Elastomeric Chains Research Articles

The effect of immersion different dietary media on the stretched clear elas-tic chains: An in vitro study

Discoloration of clear elastic modules and chains remains an issue which concerns both orthodontics and patients when the increasing demand on esthetic orthodontic appliances. This study was conducted for evaluating the effect of exposing stretched clear elastic chains to three types of dietary media (turmeric, tea and coffee) from six different companies (Ortho Technology, Opal, Ortho Organizer, American Orthodontics, Ormco and G&H). The short type elastomeric chains were cutting about 960 of its lengths from six different companies; 160 pieces from each brand. The specimens were stretched 50%, placed on plastic boards, and incubating at (37°C) in water for (1) day, (7) days, (14) days and (28) days. Once a day, the cutting pieces were immersed in the dietary testing media for ten minutes, washed and then returned to the water container. Color measurements were made before and after incubation of the specimens. The data were statistically analysed using ANOVA and LSD tests. Elastic chains from Ormco, Ortho Organizers and Ortho Technology had the least prone to discoloration, and AO, Opal and G&H companies had the most brands prone to discoloration. Tea, coffee and turmeric solutions discolored elastomeric chains from all companies in a variable degree. However, turmeric caused significantly more discoloration, followed by tea and least by coffee. Most of the discoloration caused by turmeric is in the first day and reaches a plateau at a week, while the amount of discoloration caused by tea and coffee increases gradually to peak at (28) days. Consumption of certain dietary media such as tea, turmeric and coffee caused discoloration of clear elastomeric chains. The range of discoloration increased over time.

Emergency appointments in orthodontics

Introduction Patients undergoing fixed orthodontic treatment are usually recalled electively for the adjustments of the appliances, but sometimes they appear suddenly for emergency visit which must be addressed immediately. The primary objective of this study was to assess the nature and frequency of emergency visits made by patients under labial fixed orthodontic therapy. The secondary objective was to compare these visits between genders and age groups. Materials and Methods The study was conducted at orthodontic clinic, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. All the patients undergoing fixed labial orthodontic treatment were included and followed up for a period of 6 months. The reason for emergency appointment was recorded along with the demographic and clinical details. Chi-square test was used to find out the possible association between gender and age group with emergency appointment. Results Of 327 patients undergoing active fixed orthodontic therapy, 199 were female and 128 were male. A total of 176 emergency appointments were encountered during the study period of 6 months. The most common reason was the loosening of brackets or bondable buccal tubes (118) followed by loosening of bands (45). Other reasons were trauma to the buccal mucosa by the overextended wire (5), detachment of buccal tubes from the band (5), tearing of bands (3), breakage of acrylic plate (2), loosening of ligature tie (1), and dislodgement of elastomeric chain (1). Emergency appointments were not found to have statistically significant association with age group (χ2 = 0.073, P = 0.787) or the gender (χ2 = 3.196, P = 0.074). Conclusions Loosening of the brackets or bondable buccal tubes was the most common cause for emergency visit. No significant association was found between the gender and age group with such visits.

Orthodontic anterior teeth space closure in an adult with posterior long standing fixed partial denture

This is a case report of a 40-year-old female patient with chief complaint of spacing in front teeth. Patient exhibited convex profile, incompetent lips, spacing in anterior maxillary and mandibular teeth. She had maxillary posterior long span fixed partial denture and generalised periodontitis. She was diagnosed as Class I malocclusion with proclined and spaced anterior teeth. Treatment objective include space closure, maintaining class I molar and canine relation, achieving ideal overjet and overbite and functional occlusion. Thorough oral prophylaxis was done prior to start of fixed mechanotherapy. The case was bonded (upper canine to canine and full lower arch) with 022 MBT bracket system. Aligning and levelling was done sequentially with 012,016,17x25 Niti wires. One bracket each side was bonded on the maxillary FPD abutment teeth for anchorage. Space closure was achieved using low forces with elastomeric chain on 19x25 SS wire. Total treatment time was 12 months. Ideal overjet and overbite achieved with functional occlusion. Periodontal condition improved and stable results were achieved. Patient is given fixed retention and removable hawleys retainer with tongue crib in upper arch. In the recent years, there has been an increase in number of adults seeking orthodontic treatment and orthodontists quiite often face patients with periodontal disease. Adult patients should follow regular oral hygiene measure in order to maintain periodontal health during and after active orthodontic therapy.

