occlusal and cingulum rests on healthy abutment teeth. However, implants or crowns can be used to support the removable partial denture instated on unhealthy abutment teeth. This study was conducted to investigate the fracture strength of two types of all-ceramic restorations used as abutments for the removable partial denture framework. The crowns were manufactured with two types of ceramic materials: zirconia and IPS e.max Press ceramics. The metal alloy (cobalt-chrome) was cast to form the removable partial denture framework. A universal testing machine was used to evaluate the fracture strength of both ceramic crown materials. The results presented no fractures in all-ceramic crowns, but deformation of the partial denture frameworks occurred. With the limitation of this study, it can be concluded that zirconia and IPS e.max Press ceramic can be used as abutments to provide adequate support to the removable partial denture.
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Affiliation(s)
- Fahad Hussain Alhamoudi
- Dental Technology Department, College of Applied Medical Science, King Khalid University, Abha 61421, Saudi Arabia
- Correspondence: (F.H.A.); (S.K.V.); (G.M.)
| | - Lujain Ibrahim N. Aldosari
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Abdulkhaliq Ali F. Alshadidi
- Dental Technology Department, College of Applied Medical Science, King Khalid University, Abha 61421, Saudi Arabia
| | - Saeed Awod Bin Hassan
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Maram Ali M. Alwadi
- Dental Health Department, College of Applied Medical Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Sunil Kumar Vaddamanu
- Dental Technology Department, College of Applied Medical Science, King Khalid University, Abha 61421, Saudi Arabia
- Correspondence: (F.H.A.); (S.K.V.); (G.M.)
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
- Correspondence: (F.H.A.); (S.K.V.); (G.M.)
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Thread shape, cortical bone thickness, and magnitude and distribution of stress caused by the loading of orthodontic miniscrews: finite element analysis. Sci Rep 2022; 12:12367. [PMID: 35859046 PMCID: PMC9300621 DOI: 10.1038/s41598-022-16662-w] [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: 03/22/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
Cortical bone thickness is assumed to be a major factor regulating miniscrew stability. We investigated stress distribution in two miniscrews with different thread shapes (type A and B) and in cortical bone of three different thicknesses using three-dimensional (3D) finite element (FE) models. More specifically, 3D FE models of two different miniscrews were created and placed obliquely or vertically into a cylindrical bone model representing different cortical bone thicknesses. When force was applied to the miniscrew, the stress distribution on the screw surface and in the peri-implant bone was assessed using FE methodology. Miniscrew safety was evaluated using a modified Soderberg safety factor. Screw head displacement increased with a decrease in cortical bone thickness, irrespective of screw type. The smallest minimum principal stresses on the screw surfaces remained constant in type A miniscrews on changes in cortical bone thickness. Minimum principal stresses also appeared on the cortical bone surface. Lower absolute values of minimum principal stresses were seen in type A miniscrews when placed vertically and with upward traction in obliquely placed type B miniscrews. Both miniscrews had acceptable safety factor values. Taken together, orthodontists should select and use the suitable miniscrew for each patient in consideration of bone properties.
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Dinu S, Craciunescu EL, Macasoi I, Chioran D, Rivis M, Vlad D, Milutinovici RA, Marcovici I, Dolghi A, Moaca A, Dinu DC, Dehelean C, Popa M. Toxicological Assessment of an Acrylic Removable Orthodontic Appliance Using 2D and 3D In Vitro Methods. MATERIALS 2022; 15:ma15031193. [PMID: 35161136 PMCID: PMC8838812 DOI: 10.3390/ma15031193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/20/2022] [Accepted: 02/03/2022] [Indexed: 11/29/2022]
Abstract
Malocclusion is a global health problem, mainly affecting children and adolescents. For this reason, orthodontic treatment must be, on the one hand, safe, non-toxic, and effective and, on the other hand, it must have the best possible esthetic profile. Thus, the use of orthodontic appliances is addressed to all age groups, including young children, for a long period of time, which is why their safety profile is a matter of real interest. For this reason, the purpose of the present study was to evaluate the safety and biocompatibility of an acrylic removable orthodontic appliance made of polymethylmethacrylate and stainless steel alloy made by our team of researchers. To verify the biocompatibility of the medical device, it was immersed in artificial saliva with three different pHs (3, 7, and 10) for a period of ten days. Subsequently, the three types of saliva were tested on human keratinocytes (HaCaT cell line) in terms of viability and modification of cell morphology. Finally, the use of 3D reconstructed human epidermis verified the cytotoxic and irritating potential of the medical device, thus providing relevant information regarding its biocompatibility. The results revealed that by maintaining the orthodontic device in the saliva there is no release of substances with a toxic effect on the human keratinocytes and on the 3D reconstructed human epidermis. There were also no significant changes in cell morphology. In conclusion, it is suggested that the acrylic removable appliance has a safety profile recommended for in vivo use.
