Dental Appliances Research Articles

Adherence in adult orthodontic settings: Understanding orthodontists’ predictors

Objectives: The objective of this study was to delve into predictors of adherence in adult orthodontic patients as stated by orthodontists in Saudi Arabia. Material and Methods: Ninety-one orthodontists from Saudi Arabia completed a questionnaire in relation to the importance and frequency of use of predictors of adherence. In this cross-sectional quantitative and exploratory study, orthodontists were requested to rate the predictors of adherence on a five-point Likert scale. The questionnaire in this study was categorized into four sections such as (1) evaluation – their opinion on the importance of predictor in the assessment of patient adherence, (2) application – scope of use of each predictor in the assessment of adherence in the routine practice, (3) open-ended questions to amass information about other apparent predictors of adherence, and (4) demographics. Results: Mixed and variable responses were obtained in terms of the importance and extent of application of predictors in assessing patient adherence. The survey revealed the most important predictors for adherence that included patient’s adherence to appointments and their cooperation in handling dental appliances, and maintenance of oral hygiene. However, in actual practice, orthodontists were frequently implementing factors such as the patient to keep appointments, the patient is observed to be involved in treatment, and the patient is observed to be enthusiastic about treatment. Through the open-ended questions, multiple factors were reported that need to be explored further. However, the remaining factors reported for adherence portrayed varied patterns. Conclusion: Predictors of adherence were reported with varying extent of consistency among orthodontists in Saudi Arabia. However, adherence to appointment, co-operation in handling of appliances, and oral hygiene emerged as the most significant factors by the orthodontists for adherence in cases of adult patients.

Applications, benefits, and limitations of fiber-reinforced composites in fixed prosthodontics

This study offers a comprehensive evaluation of the efficacy, benefits, and limitations of fiber-reinforced composites (FRCs) in fixed prosthodontics. Emerging as a substitute for conventional dental materials such as metals and ceramics, FRCs are now used in a variety of applications, from dental crowns and bridges to veneers. The study is based on an exhaustive literature review and explores various properties of FRCs, such as mechanical, optical, viscoelastic, adhesive, and thermal attributes. The strength and rigidity of constructions made from FRC are dependent on the polymer matrix of the FRC and the type of fiber reinforcement. In dental appliances of relatively small sizes, the quality of the load bearing FRC sub-structure is very important. A special emphasis is placed on the clinical applications and future potential of these materials. The advantages of using FRCs include their biocompatibility, light weight, durability, and aesthetic superiority. However, there are limitations, such as higher costs and concerns about long-term clinical performance, specifically related to interface degradation. The study concludes that FRCs hold significant promise in the domain of fixed prosthodontics, although further research is needed for optimizing their long-term effectiveness.

Reply to Singh, G.D. Comment on "Dao et al. Retrospective Analysis of Real-World Data for the Treatment of Obstructive Sleep Apnea with Slow Maxillary Expansion Using a Unique Expansion Dental Appliance (DNA). Pathophysiology 2023, 30, 199-208".

In response to the commentary "Response to 'Retrospective analysis of real-world data for the treatment of obstructive sleep apnea with slow maxillary expansion'" [...].

Comment on Dao et al. Retrospective Analysis of Real-World Data for the Treatment of Obstructive Sleep Apnea with Slow Maxillary Expansion Using a Unique Expansion Dental Appliance (DNA). Pathophysiology 2023, 30, 199-208.

I found the recent article by Dao et al. titled "Retrospective analysis of real-world data for the treatment of obstructive sleep apnea with slow maxillary expansion using a unique expansion dental appliance (DNA)" [...].

