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Iliadi A, Zervou SK, Koletsi D, Schätzle M, Hiskia A, Eliades T, Eliades G. Surface alterations and compound release from aligner attachments in vitro. Eur J Orthod 2024; 46:cjae026. [PMID: 38884540 PMCID: PMC11181360 DOI: 10.1093/ejo/cjae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
AIM The aim of the present study was to assess the alterations in morphology, roughness, and composition of the surfaces of a conventional and a flowable composite attachment engaged with aligners, and to evaluate the release of resin monomers and their derivatives in an aqueous environment. METHODS Zirconia tooth-arch frames (n = 20) and corresponding thermoformed PET-G aligners with bonded attachments comprising two composite materials (universal-C and flowable-F) were fabricated. The morphological features (stereomicroscopy), roughness (optical profilometry), and surface composition (ATR-FTIR) of the attachments were examined before and after immersion in water. To simulate intraoral use, the aligners were removed and re-seated to the frames four times per day for a 7-day immersion period. After testing, the eluents were analyzed by LC-MS/MS targeting the compounds Bis-GMA, UDMA, 2-HEMA, TEGDMA and BPA and by LC-HRMS for suspect screening of the leached dental material compounds and their degradation products. RESULTS After testing, abrasion-induced defects were found on attachment surfaces such as scratches, marginal cracks, loss of surface texturing, and fractures. The morphological changes and debonding rate were greater in F. Comparisons (before-after testing) revealed a significantly lower Sc roughness parameter in F. The surface composition of the aligners after testing showed minor changes from the control, with insignificant differences in the degree of C = C conversion, except for few cases with strong evidence of hydrolytic degradation. Targeted analysis results revealed a significant difference in the compounds released between Days 1 and 7 in both materials. Insignificant differences were found when C was compared with F in both timeframes. Several degradation products were detected on Day 7, with a strong reduction in the concentration of the targeted compounds. CONCLUSIONS The use of aligners affects the surface characteristics and degradation rate of composite attachments in an aqueous environment, releasing monomers, and monomer hydrolysates within 1-week simulated use.
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Affiliation(s)
- Anna Iliadi
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Greece
- Faculty of Medicine and Health Technology, University of Tampere, Finland
| | - Sevasti-Kiriaki Zervou
- Photo-Catalytic Processes and Environmental Chemistry, Institute of Nanoscience and Nanotechnology, National Centre for Scientific Research ‘Demokritos’, Athens, Greece
| | - Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, CA, USA
| | - Marc Schätzle
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Switzerland
| | - Anastasia Hiskia
- Photo-Catalytic Processes and Environmental Chemistry, Institute of Nanoscience and Nanotechnology, National Centre for Scientific Research ‘Demokritos’, Athens, Greece
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Switzerland
| | - George Eliades
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Greece
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Taylor S, Mueller E, Jones LR, Makela AV, Ashammakhi N. Translational Aspects of 3D and 4D Printing and Bioprinting. Adv Healthc Mater 2024:e2400463. [PMID: 38979857 DOI: 10.1002/adhm.202400463] [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: 02/06/2024] [Revised: 05/22/2024] [Indexed: 07/10/2024]
Abstract
Three-dimensional (3D) printed medical devices include orthopedic and craniofacial implants, surgical tools, and external prosthetics that have been directly used in patients. While the advances of additive manufacturing techniques in the production of medical devices have been on the rise, clinical translation of living cellular constructs face significant limitations in terms of regulatory affairs, process technology, and materials development. In this perspective, the current status-quo of 3D and four-dimensional (4D) (bio)printing is summarized, current advancements are discussed and the challenges that need to be addressed for improved industrial translation and clinical applications of bioprinting are highlighted. It is focused on a multidisciplinary approach in discussing the key translational considerations, from the perspective of industry, regulatory bodies, funding strategies, and future directions.
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Affiliation(s)
| | - Eva Mueller
- Ricoh 3D for Healthcare, Ricoh USA, Winston-Salem, NC 27101, USA
| | - Lamont R Jones
- Department of Otolaryngology, Henry Ford Heath, Detroit, MI 48322, USA
| | - Ashley V Makela
- Institute for Quantitative Health Science & Engineering and Department of Engineering, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Nureddin Ashammakhi
- Institute for Quantitative Health Science & Engineering and Department of Engineering, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
- College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
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Yu X, Li J, Yu L, Wang Y, Gong Z, Pan J. A fully digital workflow for the design and manufacture of a class of metal orthodontic appliances. Heliyon 2024; 10:e32064. [PMID: 38867998 PMCID: PMC11168385 DOI: 10.1016/j.heliyon.2024.e32064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 05/06/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024] Open
Abstract
Background Traditional working procedures requires a lot of clinical processes and processing time. Methods The orthodontic metal appliances were made by applying oral scanners, digital images, computer-aided design and computer-aided manufacturing (CAD-CAM) printers. Results The computer digital technology simplified the manufacturing process for dental appliances and shorten the duration for clinical operation and technical processing. Conclusions The technique described in this paper can guarantee the accuracy of orthodontic appliances and bring revolution the field. Clinical significance The CAD-CAM technology provides a fully digital workflow for manufacturing metal orthodontic appliances, which saves a considerable amount of labor and material costs, and significantly reduces heavy metal pollution in the working environment of dental technicians.
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Affiliation(s)
- Xin Yu
- Department of Orthodontics Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, 356 East Beijing Rd, Shanghai, 200001, China
- Department of Preventive Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Jiaxin Li
- Department of Preventive Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Liming Yu
- Department of Orthodontics Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, 356 East Beijing Rd, Shanghai, 200001, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Yuhui Wang
- Department of Orthodontics Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, 356 East Beijing Rd, Shanghai, 200001, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Zhicheng Gong
- Department of Dental Laboratory Center, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Jie Pan
- Department of Orthodontics Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, 356 East Beijing Rd, Shanghai, 200001, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
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Sayahpour B, Eslami S, Stuhlfelder J, Bühling S, Dahmer I, Goteni M, Kopp S, Nucci L. Evaluation of thickness of 3D printed versus thermoformed aligners: A prospective in vivo ageing experiment. Orthod Craniofac Res 2024. [PMID: 38859724 DOI: 10.1111/ocr.12822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND To compare and investigate the effects of intraoral ageing on the thickness of one group of directly printed and two groups of thermoformed aligners on the labial surface of maxillary central incisors. MATERIALS AND METHODS Six groups (12 samples per group) were included in this prospective in vivo experiment. Groups DP-Clin, INV-Clin and CA-Clin consisted of directly printed (Tera Harz TC-85 DAC resin), thermoformed (Invisalign, PU based polymer) and in house thermoformed (CA-Pro, PET-G based polymer) aligners, retrieved after 1 week of intraoral service. Groups DP-Ctr, INV-Ctr and CA-Ctr included unused aligners samples. Thickness measurements were conducted using confocal laser scanning microscopy (CLSM). Data that underwent log-10 transformation was analysed by multiple linear regression analysis (p < .05). RESULTS Statistically significant differences were found between the materials in both Clin and Ctr categories (p < .001). Group DP had the highest thickness among the groups and the least thickness was observed in the CA group (p < .001). However, intraoral ageing did not significantly affect the aligner thickness of any groups. CONCLUSIONS Both thermoforming and direct printing of clear aligners led to thickness deviations in terms of increase for printed aligners and decrease for thermoformed aligners. Intraoral ageing did not affect the aligner thickness in any of the groups.
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Affiliation(s)
- Babak Sayahpour
- Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Sara Eslami
- Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Jakob Stuhlfelder
- Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Sarah Bühling
- Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Iulia Dahmer
- Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J. W. Goethe University Frankfurt, Frankfurt am Maine, Germany
| | | | - Stefan Kopp
- Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Bandić R, Vodanović K, Vuković Kekez I, Medvedec Mikić I, Galić I, Kalibović Govorko D. Thickness Variations of Thermoformed and 3D-Printed Clear Aligners. Acta Stomatol Croat 2024; 58:145-155. [PMID: 39036327 PMCID: PMC11256873 DOI: 10.15644/asc58/2/4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/30/2024] [Indexed: 07/23/2024] Open
Abstract
Objective To assess thickness variations of thermoformed and 3D-printed clear aligners. Materials and Methods Six different thermoplastic materials with different initial thicknesses were used for aligner thermoforming using Biostar® device (Biostar®, SCHEU-DENTAL GmbH, Iserlohn, Germany). Also, two different dental resins were used to create the printed aligners in three digitally designed thicknesses using IZZI Direct printer (3Dtech, Zagreb, Croatia). The aligners were measured using an electronic micrometer (ELECTRONIC UNIVERSAL MICROMETER, Schut Geometrical Metrology, Groningen, The Netherlands, accuracy: 0.001 mm) on a total of 20 points per aligner. Statistical analysis was performed using the JASP program (JASP, University of Amsterdam, Amsterdam, The Netherlands). Results The difference between the thermoformed and printed groups was statistically significant. Significant differences between different thermoformed materials and between 3D-printed materials were found. The thickness of thermoformed aligners deviated more in the upper jaw, whereas the thickness of printed aligners deviated more in the lower jaw. Both differences were statistically significant. The greatest average deviation from the initial thickness was found in Duran 0.75; Erkodur 0.6; Erkoloc-Pro 1.0; IZZI 0.5; NextDent 0.6 and NextDent A 0.6. NextDent group had the lowest deviations for all teeth of both jaws, except for upper and lower first molar where NextDent A group was more accurate. Conclusions Thermoformed aligners showed decreased values, while printed ones showed mostly increased values compared to the original material thickness. The highest mean deviation belonged to IZZI group, and the NextDent group had the lowest mean deviation. The thickness of both aligners was thinner at the edges compared to the thickness at cusps and fissures.
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Affiliation(s)
- Ružica Bandić
- Department of Orthodontics, University of Split School of Medicine
| | | | | | - Ivana Medvedec Mikić
- Department of Endodontics and Restorative Dental Medicine, University of Split School of Medicine
- Department of Oral Surgery, University of Split School of Medicine
| | - Ivan Galić
- Department of Oral Surgery, University of Split School of Medicine
- Department of Maxillofacial Surgery, University Hospital of Split
| | - Danijela Kalibović Govorko
- Department of Orthodontics, University of Split School of Medicine
- Department of Maxillofacial Surgery, University Hospital of Split
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Iodice G, Ludwig B, Polishchuk E, Petruzzelli R, Di Cunto R, Husam S, Farella M. Effect of post-printing curing time on cytotoxicity of direct printed aligners: A pilot study. Orthod Craniofac Res 2024. [PMID: 38800926 DOI: 10.1111/ocr.12819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION The aim of this in vitro study was to examine the potential impact of different curing times of 3D-printed orthodontic aligners on their cytotoxicity. METHOD Some 60 samples of aligner material were directly 3D printed using Tera Harz TC-85 DAC resin and randomly allocated to three different curing time groups (14, 24 and 50 min). Zendura FLX samples were used as control. The samples were incubated in saliva for 14 days, and then the supernatant was collected. Human gingival fibroblasts (HGF-1)-CRL2014 were used to evaluate potential cytotoxicity. Furthermore, HGF-1 cells were plated on the samples as well as on a glass control sample. After 72 h of growth, their viability was tested. RESULTS Compared with the glass, only the 50-min curing time markedly reduced fibroblast cell growth. Additionally, a negative linear trend was observed between curing time and fibroblast growth. In comparison with the aligner control group, all samples, including the aligner control samples, exhibited a significant reduction in the viability of human fibroblasts when exposed to saliva. CONCLUSIONS 3D directly printed aligners showed a cytotoxic effect similar to that of thermoformed conventional aligners in terms of fibroblasts growth. A linear trend was found between curing time and cells growth, indicating that directly printed aligners could exhibit higher cytotoxicity if exposed to a longer curing time. This dependence on curing time underscores the importance of following a strict manufacturing process.
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Affiliation(s)
- Giorgio Iodice
- Department of Dental and Maxillo-Facial Sciences, Section of Orthodontics and Gnathology, University of Naples "Federico II", Naples, Italy
| | - Bjorn Ludwig
- Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elena Polishchuk
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | | | - Roberto Di Cunto
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Soboh Husam
- University of Medicine and Pharmacy Grigore T. Popa, Bucharest, Romania
| | - Mauro Farella
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
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Šimunović L, Čekalović Agović S, Marić AJ, Bačić I, Klarić E, Uribe F, Meštrović S. Color and Chemical Stability of 3D-Printed and Thermoformed Polyurethane-Based Aligners. Polymers (Basel) 2024; 16:1067. [PMID: 38674987 PMCID: PMC11054520 DOI: 10.3390/polym16081067] [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: 03/18/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
The significant rise in the use of clear aligners for orthodontic treatment is attributed to their aesthetic appeal, enhancing patient appearance and self-confidence. The aim of this study is to evaluate the aligners' response to common staining agents (coffee, black tea, Coca-Cola, and Red Bull) in color and chemical stability. Polyurethane-based thermoformed and 3D-printed aligners from four brands were exposed to common beverages to assess color change using a VITA Easyshade compact colorimeter after 24 h, 48 h, 72 h, and 7 days, as well as chemical stability using ATR-FTIR spectroscopy. The brand, beverage, and manufacturing method significantly influence color stability. ATR-FTIR analysis revealed compositional differences, with variations in response to beverage exposure affecting the integrity of polymer bonds. Color change analysis showed coffee as the most potent staining agent, particularly affecting Tera Harz TC85 aligners, while ClearCorrect aligners exhibited the least susceptibility. 3D-printed aligners showed a greater color change compared to thermoformed ones. Aligners with a PETG outer layer are more resistant to stains and chemical alterations than those made of polyurethane. Additionally, 3D-printed polyurethane aligners stain more than thermoformed ones. Therefore, PETG-layered aligners are a more reliable choice for maintaining the aesthetic integrity of aligners.
