Material testing of reconditioned orthodontic brackets

Abstract

While all manufacturers of orthodontic brackets label these products for single use, there are commercial providers offering bracket reconditioning (or "recycling"). We conducted this study to investigate the effects of different recycling techniques on material-related parameters in orthodontic brackets, aiming to derive indications for clinical use and conclusions about the biocompatibility, longevity, and application of recycled brackets. New metal brackets (equilibrium(®); Dentaurum, Ispringen, Germany) were compared to brackets recycled by different techniques, including direct flaming with a Bunsen burner, chemical reconditioning in an acid bath, a commercial unit (Big Jane; Esmadent, IL, USA), and outsourcing to a company (Ortho Clean, Dellstedt, Germany). Material-related examinations included the following: (1) corrosion behavior by static immersion testing and use of a mass spectrometer to determine nickel-ion concentrations in the corrosive medium, (2) surface features in scanning electron micrographs before and after corrosion testing, (3) Vickers hardness using a hardness testing machine, (4) shear bond strength as defined in DIN 13990-1, (5) dimensional stability of the bracket slots by light microscopy, and (6) frictional loss as assessed by an orthodontic measurement and simulation system (OMSS). Each examination was performed on ten brackets. Student's t-test was used for statistical analysis. Compared to the new brackets, those recycled in an acid bath or by a commercial provider revealed significant dimensional changes (p<0.05). Corrosion on the recycled brackets varied according to the recycling techniques employed. The group of brackets recycled by one company revealed hardness values that differed from those of all the other groups. No significant differences were observed in nickel-ion release, frictional loss, and shear bond strength. Recycling was found to significantly reduce the corrosion resistance and dimensional stability of orthodontic brackets. As the savings generated by recycling do not justify the risks involved, the practice of labeling orthodontic brackets for single use remains a responsible precaution that safeguards patients and orthodontists against definite risks.