Finite Element Modeling of a Biological Composite Structure Used in Orthodontic Fixed Appliances

AbstractComposite structures currently represent combinations of materials from the most different structures, chemical compositions, or geometric shapes. There is no scientific or technical field in which these materials, due to their special characteristic properties, are not present. Most of the time it is found that they cannot even be replaced. In this sense, the study presented in this work refers to the behavior of a semibiological structure. This structure is found in the field of dentistry when using fixed dental appliances. The composite structure refers to the metal bracket that is fixed by a bonding and a resin layers that are considered as adhesives to the outer surface of the tooth, i.e., to the enamel that is a biological material. In order to make a prediction of the behavior of structure during the mastication process from the point of view of the displacements and the state of tension, study starts from the practical realization of a joint by gluing the bracket on the surface of a devitalized tooth. Based on it, modeling using the finite element method allows the prediction of masticatory forces based on the analysis of stress states and displacements.

Antimicrobial and mechanical assessment of cellulose-based thermoformable material for invisible dental braces with natural essential oils protecting from biofilm formation

Controlling biofilm formation in the oral cavity during orthodontic treatments is crucial. Therefore, antimicrobial surfaces for invisible dental appliances are of interest to both therapists and patients. Here we present a cellulose-based thermoformable material used for invisible braces that can be loaded with essential oils (EOs) having antibacterial and antifungal properties. We hypothesize that this material can absorb and release EOs, thus providing an antimicrobial effect without compromising the safety and mechanical properties necessary for dental invisible braces. Conventional microbiology and isothermal microcalorimetry analyses revealed that the thermoformable material loaded with essential oils significantly delayed the biofilm formation of oral streptococci (S. mutans and S. mitis) under static conditions (p < 0.05) and while simulating saliva flow (p < 0.05). In addition, cytotoxicity tests (ISO 10993-5), revealed that the loaded material is well tolerated by human gingival fibroblasts. Finally, the loading with antibacterial agents did not significantly alter the mechanical properties and stability of the material (initial force (p = 0.916); initial stress (p = 0.465)). Compared to gold-standard clear aligner materials, this material offers a reliable transmission of forces for orthodontic treatments. Moreover, this approach exhibits the potential for acting as an oral drug delivery platform for multiple compounds.

Dental Appliances for the Treatment of Obstructive Sleep Apnea in Children: A Systematic Review and Meta-Analysis.

Background and objectives: Obstructive sleep apnea (OSA) in children is a debilitating disease, difficult to treat. Dental appliances have been proposed as a valid therapy for improving functional outcomes with good compliance rates. Herein, we aimed to perform a meta-analysis comparing clinical outcomes between OSA children treated with dental appliances versus controls. Materials Methods: The study was registered with PROSPERO. A systematic search was performed for all comparative studies examining outcomes in pediatric patients who underwent treatment of OSA with oral appliances versus controls. Data was extracted and analyzed using a random effects model via Rev Man 5.3. Results: Six studies including 180 patients were analyzed split into two groups: patients treated with dental appliances (n = 123) and the controls (n = 119). Therapy with dental appliances was shown to significantly improve the apnea-hypopnea index (p = 0.009) and enlarge the superior posterior airway space (p = 0.02). Maxilla-to-mandible measurements were not significantly different between the two groups, nor was the mean SO2 (p = 0.80). Conclusions: This is the most updated meta-analysis assessing the role of dental appliances for OSA in children; it shows that such devices can improve functional outcomes by decreasing the apnea-hypopnea index.

Application and evolution of design in oral health: A systematic mapping study with an interactive evidence map.