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Affiliation(s)
- Stefania Dinu
- Department of Pedodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania; (S.D.); (M.P.)
- Pediatric Dentistry Research Center, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei Bv., 300041 Timisoara, Romania
| | - Emanuela Lidia Craciunescu
- Department of Prostheses Technology and Dental Material, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania;
- Romania Research Center in Dental Medicine Using Conventional and Alternative Technologies, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei Bv., 300041 Timisoara, Romania
| | - Ioana Macasoi
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timisoara, Romania; (I.M.); (I.M.); (A.D.); (A.M.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Doina Chioran
- Department of Dento-Alveolar Surgery, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania
- Correspondence: (D.C.); (M.R.)
| | - Mircea Rivis
- Department of Anesthesiology and Sedation in Dentistry, Dento-Alveolar Surgery, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timisoara, Romania
- Correspondence: (D.C.); (M.R.)
| | - Daliborca Vlad
- Department of Pharmacology and Biochemistry-Pharmacology, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timisoara, Romania;
| | - Raluca Adriana Milutinovici
- Department of Orthodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania;
- Orthodontic Research Center (ORTHO-CENTER), Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, Revolutiei Ave. 1989 No. 9, 300041 Timisoara, Romania
| | - Iasmina Marcovici
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timisoara, Romania; (I.M.); (I.M.); (A.D.); (A.M.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Alina Dolghi
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timisoara, Romania; (I.M.); (I.M.); (A.D.); (A.M.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Alina Moaca
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timisoara, Romania; (I.M.); (I.M.); (A.D.); (A.M.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Dorin Cristian Dinu
- Family Dental Clinic, Private Practice, 24 Budapesta Str., 307160 Dumbravita, Romania;
| | - Cristina Dehelean
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timisoara, Romania; (I.M.); (I.M.); (A.D.); (A.M.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Malina Popa
- Department of Pedodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania; (S.D.); (M.P.)
- Pediatric Dentistry Research Center, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei Bv., 300041 Timisoara, Romania
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Differences in Metal Ions Released from Orthodontic Appliances in an In Vitro and In Vivo Setting. COATINGS 2022. [DOI: 10.3390/coatings12020190] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
The aim was to assess the composition of released metal ions from fixed orthodontic appliances both in an in vitro and in vivo setting and to compare their quantities to evaluate any possible health risks associated with them. For the in vitro setting, a set of 24 as-received sterile SS brackets, 2 SS sterile archwires, and 2 NiTi sterile archwires were aged for 90 days in artificial saliva, and released metal ion concentrations were determined by inductively coupled plasma mass spectrometry (ICP-MS), using matrix-matched standards for calibration. For the in vivo setting, 15 brackets, 15 SS, and 15 NiTi archwires were retrieved after 90 days of intraoral exposure in 15 subjects. Debris composition on each part of the orthodontic appliance was assessed using scanning electron microscopy with energy dispersive spectroscopy (SEM/EDS). The present study evidenced a difference in the composition of released metal ions from fixed orthodontic appliances detected in an in vitro and in vivo setting. Generally, the relative content of metal ions was higher in the retrieved debris than that released in artificial saliva. The concentration of released metal ions from all tested alloys was below the upper recommended limit of daily intake; however, possible local effects in terms of hypersensitivity due to their accumulation in the debris cannot be excluded even with such concentrations.
