Tissue reactions to implanted orthodontic wires in rabbits

Metal ion release from silver soldering and laser welding caused by different types of mouthwash

Objective: 

To compare metal ion release from samples welded with silver soldering and laser welding when immersed into mouthwashes with different ingredients.

Materials and Methods: 

A total of 72 samples were prepared: 36 laser welded and 36 silver soldered. Four samples were chosen from each subgroup to study the morphologic changes on their surfaces via scanning electron microscopy (SEM). Each group was further divided into four groups where the samples were submerged into mouthwash containing sodium fluoride (NaF), mouthwash containing sodium fluoride + alcohol (NaF + alcohol), mouthwash containing chlorhexidine (CHX), or artificial saliva (AS) for 24 hours and removed thereafter. Subsequently, the metal ion release from the samples was measured with inductively coupled plasma mass spectrometry (ICP-MS). The metal ion release among the solutions and the welding methods were compared. The Kruskal-Wallis and analysis of variance (ANOVA) tests were used for the group comparisons, and post hoc Dunn multiple comparison test was utilized for the two group comparisons.

Results: 

The level of metal ion release from samples of silver soldering was higher than from samples of laser welding. Furthermore, greater amounts of nickel, chrome, and iron were released from silver soldering. With regard to the mouthwash solutions, the lowest amounts of metal ions were released in CHX, and the highest amounts of metal ions were released in NaF + alcohol. SEM images were in accord with these findings.

Conclusions: 

The laser welding should be preferred over silver soldering. CHX can be recommended for patients who have welded appliances for orthodontic reasons.

Evaluation in vitro of the tensile strength of crimpable hooks used for stabilization in orthognathic surgery

OBJECTIVE

The aim of this study was to evaluate the tensile strength of crimpable hooks used for arch stabilization in orthognatic surgery.

STUDY DESIGN

Ninety stainless steel wire (0.019" × 0.026") segments, each measuring 6 cm long, were used and attached to crimpable hooks of different commercial brands. Six groups were formed (n = 10) denominated as follows: control, in which the wire segments were perpendicularly welded by spot welding machine; and the hooks groups M (Morelli), MS (Morelli with weld), TP (TP Ortho), TPS (TP with weld), TPTg (TP-tungsten), TPTgS (TP-tungsten with weld), AO (American Orthodontics), and AOS (American Orthodontics with weld). The test specimen topography was evaluated by scanning electron microscopy before and after the tensile strength tests. After obtaining the results, the analysis of variance and Kruskal-Wallis multiple-comparison tests were applied.

RESULTS

Compared with the control group, the AOS ball hooks and those from TPS required a greater amount of force to be displaced along the rectangular arch. The hooks in group M were significantly easier to displace, followed by those from AO.

CONCLUSIONS

The best ball hooks for clinical application are those from AOS and TPS.

The use of three-dimensional oral mucosa cell cultures to assess the toxicity of soldered and welded wires

The aim of the present study was to determine whether there is a difference in toxicity and loss of viability of three-dimensional (3D) reconstructed human oral epithelium (RHOE) cell cultures induced by point-welded (PW), laser-welded (LW), and silver-soldered (SiS) orthodontic wires. Three types of soldered stainless steel (SS) wires: PW, LW, and SiS were prepared (n = 3) and subjected to multiple end-point analysis (MEA). Six pieces were cut from each wire. Each piece was placed on the triplicate cell cultures (RHOE model based on TR 146 cells). After 24 hours of topical exposure, the cell cultures were cut and stained with haematoxylin/eosin. Toxicity was assessed by evaluating the morphological changes and classifying these as mild, moderate, or severe. The in vitro cell cultures were subjected to a 3-(4,5-dimethylthiazol-2-yl)2,5-diphenyl tetrazolium bromide (MTT) assay in order to quantify viability. Copper wires served as the control to determine severe toxicity and native cell cultures were used as a baseline. Untreated SS wire (0.9 mm) was included for comparison with the welded wires. Histological evaluation with respect to toxicity and measurement of viability in the 3D cell cultures showed no severe toxicity or loss of viability for any of the wires. The morphological ranking of the tested wires from mild to severe toxicity was: SS = PW = LW < SiS. MTT tests revealed the following mean viability values: native cell line (negative control) 98.1 per cent, SS 96.8 per cent, PW 95.5 per cent, LW 95.5 per cent, SiS 85.7 per cent, and copper wires (positive control) 51.2 per cent. Relative comparison between the different welding techniques tested on RHOE revealed, however, that LW and PW wires induced less toxicity/loss of viability compared with SiS wires.

Corrosion of orthodontic devices

A brief overview of the theory of corrosion and the formation of galvanic couples is presented, followed by a discussion of the metals and alloys used in the fabrication of orthodontic appliances and devices. Attention is paid to the factors that contribute to establishment of corrosion cells in the mouth. Although oral corrosion generally does not cause significant destruction of metal, it can elicit in patients adverse physiological responses such as local irritation and metal hypersensitivity. There are indications that orthodontic treatment may lower the incidence of nickel hypersensitivity. Destructive attack on orthodontic appliances does occur, however, when certain types of denture cleanser are used to clean appliances that contain soldered joints.

In vitro evaluation of dental materials

Biocompatibility has been described as the ability of a material to perform with an appropriate host response in a specific application. Appropriate host response means no (or a tolerable) adverse reaction of a living system to the presence of such a material. An adverse reaction may be due to the toxicity of a dental material. Therefore toxicity may be regarded as one reason for nonbiocompatibility of a dental material. The toxicity of a dental material can be evaluated by in vitro tests, animal experiments and clinical trials. There exists a variety of different in vitro test methods. The most widely used biological systems for toxicity screening of dental materials are cell cultures. Cell cultures for toxicity screening of dental materials are valuable tools for understanding their biological behavior, if the limitations of the methods are taken into consideration, especially concerning the interpretation of the results. Further research should concentrate on better simulations of the in vivo situation in cell cultures. In this review the applications of various cell culture methods to evaluate the cytotoxicity of a wide range of dental materials, e.g. metals, alloys, polymers and cements, are described.