There is increasing recognition of the value and capabilities of design in healthcare. Beyond the development of medical devices, design is increasingly being applied to intangible, complex and systemic healthcare problems. However, there is limited evidence on the use of design specifically in the field of oral health. This systematic mapping study aims to collate and catalogue evidence of design in oral health. A systematic search of academic databases and grey literature was performed. Duplicate results were removed, and publications relating to the same project were grouped. Reviewers from design and oral health independently screened a sample of the dataset. Projects of both relevance to oral health, and with input from a designer or clear implementation of a design methodology or approach were included. Projects were coded and plotted on a novel interactive evidence map. 119 design and oral health projects were included between 1973 and 2022. Interventional (n = 94, 79%), empirical (n = 46, 39%), methodological (n = 35, 29%) and theoretical (n = 7, 6%) design contributions were identified across the projects. The projects were categorized by four orders of design: first-graphics (n = 6, 5%), second-products (n = 41, 34%), third-interactions (n = 70, 59%), and fourth-systems (n = 2, 2%). Design was found in a diverse range of contexts in oral health; most commonly being relevant to general patients (n = 61, 51%), and for use in general dental practice (n = 56, 47%). Further design outcome categories (digital material; printed material; object; room or space; apparel; process; smart device; tangible interface; graphical interface; virtual reality; service; policy; system) and oral health themes (oral health literacy; oral care training; dental clinic design; dental instruments and equipment; personal oral care; dental appliance; clinician health and productivity; clinical information systems; informed consent; oral health promotion and prevention; oral care training; patient interactions and experience) were identified. The novel interactive evidence map of design in oral health created enables ongoing and open-ended multivariant documentation and analysis of the evidence, as well as identification of strategic opportunities. Future research and policy implications include; recognition and engagement with the full capabilities of design; integration of design experts; fostering inclusive engagement and collaboration; disentangling patient and public involvement; advancing human-centred systems approaches; adopting design-led approaches for policy-making.

Impact of orthodontic treatment on speech and phonetics: a review

Orthodontic devices, including both fixed and removable devices, have the potential to impact dental anatomy, the space within the oral cavity, the displacement of the tongue, and the production of speech. The usage of fixed labial appliances may cause transient or persistent speech and phonetics changes, particularly affecting sibilant and stopped sounds. Lingual fixed appliances, while providing aesthetic advantages, can lead to difficulties in maintaining oral hygiene, pain in the tongue, and speech disturbances. Orthodontic retainers, used post-treatment, can also affect speech and phonetics by altering the oral cavity space and tongue position. Other appliances like removable appliances, palatal expanders, and prosthetic dental appliances may also disrupt speech production. Objective, semi-objective, and subjective assessments are utilized to evaluate speech disruptions induced by orthodontic devices. Patients considering orthodontic aligners should be informed about potential temporary limitations in speech production, which can be managed by removing the device when necessary. The adaptation to orthodontic treatment may vary based on individual characteristics. Orthodontists should consider these effects and communicate them to patients. This review article explores the effect of orthodontic treatment on speech and phonetics.

Ill-Fitting Dental Appliances and Oral Cancer: A Systematic Review and Case Report

Background: Associations between the use of dental appliances and oral cancer remain controversial. No studies have reported a relationship between dental appliances in the setting of cleft palate management and oral cancer. This study characterizes the correlation between dental appliances and oral cancer and includes a case report of a patient with a history of cleft palate repair who later developed oral squamous cell carcinoma (OSCC). Methods: We performed a systematic review for studies from 1980 to 2022 of patients who had dental prostheses and who were subsequently diagnosed with OSCC. Variables included the percentage of OSCC cases wearing dental appliances, intraoral cancer location, and noted associations between reported risk factors and OSCC. Results: Of the 6323 patients from the 31 articles analyzed, the most common specified locations for the neoplastic lesion were at the gingiva and lateral border of the tongue. Seventeen studies found an association between OSCC and denture use (54.8%), while 9 studies (29.0%) specifically found a positive association between oral sores and OSCC. Our case patient had complete dental extraction at the age of 12 with subsequent life-long dentures. At age 69, he presented with invasive OSCC. Conclusions: Chronic irritation from ill-fitted dental appliances are associated with oral sores and cancer. This study reports a cleft palate repair patient with lifelong use of dentures who presented with OSCC despite having no known risk factors for oral cancer.