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Kovač V, Bergant M, Ščančar J, Primožič J, Jamnik P, Poljšak B. Causation of Oxidative Stress and Defense Response of a Yeast Cell Model after Treatment with Orthodontic Alloys Consisting of Metal Ions. Antioxidants (Basel) 2021; 11:antiox11010063. [PMID: 35052565 PMCID: PMC8772795 DOI: 10.3390/antiox11010063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 11/16/2022] Open
Abstract
Misaligned teeth have a tremendous impact on oral and dental health, and the most efficient method of correcting the problem is orthodontic treatment with orthodontic appliances. The study was conducted to investigate the metal composition of selected orthodontic alloys, the release of metal ions, and the oxidative consequences that the metal ions may cause in the cell. Different sets of archwires, stainless steel brackets, and molar bands were incubated in artificial saliva for 90 days. The composition of each orthodontic material and quantification of the concentration of metal ions released were evaluated. Metal ion mixtures were prepared to determine the occurrence of oxidative stress, antioxidant enzyme defense system, and oxidative damage to proteins. The beta titanium alloy released the fewest metal ions and did not cause oxidative stress or protein damage. The metal ions from stainless steel and the cobalt-chromium alloy can cause oxidative stress and protein damage only at high concentrations. All metal ions from orthodontic alloys alter the activity of antioxidant enzymes in some way. The determined amounts of metal ions released from orthodontic appliances in a simulated oral environment are still below the maximum tolerated dose, and the concentrations of released metal ions are not capable of inducing oxidative stress, although some changes in antioxidant enzyme activity were observed at these concentrations.
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Affiliation(s)
- Vito Kovač
- Faculty of Health Sciences, University of Ljubljana, Zdravstvena pot 5, 1000 Ljubljana, Slovenia;
| | - Matic Bergant
- Department of Environmental Sciences, Jozef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia; (M.B.); (J.Š.)
| | - Janez Ščančar
- Department of Environmental Sciences, Jozef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia; (M.B.); (J.Š.)
| | - Jasmina Primožič
- Department of Dental and Jaw Orthopedics, Medical Faculty, University of Ljubljana, Hrvatski trg 6, 1000 Ljubljana, Slovenia;
| | - Polona Jamnik
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva ulica 101, 1000 Ljubljana, Slovenia;
| | - Borut Poljšak
- Faculty of Health Sciences, University of Ljubljana, Zdravstvena pot 5, 1000 Ljubljana, Slovenia;
- Correspondence:
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Willis J, Li S, Crean SJ, Barrak FN. Is titanium alloy Ti-6Al-4 V cytotoxic to gingival fibroblasts-A systematic review. Clin Exp Dent Res 2021; 7:1037-1044. [PMID: 34018703 PMCID: PMC8638288 DOI: 10.1002/cre2.444] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/13/2021] [Accepted: 05/05/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in medical devices in relation to the toxicity of vanadium. In Dentistry, Ti-6Al-4 V remains prevalent. This systematic review aims to evaluate the effects of Ti-6Al-4 V on cells relevant to oral environments such as gingival fibroblasts. MATERIALS AND METHODS A literature search was undertaken for relevant English language publications in the following databases: Dental and Oral Science, Medline and Web of Science. The electronic search was supplemented with a search of references. RESULTS After application of inclusion and exclusion criteria. A total of eight papers are included in this review. These papers were all in vitro studies and were categorized into whole implant, discs, or implant particles based on the type of test materials used in the studies. CONCLUSION Based on the analyses of the eight included studies in this review, if Ti-6Al-4 V as a material is unchallenged, i.e., as a whole implant in pH neutral environments, there appears to be little effect on fibroblasts. If Ti-6Al-4 V is challenged through corrosion or wear (particle release), the subsequent release of vanadium and aluminium particles has an increased cytotoxic effect in vitro in comparison to commercially pure titanium, hence concerns should be raised in the clinical setting.