Leptin levels in gingival crevicular fluid during canine retraction: in vivo comparative study.

To evaluate and compare the leptin levels in gingival crevicular fluid (GCF) and rate of canine retraction using an elastomeric chain and nickel-titanium (NiTi) closed coil spring. In vivo, clinical study. Orthodontic department at ITS Centre for Dental Studies and Research, Ghaziabad, India. Twenty-seven patients reported to the Department of Orthodontics at ITS Centre for Dental Studies and Research. Twenty-seven patients were included in the study in which canine retraction was carried out with an elastomeric chain and NiTi closed coil spring on either side of the arch applying 150 g of force on both sides. GCF samples were collected before the commencement of canine retraction, on the first, seventh and 21st day after application of force and were analysed for leptin levels by the ELISA technique. Impressions for the study model were taken at baseline and after 21 days to measure the rate of tooth movement bilaterally with an electronic digital calliper. The results obtained within both groups showed a significant decrease in leptin levels from baseline to 21 days ( P = 0.0001). There was no significant difference in leptin levels between both groups, but leptin levels decreased more in the NiTi closed coil spring group. The rate of tooth movement is not significantly different between both groups, but space closure is faster in the NiTi closed coil spring group. Leptin levels in GCF showed a significant decrease during canine retraction using an elastomeric chain and NiTi coil spring; there was no significant difference in the rate of tooth movement between both the groups.

Evaluation of degradation of force of esthetic elastomeric chains

Abstract Introduction Elastomers are considered important allies to orthodontic treatment and due to the aesthetic demand, aesthetic elastomers are increasingly used in adult patients. Objective The aim of this experimental in vitro study was to evaluate the degradation of force of esthetic elastomeric chains, of three different sizes: short, medium and long. Material and method For evaluating the degradation of force, 90 elastomeric chain segments were used, divided into 9 Groups (n=10), as follows: Morelli short elastomer, Morelli medium, Morelli long, Orthometric short, Orthometric medium, Orthometric long, American Orthodontic short, American Orthodontic medium and American Orthodontic long. Acrylic plates with pins were used to provide stretching of the elastomeric chains. The initial stretching force of the elastomeric chain was 150 grams, measured by a tensiometer. After this, they were prestretched to 50% of their original length, measured in an Instron 4411 Universal test machine, and placed on the seating pin on the plate. The plate was immersed in artificial saliva at 37 °C in a plastic receptacle, and removed for measurement after a time interval of 21 days. For statistical analysis, the methodology of mixed models for repeated measures in time and Tukey-Kramer test were used. Degradation of the forces was analyzed by 2-way analysis of variance (ANOVA) and the Tukey test. Result All the elastomeric chains showed statistically significant reduction in force (p<0.05). The American Orthodontic elastomeric chains showed higher reduction in force values, irrespective of the elastic size (p<0.05). Conclusion The three commercial brands studied underwent significant reduction in the quantity of force released; the American Orthodontic brand of elastomer showed the highest value of degradation in force.

Comparative Assessment of Force Decay of the Elastomeric Chain With the Use of Various Mouth Rinses in Simulated Oral Environment: An In Vitro Study.

Aim:This study is aimed to assess the effect of different mouth rinses and its active components on the force decay of elastomeric chains. Listerine, Colgate Phos-Flur, Clohex Plus mouth rinses, 26.9% alcohol, 0.04% sodium fluoride (NaF), and 0.2% chlorhexidine were used for this study to determine its effects on force decay of elastomeric chains.Materials and Methods:Seven custom-made jigs were constructed on which 120 short module elastomeric chains were stretched to predetermined lengths between the pins. Using calibrated digital force tester, measurements of force exerted by the elastomeric chains while stretched on the framework were recorded at the time of attachment to the frame and after 24 hours, 7 days, 14 days, 21 days, and 28 days. The custom-made jigs and the elastomeric chains were allowed for complete submersion in artificial saliva throughout the test period, as well as in respective control solution and mouth rinses for 60 seconds, twice daily.Results:All test groups showed significantly more force decay than the control group. Statistically significant differences were observed when comparing force decay among the test groups except between a few.Interpretation and Conclusion:Mouth rinses cause an increase in force decay of elastomeric chain over the time. Listerine and 26.9% alcohol solution caused maximum force decay by the end of 28 days. Least force degradation of elastomeric chain was seen with the use of 0.2% chlorhexidine.

