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Gomes NB, Almeida JVFPD, Neves JG, Correr AB, Correr-Sobrinho L, Costa AR. Evaluation of mechanical properties and morphology of miniscrews Ti6Al4V cold worked versus annealed in artificial bones. Int Orthod 2024; 22:100835. [PMID: 38141559 DOI: 10.1016/j.ortho.2023.100835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/25/2023]
Abstract
PURPOSE This study aimed to evaluate the influence of different manufacturing procedures (Eli annealed - hot work versus cold worked - cold work) of the raw material under mechanical properties and morphological characteristics of orthodontic miniscrews (MS). MATERIAL AND METHODS Thirty MS were randomly separated into 3 types (n=10) according to manufacturer and manufacturing process of the raw material: type A - SIN® annealed (control group); type B - Dentfix® annealed; and, type C - Dentfix® cold worked. MI were inserted in artificial bone blocks, through the manufacturer's specific manual key attached to the digital torquemeter stabilized via custom device. Data of fracture's occurrence was performed using Fisher's exact test. Comparisons between the other two types regarding insertion torque and removal torque were performed using the Mann-Whitney test. Data of fracture torque, shear stress, normal stress and torque ratio was submitted to Kruskal Wallis and Dunn tests (α=0.05). Representative images of surface morphology and fractures were selected. RESULTS Type C showed statistically the lowest fracture torque (N.cm) (26.11±0.41) (P=0.0012) and highest torque ratio (%) (98.74±0.85) (P=0.0007). Type C showed statistically higher calculated shear (MPa) (2,432.73±508.41) and normal stress (MPa) (1,403.86±293.39) than type B and type A, showing that they differed in relation to the mechanical strength of the material with which they were made (P=0.0007). CONCLUSION Type A fractured completely inside the most apical bone. Type B and type C fractured closer to the transmucosal profile. Cold worked process should be more prone to fractures than those annealed raw manufactured.
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Affiliation(s)
- Neylla Berg Gomes
- Department of Orthodontics, Hermínio Ometto Foundation - FHO, Araras, SP, Brazil
| | | | - José Guilherme Neves
- Department of Restorative Dentistry, Dental Materials area, Piracicaba Dental School, State University of Campinas, FOP - UNICAMP, Piracicaba, SP, Brazil
| | - Américo Bortolazzo Correr
- Department of Restorative Dentistry, Dental Materials area, Piracicaba Dental School, State University of Campinas, FOP - UNICAMP, Piracicaba, SP, Brazil
| | - Lourenço Correr-Sobrinho
- Department of Restorative Dentistry, Dental Materials area, Piracicaba Dental School, State University of Campinas, FOP - UNICAMP, Piracicaba, SP, Brazil
| | - Ana Rosa Costa
- Department of Orthodontics, Hermínio Ometto Foundation - FHO, Araras, SP, Brazil; Department of Restorative Dentistry, Dental Materials area, Piracicaba Dental School, State University of Campinas, FOP - UNICAMP, Piracicaba, SP, Brazil.
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van den Braak MCT, Hoekstra JWM, Bronkhorst EM, Schols JGJH, Ongkosuwito EM, Meijer GJ, van den Beucken JJJP. The effect of surface roughening on the success of orthodontic mini-implants: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2024; 165:262-271.e3. [PMID: 38069923 DOI: 10.1016/j.ajodo.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Orthodontic mini-implants are a widely accepted treatment modality in orthodontics; however, the failure rate is moderately high. Surface roughening is the golden standard in conventional oral implantology, and this may prove beneficial for orthodontic mini-implants as well. The objective of this systematic review is to assess the effect of surface roughening on the success rate of orthodontic mini-implants in both adolescent and adult patients undergoing orthodontic treatment. METHODS Randomized studies comparing the success of surface-roughened and smooth, machined-surface orthodontic mini-implants were included. A literature search was conducted for 6 electronic databases (Pubmed/Medline, Embase, Cochrane, CINAHL, Web of Science, and Scopus), Clinical trial registry (https://www. CLINICALTRIALS gov), and grey literature (Google Scholar). A manual search of the reference lists of included studies was performed. Two authors independently performed the screening, data extraction, risk of bias, and quality assessments. The risk of bias was assessed with the Cochrane risk-of-bias 2.0 Tool. Data were synthesized using a random effect model meta-analysis presented as a forest plot. The certainty in the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool. RESULTS A total of 4226 unique records were screened, and 6 of these were included in the quantitative analysis. Four additional articles were selected for a secondary outcome. A total of 364 orthodontic mini-implants were included in the primary outcome analysis. There was no statistically significant effect of surface roughening on the success of orthodontic mini-implants (odds ratio = 0.63 favoring roughened orthodontic mini-implants; 95% confidence interval, 0.35-1.14). The secondary outcome (ie, the overall failure rate of roughened orthodontic mini-implants) was 6% based on studies with high heterogeneity. Limitations of this study were the risk of bias, study imprecision, and possible publication bias, leading to a very low certainty in the body of evidence. CONCLUSIONS There is very low-quality evidence that there is no statistically significant effect of surface roughening on the success of orthodontic mini-implants in humans. The overall failure rate of surface-roughened orthodontic mini-implants was 6%. FUNDING No funding was received for this review. REGISTRATION This study was preregistered in the Prospective Register of Systematic Reviews (CRD42022371830).