A Novel Digitized Method for the Design and Additive Manufacturing of Orthodontic Space Maintainers

Primary dentition is crucial in influencing the emergence of permanent teeth. Premature primary tooth loss can result in undesired tooth motions and space loss in the permanent dentition. Typically, fixed or removable dental appliances are adopted to maintain edentulous space until the eruption of permanent teeth. However, traditional space maintainers have limitations in terms of variability in tooth anatomy, potential allergic reactions in some individuals (i.e., nickel sensitivity), difficulties in maintaining oral hygiene, and patient acceptance. The present study introduces a fully digital framework for the design and manufacturing of customized pediatric unilateral space maintainers using generative algorithms. The proposed approach overcomes the current challenges by using a biocompatible resin material and optimizing the device’s size, design, and color. The methodology involves intraoral scanning, surface selection, and trim, generative 3D modeling, finite element analysis (FEA), and additive manufacturing (AM) through vat photopolymerization. FEA results demonstrate the device’s mechanical performance and reliability, while additive manufacturing ensures design freedom, high resolution, surface finishing, dimensional accuracy, and proper fit. The mechanical interlocking system facilitates easy and effective positioning of the device. This digital approach offers the potential for wider usage of space maintainers and can be further validated through experimental assessments and clinical studies.

A new CAD/CAM tooth mobility simulating model for dental in vitro investigations

ObjectivesTo validate a new tooth mobility simulating in vitro model for biomechanical tests of dental appliances and restorations.Material and methodsLoad-deflection curves for teeth in CAD/CAM models (n = 10/group, 6 teeth/model) of the anterior segment of a lower jaw with either low tooth mobility (LM) or high tooth mobility (HM) were recorded with a universal testing device and a Periotest device. All teeth were tested before and after different ageing protocols. Finally, vertical load capacity (Fmax) was tested in all teeth.ResultsAt F = 100 N load, vertical/horizontal tooth deflections before ageing were 80 ± 10 µm/400 ± 40 µm for LM models and 130 ± 20 µm/610 ± 100 µm for HM models. Periotest values were 1.6 ± 1.4 for LM models and 5.5 ± 1.5 for HM models. These values were within the range of physiological tooth mobility. No visible damage occurred during ageing and simulated ageing had no significant effect on tooth mobility. Fmax values were 494 ± 67 N (LM) and 388 ± 95 N (HM).ConclusionThe model is practical, easy to manufacture and can reliably simulate tooth mobility. The model was also validated for long-term testing, so is suitable for investigating various dental appliances and restorations such as retainers, brackets, dental bridges or trauma splints.Clinical relevanceUsing this in-vitro model for high standardised investigations of various dental appliances and restorations can protect patients from unnecessary burdens in trials and practice.

Defining challenging areas of the preparation finish line by using an open-source 3D modeling computer program: A tip to simplify margin identification by the dental laboratory technician

