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Blochberger BL, Symmank J, Nitzsche Á, Nietzsche S, Steiniger F, Guellmar A, Reise M, Sigusch B, Jacobs C, Hennig CL. Influence of the orthodontic bonding procedure on biofilm formation. Orthod Craniofac Res 2024; 27:95-101. [PMID: 37470303 DOI: 10.1111/ocr.12692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION In orthodontics, white spot lesions are a persistent and widespread problem caused by the demineralization of buccal tooth surfaces around bonded brackets. The remaining adhesive around the brackets leads to surface roughness, which might contribute to demineralization. The present in vitro study aimed to compare a conventional and a modern adhesive system (APC Flash-Free technology) for orthodontic brackets with regard to the adhesion of Streptococcus sobrinus, a leading caries pathogen. METHODS This in vitro study included 20 premolar teeth and compared 10 APC Flash-Free adhesive-coated ceramic brackets (FF)with 10 conventionally bonded (CB) ceramic clarity brackets. Specimens were incubated in an S. sobrinus suspension for 3 h. To evaluate the bacterial formation, samples were analysed with a scanning electron microscope (SEM). Imaging software was used to quantify and statistically compare percentage values of colonization (PVC) in both groups' adhesion and transition areas. RESULTS We found a significant difference in biofilm formation between the groups for the adhesive and transition areas. PVC in the adhesive area was approximately 10.3-fold greater for the CB group compared with the FF group (median: 3.2 vs 0.31; P < 0.0001). For the transition area, median PVC was approximately 2.4-fold greater for the CB group compared with the FF group (median: 53.17 vs 22.11; P < 0.01). CONCLUSIONS There was a significantly lower level of S. sobrinus formation around the FF bracket system than there was surrounding the conventionally bonded group. This study suggests that the FF adhesive bracket system can help reduce the occurrence of bacterial growth around orthodontic brackets.
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Affiliation(s)
| | - Judit Symmank
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Ánn Nitzsche
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Sandor Nietzsche
- Electron Microscopy Center, University Hospital Jena, Jena, Germany
| | - Frank Steiniger
- Electron Microscopy Center, University Hospital Jena, Jena, Germany
| | - André Guellmar
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Markus Reise
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Bernd Sigusch
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Collin Jacobs
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, Jena, Germany
| | - Christoph-Ludwig Hennig
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, Jena, Germany
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Hennig CL, Blochberger B, Symmank J, Nitzsche Á, Nietzsche S, Steiniger F, Dederichs M, Güllmar A, Reise M, Schulze-Späte U, Sigusch B, Jacobs C. Effects of reducing excess dental adhesive on bacterial adhesion in the bracket periphery. Clin Oral Investig 2023; 27:1993-2001. [PMID: 36809356 PMCID: PMC10160150 DOI: 10.1007/s00784-023-04924-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVES White spot lesions are one of the most common side effects of orthodontic therapy with a multibracket appliance and may indicate a preliminary stage of caries, also known as initial caries. Several approaches may be utilized to prevent these lesions, such as reducing bacterial adhesion in the area surrounding the bracket. This bacterial colonization can be adversely affected by a number of local characteristics. In this context, the effects of excess dental adhesive in the bracket periphery were investigated by comparing a conventional bracket system with the APC flash-free bracket system. MATERIALS AND METHODS Both bracket systems were applied to 24 extracted human premolars, and bacterial adhesion with Streptoccocus sobrinus (S. sobrinus) was performed for 24 h, 48 h, 7 d, and 14 d. After incubation, bacterial colonization was examined in specific areas by electron microscopy. RESULTS Overall, significantly fewer bacterial colonies were found in the adhesive area around the APC flash-free brackets (n = 507 ± 13 bacteria) than the conventionally bonded bracket systems (n = 850 ± 56 bacteria). This is a significant difference (**p = 0.004). However, APC flash-free brackets tend to create marginal gaps with more bacterial adhesion in this area than conventional bracket systems (n = 265 ± 31 bacteria). This bacterial accumulation in the marginal-gap area is also significant (*p = 0.029). CONCLUSION A smooth adhesive surface with minimal adhesive excess is beneficial for reducing bacterial adhesion but also poses a risk of marginal gap formation with subsequent bacterial colonization, which can potentially trigger carious lesions. CLINICAL RELEVANCE To reduce bacterial adhesion, the APC flash-free bracket adhesive system with low adhesive excess might be beneficial. APC flash-free brackets reduce the bacterial colonization in the bracket environment. A lower number of bacteria can minimize white spot lesions in the bracket environment. APC flash-free brackets tend to form marginal gaps between the bracket adhesive and the tooth.