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Affiliation(s)
- Jonathan Willis
- School of DentistryUniversity of Central LancashirePrestonUK
| | - Siwei Li
- Department of MaterialsRoyal School of Mines, Imperial College LondonLondonUK
| | - St John Crean
- School of DentistryUniversity of Central LancashirePrestonUK
| | - Fadi N. Barrak
- School of DentistryUniversity of Central LancashirePrestonUK
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Abstract
Malocclusion and teething problems are common health problems globally, affecting people of all ages, especially children and adolescents. In addition to the pathophysiological complications associated with orthodontic problems, they also affect the well-being of the individual. Orthodontic appliances are frequently used, even from an early age, and their activity in different biological environments is very varied and incompletely described. Due to these considerations, the purpose of the study was to evaluate the toxicological profile of the biological environment (saliva at three pH values: 3, 7, and 10) of two elastodontic orthodontic appliances: Myobrace (MB) and LM TrainerTM 2 (LMD). In vitro techniques applied were conducted on human keratinocytes to evaluate cell viability (Alamar blue assay) and gene expression real-time reverse transcription–polymerase chain reaction (RT-PCR technique). In addition, it was assessed the irritating effect on the vascular plexus using as a biological model the chorioallantoic membrane of the hen’s egg by applying the hen’s egg-chorioallantoic membrane (HET-CAM) method. The obtained results showed a decrease in cell viability up to 82% in the case of LMD at pH = 3, a slight increase in mRNA expression for the anti-apoptotic marker (Bcl-2 and Bcl-xL), and a decrease in mRNA expression for the pro-apoptotic marker (Bad), and any type of toxic change at the capillary level (irritation score being below 0.9). Based on the data obtained, it can be stated that MB and LMD biological environments, at different pH values, present a safe toxicological profile.
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Szuhanek CA, Watz CG, Avram Ș, Moacă EA, Mihali CV, Popa A, Campan AA, Nicolov M, Dehelean CA. Comparative Toxicological In Vitro and In Ovo Screening of Different Orthodontic Implants Currently Used in Dentistry. MATERIALS 2020; 13:ma13245690. [PMID: 33322183 PMCID: PMC7763890 DOI: 10.3390/ma13245690] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 12/27/2022]
Abstract
Selecting the most biocompatible orthodontic implant available on the market may be a major challenge, given the wide array of orthodontic devices currently available on the market. The latest scientific data have suggested that in vitro evaluations using oral cell lines provide reliable data regarding the toxicity of residual particles released by different types of orthodontic devices. In this regard, the in vitro biocompatibility of three different commercially available implants (stainless steel and titanium-based implants) was assessed. METHODS As an in vitro model, human gingival fibroblasts (HGFs) were employed to evaluate the cellular morphology, cell viability, and cytotoxicity by means of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and lactate dehydrogenase (LDH) assays at 24 h and 72 h post-exposure to test implants. RESULTS The results correlate the composition and topography of the implant surface with biological experimental evaluations related to directly affected cells (gingival fibroblasts) and toxicological results on blood vessels (hen's egg test-chorioallantoic membrane (HET-CAM) assay). The stainless steel implant exhibits a relative cytotoxicity against HGF cells, while the other two samples induced no significant alterations of HGF cells. CONCLUSION Among the three test orthodontic implants, the stainless steel implant induced slight cytotoxic effects, thus increased vigilance is required in their clinical use, especially in patients with high sensitivity to nickel.
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Affiliation(s)
- Camelia A. Szuhanek
- Department of Orthodontics, Faculty of Dental Medicine, Victor Babeş University of Medicine and Pharmacy, 9 No., Revolutiei Bv., 300041 Timişoara, Romania; (C.A.S.); (A.P.)
| | - Claudia G. Watz
- Departament of Pharmaceutical Physics and Biophysics, Faculty of Pharmacy, Victor Babeş University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timişoara, Romania;
- Correspondence: ; Tel.: +40-746-227-217
| | - Ștefana Avram
- Department of Pharmacognosy, Faculty of Pharmacy, Victor Babeş University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timişoara, Romania;
| | - Elena-Alina Moacă
- Departament of Toxicology, Faculty of Pharmacy, Victor Babeş University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timişoara, Romania; (E.-A.M.); (A.A.C.); (C.A.D.)