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Affiliation(s)
- Matheus C T van den Braak
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Jan Willem M Hoekstra
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud University Nijmegen Medical Center Nijmegen, The Netherlands
| | - Jan G J H Schols
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Edwin M Ongkosuwito
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Gert J Meijer
- Department of Oral Maxillofacial Surgery, Radboud University Nijmegen Medical Center Nijmegen, The Netherlands
| | - Jeroen J J P van den Beucken
- Section of Regenerative Biomaterials, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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Lee YT, Liou EJW, Chen SW. Comparison between microporous and nanoporous orthodontic miniscrews : An experimental study in rabbits. J Orofac Orthop 2024; 85:1-12. [PMID: 35593908 DOI: 10.1007/s00056-022-00398-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Surface characteristics of orthodontic miniscrews might affect survival rates and removal torque values (RTVs). This experimental study aimed to clarify whether and why a microporous or nanoporous surface promotes higher survival rates and RTVs for orthodontic miniscrews. METHODS Using a split-leg design, one set each of nonporous (sham control, n = 24) and microporous (control, n = 6), and three sets of nanoporous (experimental, n = 6 per set) miniscrews were implanted in the tibias of 12 New Zealand rabbits and immediately loaded with 1.5 N nickel-titanium coil springs for 12 weeks. The surface morphology, micropores, and nanotube diameters of the miniscrews were examined using scanning electron microscopy and field-emission scanning electron microscopy. The surface composition and thickness were determined using Auger electron spectroscopy. The survival rates and RTVs of each set were assessed. RESULTS The nanoporous miniscrews had higher survival rates, RTVs (p < 0.001), and thicker nanotube oxide thicknesses (p < 0.001) than the nonporous and microporous miniscrews. The nonporous and microporous miniscrews had no nanotube structures. The surface oxide composition was titanium dioxide (TiO2). The threshold RTV, TiO2 thickness, and nanotube diameter of nanoporous miniscrews needed to promote the experimental survival rate to 100% was determined to be 6.6 ± 0.8 N-cm (p < 0.05), 22.5 ± 4.8 nm (p < 0.05), and 17.6 ± 2.3 nm or above, respectively. CONCLUSION Nanoporous surfaces promoted higher survival rates and RTVs than microporous miniscrews. This could be due to TiO2 nanotube structures with thicker oxide layers in nanoporous miniscrews.
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Affiliation(s)
- Yueh-Tse Lee
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Linkou, 5, Fusing St., Gueishan District, Taoyuan, 333, Taiwan
| | - Eric Jein-Wein Liou
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan.