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Affiliation(s)
- Luka Šimunović
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | | | - Antun Jakob Marić
- Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, 10000 Zagreb, Croatia;
| | - Ivana Bačić
- Forensic Science Centre “Ivan Vučetić”, Ministry of the Interior, 10000 Zagreb, Croatia;
| | - Eva Klarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Flavio Uribe
- Department of Orthodontics, School of Dental Medicine, University of Connecticut, Farmington, CT 06030, USA;
| | - Senka Meštrović
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
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Palaszkó D, Németh A, Török G, Vecsei B, Vánkos B, Dinya E, Borbély J, Marada G, Hermann P, Kispélyi B. Trueness of five different 3D printing systems including budget- and professional-grade printers: An In vitro study. Heliyon 2024; 10:e26874. [PMID: 38468926 PMCID: PMC10925989 DOI: 10.1016/j.heliyon.2024.e26874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/13/2024] Open
Abstract
Problem Several types of 3D printers with different techniques and prices are available on the market. However, results in the literature are inconsistent, and there is no comprehensive agreement on the accuracy of 3D printers of different price categories for dental applications. Aim This study aimed to investigate the accuracy of five different 3D printing systems, including a comparison of budget- and higher-end 3D printing systems, according to a standardized production and evaluation protocol. Material and methods A maxillary reference model with prepared teeth was created using 16 half-ball markers with a diameter of 1 mm to facilitate measurements. A reference file was fabricated using five different 3D printers. The printed models were scanned and superimposed onto the original standard tesselation language (.stl) file, and digital measurements were performed to assess the 3-dimensional and linear deviations between the reference and test models. Results After examining the entire surface of the models, we found that 3D printers using Fused filament fabrication (FFF) technology -120.2 (20.3) μm create models with high trueness but high distortion. Distortions along the z-axis were found to be the highest with the stereolithography (SLA)-type 3D printer at -153.7 (38.7) μm. For the 4-unit FPD, we found 201.9 (41.8) μm deviation with the digital light processing (DLP) printer. The largest deviation (-265.1 (55.4) μm) between the second molars was observed for the DLP printer. Between the incisor and the second molar, the best results were produced by the FFF printer with -30.5 (76.7) μm. Conclusion Budget-friendly 3D printers are comparable to professional-grade printers in terms of precision. In general, the cost of a printing system is not a reliable indicator of its level of accuracy.
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Affiliation(s)
- Dénes Palaszkó
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Anna Németh
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Gréta Török
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Bálint Vecsei
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Boldizsár Vánkos
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Elek Dinya
- Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary
| | - Judit Borbély
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | | | - Péter Hermann
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Barbara Kispélyi
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
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Elshazly TM, Bourauel C, Aldesoki M, Salvatori D, Alhotan A, Keilig L, Ghoneima A. Effect of attachment configuration and trim line design on the force system of orthodontic aligners: A finite element study on the upper central incisor. Orthod Craniofac Res 2024. [PMID: 38459802 DOI: 10.1111/ocr.12779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES To use the finite element method (FEM) to investigate the effect of various attachment configurations and trimming line designs of orthodontic aligners on their biomechanical performance. METHOD A 3D upper jaw model was imported into 3D design software. The upper right central incisor tooth (Tooth 11) was made mobile, and its periodontal ligament (PDL) and bone structures were designed. Aligners were modelled with three distinct attachment configurations: No attachment, rectangular horizontal, rectangular vertical, and two trimming line designs; scalloped and straight extended, with a homogeneous thickness of 0.6 mm. These models were then imported into an FE software. Simulations were conducted for three different movements, including facial translation, distalization, and extrusion. RESULTS Forces were recorded at 1.3-2.6 N during facial translation, 1.4-5.9 N in distalization, and 0.0-2.0 N in extrusion. The straight extended trimming line consistently generated higher forces than the scalloped design. Attachments had no significant impact on force components during facial translation but were more effective in distalization and extrusion. The combination of a straight extended trimming line with horizontal attachments exhibited the least stresses at the apical third during distalization, and the highest stresses during extrusion, suggesting superior retention. CONCLUSIONS Rectangular attachments offer limited benefits in facial translation, but horizontal rectangular attachments can intensify load in distalization and are crucial for force generation in extrusion. Horizontal attachments are preferred over vertical options. Additionally, the straight extended trim line enhances control of tooth movement and can replace attachments in certain cases. CLINICAL RELEVANCE These findings provide biomechanical evidence and an optimal protocol to guide clinical practice in planning diverse teeth movements. The emphasis is on the influence of attachment utilization and the specific design of aligner trimming lines to enhance control over tooth movement.
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Affiliation(s)
- Tarek M Elshazly
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | | | - Mostafa Aldesoki
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
| | | | - Abdulaziz Alhotan
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ludger Keilig
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
- Department of Dental Prosthetics, Propaedeutics and Materials Science, Dental School, University Hospital Bonn, Bonn, Germany
| | - Ahmed Ghoneima
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
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Slaymaker J, Hirani S, Woolley J. Direct 3D printing aligners - past, present and future possibilities. Br Dent J 2024; 236:401-405. [PMID: 38459321 DOI: 10.1038/s41415-024-7126-0] [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: 03/31/2023] [Revised: 06/29/2023] [Accepted: 07/10/2023] [Indexed: 03/10/2024]
Abstract
The aim of this paper is to introduce the general dentist to recent advances in 3D printing technology used in orthodontics. 3D printing is a highly evolving area of dentistry with continual developments. New advances now allow the in-house delivery of printed aligners. Advocates of this new technology suggest the benefits of more prescriptive and controlled tooth movement in comparison to conventional thermoformed appliances. However, there is currently limited evidence on the efficiency of this material and more research needs to be carried out to validate this new technology.
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Affiliation(s)
| | - Sunil Hirani
- Specialist Orthodontist, Milton Keynes, England, UK
| | - Julian Woolley
- Orthodontic Registrar, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Lasance SJ, Koletsi D, Eliades G, Eliades T. Degree of cure of orthodontic composite attachments underneath aligners. Eur J Oral Sci 2024; 132:e12963. [PMID: 38040662 DOI: 10.1111/eos.12963] [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: 10/04/2023] [Accepted: 11/14/2023] [Indexed: 12/03/2023]
Abstract
The aim of this study was to assess the percentage degree of cure (DC%) of 2-mm-thick resin composite attachments used for aligner treatment. Three types of aligner - two thermoformed aligners (Clear Aligner [CLA], polyethylene terephthalate glycol modified; and Invisalign [INV], polyester urethane) and a three-dimensional-printed aligner (Graphy TC-85DAC [GRP], an acrylate-methacrylate copolymer) - were selected, along with two universal resin composites (3M Filtek Universal [FTU] and Charisma Topaz ONE [CTO]). Samples of each composite were placed under each aligner, and the degree of cure of each composite was evaluated on the top (facing the aligner) and the bottom (facing the substrate) attachment surfaces after curing. Five specimens were used per combination of aligner and composite, and an additional group of composites irradiated without aligners served as the control. The DC% measurements were performed using attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy. The DC% across the aligners were (median values) 33.8%-44.8% for CLA, 33.6%-40.8% for INV, 32.8%-40.6% for GRP, and 40.0%-51.7% for the control group. The DC% values of the attachments cured under any aligner were significantly lower than that of the corresponding control, with the values recorded on the top surfaces being 6% higher than those on the bottom surfaces after adjusting for aligner group and composite type.
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Affiliation(s)
- Sandrine Janine Lasance
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, California, USA
| | - George Eliades
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Atta I, Bourauel C, Alkabani Y, Mohamed N, Kimbe H, Alhotan A, Ghoneima A, Elshazly T. Physiochemical and mechanical characterisation of orthodontic 3D printed aligner material made of shape memory polymers (4D aligner material). J Mech Behav Biomed Mater 2024; 150:106337. [PMID: 38154364 DOI: 10.1016/j.jmbbm.2023.106337] [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: 11/18/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES To conduct a physiochemical and mechanical material analysis on 3D printed shape-memory aligners in comparison to thermoformed aligners. MATERIALS AND METHODS Four materials were examined, including three thermoformed materials: CA Pro (CP), Zendura A (ZA), Zendura FLX (ZF), and one 3D printed material: Tera Harz (TC-85). Rectangular strips measuring 50 × 10 × 0.5 mm were produced from each material. Five tests were conducted, including differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA), shape recovery tests, three-points bending (3 PB), and Vickers surface microhardness (VH). RESULTS DSC recorded glass transition temperatures (Tg) at 79.9 °C for CP, 92.2 °C for ZA, 107.1 °C for ZF, and 42.3 °C for TC-85. In DMA analysis at 20-45 °C, a prominent decrease in storage modulus was observed, exclusively for TC-85, as the temperature increased. Notably, within the temperature range of 30-45 °C, TC-85 exhibited substantial shape recovery after 10 min, reaching up to 86.1 %, while thermoformed materials showed minimal recovery (1.5-2.9 %). In 3 PB test (at 30, 37, 45 °C), ZA demonstrated the highest force at 2 mm bending, while TC-85 exhibited the lowest. Regarding VH at room temperature, there was a significant decrease for both ZA and ZF after thermoforming. ZA had the highest hardness, followed by ZF and TC-85, with CP showing the lowest values. CONCLUSIONS TC-85 demonstrates exceptional shape memory at oral temperature, improving adaptation, reducing force decay, and enabling, together with its higher flexibility, extensive tooth movement per step. Additionally, it maintains microhardness similar to thermoformed sheets, ensuring the durability and effectiveness of dental aligners. CLINICAL RELEVANCE The 3D printed aligner material with shape memory characteristics (4D aligner) has revolutionized the orthodontic aligner field. It showed mechanical properties more suitable for orthodontic treatment than thermoforming materials. Additionally, it offers enhanced control over aligner design and thickness, while optimizing the overall workflow. It also minimizes material wastage, and reduces production expenses.
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Affiliation(s)
- Islam Atta
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
| | | | - Yasmine Alkabani
- Restorative and Dental Materials Department, National Research Centre, Giza, Egypt
| | | | - Hoon Kimbe
- Research Institute of Agriculture and Life Sciences, College of Agriculture and Life Sciences, Seoul National University, Seoul, Republic of Korea
| | - Abdulaziz Alhotan
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Ghoneima
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Tarek Elshazly
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates.
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Cheng L, Feng Z, Hao Z, Si M, Yuan R, Feng Z. Molar distalization in orthodontics: a bibliometric analysis. Clin Oral Investig 2024; 28:123. [PMID: 38286861 PMCID: PMC10824817 DOI: 10.1007/s00784-024-05520-w] [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: 09/26/2023] [Accepted: 01/17/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES The study endeavors to undertake a bibliometric analysis on molar distalization, with the objective of illuminating its evolutionary trajectory, current status, and prognosticating future research hotspots and trends. MATERIAL AND METHODS A comprehensive exploration of the literature on molar distalization was carried out by conducting a search in the Web of Science (WOS) core database of the University of Hong Kong Electronic Library. The search for topic terms employed included "molar distalization," "molar distalisation," "move molar distally," "molar distal movement," and "molar backwards." The search results were subsequently subjected to meticulous analysis using CiteSpace software. This analysis encompassed various facets such as the citation count; the geographical distribution of the countries, institutions, and journals responsible for publishing the articles; the distribution of the authors; the utilization of keywords within the articles; and the analysis of references. RESULTS A total of 516 articles were included in the analysis. The top 5 countries in terms of the number of published papers were the United States (USA), South Korea, Turkey, Italy, and Germany, and the top 5 institutions in terms of the number of published papers were Kyung Hee University, A.T. Still University of Health Sciences, Catholic University of Korea, Seoul St. Mary's Hospital, and Universidade de Sao Paulo. The top 5 authors in terms of the number of published papers were Park, Kook, Bayome, Janson, and Lee. There was little cooperation overall. The top 3 journals in terms of the most published related articles were all orthodontic-related journals. After molar distalization and anchorage, the most frequently used keywords were distalization, movement, and pendulum appliance. Kinzinger GSM is the most frequently cited author in references, and one of his articles also has the highest centrality score in references. CONCLUSIONS As the tides of time shift and scholars display an ever-growing dedication to unraveling the intricacies of this therapeutic modality, the realm of molar distalization has undergone notable advancements in technology. Initially, the traditional appliance suffered from aesthetic drawbacks and discomfort. However, contemporary iterations of the appliance have transcended these limitations, boasting enhanced elegance and convenience while concurrently elevating their efficacy. Nevertheless, limitations of current appliances, including their durability and propensity for recurrence post-treatment, continue to necessitate further advancement. Hence, the ongoing scientific inquiry aims to delve deeper into refining treatment modalities and fabricating cutting-edge appliances within this realm. CLINICAL RELEVANCE This study holds the potential to significantly enhance the ability of orthodontists to devise treatment protocols and offer state-of-the-art clinical recommendations, thereby empowering them to deliver advanced and refined orthodontic interventions.
