In vitro biocompatibility of nickel-titanium esthetic orthodontic archwires

Objective:To investigate the cytotoxicity of nickel-titanium (NiTi) esthetic orthodontic archwires with different surface coatings.Materials and Methods:Three fully coated, tooth-colored NiTi wires (BioCosmetic, Titanol Cosmetic, EverWhite), two ion-implanted wires (TMA Purple, Sentalloy High Aesthetic), five uncoated NiTi wires (BioStarter, BioTorque, Titanol Superelastic, Memory Wire Superelastic, and Sentalloy), one β-titanium wire (TMA), and one stainless steel wire (Stainless Steel) were considered for this study. The wire samples were placed at 37°C in airtight test tubes containing Dulbecco’s Modified Eagle’s Medium (0.1 mg/mL) for 1, 7, 14, and 30 days. The cell viability of human gingival fibroblasts (HGFs) cultured with this medium was assessed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Data were analyzed by a two-way analysis of variance (α  =  .05).Results:The highest cytotoxic effect was reached on day 30 for all samples. The archwires exhibited a cytotoxicity on HGFs ranging from “none” to “slight,” with the exception of the BioTorque, which resulted in moderate cytotoxicity on day 30. Significant differences were found between esthetic archwires and their uncoated pairs only for BioCosmetic (P  =  .001) and EverWhite (P < .001).Conclusions:Under the experimental conditions, all of the NiTi esthetic archwires resulted in slight cytotoxicity, as did the respective uncoated wires. For this reason their clinical use may be considered to have similar risks to the uncoated archwires.     

Comparative short-term in vitro analysis of mutans streptococci adhesion on esthetic,nickel-titanium,and stainless-steel arch wires

Objective: To test the hypothesis that there are no differences in mutans streptococci (MS) adhesion between esthetic and metallic orthodontic arch wires based on their surface characteristics.Materials and Methods:Surface roughness (R_a) and apparent surface free energy (SFE) were measured for six wires—four esthetic, one nickel-titanium (NiTi), and one stainless-steel (SS)—using profilometry and dynamic contact angle analysis, respectively. The amount of MS (Streptococcus mutans and Streptococcus sobrinus) adhering to the wires was quantified using the colony-counting method. The surfaces, coating layers, and MS adhesion were also observed by scanning electron microscopy. Statistical significance was set at P < .05.Results:The R_a values of the esthetic wires were significantly different from one another depending on the coating method (P < .05). The NiTi wire showed the highest SFE, followed by the SS wire and then the four esthetic wires. The NiTi wires produced a significantly higher MS adhesion than did the SS wires (P < .05). The esthetic wires showed significantly lower MS adhesions than did the NiTi wire (P < .05). Pearson correlation analyses found moderate significant positive correlations between the SFE and the S mutans and S sobrinus adhesions (r  =  .636/.427, P < .001/P  =  .001, respectively).Conclusions:The hypothesis is rejected. This study indicates that some esthetic coatings on NiTi alloy might reduce MS adhesion in vitro in the short term.     

Influence of bracket-slot design on the forces released by superelastic nickel-titanium alignment wires in different deflection configurations

Objective:To evaluate how different bracket-slot design characteristics affect the forces released by superelastic nickel-titanium (NiTi) alignment wires at different amounts of wire deflection.Materials and Methods:A three-bracket bending and a classic-three point bending testing apparatus were used to investigate the load-deflection properties of one superelastic 0.014-inch NiTi alignment wire in different experimental conditions. The selected NiTi archwire was tested in association with three bracket systems: (1) conventional twin brackets with a 0.018-inch slot, (2) a self-ligating bracket with a 0.018-inch slot, and (3) a self-ligating bracket with a 0.022-inch slot. Wire specimens were deflected at 2 mm and 4 mm.Results:Use of a 0.018-inch slot bracket system, in comparison with use of a 0.022-inch system, increases the force exerted by the superelastic NiTi wires at a 2-mm deflection. Use of a self-ligating bracket system increases the force released by NiTi wires in comparison with the conventional ligated bracket system. NiTi wires deflected to a different maximum deflection (2 mm and 4 mm) release different forces at the same unloading data point (1.5 mm).Conclusion:Bracket design, type of experimental test, and amount of wire deflection significantly affected the amount of forces released by superelastic NiTi wires (P < .05). This phenomenon offers clinicians the possibility to manipulate the wire''s load during alignment.     