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Affiliation(s)
- Christoph-Ludwig Hennig
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany.
| | - Bijan Blochberger
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
| | - Judit Symmank
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
| | - Ánn Nitzsche
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
| | - Sandor Nietzsche
- Electron Microscopy Center, University Hospital Jena, Ziegelmühlenweg 1, 07743, Jena, Germany
| | - Frank Steiniger
- Electron Microscopy Center, University Hospital Jena, Ziegelmühlenweg 1, 07743, Jena, Germany
| | - Marco Dederichs
- Department of Prosthodontics, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
| | - André Güllmar
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
| | - Markus Reise
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
| | - Ulrike Schulze-Späte
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
- Section of Geriodontics, Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
| | - Bernd Sigusch
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
| | - Collin Jacobs
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, An Der Alten Post 4, 07743, Jena, Germany
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Sun H, Ma X, Li Z, Liu J, Wang W, Qi X. Release characteristics of enoxaparin sodium-loaded polymethylmethacrylate bone cement. J Orthop Surg Res 2021; 16:108. [PMID: 33541384 PMCID: PMC7860616 DOI: 10.1186/s13018-021-02223-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/11/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND This study aimed to prepare the polymethylmethacrylate (PMMA) bone cement release system with different concentrations of enoxaparin sodium (ES) and to investigate the release characteristics of ES after loading into the PMMA bone cement. METHODS In the experimental group, 40 g Palacos®R PMMA bone cement was loaded with various amount of ES 4000, 8000, 12,000, 16,000, 20,000, and 24,000 AXaIU, respectively. The control group was not loaded with ES. Scanning electron microscopy (SEM) was used to observe the surface microstructure of the bone cement in the two groups. In the experiment group, the mold was extracted continuously with pH7.4 Tris-HCL buffer for 10 days. The extract solution was collected every day and the anti-FXa potency was measured. The experiment design and statistical analysis were conducted using a quantitative response parallel line method. RESULTS Under the SEM, it was observed that ES was filled in the pores of PMMA bone cement polymer structure and released from the pores after extraction. There was a burst effect of the release. The release amount of ES on the first day was 0.415, 0.858, 1.110, 1.564, 1.952, and 2.513, respectively, from the six groups with various ES loading amount of 4000, 8000, 12,000, 16,000, 20,000, and 24,000 AXaIU, all reaching the peak of release on the first day. The release decreased rapidly on the next day and entered the plateau phase on the fourth day. CONCLUSION The prepared ES-PMMA bone cement has high application potential in orthopedic surgery. ES-PMMA bone cement shows good drug release characteristics. The released enoxaparin sodium has a local anti-coagulant effect within 24 h after application, but it will not be released for a long time, which is complementary to postoperative anti-coagulation therapy.
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Affiliation(s)
- Hui Sun
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xinzhe Ma
- Department of Orthopaedic Surgery, Shijiazhuang Third Hospital, Shijiazhuang, China
| | - Zhiyong Li
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jianning Liu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiangbei Qi
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
- Tiemenguan District of the Third Hospital of Hebei Medical University, Tiemenguan City, China.