The Effect of Mouth Wash Containing Alcohol on Force Degradation of Colored Elastomeric Chains

The Effect of Mouth Wash Containing Alcohol on Force Degradation of Colored Elastomeric Chains

Assessment of Myeloperoxidase Levels In Relation to the Nature and Duration of Orthodontic Forces – An In vivo, Split Mouth Study

To assess the change in the myeloperoxidase levels(MPO)in the gingival crevicular fluid(GCF) at different time intervals during the course of orthodontic treatment with the application of intermittent and continuous forces. It was an interventional, split mouth study done on twenty patients scheduled to undergo fixed orthodontic treatment with therapeutic extractions of the first premolars.Mini implant assisted enmasse retraction was done after leveling and aligning of the arch.Continuous force with the help of Niti coil spring was used in the first quadrant and intermittent force with an elastomeric chain was used in the second quadrant. MPO was collected from the GCF using What man’s paper at baseline,1 week and 2 weeks after the application of retraction forces.The levels were assessed using a commercially available ELISA kit. Mean MPO activity was increased in the GCF of all the patients at 1 and 2 weeks after retraction,in both quadrants.At 2 weeks, MPO levels at the intermittent force application site were found to be significantly higher than those at the site of continuous force application. Myeloperoxidase is a useful marker to assess inflammation associated with orthodontic tooth movement.Intermittent forces cause a higher degree of inflammation as compared to continuous forces.

In vivo evaluation of the force degradation characteristics of four contemporarily used elastomeric chains over a period of 6 weeks

BackgroundThe purpose of this study was to evaluate and compare in vivo force degradation of elastomeric chains of four different companies over a period of 6 weeks using digital force gauge. MethodsA total of 25 participants making the total sample size of 100 were included in this split mouth study. Force degradation of four elastomeric chain samples from different manufacturers, Super Slick Chain (TP Orthodontics), AlastiK (3M Unitek), Dyna-Link elastomeric chain (G&H Orthodontics), and Memory Chain (American Orthodontics), was evaluated and compared among each other using a digital force gauge in the intraoral environment at six time intervals (immediate, 1 hour, 24 hours, 1 week, 3 weeks, and 6 weeks). The elastomeric chain samples were stretched to a fixed distance of 16 mm throughout the study period. ResultsThere was a significant difference between the force degradation values of elastomeric chains supplied by different manufacturers (P < 0.001). Maximum force degradation in all four groups was recorded in the first hour of placement. After 6 weeks, the force degradation was found to be least with Super Slick chain (55% ± 5%) and maximum with Dyna-Link chain (63% ± 4%). ConclusionsThree of four elastomeric chains sustained an amount of force that can be considered adequate for canine retraction. Only one elastomeric chain suffered a major loss of force in such a way making it difficult to continue the retraction of canine after 6 weeks.

EXAMINATION OF ORTHODONTIC ELASТOMERIC CHAINS AND NiTi CLOSED COIL SPRING FORCE DURING POSTEXTRACTION SPACE CLOSURE

This paper examines the forces produced by elastomeric chains and NiTi closed coil springs during postextraction space closure. 58 postextraction spaces were analyzed, divided into two groups according to the applied mechanism. Postextraction spaces were monitored for 3 months when force strength and postextraction space width measurements were made. The measurements were carried out every 4 weeks, initially during activation of the mechanism and at the end of the active phase. The results show that elastomeric chains have more force decay over time, with the smaller amount of space closure width than NiTi closed coil springs. Keywords: elastomeric chain, NiTi closed coil spring, postextraction space.