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Affiliation(s)
- Lin Cheng
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Zezhou Feng
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Zhaonan Hao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Minmin Si
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Rui Yuan
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Zhiyuan Feng
- Department of Orthodontics, Shanxi Provincial People's Hospital, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China.
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Gabrieli R, Wenger R, Mazza M, Verné E, Baino F. Design, Stereolithographic 3D Printing, and Characterization of TPMS Scaffolds. MATERIALS (BASEL, SWITZERLAND) 2024; 17:654. [PMID: 38591518 PMCID: PMC10856394 DOI: 10.3390/ma17030654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 04/10/2024]
Abstract
Anatomical and functional tissue loss is one of the most debilitating problems and involves a great cost to the international health-care sector. In the field of bone tissue, the use of scaffolds to promote tissue regeneration is a topic of great interest. In this study, a combination of additive manufacturing and computational methods led to creating porous scaffolds with complex microstructure and mechanical behavior comparable to those of cancellous bone. Specifically, some representative models of triply periodic minimal surfaces (TPMSs) were 3D-printed through a stereolithographic technique using a dental resin. Schwarz primitive and gyroid surfaces were created computationally: they are characterized by a complex geometry and a high pore interconnectivity, which play a key role in the mechanism of cell proliferation. Several design parameters can be varied in these structures that can affect the performance of the scaffold: for example, the larger the wall thickness, the lower the elastic modulus and compressive strength. Morphological and mechanical analyses were performed to experimentally assess the properties of the scaffolds. The relationship between relative density and elastic modulus has been analyzed by applying different models, and a power-law equation was found suitable to describe the trend in both structures.
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Affiliation(s)
- Roberta Gabrieli
- Institute of Materials Physics and Engineering, Department of Applied Science and Technology, Politecnico di Torino, 10129 Torino, Italy; (R.G.); (E.V.)
| | - Raphael Wenger
- School of Engineering and Architecture Fribourg, University of Applied Sciences and Arts Western Switzerland, 1700 Fribourg, Switzerland (M.M.)
| | - Marco Mazza
- School of Engineering and Architecture Fribourg, University of Applied Sciences and Arts Western Switzerland, 1700 Fribourg, Switzerland (M.M.)
| | - Enrica Verné
- Institute of Materials Physics and Engineering, Department of Applied Science and Technology, Politecnico di Torino, 10129 Torino, Italy; (R.G.); (E.V.)
| | - Francesco Baino
- Institute of Materials Physics and Engineering, Department of Applied Science and Technology, Politecnico di Torino, 10129 Torino, Italy; (R.G.); (E.V.)
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Narongdej P, Hassanpour M, Alterman N, Rawlins-Buchanan F, Barjasteh E. Advancements in Clear Aligner Fabrication: A Comprehensive Review of Direct-3D Printing Technologies. Polymers (Basel) 2024; 16:371. [PMID: 38337260 DOI: 10.3390/polym16030371] [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: 12/26/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Clear aligners have revolutionized orthodontic treatment by offering an esthetically driven treatment modality to patients of all ages. Over the past two decades, aligners have been used to treat malocclusions in millions of patients worldwide. The inception of aligner therapy goes back to the 1940s, yet the protocols to fabricate aligners have been continuously evolved. CAD/CAM driven protocol was the latest approach which drastically changed the scalability of aligner fabrication-i.e., aligner mass production manufacturing. 3D printing technology has been adopted in various sectors including dentistry mostly because of the ability to create complex geometric structures at high accuracy while reducing labor and material costs-for the most part. The integration of 3D printing in dentistry has been across, starting in orthodontics and oral surgery and expanding in periodontics, prosthodontics, and oral implantology. Continuous progress in material development has led to improved mechanical properties, biocompatibility, and overall quality of aligners. Consequently, aligners have become less invasive, more cost-effective, and deliver outcomes comparable to existing treatment options. The promise of 3D printed aligners lies in their ability to treat malocclusions effectively while providing esthetic benefits to patients by remaining virtually invisible throughout the treatment process. Herein, this review aims to provide a comprehensive summary of studies regarding direct-3D printing of clear aligners up to the present, outlining all essential properties required in 3D-printed clear aligners and the challenges that need to be addressed. Additionally, the review proposes implementation methods to further enhance the effectiveness of the treatment outcome.
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Affiliation(s)
- Poom Narongdej
- Department of Mechanical and Aerospace Engineering, California State University Long Beach, Long Beach, CA 90840, USA
- Institute of Mathematical Sciences, Claremont Graduate University, Claremont, CA 91711, USA
| | - Mana Hassanpour
- Department of Chemical Engineering, California State University Long Beach, Long Beach, CA 90840, USA
| | - Nicolas Alterman
- Department of Mechanical and Aerospace Engineering, California State University Long Beach, Long Beach, CA 90840, USA
| | | | - Ehsan Barjasteh
- Department of Mechanical and Aerospace Engineering, California State University Long Beach, Long Beach, CA 90840, USA
- Department of Chemical Engineering, California State University Long Beach, Long Beach, CA 90840, USA
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Camenisch L, Polychronis G, Panayi N, Makou O, Papageorgiou SN, Zinelis S, Eliades T. Effect of printing orientation on mechanical properties of 3D-printed orthodontic aligners. J Orofac Orthop 2024:10.1007/s00056-023-00511-0. [PMID: 38277054 DOI: 10.1007/s00056-023-00511-0] [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: 05/06/2023] [Accepted: 12/07/2023] [Indexed: 01/27/2024]
Abstract
PURPOSE The purpose of this study was to assess differences in the fundamental mechanical properties of resin-made three-dimensional (3D) printed orthodontic aligners according to the printing orientation. METHODS Twenty resin 3D-printed dumbbell-shaped specimens and 20 orthodontic aligners were fabricated and postcured in nitrogen. Half of the specimens and aligners were built in horizontal (H), the other half in vertical (V) directions. The dumbbell-shaped specimens were loaded in a tensile testing machine, while parts of the aligners were embedded in acrylic resin, ground, polished, and then underwent instrumented indentation testing (IIT). Mechanical properties that were assessed included the yield strength (YS), breaking strength (BS), plastic strain (ε), Martens hardness (HM), indentation modulus (EIT), elastic index (ηIT), and indentation relaxation (RIT). Data were analyzed statistically with independent t‑tests or Mann-Whitney tests at α = 5%. RESULTS No significant differences were found between specimens or aligners printed either in a horizontal or a vertical direction (P > 0.05 in all instances). Overall, the 3D-printed aligners showed acceptable mechanical propertied in terms of YS (mean 19.2 MPa; standard deviation [SD] 1.7 MPa), BS (mean 19.6 MPa; SD 1.2 MPa), ε (mean 77%; SD 11%), HM (median 89.0 N/mm2; interquartile range [IQR] 84.5-90.0 NN/m2), EIT (median 2670.5 MPa; IQR 2645.0-2726.0 MPa), ηIT (median 27.5%; IQR 25.9-28.1%), and RIT (mean 65.1%; SD 3.5%). CONCLUSION Printing direction seemed to have no effect on the mechanical properties of 3D-printed resin aligners, which are promising for orthodontic use.
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Affiliation(s)
- Lukas Camenisch
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland
| | - Georgios Polychronis
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Nearchos Panayi
- Department of Dentistry, European University Cyprus, Nicosia, Cyprus
| | - Olga Makou
- Department of Dentistry, European University Cyprus, Nicosia, Cyprus
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland.
| | - Spiros Zinelis
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstr. 11, 8032, Zurich, Switzerland
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Staderini E, Chiusolo G, Guglielmi F, Papi M, Perini G, Tepedino M, Gallenzi P. Effects of Thermoforming on the Mechanical, Optical, Chemical, and Morphological Properties of PET-G: In Vitro Study. Polymers (Basel) 2024; 16:203. [PMID: 38257002 PMCID: PMC10820839 DOI: 10.3390/polym16020203] [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: 11/04/2023] [Revised: 12/30/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
The effectiveness of clear aligners in correcting malocclusions is closely linked to the properties of the materials used to make them. The polymers used in the manufacture of clear aligners have well-established properties. However, the process of manufacturing clear aligners, known as thermoforming, involves thermal and mechanical shocks that may alter these properties. The objective of this study was to evaluate the effects of thermoforming on the mechanical, optical, chemical, and morphological properties of sixty PET-G specimens. The study compared the thickness, weight, absorbance, chemical structure, surface roughness, elastic modulus, yield strength, and breaking load of thirty thermoformed specimens with thirty non-thermoformed specimens. The study introduces a new approach by using standardized samples to analyze both chemical and physical properties. The results showed statistically significant differences in thickness (-15%), weight (-11%), and surface roughness (+1233% in roughness average; +1129% in RMS roughness) of the material. Additionally, a correlation was found between reduction in thickness and increase in opalescence. There was no significant change in the functionality of the aligners after thermoforming, as no significant mechanical changes were found. However, the increase in surface roughness may lead to plaque and fluid accumulation and worsen the fit of the aligners.
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Affiliation(s)
- Edoardo Staderini
- School of Dentistry, Dean: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy; (E.S.); (G.C.); (P.G.)
- Postgraduate School of Orthodontics–Director: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giuseppe Chiusolo
- School of Dentistry, Dean: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy; (E.S.); (G.C.); (P.G.)
| | - Federica Guglielmi
- School of Dentistry, Dean: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy; (E.S.); (G.C.); (P.G.)
- Postgraduate School of Orthodontics–Director: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Massimiliano Papi
- Department of Neurosciences, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy; (M.P.); (G.P.)
- IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giordano Perini
- Department of Neurosciences, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy; (M.P.); (G.P.)
- IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Piazza Santa Margherita 2, 67100 L’Aquila, Italy
| | - Patrizia Gallenzi
- School of Dentistry, Dean: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, IRCCS “A. Gemelli” University Polyclinic Foundation, Largo Agostino Gemelli 8, 00168 Rome, Italy; (E.S.); (G.C.); (P.G.)
- Postgraduate School of Orthodontics–Director: Prof. Massimo Cordaro, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy
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Mattle M, Zinelis S, Polychronis G, Makou O, Panayi N, Papageorgiou SN, Eliades T. Effect of heat treatment and nitrogen atmosphere during post-curing on mechanical properties of 3D-printed orthodontic aligners. Eur J Orthod 2024; 46:cjad074. [PMID: 38073597 PMCID: PMC10783146 DOI: 10.1093/ejo/cjad074] [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] [Indexed: 01/12/2024]
Abstract
OBJECTIVES Three-dimensional (3D)-printed aligners present a promising orthodontic treatment modality, whose clinical success largely depends on the material's mechanical properties. The aim of this study was to evaluate the mechanical properties of resin-made 3D-printed aligners and assess the effect of two different post-curing conditions. MATERIALS AND METHODS Forty dumbbell-shaped specimens and 40 resin aligners were 3D-printed and divided into four equal groups according to post-curing conditions: presence or absence of oxygen during post-curing and water heat treatment at 85°C for 15 s or none. Samples from the central incisor of the aligner (n = 5/group) were studied by Attenuated Total Reflection Fourier-transform infrared spectroscopy (ATR-FTIR). The dumbbell-shaped specimens were loaded up to fracture under tensile mode and yield strength, ultimate tensile strength, elastic and plastic strain were calculated. The first mandibular molar area from 3D-printed aligners (n = 10/group) was cut and embedded in acrylic resin and then underwent metallographic grinding and polishing followed by instrumented indentation testing to determine the following mechanical properties: Martens hardness, indentation modulus, elastic index, and indentation relaxation. After descriptive statistics, differences according to each post-curing protocol, as well as their combination, were analyzed with linear regression modeling at a 5% significance level. RESULTS All groups showed identical ATR-FTIR spectra, while no statistically significant effects were seen for either post-curing protocol (N2 presence and heat treatment) or their combination (P > .05 in all instances). CONCLUSIONS The mechanical properties of 3D-printed resin aligners were not considerably affected either by post-curing in N2 atmosphere or heat treatment.