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Enamel demineralization around two different orthodontic bracket adhesive systems: An in vivo study. Saudi Dent J 2019; 31:99-104. [PMID: 30723365 PMCID: PMC6349995 DOI: 10.1016/j.sdentj.2018.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 11/18/2018] [Accepted: 11/18/2018] [Indexed: 11/25/2022] Open
Abstract
Objective To compare the enamel demineralization around the two precoated adhesive bracket systems, APC Flash-Free and APC PLUS (3M Unitek, Monrovia, CA, USA), in clinical settings. Material and method This prospective experimental in-vivo study included 40 premolar teeth, which were planned for extraction due to orthodontic purposes. They were divided into two groups (Group A; n = 20 teeth were bonded with APC Flash Free ceramic brackets and group B; n = 20 teeth were bonded with APC Plus ceramic bracket). After four weeks, the teeth were extracted, sectioned, and examined under the Scanning Electron Microscope (SEM) to evaluate the amount of demineralization from the enamel surface to the deepest point. Results Findings revealed that the mean values of demineralization under SEM were significantly higher in APC Plus compared to APC Flash Free (149.95 µm vs. 112.96 µm, respectively) (P < 0.05). The difference between the two systems was mainly found in the middle part of the facial surfaces, while there were no differences between the two systems in the proximal parts. Conclusion The enamel demineralization around APC Flash-Free adhesive bracket system was significantly less than that of APC plus Adhesive bracket system, which can be due to the absence of the caries promoting adhesive flash during tooth bonding using the flash free system.
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Inhibition of multispecies biofilms by a fluoride-releasing dental prosthesis copolymer. J Dent 2016; 48:62-70. [PMID: 26948665 DOI: 10.1016/j.jdent.2016.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/26/2016] [Accepted: 03/01/2016] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES This study aimed to develop a new mixed-species acidogenic biofilm model and use it to assess the antimicrobial properties of a novel fluoride-releasing copolymer. METHODS Stubs composed of a copolymer of methyl methacrylate (MMA) and 2-hydroxyethyl methacrylate (HEMA) with polymethyl methacrylate (PMMA) were produced by chemically-activated free radical polymerization. A fluoride-releasing copolymer was developed by incorporating sodium fluoride in place of a portion of the PMMA. Samples were mounted in polysulfone Modified Robbins Devices (MRDs) and were optimized for single- and mixed-species biofilm formation by Candida albicans, Lactobacillus casei and Streptococcus mutans. RESULTS Fluoride release was sustained for at least 48h in flowing conditions. Fluoride did not affect the colonization and biofilm growth of any of the microorganisms in monocultures. However, in mixed-species biofilms, cell densities of all three species were reduced approximately ten-fold (p<0.05) on the fluoridated material compared with the non-fluoridated copolymer. CONCLUSIONS These data demonstrate that intermicrobial interactions in mixed-species acidogenic biofilms are sensitive to fluoride, and that the inclusion of fluoride in a denture lining copolymer reduces the formation of polymicrobial biofilms. CLINICAL SIGNIFICANCE The growth of acidogenic microorganisms on denture materials is associated with denture stomatitis and dental caries on surrounding teeth. A fluoride-releasing copolymer that inhibits acidogenic mixed-species biofilms, such as the material described in this study, has the potential to control these diseases by limiting biofilm growth.
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Zanarini M, Pazzi E, Bonetti S, Ruggeri O, Alessandri Bonetti G, Prati C. In vitro evaluation of the effects of a fluoride-releasing composite on enamel demineralization around brackets. Prog Orthod 2012; 13:10-6. [PMID: 22583582 DOI: 10.1016/j.pio.2011.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 04/20/2011] [Accepted: 04/21/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the effectiveness of a fluoride-releasing bonding agent in inhibiting enamel demineralization around orthodontic brackets after the exposure to a demineralizing solution. MATERIALS AND METHODS Twenty-six extracted upper molars were bonded with two different composites: Transbond XT (TXT) and Transbond Plus (TPlus), fluoride-releasing (both 3M Unitek, Monrovia, CA, USA). The samples were exposed to an acid lactic solution for three days and then subjected to Metallographic Optical Microscope (MOM) and Scanning Electron Microscope/Energy Dispersive X-Ray (SEM/EDX) analyses. Enamel surface was examined in different areas: un-treated, etched and primer-painted, un-treated area with no acid exposure, central area with bracket bonded. The maximum demineralization depths and the fluoride content at 100, 200 and 300 μm depth were evaluated. RESULTS MOM analysis showed statistically significant (p<0.001) differences in demineralization depth for TPlus group compared to TXT group with lower values for the first one. EDX analysis confirmed the presence of fluoride in TPlus group. CONCLUSIONS The fluoride content of TPlus appeared able to weakly reduce the enamel demineralization.
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Affiliation(s)
- Matteo Zanarini
- Orthodontics Unit, Department of Oral Sciences, University of Bologna, Italy
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