Severe unilateral scissors-bite with a constricted mandibular arch: Bite turbos and extra-alveolar bone screws in the infrazygomatic crests and mandibular buccal shelf

A 33-year-old woman had a chief complaint of difficulty chewing, caused by a constricted mandibular arch and a unilateral full buccal crossbite (scissors-bite or Brodie bite). She requested minimally invasive treatment but agreed to anchorage with extra-alveolar temporary anchorage devices as needed. Her facial form was convex with protrusive but competent lips. Skeletally, the maxilla was protrusive (SNA, 86°) with an ANB angle of 5°. Amounts of crowding were 5mm in the mandibular arch and 3mm in the maxillary arch. The mandibular midline was deviated to the left about 2mm, which was consistent with a medially and inferiorly displaced mandibular right condyle. Ectopic eruption of the maxillary right permanent first molar to the buccal side of the mandibular first molar cusps resulted in a 2-mm functional shift of the mandible to the left, which subsequently developed into a full buccal crossbite on the right side. Treatment was a conservative nonextraction approach with passive self-ligating brackets. Glass ionomer bite turbos were bonded on the occlusal surfaces of the maxillary left molars at 1month into treatment. An extra-alveolar temporary anchorage device, a 2×12-mm OrthoBoneScrew (Newton A, HsinChu City, Taiwan), was inserted in the right mandibular buccal shelf. Elastomeric chains, anchored by the OrthoBoneScrew, extended to lingual buttons bonded on the lingually inclined mandibular right molars. Cross elastics were added as secondary uprighting mechanics. The maxillary right bite turbos were reduced at 4months and removed 1month later. At 11months, bite turbos were bonded on the lingual surfaces of the maxillary central incisors, and an OrthoBoneScrew was inserted in each infrazygomatic crest. The Class II relationship was resolved with bimaxillary retraction of the maxillary arch with infrazygomatic crest anchorage and intermaxillary elastics. Interproximal reduction was performed to correct the black interdental spaces and the anterior flaring of the incisors. The scissors-bite and linguallyinclined mandibular right posterior segment were sufficiently corrected after 3months of treatment to establish adequate intermaxillary occlusion in the right posterior segments to intrude the maxillary right molars. The anterior bite turbos opened space for extrusion of the posterior teeth to level the mandibular arch, and the infrazygomatic crest bone screws anchored the retraction of the maxillary arch. In 27months, this difficult malocclusion, with a Discrepancy Index score of 25, was treated to a Cast-Radiograph Evaluation score of 22 and a pink and white esthetic score of3.

Measurement of initial displacement of canine and molar in human maxilla under different canine retraction methods using digital holographic interferometry

An application of digital holographic interferometry for the measurement of the initial displacement of canine and molar in the human maxilla, under different canine retraction mechanisms, is presented. The objective of this study is to determine and compare the canine and molar displacements with and without transpalatal arch (TPA) on 0.018-in. stainless steel (SS) and 0.019- × 0.025-in. SS arch-wires, using three different canine retraction sliding mechanism methods: nickel–titanium (Ni–Ti)-closed coil-spring, active tie-back, and elastomeric chains. The proposed technique is highly sensitive and enables the displacement measurement of the canine and molar in human maxilla under different canine retraction methods, more precisely and accurately compared with its counterparts. The experiment was conducted on a dry human skull without mandible with intact dental arches and aligned teeth. The experimental results reveal that Ni–Ti-closed coil-spring produces maximum initial canine displacement, followed by active-tie back and elastomeric chain. It was also found that initial canine and molar displacements were more on 0.018-in. SS arch-wire as compared with 0.019 × 0.025-in. SS arch-wire. Further, the initial displacement of the molar was less when TPA was taken as an anchorage in comparison to without anchorage.