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, 199, Tung-Hwa North Rd., Taipei, 105, Taiwan.
| | - Sinn-Wen Chen
- Department of Chemical Engineering, National Tsing Hua University, #101, Sec. 2, Kuang-Fu Rd., Hsin-Chu, 300, Taiwan
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Gezer P, Yilanci H. Comparison of mechanical stability of mini-screws with resorbable blasting media and micro-arc oxidation surface treatments under orthodontic forces: An in vitro biomechanical study. Int Orthod 2023; 21:100775. [PMID: 37263049 DOI: 10.1016/j.ortho.2023.100775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION The aim of this study was to compare the primary stability of mini-screws with different surface treatments such as resorbable blasting media (RBM) and micro-arc oxidation (MAO) under in vitro orthodontic forces. MATERIAL AND METHODS Thirty-six self-drilling TiAl6V4-ELI grade 23 titanium alloy 1.6×8mm mini-screws were inserted into polyurethane foam blocks and divided into three groups according to surface properties: machine surface (MS), RBM-treated, and MAO-treated. An orthodontic force of 150g was applied to the mini-screws using NiTi coils. Maximum insertion torque (MIT) and maximum removal torque (MRT) were measured with a digital torque screwdriver during insertion and removal. For each mini-screw, stability measurements were made with the Periotest M device at day 0 and weeks 1, 2, 4, 8, and 12. RESULTS Significant differences in MIT were observed between all groups in pairwise comparisons (P<0.001) with the highest value in the MAO-treated group and the lowest in the MS group. The mean MRT values differed in all three groups (P=0.001). In pairwise comparisons of MRT, only the difference between MS group and RBM-treated group was significant. The highest value was observed in the RBM-treated group, while the lowest value was observed in the MS group. Periotest values were significantly higher in the MAO-treated group than the RBM-treated group at weeks 8 and 12. A positive significant correlation was found between MIT and MRT in all groups. No significant correlation was found between MIT, MRT and Periotest values in all groups. CONCLUSION RBM-treated group was significantly higher than the MS group in MIT and MRT values. According to Periotest values, RBM-treated group was found to be significantly more stable than the MAO-treated group at weeks 8 and 12. Therefore, RBM surface treatment was found to be more favourable than other surfaces to increase success rate in clinical applications.
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Affiliation(s)
- Pınar Gezer
- Department of Orthodontics, Faculty of Dentistry, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.
| | - Hilal Yilanci
- Department of Orthodontics, Faculty of Dentistry, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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Nishioka-Sakamoto K, Hotokezaka H, Hotokezaka Y, Nashiro Y, Funaki M, Ohba S, Yoshida N. Fixation of an orthodontic anchor screw using beta-tricalcium phosphate in a screw-loosening model in rats. Angle Orthod 2023; 93:490735. [PMID: 36762882 PMCID: PMC10117216 DOI: 10.2319/080822-558.1] [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: 08/01/2022] [Accepted: 12/01/2022] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVES To create an orthodontic anchor screw (OAS)-loosening model and to investigate whether filling the bone hole with beta-tricalcium phosphate (β-TCP) can fix the OAS against orthodontic force. MATERIALS AND METHODS Bone holes with different diameters (1.6, 2.1, or 2.5 mm) were drilled in the tibias of 11-week-old male Wistar rats, and an OAS (3.0 mm in length and 1.2 mm in diameter) was inserted. After a healing period of 2 or 4 weeks, orthodontic force was applied, and the diameter of the bone hole appropriate for the loosening model was determined. Subsequently, under the loosening model, the bone hole was filled with β-TCP, orthodontic force was applied, and movement of the OAS and surrounding tissue changes were evaluated by micro-computed tomography images and histological specimen analysis. RESULTS The bone hole of 1.6 mm in diameter was employed as the OAS-loosening model. When β-TCP was inserted into the bone hole, the linear distance and mesial tipping angle of the OAS movement decreased markedly. Furthermore, the values of bone morphometry significantly increased with β-TCP filling. CONCLUSIONS An OAS-loosening model was established in rats and demonstrated that the loosening OAS was stabilized by β-TCP filling through bone formation. β-TCP may be useful for fixation of a loosening OAS.