Sliding resistance of polycarbonate self-ligating brackets and stainless steel esthetic archwires

ObjectivesTo compare the sliding resistance forces produced by polycarbonate self-ligating brackets with esthetic archwires.Materials and methodsSamples of Opal, Oyster and conventional Blonde brackets were tested each one with 30 segments of .018x.025-in wires. The archwires were slipped at 8 mm/min for 40 seconds with an universal testing machine. Two way ANOVA with Bonferroni correction were used.ResultsBlonde brackets presented the highest sliding resistance, followed in decreasing order by Oyster and Opal. The TP Shiny Bright Wire produced the highest surface friction, while the lowest was observed for Imagination archwires (except for Opal brackets where the TP Pearltone Wire achieved the best performance).ConclusionsSelf-ligating system is more effective to reduce the sliding force resistance than conventional brackets. Esthetic stainless steel archwires produce less friction resistance than those without surface treatment. Polycarbonate self-ligating brackets are more effective to reduce the frictional forces than esthetic archwires with surface treatment.     

In vitro and in vivo biofilm adhesion to esthetic coated arch wires and its correlation with surface roughness

Objective:To evaluate the in vitro ability of esthetic coated rectangular arch wires to retain oral biofilms and in vivo biofilm formation on these wires after 4 and 8 weeks of clinical use and to correlate the findings with the surface roughness of these wires.Materials and Methods:Three brands of esthetic coated nickel-titanium (NiTi) arch wires were selected. Arch wires retrieved after 4 and 8 weeks of intraoral use were obtained from 30 orthodontic patients. Surface roughness (SR) was assessed with an atomic force microscope. In vitro adhesion assays were performed using Streptococcus mutans (MS), Staphylococcus aureus, and Candida albicans. The amount of bacterial adhesion was quantified using the colony-count method. Paired t-test, analysis of variance, post hoc Tukey''s test, and Pearson''s correlation coefficient test were used for statistical analysis at the .05 level of significance.Results:In vitro bacterial adhesion showed significant differences between wires in terms of MS adhesion (P  =  .01). All wires showed significant increases in SR (P  =  .001 after 4 weeks and .007 after 8 weeks) and biofilm adhesion (P  =  .0001 after 4 weeks and .045 after 8 weeks) after intraoral exposure. A significant positive correlation (P  =  .001 after 4 weeks and .05 after 8 weeks) was observed between these two variables in vivo, but the correlation was not significant for in vitro bacterial adhesion.Conclusions:SR and biofilm adhesion increased after intraoral use at all time intervals. There was a positive correlation between SR and biofilm adhesion in vivo only.     

Evaluation of surface roughness of orthodontic wires by means of atomic force microscopy

Abstract Objective: To compare the surface roughness of different orthodontic archwires. Materials and Methods: Four nickel-titanium wires (Sentalloy?, Sentalloy? High Aesthetic, Titanium Memory ThermaTi Lite?, and Titanium Memory Esthetic?), three β-titanium wires (TMA?, Colored TMA?, and Beta Titanium?), and one stainless-steel wire (Stainless Steel?) were considered for this study. Three samples for each wire were analyzed by atomic force microscopy (AFM). Three-dimensional images were processed using Gwiddion software, and the roughness average (Ra), the root mean square (Rms), and the maximum height (Mh) values of the scanned surface profile were recorded. Statistical analysis was performed by one-way analysis of variance (ANOVA) followed by Tukey's post hoc test (P < .05). Results: The Ra, Rms, and Mh values were expressed as the mean ± standard deviation. Among as-received archwires, the Stainless Steel (Ra = 36.6 ± 5.8; Rms = 48 ± 7.7; Mh = 328.1 ± 64) archwire was less rough than the others (ANOVA, P < .05). The Sentalloy High Aesthetic was the roughest (Ra = 133.5 ± 10.8; Rms = 165.8 ± 9.8; Mh = 949.6 ± 192.1) of the archwires. Conclusions: The surface quality of the wires investigated differed significantly. Ion implantation effectively reduced the roughness of TMA. Moreover, Teflon?-coated Titanium Memory Esthetic was less rough than was ion-implanted Sentalloy High Aesthetic.     

