Cytotoxicity of Orthodontic Wire Corroded in Fluoride Solution In Vitro

Multifunctional coatings of nickel-titanium implant toward promote osseointegration after operation of bone tumor and clinical application: a review

Metal implants, especially Ni-Ti shape memory alloy (Ni-Ti SMA) implants, have increasingly become the first choice for fracture and massive bone defects after orthopedic bone tumor surgery. In this paper, the internal composition and shape memory properties of Ni-Ti shape memory alloy were studied. In addition, the effects of porous Ni-Ti SMA on osseointegration, and the effects of surface hydrophobicity and hydrophilicity on the osseointegration of Ni-Ti implants were also investigated. In addition, the effect of surface coating modification technology of Ni-Ti shape memory alloy on bone bonding was also studied. Several kinds of Ni-Ti alloy implants commonly used in orthopedic clinic and their advantages and disadvantages were introduced. The surface changes of Ni-Ti alloy implants promote bone fusion, enhance the adhesion of red blood cells and platelets, promote local tissue regeneration and fracture healing. In the field of orthopaedics, the use of Ni-Ti shape memory alloy implants significantly promoted clinical development. Due to the introduction of the coating, the osseointegration and biocompatibility of the implant surface have been enhanced, and the success rate of the implant has been greatly improved.

Effect of Charcoal, Probiotic, and Chlorhexidine Mouthwashes on Mechanical Properties and Surface Characterization of Ceramic-Coated Nickel-Titanium Orthodontic Arch Wires: A Comparative In-Vitro Study

AIM AND OBJECTIVES

To determine the impact on the mechanical properties and surface features of ceramic-coated nickel-titanium (CC-Ni-Ti) archwires when subjected to charcoal, probiotic, and chlorhexidine mouthwashes in in vitro conditions.

MATERIALS AND METHODS

Eighty samples of 25 mm were cut from the posterior end of preformed maxillary 0.016'' CC-Ni-Ti super elastic archwires (Koden Company, USA) and distributed into four equal groups. Each group of wires was immersed in artificial saliva (Wet Mouth Mouthwash, ICPA Health Products Ltd., India) (control), charcoal mouthwash (Hello activated charcoal extra freshening mouthwash, Hello Products LLC, USA), probiotic mouthwash (Perfora, Probiotic Rinse, India), and 0.2% chlorhexidine gluconate mouthwash (Sensorange, Orange Biotech, Pvt., Ltd., India) (experimental groups) for 90 min at 37 °C. All samples were taken out of their respective solutions and washed with distilled water prior to testing. A three-point bending test was performed on 15 samples from each group using a universal testing device. During the loading and unloading of the archwires, the yield strength (YS), flexural modulus of elasticity (E), and spring back ratio (YS/E) were calculated. The remaining five wires from each group were observed under the scanning electron microscope (SEM) for surface topography evaluation.

RESULTS

The mean differences of loading YS, E, and YS/E between chlorhexidine and charcoal are 302.91 MPa, 4.28 GPa, and 0.0004, whereas unloading values are 172.32 MPa, 4.16 GPa, and 0.0003, respectively, with a statistical significance of <0.001 in terms of YS and E. The mean differences of loading YS, E, and YS/E between charcoal and probiotic are 305.36 MPa, 4.54 GPa, and 0.0005, whereas unloading values are 173.77 MPa, 3.66 GPa, and 0.0003, respectively, with a statistical significance of <0.001 in terms of YS and E. The mean differences of loading YS, E, and YS/E between chlorhexidine and probiotic are 2.45 MPa, 0.26 GPa, and 0.00007, whereas unloading values are 1.44 MPa, 0.49 GPa, and 0.0000533, respectively, with no statistical significance of >0.001 in terms of YS, E, and YS/E. Surface topography alteration was clearly appreciated in the charcoal and probiotic mouthwash groups compared to charcoal mouthwash.

CONCLUSIONS

Loading and unloading of 0.016" ceramic-coated nickel-titanium archwires showed an increase in mechanical properties except for the spring back ratio on exposure to chlorhexidine, probiotic, and charcoal mouthwashes. Chlorhexidine and probiotic mouthwashes had a higher yield strength and flexural modulus of elasticity in comparison with charcoal mouthwash and artificial saliva on 0.016" ceramic-coated nickel-titanium archwires. More corrosive changes were seen on 0.016" ceramic-coated nickel-titanium archwires when immersed in chlorhexidine, followed by probiotic and charcoal mouthwashes.