Effect of some carbonated drinks on force decay of elastomeric chains: An in vitro study

Effect of some carbonated drinks on force decay of elastomeric chains: An in vitro study

Comparison of Rate of En masse Retraction and Anchorage Loss in Conventional Labial Appliance with Labial and Lingual Force: A Clinical Study

Aims: The rate of en masse retraction and anchorage loss were compared between labial appliance with lingual force and conventional labial appliance. Subjects and Methods: The sample consists of 14 patients and they were divided into two groups. In Group 1 – labial appliance with lingual force, elastomeric chain was placed from the palatal surface of the canines to the palatal surface of the molars. In Group 2 – labial appliance with labial force, elastomeric chain was placed from the crimpable hook distal to lateral incisor to the molar tube hooks. The rate of en masse retraction and anchorage loss was calculated for both the groups during retraction in dental casts (R 0 , initial; R 1 , 4 weeks; R 2 , 8 weeks; and R 3 , 12 weeks). Statistical Analysis Used: Student's paired t -test. Results: The rate of retraction was faster and anchorage loss was lower with labial appliance with lingual force, i.e., Group 1. The difference of anchorage loss in Group 1 and Group 2 shows t = 4.824 and P value= 0.000, which is statistically highly significant. The difference of rate of retraction in Group 1 and Group 2 shows t = 3.573 and P value = 0.004, which is statistically signifcant. Conclusions: The rate of retraction was faster and anchorage loss was lower with labial appliance with lingual force, thus indicating that this new technique of space closure utilizes biomechanical advantage of lingual force in conventional labial appliance.

Nickel-titanium springs probably result in a small increase in orthodontic space closure rate compared with elastomeric power chains, but insufficient or no evidence about relative effects on other outcomes

Mohammed H, Rizk MZ, Wafaie K, Almuzian M. Effectiveness of nickel-titanium springs vs elastomeric chains in orthodontic space closure: a systematic review and meta-analysis [published online ahead of print December 19, 2017]. Orthod Craniofac Res. https://doi.org/10.1111/ocr.12210.

An in vitro study of the stretching time-associated force loss generated by elastomeric chains and NiTi closed coil springs

The study samples comprised 40 elastomeric chains (20 Dentaurum, and 20 G & H) and 15 NiTi closed spring (GAC). The elastomeric chains were submerged in 36,6 ºC artificial saliva and stretched on the instrument of resin plates at a distance of 30 mm. With an electronic dynamometer the delivered force was evaluated at different intervals: at baseline, after 1 day, 4, 7, 14, 21 and 28 days. Specimens of 15 NiTi coil springs were tested by dynamometer to evaluate force loss following 1, 2, or 3 months of use. It was observed a significant force loss of elastomeric chains after 24 hours. There was a force loss of elastomeric chains (from 34±1.3% to 53.86±2% after 28 days of activation). NiTi springs showed force loss (~13%) following 28 days of use, with a further significant loss (~6%) at 4-8 weeks; force levels remained steady thereafter. There was higher force loss in the different commercially elastomeric chains (~60%) in comparison to NiTi springs (21%).

Effect of Bleaching Mouthwash on Force Decay of Orthodontic Elastomeric Chains.

Force decay elastomeric chains are significant, and it is a clinical problem. The aim of this study was to evaluate the effects of bleaching agent in the mouthwash on the force decay of orthodontic chains. In this experimental study, 160 gray closed elastomeric chains were randomly divided into three groups (one control and two test groups). Four loops of chains were stretched for 25 mm on custom-made jig. Control group specimens were immersed in artificial saliva during the test period. Test group specimens were immersed twice a day for 30 seconds in the whitening (LISTERINE® HEALTHY WHITE™) and daily sodium fluoride (LISTERINE® TOTAL CARE ZERO) mouthwashes. All specimens were immersed in artificial saliva at 37°C. Force was measured at different time points (initial, 1, 7, 14, 21, 28 days). Statistical analysis was performed by two-way analysis of variance (ANOVA) and Bonferroni methods (a = 0.05). Force of elastomeric chains was decreased dramatically in all groups during the experiment. After 24 hours, force was decreased by 42.18, 48.34, and 53.38% in control group, daily, and bleaching mouthwash groups respectively. The corresponding numbers after 4 weeks were 66.30, 76.73, and 86.48. The difference between three groups at days 1 and 28 was statistically significant (p < 0.05). Within the limitations of the current in vitro study, bleaching and sodium fluoride mouthwashes could cause force decay of orthodontic elastomeric chains. Whitening mouthwash is more weakening for elastomeric chains. Use of whitening mouthwash by orthodontic patients could decrease the force of elastomeric chains, so it could be recommended to use them for a short time.