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Affiliation(s)
- Mélanie Mattle
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Spiros Zinelis
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Polychronis
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Olga Makou
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Nearchos Panayi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Dentistry, European University Cyprus, Nicosia, Cyprus
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Stoev YY, Uzunov TT, Stoyanova NS, Grozdanova-Uzunova RG, Kosturkov DN, Taneva IK. Mechanical properties of materials for 3D printed orthodontic retainers. Folia Med (Plovdiv) 2023; 65:986-992. [PMID: 38351789 DOI: 10.3897/folmed.65.e107299] [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: 05/31/2023] [Accepted: 08/24/2023] [Indexed: 02/16/2024] Open
Abstract
AIM The purpose of this study was to compare the mechanical properties of materials used for orthodontic retainers made by direct 3D printing and thermoforming.
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Frąckiewicz W, Królikowski M, Kwiatkowski K, Sobolewska E, Szymlet P, Tomasik M. Comparison of Dental Zirconium Oxide Ceramics Produced Using Additive and Removal Technology for Prosthodontics and Restorative Dentistry-Strength and Surface Tests: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 17:168. [PMID: 38204022 PMCID: PMC10779906 DOI: 10.3390/ma17010168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND The aim of this in vitro study was to determine the mechanical and functional properties of zirconium oxide ceramics made using 3D printing technology and ceramics produced using conventional dental milling machines. METHODS Forty zirconia samples were prepared for this study: the control group consisted of 20 samples made using milling technology, and the test group consisted of 20 samples made using 3D printing technology. Their surface parameters were measured, and then their mechanical parameters were checked and compared. Density, hardness, flexural strength and compressive strength were tested by performing appropriate in vitro tests. After the strength tests, a comparative analysis of the geometric structure of the surfaces of both materials was performed again. Student's t-test was used to evaluate the results (p < 0.01). RESULTS Both ceramics show comparable values of mechanical parameters, and the differences are not statistically significant. The geometric structure of the sample surfaces looks very similar. Only minor changes in the structure near the crack were observed in the AM group. CONCLUSION Ceramics made using additive technology have similar mechanical and surface parameters to milled zirconium oxide, which is one of the arguments for the introduction of this material into clinical practice. This in vitro study has shown that this ceramic can compete with zirconium made using CAD/CAM (Computer-Aided Design and Computer-Aided Manufacturing) methods.
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Affiliation(s)
- Wojciech Frąckiewicz
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Marcin Królikowski
- Department of Manufacturing Engineering, Faculty of Mechanical Engineering and Mechatronics, West Pomeranian University of Technology in Szczecin, 70-310 Szczecin, Poland
| | - Konrad Kwiatkowski
- Department of Mechanics and Fundamentals of Machine Design, Faculty of Mechanical Engineering and Mechatronics, West Pomeranian University of Technology in Szczecin, 70-310 Szczecin, Poland
| | - Ewa Sobolewska
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Paweł Szymlet
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Małgorzata Tomasik
- Department of Interdisciplinary Dentistry, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
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Šimunović L, Jurela A, Sudarević K, Bačić I, Haramina T, Meštrović S. Influence of Post-Processing on the Degree of Conversion and Mechanical Properties of 3D-Printed Polyurethane Aligners. Polymers (Basel) 2023; 16:17. [PMID: 38201683 PMCID: PMC10780983 DOI: 10.3390/polym16010017] [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: 11/30/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND This study explores how different post-processing methods affect the mechanical properties and degree of conversion of 3d-printed polyurethane aligners made from Tera Harz TC-85 resin. METHODS Using Fourier-transform infrared (FTIR) spectroscopy, the degree of conversion of liquid resin and post-processed materials was analyzed. This investigation focused on the effects of various post-curing environments (nitrogen vs. air) and rinsing protocols (centrifuge, ethanol, isopropanol, and isopropanol + water). The assessed mechanical properties were flexural modulus and hardness. RESULTS The degree of conversion showed no significant variance across different groups, though the polymerization environment influenced the results, accounting for 24.0% of the variance. The flexural modulus varied considerably, depending on both the rinsing protocol and the polymerization environment. The standard protocol (centrifugation followed by nitrogen polymerization) exhibited the highest flexural modulus of 1881.22 MPa. Hardness testing revealed significant differences, with isopropanol treatments showing increased resistance to wear in comparison to the centrifuge and ethanol rinse treatments. CONCLUSIONS This study conclusively demonstrates the adverse effects of oxygen on the polymerization process, underscoring the critical need for an oxygen-free environment to optimize material properties. Notably, the ethanol rinse followed by nitrogen polymerization protocol emerged as a viable alternative to the conventional centrifuge plus nitrogen method.
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Affiliation(s)
- Luka Šimunović
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Antonija Jurela
- Dental Clinic Fiziodent, 10000 Zagreb, Croatia; (A.J.); (K.S.)
| | - Karlo Sudarević
- Dental Clinic Fiziodent, 10000 Zagreb, Croatia; (A.J.); (K.S.)
| | - Ivana Bačić
- Forensic Science Centre “Ivan Vučetić”, Ministry of the Interior, 10000 Zagreb, Croatia;
| | - Tatjana Haramina
- Department of Materials, Faculty of Electrical Engineering and Computing, University of Zagreb, 10000 Zagreb, Croatia;
| | - Senka Meštrović
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
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Cintora-López P, Arrieta-Blanco P, Martin-Vacas A, Paz-Cortés MM, Gil J, Aragoneses JM. In vitro analysis of the influence of the thermocycling and the applied force on orthodontic clear aligners. Front Bioeng Biotechnol 2023; 11:1321495. [PMID: 38173871 PMCID: PMC10761475 DOI: 10.3389/fbioe.2023.1321495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
The mechanical properties of polyurethane dental aligners have been studied in an oral environment at 37°C and subjected to thermal cycling between 5°C and 55°C for long periods of time at different mechanical stresses. The aim is to determine the efficacy of the orthodontic aligner at different stress levels, the effect of thermal cycling with therapy time on tooth position correction. Sixty aligners with the same design were studied applying tensions of 0, 3 and 30 N and determining the deformation at different times from 1 to 760 h. Half of these aligners were subjected to stresses submerged in artificial saliva at 37°C and the other half were subjected to thermal cycles between 2°C and 55°C in salivary medium. Deformation was determined using a high-resolution stereo magnifier and ImageJ image analysis software. Water adsorption by the polyurethane was determined at the different test times. The results showed that in the unloaded aligners there is no appreciable deformation, but with thermal cycling there is a light shrinkage of the aligner due to the semi-crystallization process (ordering of polymeric chains) of the polyurethane. When applying loads of 3 and 30 N, creep curves with constant deformation transition zones can be seen. The transition zones decrease as the applied mechanical load increases. In addition, the significant effect of thermal cycling on the reduction of the transition zone of the aligners has been demonstrated. The transition zones are optimal for dental correction as constant stresses are exerted for tooth movement. The effect of thermal cycling shortens the constant deformation zone and reduces tooth alignment time. It was observed that the absorption of water in the aligner is constant after 1 h of immersion and does not exceed 0.4% by weight of absorbed water.
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Affiliation(s)
| | | | - Andrea Martin-Vacas
- Faculty of Dentistry, Alfonso X El Sabio University, Villanueva de la Cañada, Spain
| | | | - Javier Gil
- Faculty of Medicine and Health Sciences, Bionegineering Institute of Technology, International University of Catalunya, Barcelona, Spain
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Jeong M, Radomski K, Lopez D, Liu JT, Lee JD, Lee SJ. Materials and Applications of 3D Printing Technology in Dentistry: An Overview. Dent J (Basel) 2023; 12:1. [PMID: 38275676 PMCID: PMC10814684 DOI: 10.3390/dj12010001] [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: 10/09/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE This narrative review aims to provide an overview of the mechanisms of 3D printing, the dental materials relevant to each mechanism, and the possible applications of these materials within different areas of dentistry. METHODS Subtopics within 3D printing technology in dentistry were identified and divided among five reviewers. Electronic searches of the Medline (PubMed) database were performed with the following search keywords: 3D printing, digital light processing, stereolithography, digital dentistry, dental materials, and a combination of the keywords. For this review, only studies or review papers investigating 3D printing technology for dental or medical applications were included. Due to the nature of this review, no formal evidence-based quality assessment was performed, and the search was limited to the English language without further restrictions. RESULTS A total of 64 articles were included. The significant applications, applied materials, limitations, and future directions of 3D printing technology were reviewed. Subtopics include the chronological evolution of 3D printing technology, the mechanisms of 3D printing technologies along with different printable materials with unique biomechanical properties, and the wide range of applications for 3D printing in dentistry. CONCLUSIONS This review article gives an overview of the history and evolution of 3D printing technology, as well as its associated advantages and disadvantages. Current 3D printing technologies include stereolithography, digital light processing, fused deposition modeling, selective laser sintering/melting, photopolymer jetting, powder binder, and 3D laser bioprinting. The main categories of 3D printing materials are polymers, metals, and ceramics. Despite limitations in printing accuracy and quality, 3D printing technology is now able to offer us a wide variety of potential applications in different fields of dentistry, including prosthodontics, implantology, oral and maxillofacial, orthodontics, endodontics, and periodontics. Understanding the existing spectrum of 3D printing applications in dentistry will serve to further expand its use in the dental field. Three-dimensional printing technology has brought about a paradigm shift in the delivery of clinical care in medicine and dentistry. The clinical use of 3D printing has created versatile applications which streamline our digital workflow. Technological advancements have also paved the way for the integration of new dental materials into dentistry.
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Affiliation(s)
- Min Jeong
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
| | - Kyle Radomski
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
| | - Diana Lopez
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
| | - Jack T. Liu
- Dexter Southfield, Brookline, MA 02445, USA;
| | - Jason D. Lee
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
| | - Sang J. Lee
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.J.); (K.R.); (D.L.); (J.D.L.)
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Kapila S, Vora SR, Rengasamy Venugopalan S, Elnagar MH, Akyalcin S. Connecting the dots towards precision orthodontics. Orthod Craniofac Res 2023; 26 Suppl 1:8-19. [PMID: 37968678 DOI: 10.1111/ocr.12725] [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] [Accepted: 10/20/2023] [Indexed: 11/17/2023]
Abstract
Precision orthodontics entails the use of personalized clinical, biological, social and environmental knowledge of each patient for deep individualized clinical phenotyping and diagnosis combined with the delivery of care using advanced customized devices, technologies and biologics. From its historical origins as a mechanotherapy and materials driven profession, the most recent advances in orthodontics in the past three decades have been propelled by technological innovations including volumetric and surface 3D imaging and printing, advances in software that facilitate the derivation of diagnostic details, enhanced personalization of treatment plans and fabrication of custom appliances. Still, the use of these diagnostic and therapeutic technologies is largely phenotype driven, focusing mainly on facial/skeletal morphology and tooth positions. Future advances in orthodontics will involve comprehensive understanding of an individual's biology through omics, a field of biology that involves large-scale rapid analyses of DNA, mRNA, proteins and other biological regulators from a cell, tissue or organism. Such understanding will define individual biological attributes that will impact diagnosis, treatment decisions, risk assessment and prognostics of therapy. Equally important are the advances in artificial intelligence (AI) and machine learning, and its applications in orthodontics. AI is already being used to perform validation of approaches for diagnostic purposes such as landmark identification, cephalometric tracings, diagnosis of pathologies and facial phenotyping from radiographs and/or photographs. Other areas for future discoveries and utilization of AI will include clinical decision support, precision orthodontics, payer decisions and risk prediction. The synergies between deep 3D phenotyping and advances in materials, omics and AI will propel the technological and omics era towards achieving the goal of delivering optimized and predictable precision orthodontics.
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Affiliation(s)
- Sunil Kapila
- Strategic Initiatives and Operations, UCLA School of Dentistry, Los Angeles, California, USA
| | - Siddharth R Vora
- Oral Health Sciences, University of British Columbia, Vancouver, British Columbia, USA
| | | | - Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Sercan Akyalcin
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Spangler T, Ammoun R, Carrico CK, Bencharit S, Tüfekçi E. The effect of crowding on the accuracy of 3-dimensional printing. Am J Orthod Dentofacial Orthop 2023; 164:879-888. [PMID: 37656070 DOI: 10.1016/j.ajodo.2023.08.005] [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: 02/01/2023] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION The purpose of this study was to evaluate the accuracy of 3-dimensional (3D) printed aligners compared to conventional vacuum-formed thermoplastic aligners with varying levels of dental crowding. METHODS Digital intraoral scans of 10 cases were assigned to their respective groups (n = 10, each, 30 total) as follows: no crowding (control), moderate crowding, and severe crowding. Digital images of these models were created in standard tessellation language (STL) file format using 3Shape software and randomly 3D printed. The STL files of each case were also sent to a dental laboratory to fabricate vacuum-formed samples, the current technology used for manufacturing aligners. The intaglio surfaces of fabricated aligners in both groups were scanned using cone beam computed tomography to create STL files, which were then compared to the original STL files of the cases using Geomagic Control X software. Absolute deviations from the original file and root mean square values were recorded. A Kruskal-Wallis test was conducted to analyze the difference in average deviation, and a t-test was repeated for the RMS measure. The significance level was set at 0.05. RESULTS The crowding did not affect the trueness of aligners manufactured using 3D printing or conventional vacuum-forming techniques (P = 0.79). 3D-printed aligners showed less deviation than the vacuum-formed samples (0.1125 mm vs 0.1312 mm; P <0.01). Aligners manufactured with the vacuum-forming technique had significantly higher variation than those with the 3D printing process (P = 0.04). CONCLUSIONS 3D aligners printed directly from an STL file exhibited better precision and trueness than those fabricated using the conventional vacuum-forming technique. Since accuracy is defined as a combination of precision and trueness, it is concluded that direct printing from an STL file can be used to manufacture aligners.