| | - Ciprian V. Mihali
- Department of Life Sciences, Faculty of Medicine, Vasile Goldis Western University of Arad, 86 No., Liviu Rebreanu St., 310414 Arad, Romania;
- Molecular Research Department, Research and Development Station for Bovine, 32 No., Bodrogului St., 310059 Arad, Romania
| | - Adelina Popa
- Department of Orthodontics, Faculty of Dental Medicine, Victor Babeş University of Medicine and Pharmacy, 9 No., Revolutiei Bv., 300041 Timişoara, Romania; (C.A.S.); (A.P.)
| | - Andrada A. Campan
- Departament of Toxicology, Faculty of Pharmacy, Victor Babeş University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timişoara, Romania; (E.-A.M.); (A.A.C.); (C.A.D.)
| | - Mirela Nicolov
- Departament of Pharmaceutical Physics and Biophysics, Faculty of Pharmacy, Victor Babeş University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timişoara, Romania;
| | - Cristina A. Dehelean
- Departament of Toxicology, Faculty of Pharmacy, Victor Babeş University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timişoara, Romania; (E.-A.M.); (A.A.C.); (C.A.D.)
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Vatani M, Beigi MH, Ejeian F, Mottaghi A, Yadegari-Naeini A, Nasr-Esfahani MH. Cytotoxicity Evaluation of The Bioresorbable and Titanium Plates/Screws Used in Maxillofacial Surgery on Gingival Fibroblasts and Human Mesenchymal Bone Marrow Stem Cells. CELL JOURNAL 2019; 22:310-318. [PMID: 31863656 PMCID: PMC6947002 DOI: 10.22074/cellj.2020.6409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/08/2019] [Indexed: 12/02/2022]
Abstract
Objective Bioresorbable and titanium plates/screws are considered as a standard treatment for fixation of the bone
segments of craniofacial area and paying attention to their biocompatibility is an important issue along with other
aspects of application. The purpose of the study was to evaluate the cell viability of two types of plate and screw used
in maxillofacial surgeries in contact with gingival fibroblasts and bone marrow stem cells.
Materials and Methods In this experimental study after extraction and cultivation of cells from healthy human gingival
tissue and alveolar bone of jaw, cytotoxicity of device was evaluated. In direct contact method, samples had near
vicinity contact with the both cell lines and in indirect contact method, by-products released, like ions, from samples
after 8 weeks were used to assess cytotoxicity. Then cytotoxicity was evaluated on the 2nd, 4th and 6th day with MTS
tests and microscopy. The data were analyzed by one-way ANOVA and independent t tests.
Results There was a statistically significant difference between the German plate and screw and all the samples
studied on day 6 (P<0.05). Furthermore, a statistically significant difference was observed between both metal samples
and both bio-absorbable samples on day 6 and both cell lines (P<0.05). Comparisons between the two groups with
each other for both cell lines on the 6th day were statistically significant (P<0.05).
Conclusion Our results suggest that that cytotoxicity of biomaterial, from different brands, were not similar and some
of the biomaterial showed lower degree of toxicity compared to others and specialist using these products showed
be aware of this differences. Our investigation indicates more biocompatibility of bioresorbable plates and screws
compared to titanium. In addition our results suggest that biomaterials were not completely neutral.
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Affiliation(s)
- Masoud Vatani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran
| | - Mohammad Hossein Beigi
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Fatemeh Ejeian
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Ahmad Mottaghi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran. Electronic Address:
| | - Afshin Yadegari-Naeini
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran. Electronic Address:
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Martina S, Rongo R, Bucci R, Razionale AV, Valletta R, D'Antò V. In vitro cytotoxicity of different thermoplastic materials for clear aligners. Angle Orthod 2019; 89:942-945. [PMID: 30945933 DOI: 10.2319/091718-674.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate the in vitro cytotoxicity of different thermoplastic materials for clear aligners on human primary gingival fibroblasts (HGFs). MATERIALS AND METHODS Four materials for clear aligners were considered in this study: Duran (Scheu-Dental GmbH, Iserlohn, Germany), Biolon (Dreve Dentamid GmbH, Unna, Germany), Zendura (Bay Materials LLC, Fremont, CA, USA), and SmartTrack (Align Technology, San Jose, CA, USA). Three out of four materials (Duran, Biolon, Zendura) were assessed as thermoformed and nonthermoformed, whereas the SmartTrack was assessed only as thermoformed. The samples were placed at 37°C in airtight test tubes containing Dulbecco's Modified Eagle's Medium (DMEM; 0.1 mg/mL) for 14 days. The cell viability of HGFs cultured with this medium was assessed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Data were analyzed by means of one-way and two-way analysis of variance and post hoc tests (α = 0.05). RESULTS Each material exhibited a slight cytotoxic effect after 14 days. The highest cytotoxicity level on HGFs was achieved by Biolon (64.6% ± 3.3 of cell viability), followed by Zendura (74.4% ± 2.3 of cell viability), SmartTrack (78.8% ± 6.3 of cell viability), and finally Duran (84.6% ± 4 of cell viability), which was the least cytotoxic. In the comparison between nonthermoformed and thermoformed materials for Duran, Biolon, and Zendura, the thermoformed materials showed the highest level of cytotoxicity (P < .001). CONCLUSIONS Under the experimental conditions of this study, all the materials for clear aligners presented a slight cytotoxicity. Biolon was the most cytotoxic and the thermoforming process increased the cytotoxicity of the materials.