Nanotopography Evaluation of NiTi Alloy Exposed to Artificial Saliva and Different Mouthwashes

Nitinol (NiTi) alloy is a widely used material for the production of orthodontic archwires. Its corrosion behavior in conditions that exist in the oral cavity still remains a great characterization challenge. The motivation behind this work is to reveal the influence of commercially available mouthwashes on NiTi orthodontic archwires by performing non-electrochemical corrosion tests and quantifying the changes in the nanotopography of commercially available NiTi orthodontic wires. In this study, we examined the behavior of NiTi alloy archwires exposed for 21.5 days to different corrosive media: artificial saliva, Eludril^®, Aquafresh^®, and Listerine^®. The corrosion was characterized by contact mode atomic force microscopy (AFM) before and after the corrosion tests. A novel analysis methodology was developed to obtain insight into locations of material gain or material loss based on standard surface roughness parameters Sa, Sdr, Ssk, and S10z. The developed methodology revealed that fluoride-containing mouthwashes (Aquafresh^® and Listerine^®) dominantly cause material loss, while chloride-containing mouthwash (Eludril^®) can cause both material loss and material gain. The sample exposed to artificial saliva did not display significant changes in any parameter.

Determination of metal ions release from orthodontic archwires in artificial saliva using inductively coupled plasma-optical emission spectrometer (ICP-OES)

Over the last decades many concerns have been raised regarding the migration of potentially toxic metals from the orthodontic appliances to the oral environment due to the dynamic dominant conditions. The current study aimed to investigate the effect of the oral environment acidity and aging time on the ion release from orthodontic archwires. For this purpose, dental archwires consisted of three different alloys were immersed in artificial saliva of varied pH values for 7 and 30 days at 37±1°C. The liquid extracts were then analyzed with inductively coupled plasma-optical emission spectrometer (ICP-OES). It was found that the released ion species and the measured concentrations were not in accordance with manufacturers’ data. Furthermore, the leachates were mainly enriched with Cr and Ni ions by decreasing the saliva pH, while most of the archwires released the highest amounts of Ni, Mn and Cr ions after 30 days aging at pH = 3.5. Independent of the material type or the aging conditions, the total release of Ni and Cr ions was within the considered average dietary intake levels.

In vitro wearing away of orthodontic brackets and wires in different conditions: A review

Introduction

The release of metallic ions from orthodontic brackets and wires typically depends on their quality (chemical composition) and the medium to which they are exposed, e.g., acidic, alkaline, substances with a high fluoride concentration, etc. This review examines corrosion and wear of orthodontic brackets, wires, and arches exposed to different media, including: beverages (juices), mouthwashes and artificial saliva among others, and the possible health effects resulting from the release of metallic ions under various conditions.

Objective

This review aims to determine the exposure conditions that cause the most wear on orthodontic devices, as well as the possible health effects that can be caused by the release of metallic ions under various conditions.

Sources

A search was carried out in the Scopus database, for articles related to oral media that can corrode brackets and wires. The initial research resulted in 8,127 documents, after applying inclusion and exclusion criteria, 76 articles remained.

Conclusion

Stainless steel, which is commonly used in orthodontic devices, is the material that suffers the most wear. It was also found that acidic pH, alcohols, fluorides, and chlorides worsen orthodontic material corrosion. Further, nickel released from brackets and wires can cause allergic reactions and gingival overgrowth into patients.

Toxicological Assessment of an Acrylic Removable Orthodontic Appliance Using 2D and 3D In Vitro Methods

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.