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Affiliation(s)
- Tonya Spangler
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Rami Ammoun
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Caroline K Carrico
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Sompop Bencharit
- Office of Oral Health Innovation, Department of Oral Rehabilitation, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC
| | - Eser Tüfekçi
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va.
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Danko M, Chromy L, Ferencik N, Sestakova M, Kolembusova P, Balint T, Durica J, Zivcak J. Literature Review of an Anterior Deprogrammer to Determine the Centric Relation and Presentation of Cases. Bioengineering (Basel) 2023; 10:1379. [PMID: 38135970 PMCID: PMC10740564 DOI: 10.3390/bioengineering10121379] [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: 10/17/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
The increasing demand for dental aesthetics, articulation corrections, and solutions for pain and frequent bruxism demands quick and effective restorative dental management. The biomedical research aimed to create a beneficial, ecological, and readily available anterior deprogrammer to determine the centric relation (CR) of cases. This medical device is additively manufactured from a biocompatible material. Size is customizable based on the width of the patient's anterior central incisors. This is a pilot study with two subjects. The task was to develop a complete data protocol for the production process, computer-aided design (CAD), and three-dimensional (3D) printing of the anterior deprogrammers. The research focused on creating simple and practically applicable tools for the dentist's prescription (anterior deprogrammer in three sizes), and secondly for the communication between the dentist and the patient (computer application). The tested hypothesis was whether, according to these novel tools, it is possible to produce functional occlusal splints, which could be manufactured using current technologies. This study compared a traditional splint with a digitally designed and 3D-printed one. The tested hypothesis was whether manufactured occlusal splints differ in patients' subjective perception of comfort. Each conservative treatment was monitored for ten weeks. Initial results are promising; no statistically significant difference was found between the productive technologies.
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Affiliation(s)
- Maria Danko
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, 04200 Kosice, Slovakia; (L.C.); (N.F.); (P.K.); (T.B.); (J.Z.)
| | - Lubos Chromy
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, 04200 Kosice, Slovakia; (L.C.); (N.F.); (P.K.); (T.B.); (J.Z.)
| | - Norbert Ferencik
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, 04200 Kosice, Slovakia; (L.C.); (N.F.); (P.K.); (T.B.); (J.Z.)
| | - Marcela Sestakova
- 1st Department of Stomatology, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, 04154 Kosice, Slovakia; (M.S.); (J.D.)
| | - Petra Kolembusova
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, 04200 Kosice, Slovakia; (L.C.); (N.F.); (P.K.); (T.B.); (J.Z.)
| | - Tomas Balint
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, 04200 Kosice, Slovakia; (L.C.); (N.F.); (P.K.); (T.B.); (J.Z.)
| | - Jaroslav Durica
- 1st Department of Stomatology, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, 04154 Kosice, Slovakia; (M.S.); (J.D.)
| | - Jozef Zivcak
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, 04200 Kosice, Slovakia; (L.C.); (N.F.); (P.K.); (T.B.); (J.Z.)
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Gabalski MA, Smith KR, Hix J, Zinn KR. Comparisons of 3D printed materials for biomedical imaging applications. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2023; 24:2273803. [PMID: 38415266 PMCID: PMC10898812 DOI: 10.1080/14686996.2023.2273803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/17/2023] [Indexed: 02/29/2024]
Abstract
In biomedical imaging, it is desirable that custom-made accessories for restraint, anesthesia, and monitoring can be easily cleaned and not interfere with the imaging quality or analyses. With the rise of 3D printing as a form of rapid prototyping or manufacturing for imaging tools and accessories, it is important to understand which printable materials are durable and not likely to interfere with imaging applications. Here, 15 3D printable materials were evaluated for radiodensity, optical properties, simulated wear, and capacity for repeated cleaning and disinfection. Materials that were durable, easily cleaned, and not expected to interfere with CT, PET, or optical imaging applications were identified.
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Affiliation(s)
- Mitchell A Gabalski
- Biomedical Engineering, Michigan State University, East Lansing, MI, USA
- Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI, USA
| | - Kylie R Smith
- Biomedical Engineering, Michigan State University, East Lansing, MI, USA
- Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI, USA
| | - Jeremy Hix
- Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI, USA
- Radiology, Michigan State University, East Lansing, MI, USA
- Advanced Molecular Imaging Facility, Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI, USA
| | - Kurt R Zinn
- Biomedical Engineering, Michigan State University, East Lansing, MI, USA
- Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI, USA
- Radiology, Michigan State University, East Lansing, MI, USA
- Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
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Taher BB, Rasheed TA. The Impact of Adding Chitosan Nanoparticles on Biofilm Formation, Cytotoxicity, and Certain Physical and Mechanical Aspects of Directly Printed Orthodontic Clear Aligners. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:2649. [PMID: 37836290 PMCID: PMC10574519 DOI: 10.3390/nano13192649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023]
Abstract
Aligner treatment is associated with bacterial colonization, leading to enamel demineralization. Chitosan nanoparticles have been demonstrated to have antibacterial properties. This in vitro study aims to determine the effect of adding chitosan nanoparticles to directly 3D-printed clear aligner resin with regard to antibiofilm activity, cytotoxicity, degree of conversion, accuracy, deflection force, and tensile strength. Different concentrations (2%, 3%, and 5% w/w) of chitosan nanoparticles were mixed with the clear resin, and the samples were then 3D printed. Additionally, the thermoforming technique for aligner manufacturing was utilized. The obtained specimens were evaluated for antibiofilm activity against Streptococcus mutans bacteria and cytotoxicity against L929 and 3T3 cell lines. Additionally, Fourier transform infrared spectroscopy via attenuated total reflection analysis was used to assess the degree of conversion. Geomagic Control X software was utilized to analyze the accuracy. In addition, the deflection force and tensile strength were evaluated. The results indicated a notable reduction in bacterial colonies when the resin was incorporated with 3 and 5% chitosan nanoparticles. No significant changes in the cytotoxicity or accuracy were detected. In conclusion, integrating biocompatible chitosan nanoparticles into the resin can add an antibiofilm element to an aligner without compromising the material's certain biological, mechanical, and physical qualities at specific concentrations.
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Affiliation(s)
- Botan Barzan Taher
- Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, University of Sulaimani, Sulaymaniyah 46001, Iraq;
| | - Tara Ali Rasheed
- Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, University of Sulaimani, Sulaymaniyah 46001, Iraq;
- College of Dentistry, American University of Iraq-Sulaimani, Sulaymaniyah 46001, Iraq
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AlMogbel A. Clear Aligner Therapy: Up to date review article. J Orthod Sci 2023; 12:37. [PMID: 37881665 PMCID: PMC10597356 DOI: 10.4103/jos.jos_30_23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 10/27/2023] Open
Abstract
The advantages of Clear Aligners Therapy (CAT) include the braces being virtually invisible, comfortable to wear, and removable for eating and brushing; that way, CAT can be used to treat a wide range of orthodontic issues. In 1999, the company Align Technology introduced the frst commercial clear aligner system called Invisalign. The Invisalign system was initially only available to orthodontists, but later became available to general dentists as well. The system quickly gained popularity among patients who were looking for a more discreet and comfortable alternative to traditional braces. In 2000, Align Technology received FDA clearance for the Invisalign system, which further increased its popularity. The biomechanics of clear aligners involve the use of custom-made tooth aligners that are specifcally shaped to guide teeth into desired positions. These aligners are typically made from flexible materials such as polyurethane or ethylene vinyl acetate and are adjusted to apply the necessary forces for tooth movement. Attachment devices, such as power ridges or buttons, are often used to enhance or assist in specifc tooth movements and for retention of the aligner. The use of attachments allows for the exertion of desired force on the teeth, which is crucial for the success of Clear Aligner Therapy. CAT should be used if patients are concerned about the esthetic appearances of their teeth-for example, actors and other individuals that rely on their appearances in public in a professional context-and if the misalignment is not severe, so that clear aligners can still work. One should not use CAT in cases of severe crowding or spacing issues that require extractions. If the patient has complex jaw discrepancies or skeletal issues or if teeth need to be moved extensively in multiple directions, CAT is likely not going to be strong enough. In conclusion, Clear Aligner Therapy is a safe, effective, and convenient orthodontic treatment option that offers patients a virtually invisible way to achieve a straighter, more beautiful smile. With continued advancements in technology and a growing body of research supporting its effectiveness, the future of Clear Aligner Therapy looks bright.
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Affiliation(s)
- AbdulMajeed AlMogbel
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
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30
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Topsakal KG, Aksoy M, Duran GS. The effect of aging on the mechanical properties of 3-dimensional printed biocompatible resin materials used in dental applications: An in vitro study. Am J Orthod Dentofacial Orthop 2023; 164:441-449. [PMID: 37330725 DOI: 10.1016/j.ajodo.2023.05.023] [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: 11/01/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION The mechanical properties of biocompatible printable resin materials in an intraoral environment is still being investigated. This study aimed to assess the effect of the aging process on the mechanical properties of resin samples produced by stereolithography appearance (SLA) and digital light processing (DLP) 3-dimensional printer systems. METHODS The cylindrical sample (4.00 × 20.00 mm) was designed by software, and the data were transformed into digital format. A DLP printer (n = 40) and an SLA printer (n = 40) carried out the printing process. The aging procedure was applied to 20 samples from each group using a thermocycling device. After the aging procedure, the samples were placed in the universal testing device for the 3-point bending test. RESULTS This study showed that the aging procedure decreased maximum load, bending stress, and Young's modulus values and increased maximum deflection values of the DLP group (P <0.01). However, no statistical difference was detected in the parameters compared with the SLA group except for the maximum deflection values. Furthermore, statistically significant differences were found between maximum deflection and Young's module values of SLA and DLP control and study groups (P <0.05). CONCLUSIONS This in vitro study revealed that the biocompatible printable resin materials produced by DLP and SLA printers had the mechanical strength to resist the values resembling the physiological occlusal forces even after the aging procedure and could produce intraoral appliances.
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Affiliation(s)
- Kübra Gülnur Topsakal
- Department of Orthodontics, Faculty of Gulhane Dental Medicine, University of Health Sciences, Ankara, Turkey.
| | - Merve Aksoy
- Department of Pediatric Dentistry, Faculty of Gulhane Dental Medicine, University of Health Sciences, Ankara, Turkey
| | - Gökhan Serhat Duran
- Department of Orthodontics, Faculty of Gulhane Dental Medicine, University of Health Sciences, Ankara, Turkey
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Shrivastava A, Mohanty P, Dash BP, Jena S, Sahoo N. Proficiency of Clear Aligner Therapy: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e45072. [PMID: 37842499 PMCID: PMC10568240 DOI: 10.7759/cureus.45072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
The aim of this study was to evaluate the efficacy and efficiency of orthodontic treatment using clear aligner therapy (CAT). This efficiency was measured using the Peer Assessment Rating (PAR) index, the American Board of Orthodontics (ABO) index, or the similarity between the final ClinCheck and the final scanned models. A search was done electronically between 1998 and 2021 using the Cochrane Library, PubMed, and Google Scholar databases. Three reviewers individually rated the articles. The ROBINS tool and the Cochrane risk of bias tool were used to evaluate the quality of observational research and randomized controlled trials, respectively. The degree of certainty for each selected outcome was evaluated using the grading of recommendations assessment, development, and evaluation (GRADE) approach. Six studies with a total of 166 participants were considered after the full texts of 61 potential reports were reviewed. This research included in the review covered the period from 1998 to 2021 in retrospect. According to the current systematic review and meta-analysis, transparent aligners had a successful outcome. In mild to moderate cases, aligner treatment appears to have a significant advantage in terms of efficiency (treatment time); nonetheless, insufficient evidence of efficacy was observed based on multiple cross-sectional investigations. When compared to traditional brackets, clear aligners provided a more stable course of treatment.