Intraoral data acquisition and computer-aided design and computer-aided manufacturing (CAD-CAM) systems have simplified and expedited the fabrication of dental prostheses. 1 Van Noort R. The future of dental devices is digital. Dent Mater. 2012; 28: 3-12 Crossref PubMed Scopus (801) Google Scholar ,2 Giuliodori G. Rappelli G. Aquilanti L. Intraoral scans of full dental arches: an in vitro measurement study of the accuracy of different intraoral scanners. Int J Environ Res Public Health. 2023; 20: 4776 Crossref Scopus (0) Google Scholar Contemporary dental CAD-CAM provides the freedom to design and fabricate diverse dental devices, including custom impression trays, surgical templates, and removable and fixed dental prostheses. 1 Van Noort R. The future of dental devices is digital. Dent Mater. 2012; 28: 3-12 Crossref PubMed Scopus (801) Google Scholar ,3 Revilla-León M. Özcan M. Additive manufacturing technologies used for processing polymers: current status and potential application in prosthetic dentistry. J Prosthodont. 2019; 28: 146-158 Crossref PubMed Scopus (217) Google Scholar ,4 Turkyilmaz I. Wilkins G.N. Varvara G. Tooth preparation, digital design and milling process considerations for CAD/CAM crowns: understanding the transition from analog to digital workflow. J Dent Sci. 2021; 16: 1312-1314 Crossref Scopus (8) Google Scholar These dental appliances are created from a digital file that recreates the surface geometry of the target object, typically a standard tessellation language (STL) file. 5 Grant G.T. Campbell S.D. Masri R.M. Andersen M.R. The American college of prosthodontist digital dentistry glossary development task force. Glossary of digital terms. J Prosthodont. 2016; 25: S2-S9 Crossref PubMed Scopus (27) Google Scholar A prerequisite for accurate manufacture is the exact capture and identification of the fine details in the target intraoral structures. An accurate capture can be challenging when the preparation finish line is subgingival, when abundant bleeding or salivation occurs, or when operator scanning skills and speed are still developing. 6 Mangano F. Gandolfi A. Luongo G. Logozzo S. Intraoral scanners in dentistry: a review of the current literature. BMC Oral Health. 2017; 17: 149 Crossref PubMed Scopus (308) Google Scholar Additionally, the location of fine details can be challenging for the dental laboratory technician to visualize when the CAD file is outsourced for the manufacture of the definitive restoration, since STL files lack attributes such as color and texture. 5 Grant G.T. Campbell S.D. Masri R.M. Andersen M.R. The American college of prosthodontist digital dentistry glossary development task force. Glossary of digital terms. J Prosthodont. 2016; 25: S2-S9 Crossref PubMed Scopus (27) Google Scholar These features help differentiate the tooth from its surrounding tissues when finish lines are subgingival or when displacement is limited. The present article presents a straightforward workflow that defines challenging areas of the preparation finish line by using an open-source 3D modeling computer program. This procedure can be used to communicate the finish line observed to the dental laboratory technician when STL files are used to design the definitive restoration and stops the technician guessing the finish line, since the hard-to-see areas are defined by the clinician. Additionally, this approach has advantages over the margin tracing and sculpting tools available in most 3-dimensional (3D) CAD computer programs since it allows selecting the critical areas around the finish line considering the mesh geometry of the 3D file. Visualizing the 3D mesh permits a more precise selection, which can minimize distortion as even the smallest changes in the mesh surface can be observed if transformation or sculpting procedures are used.

Assessment of mechanical characteristics of polyetheretherketone as orthodontic fixed lingual retainers

Background/purposePolyetheretherketone (PEEK) is known for its strength, flexibility, biocompatibility, and potential as a replacement for metals in dental appliances; however, uncertainty remains about the mechanical characteristics and dimensions of PEEK-made orthodontic fixed lingual retainers (FLRs). This study aimed to determine the optimal shape of PEEK-made orthodontic FLRs using the finite element method (FEM) and the three-point bending test (TPBT). Materials and methodsSeventy-five three-dimensional PEEK rod-shaped models were created, which included five thicknesses (0.4, 0.6, 0.8, 1.0, and 1.2 mm), five widths (0.7, 0.9, 1.1, 1.3, and 1.5 mm), and three cross-sectional shapes (rectangular, oval, and hemielliptical). A 0.9-mm (0.036-inch) stainless steel wire (SSW) was used as a control and the FEM was used to determine six optimal dimensions among the PEEK models. The selected models were then fabricated and subjected, along with the SSW, to the experimental TPBT to assess their mechanical responses against lingual and biting pressures. ResultsThe FEM analysis revealed that Von Mises stresses on the PEEK models decreased with an increase in width and thickness. Six optimal shapes of PEEK models were chosen based on acceptable lingual and biting stresses as well as patient comfort compared to the SSW. Furthermore, PEEK models showed significantly lower deformation during the 3.1-mm deflection test than did the SSW, while no notable differences were observed among different sizes of PEEK models. The hemielliptical PEEK model with a thickness of 1.0 mm and width of 1.5 mm was found to be mechanically robust enough to withstand lingual forces, while none of the PEEK models, including the SSW, were able to resist biting forces. ConclusionWithin the limitations of this in vitro study, PEEK-made orthodontic FLRs with a hemielliptical cross-sectional shape and a thickness-to-width ratio of 1.0:1.5 would be suitable for use as orthodontic FLRs.