Is titanium alloy Ti-6Al-4 V cytotoxic to gingival fibroblasts-A systematic review

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.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Corrosion induced fracture of NiTi wires in simulated oral environments

This work aims to assess the influence of corrosion on fracture of nickel titanium (NiTi) superelastic wires in physiological solutions (9 g/l NaCl) with and without addition of 1 g/l NaF. The electrochemical cell was coupled to a Hounsfield Tensiometer tensile machine commonly used for corrosion investigation of alloys under stress and strain. Corrosion tests were performed on unstrained and strained conditions up to 4% total strain. This strain limit corresponds to 50% of the total elongation achieved into the superelastic stress plateau of the alloy. All wire specimens were analyzed after testing by scanning electron microscopy (SEM). The results showed that localized corrosion occurred for NiTi wires in solution containing fluoride, while no corrosion attack was detected in NaCl 9 g/l solution. There was no significant difference between the corrosion resistance of unstrained and strained wires. However, brittle like fracture occurred in NaCl + NaF solution within the superelastic domain of the material. The most relevant conclusion achieved is that the use of superelastically strained NiTi in oral environments in the presence of fluoride is followed by significant risk of corrosion induced fracture.

Comparative Evaluation of Biofilm Adhesion to Different Types of Archwire and Microbiological Colonization During Orthodontic Treatment

Objective:

To evaluate the biofilm adhesion to 4 types of ‘as retrieved’ archwires during orthodontic treatment. To compare biofilm formation by viable cell counting (colony-forming units [CFU]) of microbes ( Staphylococcus aureus, Streptococcus mutans and Candida albicans).

Methods:

The study was conducted on 40 patients who were divided into 4 equal groups based on the type of archwire of same cross-section (0.019" × 0.025"): group 1—copper-nickel titanium (Cu-NiTi); group 2—titanium molybdenum alloy (TMA); group 3—stainless steel (SS); and group 4—aesthetic coated SS. After 1 month of fixed orthodontic therapy, the archwires were removed carefully from the oral cavity.

Results:

Biofilm absorbance and biofilm concentration were significant ( P ≤ .05) in all the 4 groups.

Conclusion:

The group 2 wire showed the maximum affinity for biofilm absorbance and biofilm concentration, whereas the group 4 wire showed the least affinity. The group 4 wire promoted less retention of oral bacteria compared with the wires of the other groups, whereas the group 1 wire showed maximum retention. In the present study, all types of wire showed maximum affinity for S mutans and the least affinity for C albicans, except for the group 1 wire, which showed maximum affinity for S aureus. Biofilm adhesion could be a significant determining factor in the selection of orthodontic archwire for patients primarily at risk of dental caries or periodontal diseases, or both.

Cytotoxicity and oxidative stress induced by nickel and titanium ions from dental alloys on cells of gastrointestinal tract

The aim was to explore the biological effect of nickel (Ni) and titanium (Ti) ions released from dental alloys. NiTi alloy were exposed to 40 mL of artificial saliva (pH = 4.8, t = 37 °C). The dynamics of Ni and Ti ions release during corrosion were recorded on the 3th, 7th and 14th day. Biological effect of Ni and Ti ions released from alloy was explored on cell lines of human tongue CAL 27, liver Hep G2 and colon Caco-2. Neutral Red uptake assay for the estimation of cell viability/cytotoxicity and 2',7'-dichlorofluorescein diacetate fluorimetric assay for reactive oxygen species were used. Cells were exposed to the following concentration of corrosion products: 5.0×, 1.0×, 0.5 and 0.1× during the period of 24, 48 and 72 h. To check the effect of each metal separately, cells were exposed to nickel-chloride and titanium-dioxide of corresponding concentration. The release of Ni is higher than of Ti (15.1-30.4 μg/L for Ni and 9.0-17.3 μg/L for Ti, respectively) and 5× higher concentrations are needed to induce cytotoxic effect. Ni and Ti ions alone do not induce a major cytotoxic effect, but their combination does indicating their synergistic effect. Increase in concentration of Ni and Ti tends to increase cytotoxicity, Ti more than Ni. Cytotoxicity and induction of free radicals are in strong positive linear correlation. Ions released from NiTi alloy during 14 days do not induce significant cytotoxic effect and would not have a clinically important impact. Cytotoxic effect is largely the result of the induction of free radicals.