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Affiliation(s)
- Akshay Shrivastava
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) (Deemed to be University), Bhubaneswar, IND
| | - Pritam Mohanty
- Department of Orthodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) (Deemed to be University), Bhubaneswar, IND
| | - Bhagabati P Dash
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) (Deemed to be University), Bhubaneswar, IND
| | - Sanghamitra Jena
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) (Deemed to be University), Bhubaneswar, IND
| | - Nivedita Sahoo
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) (Deemed to be University), Bhubaneswar, IND
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Pasini M, Carli E, Giambastiani F, Giuca MR, Tripodi D. Three-Dimensional Analysis of Upper and Lower Arches Using Digital Technology: Measurement of the Index of Bolton and Correspondence between Arch Shapesand Orthodontic Arches. Dent J (Basel) 2023; 11:188. [PMID: 37623284 PMCID: PMC10453238 DOI: 10.3390/dj11080188] [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: 06/08/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION Thanks to the great development of digital technology, viaCAD (computer-aided design) and CAM (computer-aided manufacturing) systems, digital models canbe used as an aid for orthodontic planning decision-making processes as there are numerous studies in the literature that support the validity ofthe digital model measurements of anterior teeth and the total coefficient of Bolton analysis. The aim of the present study isto compare the average length value of the current upper and lower arches with that of a hypothetical nickel-titanium wire and to confirm the reliability and accuracy of digitally taken measurements of the anterior and total Bolton coefficients.In this retrospective study, dental casts of 138 Caucasian adolescent patients were scanned with an extraoral scanner, and Ortho3Shape software was adopted for the following dental cast measurements: actual and ideal lengths of the lower arches and anterior and total Bolton coefficients.In the present study, we found that the mean value of the anterior coefficients of the Bolton index was compatible with those of previous studies, confirming the reliability of digital measurements.Therefore, digital CAD/CAM models may be a viable alternative to plaster models, as they can facilitate model preservation and recovery. For future studies, it would be better to use intraoral scanners (IOSs) to ensure greater accuracy, since they only require one step and allow obtaining better results for the patients.
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Affiliation(s)
- Marco Pasini
- Unit of Pediatric Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy; (M.P.); (E.C.); (M.R.G.)
| | - Elisabetta Carli
- Unit of Pediatric Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy; (M.P.); (E.C.); (M.R.G.)
| | - Federico Giambastiani
- Unit of Pediatric Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy; (M.P.); (E.C.); (M.R.G.)
| | - Maria Rita Giuca
- Unit of Pediatric Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy; (M.P.); (E.C.); (M.R.G.)
| | - Domenico Tripodi
- Department of Medical, Oral and Biotechnological Sciences, Dental School, University “G. D’Annunzio” of Chieti-Pescara, 66013 Chieti, Italy;
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Grzebieluch W, Grajzer M, Mikulewicz M. Comparative Analysis of Fused Deposition Modeling and Digital Light Processing Techniques for Dimensional Accuracy in Clear Aligner Manufacturing. Med Sci Monit 2023; 29:e940922. [PMID: 37533235 PMCID: PMC10413909 DOI: 10.12659/msm.940922] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/06/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND This study aimed to compare fused deposition modeling (FDM) and digital light processing (DLP) techniques in terms of dimensional accuracy for printing dental models used for the manufacture of clear dental aligners. MATERIAL AND METHODS Based on the intraoral scan of an adult patient, a sequence of 10 aligner models was created using BlueSkyPlan4. The test models (n=30) were fabricated with 2 desktop 3D printers: (DLP) and (FDM) printers. Two groups of samples were created (digitized using a desktop optical scanner). To calculate trueness (n=20) and precision (n=10), printed models were compared to the source files (REF). REF, DLP, and FDM files were superimposed and converted to point clouds. The cloud-to-cloud distances were calculated using CloudCompare software. Using the same algorithm, distortions of models were measured. Data were analyzed using one-way ANOVA and Tukey's post hoc test. RESULTS Significant differences were found between the trueness and precision of DLP and FDM groups. The average calculated trueness of DLP and FDM was 0.096 mm (0.021) (P<0.001) and 0.063 mm (0.024) (P<0.001), respectively. The average calculated precision of DLP and FDM was 0.027 mm (0.003) (P<0.001) and 0.036 mm (0.003) (P<0.001), respectively. A widening (0.158 mmfor DLP and 0.093 mmfor FDM, P=0.05) and twisting (0.03 mmfor DLP and 0.043 mmfor FDM, P=0.05) of the printed models was observed. CONCLUSIONS Both printers had sufficient precision for aligner models manufacturing. FDM showed a higher trueness and this device can be applied as an alternative to DLP. Polymerization shrinkage is a significant factor in decreasing the trueness of DLP printers.
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Affiliation(s)
- Wojciech Grzebieluch
- Department of Conservative Dentistry with Endodontics, Wrocław Medical University, Wrocław, Poland
| | - Magdalena Grajzer
- Department of Dietetics and Food Science, Wrocław Medical University, Wrocław, Poland
| | - Marcin Mikulewicz
- Division of Facial Abnormalities, Department of Dentofacial Orthopedics and Orthodontics, Wrocław Medical University, Wrocław, Poland
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Grant J, Foley P, Bankhead B, Miranda G, Adel SM, Kim KB. Forces and moments generated by 3D direct printed clear aligners of varying labial and lingual thicknesses during lingual movement of maxillary central incisor: an in vitro study. Prog Orthod 2023; 24:23. [PMID: 37423974 DOI: 10.1186/s40510-023-00475-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/15/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVE The objective of this study was to measure the forces and moments exerted by direct printed aligners (DPAs) with varying facial and lingual aligner surface thicknesses, in all three planes of space, during lingual movement of a maxillary central incisor. MATERIALS AND METHODS An in vitro experimental setup was used to quantify forces and moments experienced by a programmed tooth to be moved and by adjacent anchor teeth, during lingual movement of a maxillary central incisor. DPAs were directly 3D-printed with Tera Harz TC-85 (Graphy Inc., Seoul, South Korea) clear photocurable resin in 100-µm layers. Three multi-axis sensors were used to measure the moments and forces generated by 0.50 mm thick DPAs modified with labial and lingual surface thicknesses of 1.00 mm in selective locations. The sensors were connected to three maxillary incisors (the upper left central, the upper right central, and the upper left lateral incisors) during 0.50 mm of programmed lingual bodily movement of the upper left central incisor. Moment-to-force ratios were calculated for all three incisors. Aligners were benchtop tested in a temperature-controlled chamber at intra-oral temperature to simulate intra-oral conditions. RESULTS The results showed that increased facial thickness of DPAs slightly reduced force levels on the upper left central incisor compared to DPAs of uniform thickness of 0.50 mm. Additionally, increasing the lingual thickness of adjacent teeth reduced force and moment side effects on the adjacent teeth. DPAs can produce moment-to-force ratios indicative of controlled tipping. CONCLUSIONS Targeted increases in thickness of direct 3D-printed aligners change the magnitude of forces and moments generated, albeit in complex patterns that are difficult to predict. The ability to vary labiolingual thicknesses of DPAs is promising to optimize the prescribed orthodontic movements while minimizing unwanted tooth movements, thereby increasing the predictability of tooth movements.
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Affiliation(s)
- James Grant
- Department of Orthodontics, Saint Louis University, 3320 Rutger St, St Louis, MO, 63104, USA
| | - Patrick Foley
- Department of Orthodontics, Saint Louis University, 3320 Rutger St, St Louis, MO, 63104, USA
| | - Brent Bankhead
- Department of Orthodontics, Saint Louis University, 3320 Rutger St, St Louis, MO, 63104, USA
| | - Gabriel Miranda
- Department of Orthodontics, Saint Louis University, 3320 Rutger St, St Louis, MO, 63104, USA
| | - Samar M Adel
- Department of Orthodontics, Saint Louis University, 3320 Rutger St, St Louis, MO, 63104, USA
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ki Beom Kim
- Department of Orthodontics, Saint Louis University, 3320 Rutger St, St Louis, MO, 63104, USA.
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Lümkemann N, Klimenta M, Hoffmann M, Meinen J, Stawarczyk B. Dimensional Stability and Reproducibility of Varying FFF Models for Aligners in Comparison to Plaster Models. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4835. [PMID: 37445149 DOI: 10.3390/ma16134835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023]
Abstract
To test the impact of FFF filaments, printing parameters, thermoforming foils, repeated thermoforming cycles, and type of jaw on the dimensional stability of FFF models for aligners and to compare them with plaster models, FFF models (maxilla, n = 48; mandible, n = 48) from two filaments (SIMPLEX aligner and Renfert PLA HT, both Renfert GmbH) were fabricated using four printing parameters (one, two, or three loops; four loops acted as the default) and conventional plaster models (n = 12) based on a young, female dentition. All models were thermoformed under pressure three times in total using two different thermoforming foils, namely 0.75 mm × 125 mm Ø aligner foil (CA Pro+ Clear Aligner, Scheu Dental) and 1.0 mm × 125 mm Ø Duran foil (Duran+, Scheu Dental). Aligner foil was heated at 220 °C for 25 s and Duran foil at 220 °C for 30 s. All models were scanned after fabrication as well as after each thermoforming cycle. The obtained STL datasets were analyzed using the local best-fit method (GOM Inspect Pro, Carl Zeiss Metrology GmbH). Data were analyzed using a Kolmogorov-Smirnov-test, a one-way ANOVA with post-hoc Scheffé, and a t-test (p < 0.05). The dimensional stability of the models was most strongly affected by the printing parameters (number of loops; ηp2 = 0.768, p < 0.001) followed by the thermoforming foil used (ηp2 = 0.663, p < 0.001) as well as the type of model (ηp2 = 0.588, p < 0.001). In addition, various interactions showed an influence on the dimensional stability (ηp2 = 0.041-0.386, p < 0.035). SIMPLEX maxillary models (default; four loops), thermoformed using aligner foil, showed higher deformation stability than did plaster models. These initial FFF models provide comparable precision to plaster models, but the dimensional stability of the FFF models, in contrast to that of plaster models, decreases with increasing numbers of thermoforming cycles.
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Affiliation(s)
- Nina Lümkemann
- Department of Prosthetic Dentistry, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Melisa Klimenta
- Department of Prosthetic Dentistry, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Moritz Hoffmann
- Department of Prosthetic Dentistry, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - John Meinen
- Department of Prosthetic Dentistry, LMU University Hospital, LMU Munich, 80336 Munich, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, LMU University Hospital, LMU Munich, 80336 Munich, Germany
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Park SY, Choi SH, Yu HS, Kim SJ, Kim H, Kim KB, Cha JY. Comparison of translucency, thickness, and gap width of thermoformed and 3D-printed clear aligners using micro-CT and spectrophotometer. Sci Rep 2023; 13:10921. [PMID: 37407694 DOI: 10.1038/s41598-023-36851-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/11/2023] [Indexed: 07/07/2023] Open
Abstract
The present study compared the thickness and gap width of thermoformed and 3D-printed clear aligners (CAs) using micro-computed tomography (micro-CT) and evaluated their translucency using spectrophotometer. Four groups of CAs were tested: thermoformed with polyethylene terephthalate glycol (TS) or copolyester-elastomer combination (TM), and 3D-printed TC-85 cleaned with alcohol (PA) or with centrifuge (PC). CIELab coordinates were measured (n = 10) to evaluate translucency. CAs (n = 10) were fitted onto respective models and micro-CT was performed to evaluate the thickness and gap width. Thickness and gap width were measured for different tooth type and location in sagittal sections on all sides. The PC group showed significantly higher translucency than the PA group, which was similar to the TS and TM groups (p < 0.01). After the manufacturing process, thickness reduction was observed in the thermoformed groups, whereas thickness increase was observed in the 3D printed-groups. The TM group showed the least gap width amongst the groups (p < 0.01). Thermoformed and 3D-printed CAs had significantly varied thicknesses and regions of best fit depending on the tooth type and location. Differences in the translucency and thickness of the 3D-printed CAs were observed depending on the cleaning methods.
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Affiliation(s)
- So Yeon Park
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Institute for Innovation in Digital Healthcare, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Hyung-Seog Yu
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Institute for Innovation in Digital Healthcare, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Su-Jung Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, South Korea
| | - Hoon Kim
- Laboratory of Adhesion & Bio-Composites, Forestry and Bioresources, Seoul National University, Seoul, South Korea
| | - Ki Beom Kim
- Department of Orthodontics, Saint Louis University, Saint Louis, MO, USA
| | - Jung-Yul Cha
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Institute for Innovation in Digital Healthcare, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Khashashneh M, Ratnayake J, Choi JJE, Mei L, Lyons K, Brunton P. The Effect of 10% Carbamide Peroxide Dental Bleaching on the Physical Properties of Invisalign Aligners: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114125. [PMID: 37297258 DOI: 10.3390/ma16114125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
The high aesthetic demands of patients have increased their requests to align their teeth using clear aligners, including Invisalign. Patients also want to have their teeth whitened for the same purpose; the use of Invisalign as a bleaching tray at night has been reported in few studies. However, whether 10% carbamide peroxide affects the physical properties of Invisalign is unknown. Therefore, the objective of this study was to evaluate the effect of 10% carbamide peroxide on the physical properties of Invisalign when used as a bleaching tray at night. Twenty-two unused Invisalign aligners (Santa Clara, CA, USA) were used to prepare 144 specimens to test their tensile strength, hardness, surface roughness, and translucency. The specimens were divided into four groups: a testing group at baseline (TG1), a testing group after application of bleaching material at 37 °C for 2 weeks (TG2), a control group at baseline (CG1), and a control group after immersion in distilled water at 37 °C for 2 weeks (CG2). Statistical analysis was conducted using a paired t-test, Wilcoxon signed rank test, independent samples t-test, and Mann-Whitney test to compare samples in CG2 to CG1, TG2 to TG1, and TG2 to CG2. Statistical analysis showed no statistically significant difference between the groups for all physical properties, except for hardness (p-value < 0.001) and surface roughness (p-value = 0.007 and p-value < 0.001 for the internal and external surface roughness, respectively), which revealed a reduction in hardness values (from 4.43 ± 0.86 N/mm2 to 2.2 ± 0.29 N/mm2) and an increase in surface roughness (from 1.6 ± 0.32 Ra to 1.93 ± 0.28 Ra and from 0.58 ± 0.12 Ra to 0.68 ± 0.13 Ra for the internal and external surface roughness, respectively) after 2 weeks of dental bleaching. Results showed that Invisalign can be used for dental bleaching without excessive distortion or degradation of the aligner material. However, future clinical trials are required to further assess the feasibility of using Invisalign for dental bleaching.