Evaluation of separating media for autopolymerizing acrylic resin fabricated on 3D-printed acrylate-based resin dental casts

Statement of problemLimited data are available regarding the most suitable separating medium for fabricating dental acrylic resin prostheses or appliances on 3-dimensional (3D)-printed resin casts. PurposeThe purpose of this in vitro study was to investigate and evaluate different separating media in terms of the ease of removal and detail reproduction of an autopolymerizing acrylic resin fabricated on acrylate-based 3D-printed resin casts. Material and methodsA cube-shaped cast was designed with a built-in truncated cone-shaped hole and a V-shaped groove at the base. Seventy-five casts were 3D-printed using acrylate-based resin and assigned to 5 groups according to the applied separating media: Siliform BEA (silicone-based), IMPRIMO 3D (alginate-based), 3D Modellisolierung (wax-based), TECHNOSIL (alginate-based), and none (control). After the application of the separating media, the truncated cone-shaped holes in the specimens were filled with autopolymerizing acrylic resin. The efficacy of the separating media was evaluated according to the ease of removal on a scale of 1 to 3 and accurate detail reproduction of the V-shaped groove on a scale of 1 to 3 under ×6 magnification. The nonparametric Kruskal-Wallis rank test was used to identify significant differences among the separating media (α=.05). ResultsSignificant differences were found among the groups (P<.001). Siliform BEA and 3D Modellisolierung had the best mean rank in both the ease of removal and detail reproduction scores, which were significantly different from those of the alginate-based separating media (IMPRIMO 3D and TECHNOSIL) and the control group (P<.01). ConclusionsThe dedicated silicone- and wax-based separating media for 3D-printed casts exhibited the most favorable performance in terms of ease of removal and detail reproduction.

Retrospective Analysis of Real-World Data for the Treatment of Obstructive Sleep Apnea with Slow Maxillary Expansion Using a Unique Expansion Dental Appliance (DNA).

In addition to mandibular advancement devices, dental expansion appliances are an important clinical approach for achieving an increased intra-oral space that promotes airflow and lessens the frequency or severity of apneic events in patients diagnosed with obstructive sleep apnea (OSA). It has been thought that dental expansion in adults must be preceded by oral surgery; however, in this paper, we examine the results of a new technique for slow maxillary expansion without any surgical procedures. The palatal expansion device, DNA (Daytime-Nighttime Appliance), was reviewed in this retrospective study, particularly regarding its effects on measurements of transpalatal width, airway volume, and apnea-hypopnea indices (AHI) as well as its common modalities and complications. The DNA effectively reduced AHI by 46% (p = 0.00001) and significantly increased both airway volume and transpalatal width (p < 0.00001). After DNA treatment, 80% of patients showed some improvement in AHI scores with 28% of patients having their OSA symptoms completely resolved. Compared to the use of mandibular appliances, this approach is intended to create a sustained improvement in airway management that can reduce or eliminate dependence on continuous positive airway pressure (CPAP) or other OSA treatment devices.

Comparing the physical and mechanical properties of different biocompatible three-dimensional resin materials in possible use of dental appliances: An in vitro study.

This study aimed to assess the colour stability, water sorption, microhardness and water contact angle of two different 3D printing systems (SLA and DLP) in a possible use of producing paediatric and orthodontic dental appliances. SLA and DLP printer systems produced a total of 160 disk samples with a diameter of 15.00 mm and a height of 2.00 mm. Colour changes of 64 samples were assessed in distilled water, coffee, coke and cherry juice and Vicker's microhardness tests were also conducted. Solubility and water sorption were held following the water contact angle assessment. Statistical analyses were performed using the SPSS software. Mann-Whitney-U test, Friedman test and Bonferroni post hoc Multiple Comparison Test were performed. In DLP and SLA groups, coffee had a statistically significant colouring effect regarding the assessment periods (P = .001, 20.09 ± 2.96, 22.09 ± 3.51, respectively), and the discolouration effect of coffee was higher in the SLA group at all endpoints (P < .05). At the same time, DLP was more affected by coke solution in T0-T1 and T0-T7 (P < .05). The values of water sorption showed statistically significant differences in the group of DLP compared to the SLA (P = .01, 121.11 ± 10.54, 92.78 ± 8.70, respectively). No statistical significance was detected between the solubility values and water contact angle of SLA and DLP groups. The SLA printer's microhardness values revealed statistically significantly higher values than the DLP group (P = .001) and a decrease was detected following the immersion period in the microhardness values of the SLA group (P = .022). The compared groups exposed to staining solutions revealed colour changes above the clinically acceptable values at all periods (ΔE00 = 2.25).