Effects of magnetic fields from electric toothbrushes on fluoride- and oral bacteria-induced corrosion of orthodontic metallic wires

Corrosion of metallic materials in the oral cavity could trigger metal allergy in patients. To clarify the risk elevation of magnetic fields (MFs) exposure on metallic corrosion when combined with fluoride-containing dental care products and indigenous oral bacteria, we investigated electric toothbrush-derived MF-induced corrosion of orthodontic stainless steel (SUS) and nickel titanium (Ni-Ti) wires in the presence of fluoride and oral bacteria, i.e. Streptococcus (S) mutans and S. sanguinis. MFs induced an electric current in the wires under both environments. Oral bacteria corroded SUS wires, and fluoride corroded SUS and Ni-Ti wires as previously reported; however, no additive or synergistic effects of MF exposure on fluoride- and microbiologically-induced metallic corrosion were observed. These results suggest that the MFs from electric toothbrushes do not increase the risk of corrosion of metallic appliances, given that the oral environment of patients is exposed to oral bacteria and fluoride-containing products.

Corrosion of Nickel-Titanium Orthodontic Archwires in Saliva and Oral Probiotic Supplements

Objectives

The aim of the study was to examine how probiotic supplements affect the corrosion stability of orthodontic archwires made of nickel-titanium alloy (NiTi).

Materials and Methods

NiTi archwires (0.508x0.508 and having the length of 2.5 cm) were tested. The archwires (composition Ni=50.4%, Ti=49.6%) were uncoated, nitrified and rhodium coated. Surface microgeometry was observed by using scanning electron microscope and surface roughness was measured by profilometer through these variables: roughness average, maximum height and maximum roughness depth. Corrosion was examined by electrochemical method of cyclic polarisation.

Results

Rhodium coated alloy in saliva has significantly higher general corrosion in saliva than nitrified alloy and uncoated alloy, with large effect size (p=0.027; η2=0.700). In the presence of probiotics, the result was even more pronounced (p<0.001; η2=0.936). Probiotic supplement increases general and localised corrosion of rhodium coated archwire and slightly decreases general corrosion and increases localised corrosion in uncoated archwire, while in the case of nitrified archwire the probability of corrosion is very low. The differences in surface roughness between NiTi wires before corrosion are not significant. Exposure to saliva decreases roughness average in rhodium coated wire (p=0.015; η2=0.501). Media do not significantly influence surface microgeometry in nitrified and uncoated wires.

Conclusion

Probiotic supplement affects corrosion depending on the type of coating of the NiTi archwire. It increases general corrosion of rhodium coated wire and causes localised corrosion of uncoated and rhodium coated archwire. Probiotic supplement does not have greater influence on surface roughness compared to that of saliva.

Galvanic coupling of steel and gold alloy lingual brackets with orthodontic wires: Is corrosion a concern?

OBJECTIVES

The aim of this research was to assess galvanic behavior of lingual orthodontic brackets coupled with representative types of orthodontic wires.

MATERIALS AND METHODS

Three types of lingual brackets: Incognito (INC), In-Ovation L (IOV), and STb (STB) were combined with a stainless steel (SS) and a nickel-titanium (NiTi) orthodontic archwire. All materials were initially investigated by scanning electron microscopy / x-ray energy dispersive spectroscopy (SEM/EDX) while wires were also tested by x-ray diffraction spectroscopy (XRD). All bracket-wire combinations were immersed in acidic 0.1M NaCl 0.1M lactic acid and neutral NaF 0.3% (wt) electrolyte, and the potential differences were continuously recorded for 48 hours.

RESULTS

The SEM/EDX analysis revealed that INC is a single-unit bracket made of a high gold (Au) alloy while IOV and STB are two-piece appliances in which the base and wing are made of SS alloys. The SS wire demonstrated austenite and martensite iron phase, while NiTi wire illustrated an intense austenite crystallographic structure with limited martensite. All bracket wire combinations showed potential differences below the threshold of galvanic corrosion (200 mV) except for INC and STB coupled with NiTi wire in NaF media.

CONCLUSIONS

The electrochemical results indicate that all brackets tested demonstrated galvanic compatibility with SS wire, but fluoride treatment should be used cautiously with NiTi wires coupled with Au and SS brackets.

