1
|
Olteanu ND, Taraboanta I, Panaite T, Balcos C, Rosu SN, Vieriu RM, Dinu S, Zetu IN. Color Stability of Various Orthodontic Clear Aligner Systems after Submersion in Different Staining Beverages. MATERIALS (BASEL, SWITZERLAND) 2024; 17:4009. [PMID: 39203186 PMCID: PMC11355976 DOI: 10.3390/ma17164009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 09/03/2024]
Abstract
This study aimed to compare the color changes in two different orthodontic clear aligner systems after submersion in various beverages for 14 days. The tested aligner systems were Taglus Premium made of polyethylene terephthalate glycol (the TAG group) and CA® Prodin+ made of a transparent copolyester and a thermoplastic elastomer (the PRO group). A total of 56 samples were firstly divided into two groups according to the tested system-TAG and PRO. Each group was subsequently divided in four subgroups according to immersion solution: A-artificial saliva, B-cola, C-coffee, D-red wine. Color measurements were performed on Days 1, 7 and 14 using a portable colorimeter and the CIE L*a*b* system. The obtained results showed significant color changes in both materials when exposed to coffee and red wine (p > 0.05). Samples in the PRO group showed a greater susceptibility to discoloration (higher ΔE values) when compared to the TAG group after submersion in cola (p = 0.025), coffee (p = 0.005) and red wine (p = 0.041) solutions. Statistical analysis revealed that all of the color parameters ΔL*, Δa*, Δb* and ΔE of both tested materials were affected by submersion in coffee solution for 14 days. In conclusion, the CA® Pro+ aligner system is more prone to staining compared to the Taglus material after submersion for 14 days in cola, coffee and red wine solutions. Submersion for 14 days in coffee solution alters all of the color parameters (ΔL, Δa, Δb and ΔE) of both tested aligner materials.
Collapse
Affiliation(s)
- Nicolae Daniel Olteanu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine “Grigore T. Popa”, University of Medicine and Pharmacy from Iasi, Str. Universitatii 16, 700115 Iasi, Romania; (N.D.O.); (I.T.); (T.P.); (C.B.); (R.M.V.); (I.N.Z.)
| | - Ionut Taraboanta
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine “Grigore T. Popa”, University of Medicine and Pharmacy from Iasi, Str. Universitatii 16, 700115 Iasi, Romania; (N.D.O.); (I.T.); (T.P.); (C.B.); (R.M.V.); (I.N.Z.)
| | - Tinela Panaite
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine “Grigore T. Popa”, University of Medicine and Pharmacy from Iasi, Str. Universitatii 16, 700115 Iasi, Romania; (N.D.O.); (I.T.); (T.P.); (C.B.); (R.M.V.); (I.N.Z.)
| | - Carina Balcos
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine “Grigore T. Popa”, University of Medicine and Pharmacy from Iasi, Str. Universitatii 16, 700115 Iasi, Romania; (N.D.O.); (I.T.); (T.P.); (C.B.); (R.M.V.); (I.N.Z.)
| | - Sorana Nicoleta Rosu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine “Grigore T. Popa”, University of Medicine and Pharmacy from Iasi, Str. Universitatii 16, 700115 Iasi, Romania; (N.D.O.); (I.T.); (T.P.); (C.B.); (R.M.V.); (I.N.Z.)
| | - Raluca Maria Vieriu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine “Grigore T. Popa”, University of Medicine and Pharmacy from Iasi, Str. Universitatii 16, 700115 Iasi, Romania; (N.D.O.); (I.T.); (T.P.); (C.B.); (R.M.V.); (I.N.Z.)
| | - Stefania Dinu
- Department of Pedodontics, Faculty of Dental Medicine, “Victor Babes”, University of Medicine and Pharmacy Timisoara, No. 9, Revolutiei Bv., 300041 Timisoara, Romania;
| | - Irina Nicoleta Zetu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine “Grigore T. Popa”, University of Medicine and Pharmacy from Iasi, Str. Universitatii 16, 700115 Iasi, Romania; (N.D.O.); (I.T.); (T.P.); (C.B.); (R.M.V.); (I.N.Z.)