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Affiliation(s)
- Majd Khashashneh
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
- Faculty of Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Jithendra Ratnayake
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Joanne Jung Eun Choi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Li Mei
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Karl Lyons
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Paul Brunton
- DVCA, Curtin Perth, Curtin University, Bentley, WA 6102, Australia
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Vasoglou G, Patatou A, Vasoglou M. Bimaxillary Dentoalveolar Protrusion Case Treated with Anchorage by Buccally Implemented Mini-Implants Using a 3D-Printed Surgical Guide. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050879. [PMID: 37238427 DOI: 10.3390/children10050879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
The article presents a case of bimaxillary dentoalveolar protrusion treated by distalizing the upper and lower teeth, using anchorage from mini implants. A 16-year-old male patient presented with severe upper and lower incisor proclination with protruding lips and a convex profile, with a background of bimaxillary dentoalveolar protrusion. Instead of having four premolars extracted, retraction of the dentition was decided with absolute anchorage, provided by mini implants. In order to carry out the procedure in one stage, four mini-implants were inserted as close to the root of the 1st molars as possible. Implementation was facilitated by a surgical template which was created on a digital model and then 3D printed. Accurate placement was achieved and the case was successfully treated by significant uprighting of the incisors and retraction of the anterior dentition, closing the spaces in the upper and lower arch. Facial aesthetics were also improved. A digitally designed surgical guide was utilized in this case of bimaxillary dentoalveolar protrusion in order to facilitate the accurate placement of the mini implants which were used for a one-stage retraction of the dentition.
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Affiliation(s)
| | | | - Michail Vasoglou
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Patano A, Malcangi G, Inchingolo AD, Garofoli G, De Leonardis N, Azzollini D, Latini G, Mancini A, Carpentiere V, Laudadio C, Inchingolo F, D'Agostino S, Di Venere D, Tartaglia GM, Dolci M, Dipalma G, Inchingolo AM. Mandibular Crowding: Diagnosis and Management-A Scoping Review. J Pers Med 2023; 13:jpm13050774. [PMID: 37240944 DOI: 10.3390/jpm13050774] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Crowding is the most frequent malocclusion in orthodontics, with a strong hereditary tendency. It already occurs in pediatric age and is mainly hereditary. It is a sign of a lack of space in the arches, and is not self-correcting, but can worsen over time. The main cause of the worsening of this malocclusion is a progressive and physiological decrease in the arch perimeter. METHODS To identify relevant studies investigating the most common possible treatments for mandibular dental crowding, a comprehensive search of PubMed, Scopus and Web of Science was conducted encompassing the last 5 years (2018-2023) using the following MeSH: "mandibular crowding AND treatment" and "mandibular crowding AND therapy ". RESULTS A total of 12 studies were finally included. An orthodontic treatment cannot ignore the concept of "guide arch", which concerns the lower arch, because of the objective difficulty in increasing its perimeter; the bone structure of the lower jaw is more compact than that of the upper one. Its expansion, in fact, is limited to a slight vestibularization of the incisors and lateral sectors that may be associated with a limited distalization of the molars. CONCLUSIONS There are various therapeutic solutions available to the orthodontist, and a correct diagnosis through clinical examination, radiographs and model analysis are essential. The decision of how to deal with crowding cannot be separated from an overall assessment of the malocclusion to be treated.
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Affiliation(s)
- Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Grazia Garofoli
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Nicole De Leonardis
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Daniela Azzollini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giulia Latini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Claudia Laudadio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Silvia D'Agostino
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, 66100 Chieti, Italy
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy
- UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Marco Dolci
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, 66100 Chieti, Italy
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
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Tsoukala E, Lyros I, Tsolakis AI, Maroulakos MP, Tsolakis IA. Direct 3D-Printed Orthodontic Retainers. A Systematic Review. CHILDREN 2023; 10:children10040676. [PMID: 37189925 DOI: 10.3390/children10040676] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
Three-dimensional (3D) printing technology has shed light on many fields in medicine and dentistry, including orthodontics. Direct 3D-printed prosthetics, implants or surgical devices are well-documented. The fabrication of orthodontic retainers using CAD technology and additive manufacturing is an emerging trend but the available data are scarce. The research approach of the present review included keywords in Medline, Scopus, Cochrane Library and Google Scholar up to December 2022. The searching process concluded with five studies eligible for our project. Three of them investigated directly 3D-printed clear retainers in vitro. The other two studies investigated directly 3D-printed fixed retainers. Among them, one study was in vitro and the second was a prospective clinical trial. Directly 3D-printed retainers can be evolved over time as a good alternative to all the conventional materials for retention. Devices that are 3D-printed are more time and cost efficient, offer more comfortable procedures for both practitioners and patients and the materials used in additive manufacturing can solve aesthetic problems, periodontal issues or problems with the interference of these materials with magnetic resonance imaging (MRI). More well-designed prospective clinical trials are necessary for more evaluable results.
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Affiliation(s)
- Efthimia Tsoukala
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
| | - Ioannis Lyros
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
| | - Apostolos I. Tsolakis
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
- Department of Orthodontics, School of Dentistry, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Michael P. Maroulakos
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
| | - Ioannis A. Tsolakis
- Department of Orthodontics, School of Dentistry, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Quinzi V, Orilisi G, Vitiello F, Notarstefano V, Marzo G, Orsini G. A spectroscopic study on orthodontic aligners: First evidence of secondary microplastic detachment after seven days of artificial saliva exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 866:161356. [PMID: 36603638 DOI: 10.1016/j.scitotenv.2022.161356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/20/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Clear orthodontic aligners have recently seen increasing popularity. The thermoplastic materials present several advantages, even if it is known that all plastic products can be subjected to environmental and mechanical degradation, leading to the release of microplastics (MPs). Their ingestion could cause oxidative stress and inflammatory lesions. This study aims to evaluate the potential detachment of MPs by clear aligners due to mechanical friction simulated with a 7-day protocol in artificial saliva. The study was performed on orthodontic clear aligners from different manufacturers: Alleo (AL); FlexiLigner (FL); F22 Aligner (F22); Invisalign® (INV); Lineo (LIN); Arc Angel (ARC), and Ortobel Aligner (OR). For each group, two aligners were immersed in artificial saliva for 7 days and stirred for 5 h/day, simulating the physiological teeth mechanical friction. After 7 days, the artificial saliva was filtered; then, filters were analyzed by Raman Microspectroscopy (RMS) and Scanning Electron Microscopy (SEM), respectively to chemically identify the polymeric matrix and to measure the number and size of the detected MPs. RMS spectra revealed that AL, FL, LIN, ARC, and OR aligners were composed by polyethylene terephthalate, while F22 and INV ones by polyurethane. SEM analysis showed that the highest number of MPs was found in ARC and the lowest in INV (p < 0.05). As regards MPs' size, no statistically significant difference was found among groups, with most MPs ranging from 5 to 20 μm. Noteworthy, a highly significant correlation (p < 0.0001) was highlighted between the distribution of MPs size and the different typologies of aligners. This in vitro study highlighted for the first time the detachment of MPs from clear aligners due to mechanical friction. This evidence may represent a great concern in the clinical practice since it could impact human general health.
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Affiliation(s)
- Vincenzo Quinzi
- Università degli Studi dell'Aquila, Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'Ambiente, Piazza Salvatore Tommasi, 67100 L'Aquila, Italy
| | - Giulia Orilisi
- Università Politecnica delle Marche, Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Via Tronto 10, 60126 Ancona, Italy
| | - Flavia Vitiello
- Università Politecnica delle Marche, Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Via Tronto 10, 60126 Ancona, Italy
| | - Valentina Notarstefano
- Università Politecnica delle Marche, Dipartimento di Scienze della Vita e dell'Ambiente, Via Brecce Bianche, 60131 Ancona, Italy
| | - Giuseppe Marzo
- Università degli Studi dell'Aquila, Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'Ambiente, Piazza Salvatore Tommasi, 67100 L'Aquila, Italy
| | - Giovanna Orsini
- Università Politecnica delle Marche, Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche, Via Tronto 10, 60126 Ancona, Italy.
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Goracci C, Juloski J, D’Amico C, Balestra D, Volpe A, Juloski J, Vichi A. Clinically Relevant Properties of 3D Printable Materials for Intraoral Use in Orthodontics: A Critical Review of the Literature. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16062166. [PMID: 36984045 PMCID: PMC10058724 DOI: 10.3390/ma16062166] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 06/05/2023]
Abstract
The review aimed at analyzing the evidence available on 3D printable materials and techniques used for the fabrication of orthodontic appliances, focusing on materials properties that are clinically relevant. MEDLINE/PubMed, Scopus, and Cochrane Library databases were searched. Starting from an initial retrieval of 669 citations, 47 articles were finally included in the qualitative review. Several articles presented proof-of-concept clinical cases describing the digital workflow to manufacture a variety of appliances. Clinical studies other than these case reports are not available. The fabrication of aligners is the most investigated application of 3D printing in orthodontics, and, among materials, Dental LT Clear Resin (Formlabs) has been tested in several studies, although Tera Harz TC-85 (Graphy) is currently the only material specifically marketed for direct printing of aligners. Tests of the mechanical properties of aligners materials lacked homogeneity in the protocols, while biocompatibility tests failed to assess the influence of intraoral conditions on eluents release. The aesthetic properties of 3D-printed appliances are largely unexplored. The evidence on 3D-printed metallic appliances is also limited. The scientific evidence on 3D printable orthodontic materials and techniques should be strengthened by defining international standards for laboratory testing and by starting the necessary clinical trials.
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Affiliation(s)
- Cecilia Goracci
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Jovana Juloski
- Department of Orthodontics, School of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Claudio D’Amico
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Dario Balestra
- School of Dental Medicine, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - Alessandra Volpe
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Jelena Juloski
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
- Clinic for Paediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Alessandro Vichi
- Dental Academy, University of Portsmouth, Portsmouth PO1 2QG, UK
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Dai J, Li P, Spintzyk S, Liu C, Xu S. Influence of additive manufacturing method and build angle on the accuracy of 3D-printed palatal plates. J Dent 2023; 132:104449. [PMID: 36773740 DOI: 10.1016/j.jdent.2023.104449] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/16/2023] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVES In this in vitro study, the effects of additive manufacturing (AM) methods and build angles on the trueness and precision of 3D-printed palatal plate orthodontic appliances for newborns and infants were examined. METHODS Specimens were fabricated by different representative AM methods, including digital light processing (DLP), fused filament fabrication (FFF), and MultiJet printing (MJP). Three build angles (0°, 45°, and 90°) were used. After scanning, all specimens were analyzed using the 3D inspection software. The root mean square values were measured for trueness and precision. Color maps were created to detect deviations in samples. The data were statistically analyzed with a two-way ANOVA. RESULTS The trueness and precision were statistically influenced by both AM methods and build angles (p < 0.05). Moreover, the root mean square values of the 45° DLP (0.0221 ± 0.0017 μm) and the 0° MJP (0.0217 ± 0.0014 μm) were significantly lower compared to those in other groups (p < 0.001). CONCLUSIONS AM methods (DLP, FFF, and MJP) and build angles (0°, 45°, and 90°) significantly impacted the dimensional accuracy of additively manufactured palatal plate orthodontic appliances. Also, the 45° DLP and the 0° MJP were associated with the highest trueness and precision. CLINICAL SIGNIFICANCE All tested AM methods with different build angles yielded clinically acceptable outcomes (within an acceptance range of ±300 μm for trueness), achieving the highest accuracy with a technology-specific suitable build angle.
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Affiliation(s)
- Jingtao Dai
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China
| | - Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China
| | - Sebastian Spintzyk
- ADMiRE Reseach Center - Additive Manufacturing, intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Europastraße 4, Villach 9524, Austria
| | - Chufeng Liu
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China.
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China.