In vitro and in vivo evidence of the cytotoxic and genotoxic effects of metal ions released by orthodontic appliances: A review

Intraoral fixed orthodontic appliances are frequently used in the clinical practice of dentistry. They are made from alloys containing different metals at various percentages. The use of these appliances leads to the long-term exposure of patients to these materials, and the potential toxic effects of this exposure raises concerns about patient safety. Thus, the biocompatibility (corrosion behaviour and toxicity) of these materials has to be evaluated prior to clinical use. In the present report, the most recent studies in the scientific literature examining metal ion release from orthodontic appliances and the toxic effects of these ions have been reviewed with a special focus on cytotoxicity and genotoxicity. Previous studies suggest that a case-by-case safety evaluation is required to take into account the increasing variability of materials, their composition and the manufacturing processes. Moreover, in vivo toxicity studies in regard to metal release, cytotoxicity and genotoxicity are still scarce. Therefore, in vitro and in vivo monitoring studies are needed to establish cause-effect relationships between metal ion release and biomarkers of cytotoxicity and genotoxicity. Further investigations could be performed to elucidate the toxic mechanisms involved in the observed effects with a special emphasis on oxidative damage.

An in vitro assessment of the mechanical characteristics of nickel-titanium orthodontic wires in Fluoride solutions with different acidities

Objectives:

The aim was to evaluate the in vitro effects of fluoride solutions with different acidities on load-deflection characteristics of nickel-titanium (NiTi) orthodontic wires.

Materials and Methods:

In this study, which lasted 30 days, 36 (3 cm long, 0.016 × 0.022 inches, SENT 1622, G & H wire Company, Greenwood, Indiana, USA) NiTi wires, were divided into three experimental groups of 12 each. Two groups were subjected to 0.05 topical fluoride mouthwash with different acidities (G1, pH 4; G2, pH 6.6) for 90 s, twice a day, and kept in normal saline after that. The third group (G3, the control group) was kept in normal saline only. Load and unload forces were measured with three bracket bending test in a universal testing machine (Testometric Co, Rochdale, UK). Loading and unloading plateaus and hysteresis were also recorded. Data were then analyzed using analysis of variance and honestly significant difference Tukey at P < 0.05.

Results:

During the loading phase, there was a significant difference between deflections (P < 0.001); but there was no interaction effect (P = 0.191) and no significant difference among three groups (P = 0.268). In the unloading phase, there was a significant difference between deflections (P < 0.001) and an interaction effect was also observed (P = 0.008). Further, significant differences noted among three groups (P = 0.037). Only in the unloading phase, at deflections of 2.2 through 0.2 mm, significant differences between the mean force values of the G1 and G3 groups were observed (P = 0.037).

Conclusion:

Based on this in-vitro study, compared to neutral fluoride solution, daily mouthwash with a fluoride solution with more acidic pH of 4 affected the NiTi wires load-deflection characteristics during the unloading phase. This finding may have clinical implications and can be further validated by in-vivo studies.

Degradation of the mechanical properties of orthodontic NiTi alloys in the oral environment: an in vitro study

Appropriate characterization studies are needed to demonstrate the mechanical and biological effects of interaction between archwires and the oral environment. The aim of this study was to investigate, in vitro, the impact of this acidic and fluoridated environment on the electrochemical behavior and the mechanical properties of orthodontic alloys in nickel titanium and in stainless steel (controls) for the following parameters: Young's modulus (E), elastic limit (σe) and the maximum tensile load (σm). Six samples of each archwire alloy were used to assess these parameters. An Instron universal test apparatus (model - 88512) was used for the traction tests on the wires after immersion in solutions at different concentrations of fluoride and at various pH levels. Observations were made using an electron scanning microscope (ESM) to evaluate the surface and an ICP (inductively coupled plasma) mass spectroscopy analysis was made to quantify the substances released into the immersion solution. For the NiTi archwires, immersion in the fluoridated and acidic medium showed a statistically significant reduction of the Young's modulus (E), the elastic limit (σe) and the maximum tensile load (σm). Similarly, a higher level of released nickel proportionate to the increase in the fluoride concentration and acidity was observed in the immersion solutions. ESM observations revealed the status of the surface of the different alloys and the presence of corrosive pitting.

Comparative short-term in vitro analysis of mutans streptococci adhesion on esthetic, nickel-titanium, and stainless-steel arch wires

OBJECTIVE

To test the hypothesis that there are no differences in mutans streptococci (MS) adhesion between esthetic and metallic orthodontic arch wires based on their surface characteristics.