| |
Collapse
|
2
|
Medeiros RB, Santos RF, Mendes-Miguel JA, Rothier EKC, Mendes FM, Dominguez GC. Accuracy of arch expansion with two thermoplastic materials in Invisalign® patients: EX30® and SmartTrack®. Dental Press J Orthod 2024; 29:e2423212. [PMID: 38865514 PMCID: PMC11163956 DOI: 10.1590/2177-6709.29.2.e2423212.oar] [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: 10/16/2023] [Accepted: 03/25/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVE The purpose of this retrospective study was to compare accuracy of arch expansion using two different thermoplastic materials in Invisalign aligners: EX30® (Polyethylene Terephthalate Glycol, or PETG) and SmartTrack® (polyurethane). METHODS The study sample comprised 65 adult patients consecutively treated with Invisalign from two private practices: group 1 - treated with EX30® (358 teeth) and group 2 - treated with SmartTrack® (888 teeth). Six hundred and twenty-three measurements were assessed in three digital models throughout treatment: model 1 - initial, model 2 - predicted tooth position, and model 3 - achieved position. Sixteen reference points per arch were marked and, after best alignment, 2 points per tooth were copied from one digital model to another. Linear values of both arches were measured for canines, premolars, and first molars: on lingual gingival margins and cusp tips of every tooth. Comparisons were performed by Wilcoxon and Mann-Whitney test. RESULTS Both termoplastic materials presented significant differences between predicted and achieved values for all measurements, except for the lower molar cusp tip in the SmartTrack® group. There is no statistical difference in the accuracy of transverse expansion between these two materials. Overall accuracy for EX30® aligners in maxilla and mandible were found to be 37 and 38%, respectively; and Smarttrack® presented an overall accuracy of 56.62% in the maxilla and 68.72% in the mandible. CONCLUSIONS It is not possible to affirm one material expands better than the other. Further controlled clinical studies should be conducted comparing SmartTrack® and EX30® under similar conditions.
Collapse
Affiliation(s)
- Raquel Bueno Medeiros
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Ortodontia (São Paulo/SP, Brazil)
| | - Renata Faria Santos
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Ortodontia (São Paulo/SP, Brazil)
| | - Jose Augusto Mendes-Miguel
- Universidade Estadual do Rio de Janeiro, Faculdade de Odontologia, Departamento de Ortodontia (Rio de Janeiro/RJ, Brazil)
| | | | - Fausto Medeiros Mendes
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Odontopediatria (São Paulo/SP, Brazil)
| | - Gladys Cristina Dominguez
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Ortodontia (São Paulo/SP, Brazil)
| |
Collapse
|
3
|
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.
Collapse
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;
| |
Collapse
|
4
|
Nayak AS, H C KK. A comparative study on tensile strength of various thermoplastic polymers sheets following thermoforming on a pre-treatment and post-treatment maxillary model of a patient: an in vitro study. Clin Oral Investig 2024; 28:240. [PMID: 38570397 DOI: 10.1007/s00784-024-05640-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/30/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Thermoplastic polymers show alteration in their mechanical properties after thermoforming on a dental model. The purpose of this in-vitro study was to evaluate the tensile strength of different thermoplastic polymer sheets thermoformed on a pre-treatment (moderate crowding) and post-treatment (well-aligned) maxillary model of a patient. MATERIALS AND METHODS Forty maxillary models (Twenty Pre-treatment & twenty Post-treatment of uniform dimension) were made by duplicating them using alginate Hydrogum 5 (Zhermack). Samples were then divided into eight groups of 5 samples each. The thermoplastic sheets Imprelon® (Scheu-Dent), AVAC R® (Jaypee), Placa Crystal® (BioART), EZ-VAC® (3A Medes)-1.0 mm thick were thermoformed on these models respectively. The sample was retrieved using ceramic bur mounted on a straight hand-piece and subjected for testing using TINIUS Olsen 10ST micro universal testing machine and recorded. RESULTS There was no statistically significant difference (P > .05) in tensile strength of thermoformed thermoplastic polymer sheets between pre-treatment and post-treatment maxillary model. Tensile strength of EZ-VAC (3A Medes) showed higher variation between pre-treatment and post-treatment maxillary model though it was found to be statistically insignificant (P > .05). Significant difference (P < .05) was seen between groups when they were compared separately among pre-treatment and post-treatment models. CONCLUSION Placa Crystal (BioART) among the pre-treatment group, EZ - VAC (3A Medes) among the post-treatment group, showed highest tensile strength. CLINICAL RELEVANCE Results of the study highlights the necessity to test materials in conditions which stands in accordance with the clinical scenario to a considerable extent and also emphasizes the need for further study in aligner.