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Li M, Wang M, Wei L, Werner A, Liu Y. Biomimetic calcium phosphate coating on medical grade stainless steel improves surface properties and serves as a drug carrier for orthodontic applications. Dent Mater 2023; 39:152-161. [PMID: 36610898 DOI: 10.1016/j.dental.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/05/2022] [Accepted: 12/24/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Recently, stainless steel (SSL) miniscrew implants have been used in orthodontic clinics as temporary anchorage devices. Although they have excellent physical properties, their biocompatibility is relatively poor. Previously, our group developed a two-phase biomimetic calcium phosphate (BioCaP) coating that can significantly improve the biocompatibility of medical devices. This study aimed to improve the biocompatibility of SSL by coating SSL surface with the BioCaP coating. METHODS Titanium (Ti) discs and SSL discs (diameter: 5 mm, thickness: 1 mm) were used in this study. To form an amorphous layer, the Ti discs were immersed in a biomimetic modified Tyrode solution (BMT) for 24 h. The SSL discs were immersed in the same solution for 0 h, 12 h, 24 h, 36 h and 48 h. To form a crystalline layer, the discs were then immersed in a supersaturated calcium phosphate solution (CPS) for 48 h. The surface properties of the BioCaP coatings were analysed. In addition, bovine serum albumin (BSA) was incorporated into the crystalline layer during biomimetic mineralisation as a model protein. RESULTS The morphology, chemical composition and drug loading capacity of the BioCaP coating on smooth SSL were confirmed. This coating improved roughness and wettability of SSL surface. In vitro, with the extension of BMT coating period, the cell seeding efficiency, cell spreading area and cell proliferation on the BioCaP coating were increased. SIGNIFICANCE These in vitro results show that the BioCaP coating can improve surface properties of smooth medical grade SSL and serve as a carrier system for bioactive agents.
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Affiliation(s)
- Menghong Li
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands
| | - Mingjie Wang
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands
| | - Lingfei Wei
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands; Department of Oral Implantology, Yantai Stomatological Hospital, Yantai, China; Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, China
| | - Arie Werner
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands
| | - Yuelian Liu
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands.
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Li M, Wu G, Wang M, Hunziker EB, Liu Y. Crystalline Biomimetic Calcium Phosphate Coating on Mini-Pin Implants to Accelerate Osseointegration and Extend Drug Release Duration for an Orthodontic Application. NANOMATERIALS 2022; 12:nano12142439. [PMID: 35889663 PMCID: PMC9324071 DOI: 10.3390/nano12142439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 01/25/2023]
Abstract
Miniscrew implants (MSIs) have been widely used as temporary anchorage devices in orthodontic clinics. However, one of their major limitations is the relatively high failure rate. We hypothesize that a biomimetic calcium phosphate (BioCaP) coating layer on mini-pin implants might be able to accelerate the osseointegration, and can be a carrier for biological agents. A novel mini-pin implant to mimic the MSIs was used. BioCaP (amorphous or crystalline) coatings with or without the presence of bovine serum albumin (BSA) were applied on such implants and inserted in the metaphyseal tibia in rats. The percentage of bone to implant contact (BIC) in histomorphometric analysis was used to evaluate the osteoconductivity of such implants from six different groups (n=6 rats per group): (1) no coating no BSA group, (2) no coating BSA adsorption group, (3) amorphous BioCaP coating group, (4) amorphous BioCaP coating-incorporated BSA group, (5) crystalline BioCaP coating group, and (6) crystalline BioCaP coating-incorporated BSA group. Samples were retrieved 3 days, 1 week, 2 weeks, and 4 weeks post-surgery. The results showed that the crystalline BioCaP coating served as a drug carrier with a sustained release profile. Furthermore, the significant increase in BIC occurred at week 1 in the crystalline coating group, but at week 2 or week 4 in other groups. These findings indicate that the crystalline BioCaP coating can be a promising surface modification to facilitate early osseointegration and increase the success rate of miniscrew implants in orthodontic clinics.
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Affiliation(s)
- Menghong Li
- Department of Oral Cell Biology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (M.L.); (G.W.); (M.W.)
| | - Gang Wu
- Department of Oral Cell Biology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (M.L.); (G.W.); (M.W.)
| | - Mingjie Wang
- Department of Oral Cell Biology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (M.L.); (G.W.); (M.W.)
| | - Ernst B. Hunziker
- Centre of Regenerative Medicine for Skeletal Tissues, Department of Clinical Research, University of Bern, 3010 Bern, Switzerland;
- Group for Bone Biology, Department of Clinical Research, University of Bern, 3010 Bern, Switzerland
| | - Yuelian Liu
- Department of Oral Cell Biology, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (M.L.); (G.W.); (M.W.)
- Correspondence: ; Tel.: +31-2-0598-0626
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