MATERIALS AND METHODS

Surface roughness (Ra) and apparent surface free energy (SFE) were measured for six wires-four esthetic, one nickel-titanium (NiTi), and one stainless-steel (SS)-using profilometry and dynamic contact angle analysis, respectively. The amount of MS (Streptococcus mutans and Streptococcus sobrinus) adhering to the wires was quantified using the colony-counting method. The surfaces, coating layers, and MS adhesion were also observed by scanning electron microscopy. Statistical significance was set at P < .05.

RESULTS

The Ra values of the esthetic wires were significantly different from one another depending on the coating method (P < .05). The NiTi wire showed the highest SFE, followed by the SS wire and then the four esthetic wires. The NiTi wires produced a significantly higher MS adhesion than did the SS wires (P < .05). The esthetic wires showed significantly lower MS adhesions than did the NiTi wire (P < .05). Pearson correlation analyses found moderate significant positive correlations between the SFE and the S mutans and S sobrinus adhesions (r  =  .636/.427, P < .001/P  =  .001, respectively).

CONCLUSIONS

The hypothesis is rejected. This study indicates that some esthetic coatings on NiTi alloy might reduce MS adhesion in vitro in the short term.

Mapping chemical elements on the surface of orthodontic appliance by SEM-EDX

Background

During orthodontic treatment, the various elements that constitute the fixed appliance undergo different processes. As a result of a change of the surface, elution/coverage of metals on the surface can be observed in the process of corrosion/passivation.

Material/Methods

Scanning electron microscopy with an energy-dispersive X-ray analytical system (SEM-EDX) was used to analyze the composition of stainless steel elements of orthodontic fixed appliances (before and after orthodontic treatment), to obtain the composition of the surface of the elements. The analyzed elements were: brackets (Victory Series APC PLUS 022, 3M Unitek, Monrovia, CA, USA); wires (0.017×0.025, 3M Unitek, Monrovia, CA, USA); and bands (37+, 3M Unitek, Monrovia, CA, USA).

Results

The results showed a decrease of chromium and iron contribution to the surface, with increase of oxygen content in used vs. new elements of the appliance.

Conclusions

Our results confirm the formation of oxides (passivation layer) on the surface of stainless steel as a result of the presence of the orthodontic appliance in patients’ oral cavities.

Effect of pH on in vitro biocompatibility of orthodontic miniscrew implants

Background

Although the clinical use of miniscrews has been investigated on a large scale, little is known about their biocompatibility. Since low pH can affect corrosion resistance, the aim of this study was to evaluate the cytotoxic effect of orthodontic miniscrews in different pH conditions.

Methods

Four orthodontic miniscrews of stainless steel and grade IV and grade V titanium were immersed in a pH 7 and pH 4 saline solution for 1, 7, 14, 21, 28, and 84 days. Human osteogenic sarcoma cells (U2OS), permanent human keratinocytes (HaCat), and primary human gingival fibroblasts (HGF) were exposed to eluates, and the mitochondrial dehydrogenase activity was measured after 24 h to assess the cytoxicity. The results were analyzed using the Mann-Whitney U test (P < 0.05).

Results

When exposed to pH 7-conditioned eluates, the cell lines showed an even greater viability than untreated cells. On the contrary, the results revealed a statistically significant decrease in U2OS, HaCat, and HGF viability after exposure to eluates obtained at pH 4. Among the cell lines tested, HGF showed the most significant decrease of mitochondrial activity. Interestingly, grade V titanium miniscrews caused highest toxic effects when immersed at pH 4.

Conclusions

The results suggested that at pH 7, all the miniscrews are biocompatible while the eluates obtained at pH 4 showed significant cytotoxicity response. Moreover, different cell lines can produce different responses to miniscrew eluates.

Assessment of nickel titanium and beta titanium corrosion resistance behavior in fluoride and chloride environments

Objective:

To assess the influence of fluoride concentration on the corrosion behavior of nickel titanium (NiTi) superelastic wire and to compare the corrosion resistance of NiTi with that of beta titanium alloy in physiological solution with and without addition of fluoride.

Materials and Methods:

NiTi corrosion resistance was investigated through electrochemical impedance spectroscopy and anodic polarization in sodium chloride (NaCl 0.15 M) with and without addition of 0.02 M sodium fluoride (NaF), and the results were compared with those associated with beta titanium. The influence of fluoride concentration on NiTi corrosion behavior was assessed in NaCl (0.15 M) with and without 0.02, 0.04, 0.05, 0.07, and 0.12 M NaF solution. Galvanic corrosion between NiTi and beta titanium were investigated. All samples were characterized by scanning electron microscopy.