Collapse
Affiliation(s)
- Ashwath S Nayak
- Department of Orthodontics and Dentofacial Orthopedics, Bapuji Dental College and Hospital, Davangere, Karnataka, India, 577004.
| | - Kiran Kumar H C
- Department of Orthodontics and Dentofacial Orthopedics, Bapuji Dental College and Hospital, Davangere, Karnataka, India, 577004
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
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.
Collapse
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.
| |
Collapse
|
7
|
Aldweesh AH, Al-Maflehi NS, AlGhizzi M, AlShayea E, Albarakati SF. Comparison of mechanical properties and color stability of various vacuum-formed orthodontic retainers: An in vitro study. Saudi Dent J 2023; 35:953-959. [PMID: 38107045 PMCID: PMC10724479 DOI: 10.1016/j.sdentj.2023.09.004] [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: 07/03/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 12/19/2023] Open
Abstract
Vacuum-formed retainer (VFR) is the most used retainer due to its higher aesthetic properties and lower cost, their mechanical properties of are important in determining the stability and long-term use of appliances made out of them. AIM This study aimed to evaluate and compare the flexural modulus, surface hardness, and color stability of three different VFR materials. METHODS Three different VFR materials, namely Duran, Keystone, and Zendura, of 1 mm thickness, were tested after thermoforming for flexural modulus, hardness, and color stability. They were formed over a stainless-steel model of 12 mm diameter and 6 mm height. RESULTS There were significant statistical differences (p = 0.000) in the flexural modulus and hardness of the three materials. Regarding color stability, Zendura exhibited significantly higher ΔE* values than Keystone and Duran (p < 0.05). CONCLUSIONS Zendura had the highest flexural modulus and hardness compared with Duran and Keystone; however, it is more susceptible to color change compared to the other tested materials.
Collapse
Affiliation(s)
- Aljazi H. Aldweesh
- Division of Orthodontics, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nassr S. Al-Maflehi
- Periodontics and Community Dentistry, College of Dentistry, King Saud University, Saudi Arabia
| | | | - Eman AlShayea
- Division of Orthodontics, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sahar F. Albarakati
- Division of Orthodontics, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
8
|
Šimunović L, Jurela A, Sudarević K, Bačić I, Meštrović S. Differential Stability of One-layer and Three-layer Orthodontic Aligner Blends under Thermocycling: Implications for Clinical Durability. Acta Stomatol Croat 2023; 57:286-299. [PMID: 38283309 PMCID: PMC10812913 DOI: 10.15644/asc57/4/1] [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: 10/25/2023] [Accepted: 12/01/2023] [Indexed: 01/30/2024] Open
Abstract
Objectives To optimize the therapeutic usefulness of aligners, it is crucial to understand how their mechanical properties alter with time. Materials and methods Specimens from four different brands, including Duran+, CA® Pro, Zendura A, and Zendura FLX, were produced for material testing of thermoplastic orthodontic aligners (TOA) using dimensions measuring 4mm x 10mm. Each brand's 24 samples were split into three groups as follows: G1 being thermoformed, G2 being thermoformed and underwent 500 thermocycles (simulating 7 days), and G3 being thermoformed and underwent 1000 thermocycles (simulating 14 days). Surface roughness, modulus of elasticity in bending, and spectrophotometry were used to assess the effect of aging on TOAs. Results After 1000 thermocycles, Duran+ had the highest modulus of elasticity and differed statistically from all other groups. The intragroup comparison showed that only Duran+'s elastic modulus significantly changed after 1000 thermocycles in comparison with the control group. Surface roughness values (Ra), did not statistically differ among brands or thermocycling group measures. The change in chemical properties was not significant in any brand. Conclusion One-layer PETG (Duran+) failed to demonstrate stability after in vitro aging, thus suggesting that clinicians should be aware of the change in mechanical properties when using one-layer PETG (Duran +) in a 2 weeks regime.
Collapse
Affiliation(s)
- Luka Šimunović
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | | | | | - Ivana Bačić
- Forensic Science Centre "Ivan Vučetić", Ministry of the Interior, Ilica 351, 10000 Zagreb, Croatia
| | - Senka Meštrović
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| |
Collapse
|
9
|
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.
Collapse
Affiliation(s)
- AbdulMajeed AlMogbel
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
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.