PROCESSING REMOVABLE ORTHODONTIC APPLIANCE FOR SINGLE TOOTH ANTERIOR CROSSBITE USING EXPANSION SCREW

Background: Anterior crossbite is a case that when upper anterior are positioned palatally than lower anterior teeth in centric occlusion. Orthodontic appliances using expansion screw could be solution for tooth anterior crossbite treatment. Purpose: To figure out the optimal fabrication process of orthodontic appliances in single tooth anterior crossbite case using expansion screw. Case analysis: Dental laboratory provided the maxillary dental appliance with single tooth anterior crossbite on teeth 21. Dental technician also received orthodontic appliance using expansion screw. Result: Orthodontic appliance design was Adams claps on teeth 16, 26, labial bow on teeth 13, 12, 11, 21, 22, 23. Additional posterior bite plane, also expansion screw was located on maxillary left first incisor, palatal section. Conclusion: Design and making orthodontic appliances using expansion screw begins with drawing design, positioning Adams clasps and labial bow sectional screw mini mounting, then acrylic packing. Final step was finishing polishing acrylic plate.

FABRICATION OF SIMPLE SPACE REGAINER FOR SPACE LOSS CASE

Background: Anterior crossbite is a case that when upper anterior are positioned palatally than lower anterior teeth in centric occlusion. Orthodontic appliances using expansion screw could be solution for tooth anterior crossbite treatment. Purpose: To figure out the optimal fabrication process of orthodontic appliances in single tooth anterior crossbite case using expansion screw. Case analysis: Dental laboratory provided the maxillary dental appliance with single tooth anterior crossbite on teeth 21. Dental technician also received orthodontic appliance using expansion screw. Result: Orthodontic appliance design was Adams claps on teeth 16, 26, labial bow on teeth 13, 12, 11, 21, 22, 23. Additional posterior bite plane, also expansion screw was located on maxillary left first incisor, palatal section. Conclusion: Design and making orthodontic appliances using expansion screw begins with drawing design, positioning Adams clasps and labia bow sectional screw mini mounting, then acrylic packing. Final step was finishing polishing acrylic plate.

Topographical and Optical Characteristics of Thermoplastic Dental Appliances Materials Related to Water Sorption

Clear thermoplastic materials have increased in popularity in the dental field due to their various applications, combination of excellent aesthetics, and good biomechanical behavior, but they may be influenced by different environmental conditions. The purpose of the present study was to assess the topographical and optical characteristics of thermoplastic dental appliances materials relative to water sorption. PET-G polyester thermoplastic materials were evaluated in this study. Related to water uptake and desiccation stages, surface roughness was analyzed, and three-dimensional AFM profiles were generated for nano-roughness measurements. Optical CIE L*a*b* coordinates were recorded and parameters like translucency (TP), contrast ratio for the opacity (CR), and opalescence (OP) were derived. Levels of color changes were achieved. Statistical analyses were performed. Water uptake significantly increases the specific weight of the materials, and after desiccation, the mass decreases. Roughness increased after water immersion as well. Regression coefficients indicated a positive correlation between TP and a* and between OP and b*. Studied PET-G materials have a different behavior to water exposure, but for all their specific weight, they increased significantly within the first 12 h. It is accompanied by an increase in the roughness values, even if they continue to be kept below the critical mean surface roughness. On nano-level, 3D images show an increase in inhomogeneity in the network structure of particles. Slight color changes were registered.