Results:

Polarization resistance decreased when NaF concentration was increased, and, depending on NaF concentration, NiTi can suffer localized or generalized corrosion. In NaCl solution with 0.02 M NaF, NiTi suffer localized corrosion, while beta titanium alloys remained passive. Current values near zero were observed by galvanic coupling of NiTi and beta titanium.

Conclusions:

There is a decrease in NiTi corrosion resistance in the presence of fluoride. The corrosion behavior of NiTi alloy depends on fluoride concentration. When 0.02 and 0.04 M of NaF were added to the NaCl solution, NiTi presented localized corrosion. When NaF concentration increased to 0.05, 0.07, and 0.12 M, the alloy presented general corrosion. NiTi corrosion resistance behavior is lower than that of beta titanium. Galvanic coupling of these alloys does not increase corrosion rates.

MR T1 and T2 relaxations in cysts and abscesses measured by 1.5 T MRI

OBJECTIVES

The main objective of this study was to make a comparison between the relaxation rates in jaw cysts and abscesses. Such a comparison should provide quantitative information for MR image analysis.

METHODS

A phantom containing 20 odontogenic jaw cysts and 11 jaw abscesses was imaged with 1.5 T MR. T(1) measurements were performed by using a mixed sequence of inversion recovery and spin echo, while T(2) measurements were carried out by the Carr-Purcell Meiboom-Gill (CPMG) sequence. Cystic fluids and abscesses were compared statistically.

RESULTS

In cysts and abscesses, respectively, the mean 1/T(1) was 0.9355 s(-1) and 0.8245 s(-1) and the mean 1/T(2) was 2.4575 s(-1) and 4.7073 s(-1). The 1/T(2) in cysts was very highly significantly different from that in abscesses (p = 0.0001). Both T(1) and T(2) were linearly proportional to material contents. T(2) relaxivities [26.458 ml (g s)(-1) for abscesses and 21.455 ml (g s)(-1) for cysts] were higher than T(1) relaxivities [5.4766 ml (g s)(-1) for abscesses and 10.075 ml (g s)(-1) for cysts].

DISCUSSION

Present T(2) measurements differentiate cysts from abscesses with a confidence interval of 95%. Because in vivo and in vitro image contrasts are changed by the same parameters, the T(2) findings should present valuable information for in vivo MRI. Hence the significant difference and the relaxivities may provide quantitative information for clinicians and researchers making image analyses.

CONCLUSION

T(2) may differentiate cysts from abscesses. The difference in T(2) is related to the material content of samples.

Corrosion in Haas expanders with and without use of an antimicrobial agent: an in situ study

Objectives

The purpose of this study was to evaluate in situ the occurrence of corrosion in the soldering point areas between the wire, silver brazing and band in Haas expanders.

Material and Methods

Thirty-four 7-12-year-old patients who needed maxillary expansion with a Haas expander were randomly assigned to two groups of 17 individuals each, according to the oral hygiene protocol adopted during the orthodontic treatment: Group I (control), toothbrushing with a fluoride dentifrice and Group II (experimental), toothbrushing with the same dentifrice plus 0.12% chlorhexidine gluconate (Periogard^®) mouthrinses twice a week. The appliances were removed after approximately 4 months. Fragments of the appliances containing a metallic band with a soldered wire were sectioned at random for examination by stereomicroscopy, scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy (EDS). Data were analyzed statistically by Fisher's test at 5% significance level.

Results

The analysis by optical microscopy revealed areas with color change suggestive of corrosion in the soldering point areas joining the band and the wire in all specimens of both groups, with no statistically significant difference between the groups (p=1). The peaks of chemical elements (Ni, Fe, Cr, O, C and P) revealed by EDS were also similar in both groups.

Conclusion:

Color changes and peaks of chemical elements suggestive of corrosion were observed in the soldering point areas between the wire, silver brazing and band in both control and experimental groups, which indicate that the 0.12% chlorhexidine gluconate mouthrinses did not influence the occurrence of corrosion in situ.