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Scribante A, Montasser MA, Radwan ES, Bernardinelli L, Alcozer R, Gandini P, Sfondrini MF. Reliability of Orthodontic Miniscrews: Bending and Maximum Load of Different Ti-6Al-4V Titanium and Stainless Steel Temporary Anchorage Devices (TADs). MATERIALS (BASEL, SWITZERLAND) 2018; 11:E1138. [PMID: 29976856 PMCID: PMC6073155 DOI: 10.3390/ma11071138] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/25/2018] [Accepted: 07/03/2018] [Indexed: 11/30/2022]
Abstract
Temporary anchorage devices (TADs) have been introduced into orthodontic clinical practice in order to allow tooth movements while avoiding strain on adjacent teeth. Miniscrews are available in the market with different diameters and materials. Accordingly, the purpose of the present report was to measure and compare the forces to bend and fracture different mini implants. Ti-6Al-4V titanium and stainless steel TADs of different manufacturers (Spider ScrewHDC; Mini Implants⁻Leone; Benefit⁻Orteam; Storm⁻Kristal) were evaluated. Two different diameters (1.5 mm and 2.0 mm) were tested. The sample included 10 unused specimens for each group, blocked in an Instron Universal Testing Machine, and a shear load was applied at the neck of the miniscrew. The force to bend the miniscrew was measured at 0.1 mm and 0.2 mm deflections. Also, the maximum force before screw fracture was recorded. Data were submitted for statistical analysis. Results showed significantly higher forces for 2.0 mm than 1.5 mm screws, both at 0.1 mm and 0.2 mm deflections and at maximum load. Moreover, no significant differences were reported between titanium and stainless steel miniscrews of equal diameters.
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Affiliation(s)
- Andrea Scribante
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Mona A Montasser
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura 35511, Egypt.
| | - Eman Saad Radwan
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura 35511, Egypt.
| | - Luisa Bernardinelli
- Section of Statistics, Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Roberto Alcozer
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Paola Gandini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Maria Francesca Sfondrini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy.
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15
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Scribante A, Montasser MA, Radwan ES, Bernardinelli L, Alcozer R, Gandini P, Sfondrini MF. Reliability of Orthodontic Miniscrews: Bending and Maximum Load of Different Ti-6Al-4V Titanium and Stainless Steel Temporary Anchorage Devices (TADs). MATERIALS (BASEL, SWITZERLAND) 2018. [PMID: 29976856 DOI: 10.3390/ecms2018-05219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Temporary anchorage devices (TADs) have been introduced into orthodontic clinical practice in order to allow tooth movements while avoiding strain on adjacent teeth. Miniscrews are available in the market with different diameters and materials. Accordingly, the purpose of the present report was to measure and compare the forces to bend and fracture different mini implants. Ti-6Al-4V titanium and stainless steel TADs of different manufacturers (Spider ScrewHDC; Mini Implants⁻Leone; Benefit⁻Orteam; Storm⁻Kristal) were evaluated. Two different diameters (1.5 mm and 2.0 mm) were tested. The sample included 10 unused specimens for each group, blocked in an Instron Universal Testing Machine, and a shear load was applied at the neck of the miniscrew. The force to bend the miniscrew was measured at 0.1 mm and 0.2 mm deflections. Also, the maximum force before screw fracture was recorded. Data were submitted for statistical analysis. Results showed significantly higher forces for 2.0 mm than 1.5 mm screws, both at 0.1 mm and 0.2 mm deflections and at maximum load. Moreover, no significant differences were reported between titanium and stainless steel miniscrews of equal diameters.