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Degree of conversion of 3D printing resins used for splints and orthodontic appliances under different postpolymerization conditions. Clin Oral Investig 2023:10.1007/s00784-023-04893-8. [PMID: 36757463 DOI: 10.1007/s00784-023-04893-8] [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: 05/16/2022] [Accepted: 02/01/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVES To measure the degree of conversion (DC) of different 3D printing resins used for splints or orthodontic appliances under different postpolymerization conditions. MATERIALS AND METHODS Five 3D-printed photopolymer resins were studied. Each resin was analyzed in liquid form (n = 15), and then cylindrical specimens (n = 135) were additively manufactured and postcured with Form Cure (Formlabs) at different times (10, 60, and 90 min) and temperatures (20 °C, 60 °C, and 80 °C). The DC of each specimen was measured with Fourier transform infrared spectroscopy (FTIR). The data were statistically analyzed using a 3-way ANOVA followed by Tukey's post hoc test. RESULTS The time and temperature of postpolymerization significantly influenced the DC of each resin: when time and/or temperature increased, the DC increased. For all resins tested, the lowest DC was obtained with a postcuring protocol at 10 min and 20 °C, and the highest DC was obtained at 90 min and 80 °C. However, at 80 °C, the samples showed a yellowish color. CONCLUSIONS With the Form Cure device, the time and temperature of postcuring could have an impact on the DC of the 3D printing resins studied. The DC of the 3D printing resins could be optimized by adjusting the postpolymerization protocol. CLINICAL RELEVANCE Regardless of the resin used, when using the Form Cure device, postcuring at 60 min and 60 °C would be the minimal time and temperature conditions for achieving proper polymerization. Beyond that, it would be preferable to increase the postcuring time to boost the DC.
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Rezaie F, Farshbaf M, Dahri M, Masjedi M, Maleki R, Amini F, Wirth J, Moharamzadeh K, Weber FE, Tayebi L. 3D Printing of Dental Prostheses: Current and Emerging Applications. JOURNAL OF COMPOSITES SCIENCE 2023; 7:80. [PMID: 38645939 PMCID: PMC11031267 DOI: 10.3390/jcs7020080] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Revolutionary fabrication technologies such as three-dimensional (3D) printing to develop dental structures are expected to replace traditional methods due to their ability to establish constructs with the required mechanical properties and detailed structures. Three-dimensional printing, as an additive manufacturing approach, has the potential to rapidly fabricate complex dental prostheses by employing a bottom-up strategy in a layer-by-layer fashion. This new technology allows dentists to extend their degree of freedom in selecting, creating, and performing the required treatments. Three-dimensional printing has been narrowly employed in the fabrication of various kinds of prostheses and implants. There is still an on-demand production procedure that offers a reasonable method with superior efficiency to engineer multifaceted dental constructs. This review article aims to cover the most recent applications of 3D printing techniques in the manufacturing of dental prosthetics. More specifically, after describing various 3D printing techniques and their advantages/disadvantages, the applications of 3D printing in dental prostheses are elaborated in various examples in the literature. Different 3D printing techniques have the capability to use different materials, including thermoplastic polymers, ceramics, and metals with distinctive suitability for dental applications, which are discussed in this article. The relevant limitations and challenges that currently limit the efficacy of 3D printing in this field are also reviewed. This review article has employed five major scientific databases, including Google Scholar, PubMed, ScienceDirect, Web of Science, and Scopus, with appropriate keywords to find the most relevant literature in the subject of dental prostheses 3D printing.
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Affiliation(s)
- Fereshte Rezaie
- Department of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz P.O. Box 5163639888, Iran
| | - Masoud Farshbaf
- Department of Medical Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz P.O. Box 5163639888, Iran
| | - Mohammad Dahri
- Research Center for Pharmaceutical Nanotechnology, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz P.O. Box 5163639888, Iran
| | - Moein Masjedi
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz P.O. Box 6468571468, Iran
| | - Reza Maleki
- Department of Chemical Technologies, Iranian Research Organization for Science and Technology (IROST), Tehran P.O. Box 33535111, Iran
| | - Fatemeh Amini
- School of Dentistry, Shahed University of Medical Sciences, Tehran P.O. Box 5163639888, Iran
| | - Jonathan Wirth
- School of Dentistry, Marquette University, Milwaukee, WI 53233, USA
| | - Keyvan Moharamzadeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates
| | - Franz E. Weber
- Center for Dental Medicine/Cranio-Maxillofacial and Oral Surgery, Oral Biotechnology and Bioengineering, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Lobat Tayebi
- School of Dentistry, Marquette University, Milwaukee, WI 53233, USA
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Inchingolo AM, Malcangi G, Costa S, Fatone MC, Avantario P, Campanelli M, Piras F, Patano A, Ferrara I, Di Pede C, Netti A, de Ruvo E, Palmieri G, Settanni V, Carpentiere V, Tartaglia GM, Bordea IR, Lorusso F, Sauro S, Di Venere D, Inchingolo F, Inchingolo AD, Dipalma G. Tooth Complications after Orthodontic Miniscrews Insertion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1562. [PMID: 36674316 PMCID: PMC9867269 DOI: 10.3390/ijerph20021562] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 05/13/2023]
Abstract
Orthodontic miniscrews (OM) are widely used in modern orthodontic clinical practice to improve skeletal anchorage and have a high safety profile. A complication at the time of OM insertion is tooth root perforation or periodontal ligament trauma. Rarely, OM injury can cause permanent damage, such as ankylosis, osteosclerosis, and loss of tooth vitality. The aim of this work was to analyze potential risks and dental complications associated with the use of OMs. A search of the PubMed, Cochrane, Web of Science, and Scopus databases was conducted without a time limit using the keywords "orthodontic mini-screw" and "dental damage", resulting in 99 studies. After screening and eligibility, including articles obtained through a citation search, 13 articles were selected. Four studies revealed accidental injuries caused by OM. Most of the damage was localized at the root level and resolved spontaneously with restorative cement formation after prompt removal of the OM, while the pain disappeared. In some cases, irreversible nerve damage, extensive lesions to the dentin-pulp complex, and refractory periapical periodontitis occurred, requiring endodontic and/or surgical treatment. The choice of insertion site was the most important element to be evaluated during the application of OMs.
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Affiliation(s)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Stefania Costa
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Pasquale Avantario
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Merigrazia Campanelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Chiara Di Pede
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Anna Netti
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Elisabetta de Ruvo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vito Settanni
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Salvatore Sauro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, University CEU Cardenal Herrera, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
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Inchingolo AM, Malcangi G, Ferrara I, Viapiano F, Netti A, Buongiorno S, Latini G, Azzollini D, De Leonardis N, de Ruvo E, Mancini A, Rapone B, Venere DD, Patano A, Avantario P, Tartaglia GM, Lorusso F, Scarano A, Sauro S, Fatone MC, Bordea IR, Inchingolo F, Inchingolo AD, Dipalma G. Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1302. [PMID: 36674058 PMCID: PMC9859463 DOI: 10.3390/ijerph20021302] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
An abnormal and hypertrophied upper labial frenulum (ULF) can cause diastemas, gingival recession, eruption abnormalities, and the onset of carious and periodontal problems in the upper central incisors, as well as aesthetic and functional disorders of the upper lip. The goal of this investigation is to review the evidence on the surgical techniques that are currently available for treating ULF in order to identify the best approach. PubMed, Scopus, Cochrane Library, and Embase were searched for papers that matched our topic from 13 November 2012 up to 22 November 2022 using the following Boolean keywords: "frenulum" and "surgery*". A total of eight articles were selected for the purpose of the review. ULF can be surgically treated using either traditional scalpel surgery or laser surgery. The latter is the better option due to its intra- and post-operative benefits for both the patients and the clinicians, in terms of faster healing, fewer side effects and discomfort, and greater patient compliance. However, a higher learning curve is required for this technique, especially to calibrate the appropriate power of the laser. To date, it is not possible to identify which type of laser achieves the best clinical results for the treatment of ULF.
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Affiliation(s)
- Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Anna Netti
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Silvio Buongiorno
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giulia Latini
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Daniela Azzollini
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Nicole De Leonardis
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Elisabetta de Ruvo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Assunta Patano
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Pasquale Avantario
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Salvatore Sauro
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
| | | | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
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Topsakal KG, Aksoy M, Duran GS. In vitro examination of fracture resistance of 3D-printed resin blocks in different diameters. APOS TRENDS IN ORTHODONTICS 2023. [DOI: 10.25259/apos_170_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objectives:
The intraoral use of commercial printable polymers in dental patients is still a challenge due to the unknown physical properties of the materials. The present study aimed to comparably evaluate the maximum load and deflection values of three-dimensional-printed resin blocks in different diameters that can be used intraorally in dental patients.
Material and Methods:
Forty-five cylindrical resin blocks in diameters of 2 mm (Group 1, n = 15), 3 mm (Group 2, n = 15), and 4 mm (Group 3, n = 15) and lengths of 20 mm were designed and printed. The samples were placed in the universal testing device to conduct the 3-point bending test. According to the Shapiro–Wilk normality test results, Kruskal–Wallis and Mann–Whitney U tests were performed for the statistical analysis. The level of statistical significance was accepted as P < 0.05.
Results:
The values for the maximum load (N) and deflection (mm) in the study groups were 218.4 ± 31.9, 2.96 ± 0.86 in Group 3; 77.05 ± 61.5, 3.91 ± 0.92 in Group 2; and 19.67 ± 2.63, 4.06 ± 1.02 in Group 1, respectively. The mean values of maximum load for Group 3 were superior to Group 2 (P = 0.020) and Group 1 (P = 0.00). Group 2 revealed higher maximum load results than Group 1 (P = 0.003). The mean values of maximum deflection in Group 3 were lower compared to Group 2 (P = 0.014) and Group 1 (P = 005).
Conclusion:
The results of this in vitro study encourage the use of resin-printed intraoral appliances in place of conventional treatment modalities.
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Affiliation(s)
| | - Merve Aksoy
- Gülhane Faculty of Dental Medicine, Department of Pediatric Dentistry, University of Health Sciences, Ankara, Turkey,
| | - Gökhan Serhat Duran
- Gülhane Faculty of Dental Medicine, Department of Orthodontics, Ankara, Turkey,
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Rajasekaran A, Chaudhari PK. Integrated manufacturing of direct 3D-printed clear aligners. FRONTIERS IN DENTAL MEDICINE 2023. [DOI: 10.3389/fdmed.2022.1089627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The inception of the laboratory work for a removable tooth moving appliance construction by sectioning the teeth from the malocclusion model to align them with wax and achieve minor dental correction has evolved into a state of digital planning and appliance manufacturing for a wide spectrum of malocclusion. The disruptive technology of directly printing clear aligners has drawn the clinician and researcher's interest in the orthodontic fraternity contemporarily. This workflow enables to the development of an in-house aligner system with complete control over desired aligner thickness, extent, and attachments; also technically resource-efficient with greater accuracy by excluding all the intermediate steps involved in the thermoforming method of manufacturing. This promising exploratory subject demands to be well-received with further research-based improvements. This article intends to summarize the digital orthodontic workflow and the literature evidence.
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50
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Frazier K, Cevidanes L, Pannu DS, León MR, Urquhart O. Intraoral appliance use in dental practice: An American Dental Association Clinical Evaluators Panel survey. J Am Dent Assoc 2022; 153:1189-1190.e2. [PMID: 36435530 DOI: 10.1016/j.adaj.2022.09.010] [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: 09/19/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND A growing variety of intraoral appliances are being used in dental practice. Insight about the range of applications and practice workflow as well as factors effecting change in practice trends was sought. METHODS A survey was developed to ascertain intraoral appliance use, fabrication methods, staff involvement, and patient experiences in dental practice. The survey was sent to ADA Clinical Evaluators Panel members on July 25, 2022, in Qualtrics and remained open for 2 weeks. After 1 week, those who had not responded yet were sent reminders. Data were analyzed descriptively in SAS Version 9.4. RESULTS Of the 286 respondents (a 28% response rate), 88% reported providing patients with intraoral appliances apart from providing patients with removable partial dentures. More than one-half of the respondents reported offering bleaching trays (88%), flippers or Essix retainers (83%), splints (81%), athletic mouthguards (72%), orthodontic retainers (60%), fluoride trays (56%), and clear aligners (55%). The biggest changes to practice in the past 5 years with respect to intraoral appliances have been intraoral scanning (56%) and the increase in the variety of intraoral appliances in use. Although 72% reported dental assistants were involved in obtaining impressions and fabricating models for intraoral appliances and 76% reported that laboratory technicians were involved in fabricating intraoral appliances, nearly all (97%) respondents indicated that the dentist was involved in the delivery of appliances to patients. Patient education about the use of their appliances appeared to be delivered using multiple approaches, given that it was reported to occur orally (95%), in print (61%), and visually (42%). That 90% of respondents reported having engaged in continuing education courses about intraoral appliances aligns with these appliances becoming a routine part of dental practice, with both increasing applications and improvements in the relevant technology. CONCLUSIONS Intraoral appliances were found to be used commonly in dental practice, and often multiple members of the dental care team were engaged in the fabrication processes. PRACTICAL IMPLICATIONS There likely will be ongoing interest in relevant learning opportunities about technologic advances as well as the increasingly diverse list of applications for intraoral appliances.
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