Release of metal ions from orthodontic appliances by in vitro studies: a systematic literature review

In the present work, a systematic literature review on release of metal ions from orthodontic appliances under in vitro conditions is described. Detailed and schematic analysis of used materials and applied methods (immersion media, incubation time, temperature, and analytical techniques) is provided. The PubMed search identified 40 studies, among which eight met the selection criteria. One additional study was included in the review. All the authors agreed that the doses of released metal ions were far below the toxic level and the dietary intake. Although the concentrations of metal ions in immersion media greatly differed, the general conclusions were coherent. It must be underlined that the main disadvantage of in vitro tests was that the experimental setup did not reflect in vivo conditions, e.g., the presence of biofilm, which grows on the surface of the materials in oral cavity. The presence and activity of microflora to a large extent is responsible for the process of corrosion, in particular, biodeterioration. The further scheme of in vitro research should incorporate changeable conditions of oral cavity environment (pH, dynamic conditions-saliva flow) and the presence of microbiological flora (microbiological attack) in the experimental design and, first of all, the real proportions of appliance elements.

Evaluation of the cytotoxicity of latex and non-latex orthodontic separating elastics

OBJECTIVE

To test the hypothesis that a difference in cytotoxicity exists between latex and non-latex orthodontic separating elastics.

MATERIAL AND METHODS

Five intra-oral separating elastics from different manufactures (four latex and one non-latex) were divided into five groups of 15 elastics each: Group MA (non-latex elastics, Masel), Group MO (natural latex, Morelli), Group DE (natural latex, Dentaurum), Group TP (natural latex, TP Orthodontics) and Group UN (natural latex, Unitek). The cytotoxicity assay was performed using cell cultures (epithelial HEp-2 cells originating from human laryngeal carcinoma) that were submitted to the cell viability test with neutral red (dye-uptake) at 24, 48, 72 and 168 h. Analysis of variance (anova) with multiple comparisons and Tukey's test were employed (p < 0.05).

RESULTS

The results showed no statistically significant differences between groups MA, DE, TP and UN in relation to Group CC (cell control) for experimental times of 24, 48 and 168 h (p > 0.05). Morelli, Dentaurum, TP Orthodontics and Unitek elastics induced a great amount of cell lyses at 72 h.

CONCLUSION

One can demonstrate that the Masel elastic induced less cell lysis compared with other elastics, but all trademarks were found to be clinically biocompatible.

CLINICAL RELEVANCE

Separating orthodontic elastics are used in the interdental subgingival region with the aim to separate the teeth for placement of orthodontic bands. However, latex has been known to cause allergy. As these materials are widely used in clinical orthodontics, care regarding the cytotoxicity of orthodontic elastics should be taken. Thus, clinically proven biocompatible materials should be acquired whenever possible.

Cytotoxicity of intermaxillary orthodontic elastics of different colors: an in vitro study

Objectives:

Natural latex does not fall into the category of materials known to be entirely inoffensive. The purpose of this in vitro study was to test the hypothesis that there is no difference in the cytotoxicity between elastics of different colors and those from different manufacturers.

Material and Methods:

Different latex intraoral elastics of different colors (5/16 = 7.9 mm, mean load) were compared. The sample was divided into 7 groups of 24 elastics each: Group T (TP Orthodontics, natural latex elastics, control); Groups U1, U2, U3, U4, U5 and U6 (Uniden, natural latex elastics and colored elastics, namely, green, pink, yellow, red and purple, respectively). Cytotoxicity assays were performed by using cell culture medium containing epithelioid-type cells (Hep-2 line) derived from human laryngeal carcinoma. The cytotoxicity was evaluated by using the "dye-uptake" test, which was employed at two different moments (0 and 24 h). Data were compared by analysis of variance (ANOVA) and Tukey's test (p<0.05).

Results:

There was statistically significant difference (p<0.05) between Group T and all other groups (U1, U2, U3, U4, U5 and U6) at 0 and 24 h. No statistically significant difference (p<0.05) was found between Groups U1 and U5, U1 and U6, U2 and U3, U2 and U4, U2 and U5, U2 and U6, U3 and U4, U3 and U5, U3 and U6, U4 and U5, U4 and U6, and U5 and U6 at 0 and 24 h.

Conclusions:

The TP Orthodontics elastics promoted less cell lysis compared to the Uniden elastics regardless of their color.