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Affiliation(s)
- Andrea Scribante
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Mona A Montasser
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura 35511, Egypt.
| | - Eman Saad Radwan
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura 35511, Egypt.
| | - Luisa Bernardinelli
- Section of Statistics, Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Roberto Alcozer
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Paola Gandini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy.
| | - Maria Francesca Sfondrini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy.
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Ghazal ARA, Hajeer MY, Al-Sabbagh R, Alghoraibi I, Aldiry A. An evaluation of two types of nickel-titanium wires in terms of micromorphology and nickel ions' release following oral environment exposure. Prog Orthod 2015; 16:9. [PMID: 26061986 PMCID: PMC4437993 DOI: 10.1186/s40510-015-0081-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 04/27/2015] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to compare superelastic and heat-activated nickel-titanium orthodontic wires’ surface morphology and potential release of nickel ions following exposure to oral environment conditions. Methods Twenty-four 20-mm-length distal cuts of superelastic (NiTi Force I®) and 24 20-mm-length distal cuts of heat-activated (Therma-Ti Lite®) nickel-titanium wires (American Orthodontics, Sheboygan, WI, USA) were divided into two equal groups: 12 wire segments left unused and 12 segments passively exposed to oral environment for 1 month. Scanning electron microscopy and atomic force microscopy were used to analyze surface morphology of the wires which were then immersed in artificial saliva for 1 month to determine potential nickel ions’ release by means of atomic absorption spectrophotometer. Results Heat-activated nickel-titanium (NiTi) wires were rougher than superelastic wires, and both types of wires released almost the same amount of Ni ions. After clinical exposure, more surface roughness was recorded for superelastic NiTi wires and heat-activated NiTi wires. However, retrieved superelastic NiTi wires released less Ni ions in artificial saliva after clinical exposure, and the same result was recorded regarding heat-activated wires. Conclusions Both types of NiTi wires were obviously affected by oral environment conditions; their surface roughness significantly increased while the amount of the released Ni ions significantly declined.
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Revisiting the stability of mini-implants used for orthodontic anchorage. J Formos Med Assoc 2014; 114:1122-8. [PMID: 25260551 DOI: 10.1016/j.jfma.2014.08.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 07/31/2014] [Accepted: 08/04/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND/PURPOSE The aim of this study is to comprehensively analyze the potential factors affecting the failure rates of three types of mini-implants used for orthodontic anchorage. METHODS Data were collected on 727 mini-implants (miniplates, predrilled titanium miniscrews, and self-drilling stainless steel miniscrews) in 220 patients. The factors related to mini-implant failure were investigated using a Chi-square test for univariate analysis and a generalized estimating equation model for multivariate analysis. RESULTS The failure rate for miniplates was significantly lower than for miniscrews. All types of mini-implants, especially the self-drilling stainless steel miniscrews, showed decreased stability if the previous implantation had failed. The stability of predrilled titanium miniscrews and self-drilling stainless steel miniscrews were comparable at the first implantation. However, the failure rate of stainless steel miniscrews increased at the second implantation. The univariate analysis showed that the following variables had a significant influence on the failure rates of mini-implants: age of patient, type of mini-implant, site of implantation, and characteristics of the soft tissue around the mini-implants. The generalized estimating equation analysis revealed that mini-implants with miniscrews used in patients younger than 35 years, subjected to orthodontic loading after 30 days and implanted on the alveolar bone ridge, have a significantly higher risk of failure. CONCLUSION This study revealed that once the dental surgeon becomes familiar with the procedure, the stability of orthodontic mini-implants depends on the type of mini-implant, age of the patient, implantation site, and the healing time of the mini-implant. Miniplates are a more feasible anchorage system when miniscrews fail repeatedly.
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