Debris,Roughness and Friction of Stainless Steel Archwires Following Clinical Use

Objective:To investigate the degree of debris, roughness, and friction of stainless steel orthodontic archwires before and after clinical use.Materials and Methods:For eight individuals, two sets of three brackets (n  =  16) each were bonded from the first molar to the first premolar. A passive segment of 0.019- × 0.025-inch stainless steel archwire was inserted into the brackets and tied by elastomeric ligature. Debris level (via scanning electron microscopy), roughness, and frictional force were evaluated as-received and after 8 weeks of intraoral exposure. Mann-Whitney, Wilcoxon signed-rank, and Spearman correlation tests were used for statistical analysis at the .05 level of significance.Results:There were significant increases in the level of debris (P  =  .0004), roughness of orthodontic wires (P  =  .002), and friction (P  =  .0001) after intraoral exposure. Significant positive correlations (P < .05) were observed between these three variables.Conclusion:Stainless steel rectangular wires, when exposed to the intraoral environment for 8 weeks, showed a significant increase in the degree of debris and surface roughness, causing an increase in friction between the wire and bracket during the mechanics of sliding.     

Streptococcus mutans adhesion on nickel titanium (NiTi) and copper-NiTi archwires: A comparative prospective clinical study

Objectives:To compare the adhesion of Streptococcus mutans to nickel titanium (NiTi) and copper-NiTi (Cu-NiTi) archwires and to correlate the adhesion to surface characteristics (surface free energy and surface roughness) of these wires.Materials and Methods:A total of 16 patients undergoing orthodontic treatment with preadjusted edgewise appliances were included in the study. 0.016” and 0.016” × 0.022” NiTi and Cu-NiTi archwires in as-received condition and after 4 weeks of intraoral use were studied for S mutans adhesion using real-time polymerase chain reaction. Surface roughness and surface free energy were studied by three-dimensional surface profilometry and dynamic contact angle analysis, respectively.Results:S mutans adhesion was more in Cu-NiTi archwires. These wires exhibited rougher surface and higher surface free energy when compared to NiTi archwires.Conclusions:S mutans adhesion, surface roughness, and surface free energy were greater in Cu-NiTi than NiTi archwires. Surface roughness and surface free energy increased after 4 weeks of intraoral exposure for all of the archwires studied. A predominantly negative correlation was seen between the cycle threshold value of adherent bacteria and surface characteristics.     

Corrosion resistance of surface modified nickel titanium archwires

Objective:To compare the corrosion behavior of commercially available surface modified nickel titanium (NiTi) arch wires with respect to a conventional NiTi and to evaluate its association with surface characteristics.Materials and Methods:Five types of surface modified arch wires and a conventional NiTi arch wire, all from different manufacturers, were evaluated for their corrosion resistance from breakdown potential in an anodic polarization scan in Ringer''s solution. Surface characteristics were determined from scanning electron microscopy, atomic force microscopy, and energy dispersive analysis. One-way analysis of variance and post hoc Duncan''s multiple range tests were used to evaluate statistical significance.Results:Surface modified NiTi wires showed significant improvement in corrosion resistance and reduction in surface roughness values. Breakdown potentials increased in the order of group 6 (conventional; 204 mV) < group 1 (nitride; 333 mV) < group 5 (epoxy resin; 346mV) < group 3 (oxide; 523 mV) < group 2 (gold; 872 mV) < group 4 (Teflon; 1181 mV), but root mean square (RMS) roughness values, which indicated surface roughness, followed a different pattern: group 3 (oxide; 74.12 nm) < group 1 (nitride; 221.651 nm) < group 4 (Teflon; 278.523 nm) < group 2 (gold; 317.894 nm) < group 5 (epoxy resin; 344.236 nm) < group 6 (conventional; 578.555 nm).Conclusions:Surface modification of NiTi wires proved to be effective in improving its corrosion resistance and decreasing surface roughness. However, neither factor could maintain a direct, one-to-one relationship. It meant that the type and nature of coating material can effectively influence the anticorrosive features of NiTi wires, compared with its surface roughness values.     