Collapse
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.
| |
Collapse
|
12
|
Susarchick L, Virji I, Viana G, Mahmoud M, Allareddy V, Gruber M, Lukic H, Megremis S, Atsawasuwan P. The Effects of Staining and Cleaning on the Color and Light Transmittance Changes of a Copolyester Retainer Material with Different Surface Textures. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15196808. [PMID: 36234148 PMCID: PMC9570909 DOI: 10.3390/ma15196808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 05/27/2023]
Abstract
This study evaluated the efficacy of different cleaning methods with respect to changes in the color and light transmittance of both rough and smooth thermoformed, copolyester retainer specimens, after staining in different solutions. Four hundred copolyester sheets (Essix ACE) specimens were fabricated over molds with different surface textures, smooth and rough. The specimens were stained in four different solutions (n = 100 per solution) over 28 days; then, each of the four groups of 100 stained specimens was sub-divided into five groups of 20 specimens and subjected to a different destaining solution. The specimens were sub-divided with half subjected to an additional ultrasonic cleaning procedure. Light transmittance and color changes were analyzed using a spectrometer/integrating sphere assembly and a spectrophotometer. Mean difference comparisons were performed using appropriate statistical tests at p = 0.05. All five destaining solutions proved to be effective at removing coffee and tea stains. The surface roughness of the retainer material plays a significant role in the ability of cleaning solutions to remove stains, demonstrating a greater effect on cleaning rough specimens with respect to improvements in light transmittance and greater changes in color. Additionally, an ultrasonic cleaning unit generally enhanced the ability of all five solutions to clean the tea-stained specimens. However, the enhancements were only significant for light transmittance.
Collapse
Affiliation(s)
- Laurie Susarchick
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Insia Virji
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Grace Viana
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Mervat Mahmoud
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA
| | | | - Max Gruber
- Dental Materials & Devices Research—American Dental Association, Chicago, IL 60610, USA
| | - Henry Lukic
- Dental Materials & Devices Research—American Dental Association, Chicago, IL 60610, USA
| | - Spiro Megremis
- Dental Materials & Devices Research—American Dental Association, Chicago, IL 60610, USA
| | - Phimon Atsawasuwan
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA
| |
Collapse
|
13
|
Warnecki M, Sarul M, Kozakiewicz M, Zięty A, Babiarczuk B, Kawala B, Jurczyszyn K. Surface Evaluation of Aligners after Immersion in Coca-Cola and Orange Juice. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15186341. [PMID: 36143665 PMCID: PMC9504463 DOI: 10.3390/ma15186341] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 05/31/2023]
Abstract
Orthodontic removable appliances made of transparent thermoplastic materials-aligners-are becoming increasingly popular in contemporary orthodontic practice. It is important for the clinician to fully understand the mechanical properties and behavior of the appliance used. Because of that, the aim of our study was to investigate the changes in aligner surface after immersion in Coca-Cola and orange juice. For surface evaluation, fractal analysis, texture analysis, and wetting angle measurement were performed. Statistically significant changes were found between some of the groups in the fractal dimension analysis. In texture analysis, all but one intergroup comparison showed statistically significant differences. For wetting angle assessment, statistically significant differences were found. These were, however, more numerous when assessing glycol droplets, rather than water droplets. Fractal dimension analysis confirmed a correlation between the intensity of changes in the aligner surface with immersion time in the liquids assessed. Texture analysis showed a high sensitivity to the changes in aligner surface. It failed, however, to reveal changes relative to immersion time. Wetting angle analysis revealed aligner surface degradation for Coca-Cola. It did not, however, prove the dependence of the intensity of this degradation as a function of time. Both Coca-Cola and orange juice can cause aligner surface degradation.