A comparative evaluation of osteoprotegerin and receptor activator of nuclear kappa B ligand in gingival crevicular fluid during canine retraction with elastomeric chain and nickel titanium coil spring: Anin vivostudy

Objective: The objective of this study is to evaluate and compare the level of receptor activator of nuclear kappa B ligand (RANKL) and osteoprotegerin (OPG) in gingival crevicular fluid (GCF) during canine retraction with nickel-titanium (NiTi) coil spring and elastomeric chain. Materials and Methods: Ten patients between the ages of 13–17 years requiring canine distalization after first premolar extraction were selected. NiTi coil spring was placed on one side and elastomeric chain on the contralateral side. GCF sampling was done at baseline, 1 h, 24 h, 168 h, 1 month from the distal site of the test teeth after the application of compressive force. RANKL and OPG concentration were detected by enzyme-linked immunosorbent assay. Results: In the NiTi coil spring side, the RANKL levels in GCF increased and OPG levels decreased in a time-dependent manner. Increase in RANKL and decrease in OPG were significant when compared with the baseline. In the elastomeric chain side, the RANKL levels were significantly higher and the OPG levels significantly lower at 24 h, the RANKL levels showed a significant decrease and OPG levels showed a significant increase from 24 h to 1 month time intervals. The RANKL and OPG levels in GCF when compared individually to the NiTi coil spring and elastomeric chain showed a significant difference at 24 h, 168 h, and 1 month after initiation of compressive force. Conclusion: The result suggests that RANKL and OPG expression during orthodontic tooth movement varies at different time intervals and according to the type of force delivery system.

Anterior Open Bite Treated by Maxillary Posterior Teeth Intrusion Using Zygomatic Miniplates: A Case Report

This case report aims to demonstrate the successful utilization of zygomatic miniplates in the treatment of an adult patient with anterior open bite (AOB). During treatment of anterior open bite, incisor extrusion may compromise facial esthetics in cases with long facial height and/or sufficient incisor exposure at rest and smile.The intrusion of posterior teeth has the advantage of correcting vertical dimension and maintaining proper incisors show. The patient, a 22-year-old boy, had an anterior open bite of 4.5 mm with increased lower facial height, bilateral posterior crossbite, and two different occlusal planes in the upper arch. Titanium miniplates were used to intrude maxillary posterior teeth with a transpalatal arch appliance to limit buccal tipping.The intrusive force was then applied through elastomeric chains placed bilaterally in the maxillary arch between the miniplate and posterior teeth.The anterior open bite was corrected within 7 months of intrusion with decreased lower facial heightand significant improvement in anteroposterior jaw relationship. This report emphasizes the significant role of facial appearance and smile. Most of the non-surgical approaches are not suitable for open bite correction in cases with long facial height and/or sufficient incisor exposure at rest and smile because of their extrusive mechanics which compromise the facial and smile esthetics. The intrusion of posterior teeth using min iplates allowing a counterclockwise rotation of the mandible to correct anterior open bite without compromising facial esthetic and smile.

Effects of variation in temperature on the permanent deformation of elastic chains.

Aim: The Aim of the study is to check the effects of variation in temperature on the Permanent deformation of elastic chains. Objective: To investigate the effect of variation in temperature on the permanent deformation of elastic chains. Materials and method: Samples of elastic chains are taken and subjected to various temperature for 5 minutes 4 times a day .Samples are put under 5 groups;Group 1 was subjected to a temperature of 0°,Group 2 was subjected to a temperature of 20°,Group 3was subjected to a temperature of 40°,Group 4 was subjected to a temperature of 60°,Group 5 was subjected to a temperature of 80°.Background: In orthodontic treatment,elastomeric chains exhibit good elasticity they are used for retraction,space closure.The main advantage of these elastomeric chains are they are cost efficient,ease of application, patient and clinician comfort.Any alteration in the mechanical properties of elastomers affects the function of the chains.It s influenced by the change in temperature due to consumption of very cold to very hot food.Constant exposure to such varying temperatures may affect the elastomers and lead to deformation.