Evaluation of torque moment in esthetic brackets from bendable alloy wires

ObjectivesTo examine the torque moment that occurs between esthetic brackets and bendable alloy (stainless steel [SS], titanium-molybdenum [Ti-Mo], and titanium-niobium [Ti-Nb]) wires.Materials and MethodsThis study examined ceramic (CR), zirconium oxide (ZC), polycarbonate (PC), and conventional metallic brackets (MT) (upper, 0.018-inch and 0.022-inch slots) combined with SS, Ti-Mo, and Ti-Nb wires using elastic module ligation. The torque moments delivered by various wire and bracket combinations were measured using a torque gauge apparatus. The wire torque angles at 5–40° were examined.ResultsThe torque value increased in the order of CR, ZC, MT, and PC brackets for both 0.018-inch and 0.022-inch slots. The fracture points of the CR and ZC brackets combined with SS and Ti-Mo wires were approximately more than 30° and 35°, respectively. No fracture points were detected in the combination of ZC brackets and Ti-Nb wires.ConclusionsThe current study identified the material characteristics of CR, ZR, and PC brackets during torque tooth movements. The present results demonstrate a characteristic combined effect between different esthetic brackets and bendable alloy wires.     

Effect of time and pH on physical-chemical properties of orthodontic brackets and wires

Objective:To test the hypothesis that treatment time, debris/biofilm, and oral pH have an influence on the physical-chemical properties of orthodontic brackets and arch wires.Materials and Methods:One hundred twenty metal brackets were evaluated. They were divided into four groups (n  =  30) according to treatment time: group C (control) and groups T12, T24, and T36 (brackets recovered after 12, 24, and 36 months of treatment, respectively). Rectangular stainless-steel arch wires that remained in the oral cavity for 12 to 24 months were also analyzed. Dimensional stability, surface morphology, composition of brackets, resistance to sliding of the bracket-wire set, surface roughness of wires, and oral pH were analyzed. One-way analysis of variance, followed by a Tukey multiple comparisons test, was used for statistical analysis (P < .05).Results:Carbon and oxygen were shown to be elements that increased expressively and in direct proportion to time, and there was a progressive increase in the coefficient of friction and roughness of wires as a function of time of clinical use after 36 months. Oral pH showed a significant difference between group T36 and its control (P  =  .014).Conclusions:The hypothesis was partially accepted: treatment time and biofilm and debris accumulation in bracket slots were shown to have more influence on the degradation process and frictional force of these devices than did oral pH.     

Canine retraction rate with self-ligating brackets vs conventional edgewise brackets

Objective:To compare the rates of retraction down an archwire of maxillary canine teeth when bracketed with a self-ligating bracket was used on one side and a conventional bracket on the other.Materials and Methods:In 43 patients requiring maxillary premolar extraction, a self-ligating bracket (Damon3, SmartClip) was used on the maxillary canine on one side and a conventional bracket (Victory Series) on the other. The teeth were retracted down a 0.018-inch stainless steel archwire, using a medium Sentalloy retraction spring (150 g). The rates of retraction were analyzed using a paired t-test.Results:The mean movement per 28 days for the conventional bracket was 1.17 mm. For the Damon bracket it was 0.9 mm and for the SmartClip bracket it was 1.10 mm. The differences between the conventional and self-ligating brackets were statistically significant: paired t-test, SmartClip, P < .0043; Damon3, P < .0001).Conclusion:The retraction rate is faster with the conventional bracket, probably because of the narrower bracket width of the self-ligating brackets.     

Role of lubricants on friction between self-ligating brackets and archwires

Objective:To evaluate the effect of different lubricants on friction between orthodontic brackets and archwires.Materials and Methods:Active (Quick, Forestadent) and passive (Damon 3MX, Ormco) self-ligating brackets underwent friction tests in the presence of mucin- and carboxymethylcellulose (CMC)–based artificial saliva, distilled water, and whole human saliva (positive control). Dry friction (no lubricant) was used as the negative control. Bracket/wire samples (0.014 × 0.025 inch, CuNiTi, SDS Ormco) underwent friction tests eight times in a universal testing machine.Results:Two-way analysis of variance showed no significant interaction between bracket type and lubricant (P  =  .324). Friction force obtained with passive self-ligating brackets was lower than that for active brackets (P < .001). Friction observed in the presence of artificial saliva did not differ from that generated under lubrication with natural human saliva, as shown by Tukey test. Higher friction forces were found with the use of distilled water or when the test was performed under dry condition (ie, with no lubricant).Conclusion:Lubrication plays a role in friction forces between self-ligating brackets and CuNiTi wires, with mucin- and CMC-based artificial saliva providing a reliable alternative to human natural saliva.     

The effect of surface treatment and clinical use on friction in NiTi orthodontic wires.