Collapse
Affiliation(s)
- Maciej Warnecki
- Independent Researcher, Niemodlińska 63, 45-864 Opole, Poland
| | - Michał Sarul
- Department of Integrated Dentistry, Wrocław Medical University, 50-425 Wrocław, Poland
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego Str., 90-549 Lodz, Poland
| | - Anna Zięty
- Department of Mechanics, Materials and Biomedical Engineering, Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Smoluchowskiego 25, 50-372 Wrocław, Poland
| | - Bartosz Babiarczuk
- Department of Mechanics, Materials and Biomedical Engineering, Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Smoluchowskiego 25, 50-372 Wrocław, Poland
| | - Beata Kawala
- Department of Dentofacial Orthopedics and Orthodontics, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland
| | - Kamil Jurczyszyn
- Department of Oral Surgery, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland
| |
Collapse
|
14
|
Khijmatgar S, Tumedei M, Del Fabbro M, Tartaglia GM. Effectiveness and Efficacy of Thermoformed and 3D Printed Aligners in Correcting Malocclusion (Spacing) and Its Impact on Periodontal Oral Health and Oral Microbiome: A Double-Blinded Parallel Randomized Controlled Multicenter Clinical Trial. Microorganisms 2022; 10:microorganisms10071452. [PMID: 35889171 PMCID: PMC9319547 DOI: 10.3390/microorganisms10071452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 02/01/2023] Open
Abstract
Aligners are the common devices used in orthodontics for the correction of malocclusion. Various materials and techniques are employed to fabricate aligners. One of those includes thermoformed and 3D aligners. These aligners can be worn for several days, and their impact on periodontal health is not known. Therefore, the aim of our protocol is to determine the effectiveness of these aligners in correcting malocclusion and their impact on periodontal health and oral microbiome. A double-blinded randomized controlled clinical trial with a total of n = 60 patients will be included with n = 30 in each group (Test: 3D printed aligners and Control: Thermoformed). The evaluation of oral health indices such as basic periodontal examination (BPE), periodontal screening and recording (PSR) that provide the status of periodontal health will be recorded. The oral microbiome assessment will be conducted with polymerase chain reaction (PCR). The primary endpoint will be the correction of malocclusion, and the secondary end point will be the status of periodontal health and oral microbiome. The duration of follow-up for each group will be 7 days for periodontal health and oral microbiome and 6 months for the space closure of 5 mm by 3D and thermoformed aligners.
Collapse
Affiliation(s)
- Shahnawaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (M.D.F.); (G.M.T.)
- Correspondence:
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (M.D.F.); (G.M.T.)
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (M.D.F.); (G.M.T.)
- IRCCS Fondazione Ca’Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy; (M.T.); (M.D.F.); (G.M.T.)
- IRCCS Fondazione Ca’Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| |
Collapse
|
15
|
Alhendi A, Khounganian R, Ali R, Syed SA, Almudhi A. Structural Conformation Comparison of Different Clear Aligner Systems: An In Vitro Study. Dent J (Basel) 2022; 10:dj10050073. [PMID: 35621526 PMCID: PMC9139589 DOI: 10.3390/dj10050073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 12/10/2022] Open
Abstract
The aim of this study was to evaluate the structural conformations of three clear aligner systems, Eon®, SureSmile®, and Clarity®, and compare them with the most commonly used system, Invisalign®. Clear aligner samples from Invisalign®, Eon®, SureSmile®, and Clarity® were cut into 5 × 5 mm squares and exposed to artificial saliva for 2 weeks. The specimens were then subjected to a Vickers hardness test by applying three separate indentations with a 25 gf load for 15 s. Hardness was calculated using the following formula: Vickers hardness number = 1.854 (F/D2). Fourier transform infrared spectroscopy (FTIR) analysis was performed, with a diamond hemisphere and infrared beam being allowed to pass through each specimen. A mid-infrared range from 4000 to 375 cm−1 was recorded. The samples were also evaluated using scanning electron microscopy (SEM) combined with energy-dispersive X-ray microanalysis spectroscopy at different magnifications. No statistically significant differences were observed between the included systems with regard to hardness. All systems showed a polyurethane-based material, as illustrated by the FTIR analysis. Some structural variations were noted in the Invisalign® system, which had a more homogeneous architecture. Statistically significant differences in the carbon weights were found among the systems. The four systems presented comparable hardness levels. Mild molecular composition differences were found, but all systems had the similarity of being composed of a polyurethane-based material. Carbon and oxygen were the main elements, as they were located in all studied clear aligners. The SEM analysis revealed that Invisalign® had a smoother surface than the other three systems. All included clear aligners had similar characteristics with minimal differences, providing a wide variety of options for clinical orthodontic treatment according to patients’ demands.
Collapse
Affiliation(s)
- Aseel Alhendi
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
- Correspondence: ; Tel.: +966-541-419-097
| | - Rita Khounganian
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Raisuddin Ali
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Saeed Ali Syed
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Abdullazez Almudhi
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| |
Collapse
|