OBJECTIVES: Since the low friction of NiTi wires allows a rapid and efficient orthodontic tooth movement, the aim of this research was to investigate the friction and surface roughness of different commercially available superelastic NiTi wires before and after clinical use. The surface of all of the wires had been pre-treated by the manufacturer. MATERIALS: Forty superelastic wires (Titanol Low Force, Titanol Low Force River Finish Gold, Neo Sentalloy, Neo Sentalloy Ionguard) of diameter 0.016 x 0.022 in. were tested. The friction for each type of NiTi archwire ligated into a commercial stainless steel bracket was determined with a universal testing machine. Having ligated the wire into the bracket, it could then be moved forward and backwards along a fixed archwire whilst a torquing moment was applied. The surface roughness was investigated using a profilometric measuring device on defined areas of the wire. Statistical data analysis was conducted by means of the Wilcoxon test. RESULTS: The results showed that initially, the surface treated wires demonstrated significantly (p < 0.01) less friction than the non-treated wires. The surface roughness showed no significant difference between the treated and the non-treated surfaces of the wires. All 40 wires however showed a significant increase in friction and surface roughness during clinical use. SIGNIFICANCE: Whilst the Titanol Low Force River Finish Gold (Forestadent, Pforzheim, Germany) wires showed the least friction of all the samples and consequently should be more conservative on anchorage, the increase in friction of all the surface treated wires during orthodontic treatment almost cancels out this initial effect on friction. It is therefore recommended that surface treated NiTi orthodontic archwires should only be used once.     

The effect of water storage on the bending properties of esthetic,fiber-reinforced composite orthodontic archwires

Objective:To study the effect of water storage on the bending properties of fiber-reinforced composite archwires and compare it to nickel-titanium (NiTi), stainless steel (SS), and beta-titanium archwires.Materials and Methods:Align A, B, and C and TorQ A and B composite wires from BioMers Products, 0.014-, 0.016, and 0.018-inch, and 0.019 × 0.025-inch NiTi, 0.016-inch SS, and 0.019 × 0.025-inch beta-titanium archwires were tested (n  =  10/type/size/condition). A 20-mm segment was cut from each end of the archwire; one end was then stored in water at 37°C for 30 days, while the other was stored dry. The segments were tested using three-point bending to a maximum deflection of 3.1 mm with force monitored during loading (activation) and unloading (deactivation). Statistical analysis was completed via two-way analysis of variance with wire and condition (dry and water-stored) as factors.Results:In terms of stiffness and force delivery during activation, in general: beta-titanium was > TorQ B > TorQ A > 0.019 × 0.025-inch NiTi and 0.016-inch SS > Align C > 0.018-inch NiTi > Align B > 0.016-inch NiTi > Align A > 0.014-inch NiTi. Water exposure was detrimental to the larger translucent wires (Align B and C, TorQ A and B) because they were more likely to craze during bending, resulting in decreased forces applied at a given deflection. Align A and the alloy wires were not significantly (P > .05) affected by water storage. Overall, the alloy wires possessed more consistent force values compared to the composite wires.Conclusion:Environmental conditions are more likely to affect fiber-reinforced composite archwires compared to alloy wires.     

Torsional strength of computer-aided design/computer-aided manufacturing–fabricated esthetic orthodontic brackets

Objective:To fabricate orthodontic brackets from esthetic materials and determine their fracture resistance during archwire torsion.Materials and Methods:Computer-aided design/computer-aided manufacturing technology (Cerec inLab, Sirona) was used to mill brackets with a 0.018 × 0.025-inch slot. Materials used were Paradigm MZ100 and Lava Ultimate resin composite (3M ESPE), Mark II feldspathic porcelain (Vita Zahnfabrik), and In-Ceram YZ zirconia (Vita Zahnfabrik). Ten brackets of each material were subjected to torque by a 0.018 × 0.025-inch stainless steel archwire (G&H) using a specially designed apparatus. The average moments and degrees of torsion necessary to fracture the brackets were determined and compared with those of commercially available alumina brackets, Mystique MB (Dentsply GAC).Results:The YZ brackets were statistically significantly stronger than any other tested material in their resistance to torsion (P < .05). The mean torques at failure ranged from 3467 g.mm for Mark II to 11,902 g.mm for YZ. The mean torsion angles at failure ranged from 15.3° to 40.9°.Conclusion:Zirconia had the highest torsional strength among the tested esthetic brackets. Resistance of MZ100 and Lava Ultimate composite resin brackets to archwire torsion was comparable to commercially available alumina ceramic brackets.