Elastomeric Modules Research Articles

Clinical efficiency of new generation elastomeric ligatures over conventional: An in-vivo study

Friction being an imperative element in clinical orthodontics affects all stages of treatment and high frictional forces can affect the treatment duration and outcome in a deleterious manner. This study was done to appraise frictional resistance of non-conventional elastomeric modules in comparison with conventional elastomeric modules, during the retraction of teeth. The study sample size includes 30 patients (11 males and 19 females) undergoing orthodontic treatment. They were grouped into 3, namely, Group A- Slide nonconventional elastomeric ligatures Group B- super slick nonconventional elastomeric ligatures, and Group C- the conventional ligature. The study models were obtained to assess canine retraction rate, anchor loss, canine rotation, and molar rotations at different time intervals and subjected to statistical analysis. : The canine retraction rate(maxilla) for Group A, B and C was 1.674+/-0.092, 1.187+/-0.156, and 1.147+/-0.113,(mandible)1.765+0.099, 1.300+0.099 and 1.270+0.111 respectively. Mean anchorage loss(maxilla) group A- 1.054mm, group B- 1.080mm, group C -1.715mm (mandible) 1.024mm, 0.952mm and 1.664mm respectively. Canine rotation(maxilla) of Group A, B and C is 8.550+/-1.506, 5.300+/-1.386, 6.100+/-1.315and(mandible) 8.930/-+1.474, 5.830+/-1.096, 6.880+/-1.813 respectively. Mean molar rotation (maxilla) 2.580+0.735, 2.210+0.549 and 2.210+0.700 (mandible)2.900+0.541, 2.650+0.639 and 2.780+0.604 in group A, B and C respectively. Mean anchor loss was lesser in non-conventional modules, canine retraction rate was higher with Slide ligature, canine rotations were least in superslick more in Slide ligature, and rotation of molar was apparent for all the groups.

A Comparative Evaluation of Frictional Resistance of Various Lingual Brackets With Nitinol (NiTi) Archwires of Different Dimensions: An In Vitro Study.

Introduction Orthodontic mechanics involves transferring some of the applied force to the tooth's supporting components via friction, which in turn allows the tooth to move more easily. Aim The purpose of this in vitro experiment was to examine the frictional resistance (FR) of different lingual brackets utilizing Instron universal testing machines and nitinol (NiTi) archwires of varying sizes. Materials and methods Twenty-four sectional anterior die stones were replicated from a study model. They were categorized into eight categories, with the Libral lingual bracket and the JJ lingual bracket having 0.012" and 0.014" inch NiTi archwire, which were further subdivided into six subgroups. Three brackets were bonded to the anterior teeth of the upper and lower segments and replicated on other models with the help of silicon putty. Elastomeric modules were ligated to two diameters of NiTi wire (0.012" and 0.014") in each model. An Instron universal testing machine was used to measure the frictional force. Numerical data and descriptive statistics such as mean and standard deviation have been shown. Results In the overall analysis, it was observed that among JJ Orthodontics samples using 0.012" NiTi archwires, the maxilla exhibited a higher FR (4.205N) compared to the mandible (4.092N). Similarly, in the case of Libral Orthodontics samples with 0.012" NiTi archwires, the maxilla also demonstrated a higher FR (5.10N) than the mandible (4.97N). However, this trend did not hold for samples using 0.014" NiTi archwires. There was a statistically nonsignificant difference (p > 0.05) in the values between all the pairs of groups. Conclusion The present study concludes that Libral lingual brackets produced overall more FR than JJ lingual brackets.

Effect of Elastomeric Module Degradation and Ligation Methods on Kinetic Friction between NiTi or Stainless Steel Wires and Stainless Steel Brackets.

Objectives: The reduction of resistance to sliding between the archwire and bracket promotes more seamless tooth movement, leading to a faster and improved orthodontic treatment experience. This research aimed to examine how the degradation of elastomeric modules, different ligation methods, bracket-wire angle, and wire type (nickel titanium, NiTi or stainless-steel, SS) impact the kinetic friction resulting from the interaction between NiTi or SS archwires and SS brackets. Materials and Methods: The current in vitro study was conducted on nine groups, including NiTi and SS archwires with three types of ligations (O-ring, figure of 8, and SS wire ligature) and two bracket-wire angles (0˚ and 10˚). The kinetic friction in each group was measured using a Universal Testing Machine at four time intervals: baseline, day one, week one, and week four. Repeated measures ANOVA, Mauchly test of sphericity followed by the Greenhouse-Geisser test, and relevant post hoc tests were used for statistical analysis (P<0.05). Results: The authors found a decrease in kinetic friction in all types of ligations, which confirmed the effect of time on the degradation of ligation modules. The kinetic friction of figure of 8 ligations was higher than both O-ring and SS wire ligations. No difference was observed between O-ring and SS wire ligations. Furthermore, the bracket-wire angle did not affect friction. Conclusion: The authors suggest that the use of figure of 8 ligations in NiTi and SS wires should be limited due to their high friction and replaced with other types of ligations, if possible.

Do Oral Antiseptics Affect the Force Degradation of Elastomeric Chains?

Objective: This study aimed to compare the force degradation of elastomeric chains submerged in commonly used mouthrinses. Methods: One hundred samples of elastomeric orthodontic chains from five different brands (Ormco, GC, RMO, Forestandent, and 3M Unitek) were initially activated on double length, and the force was measured with a universal mechanical testing machine. Then, elastomeric modules were thermocycled and immersed into four different mouthrinses: Octenident, Vitis Orthodontic, Perio Plus+, and Listerine through a total number of three cycles which simulated 30 days of intraoral exposure. Force decay was measured after each cycle. Results: All specimens showed statistically significant force degradation over the tested period (p &lt; 0.001). After thermocycling and immersion in oral antiseptics, the lowest measured force was found in Forestadent EOC in Listerine with a median of 70 cN (70–75 cN) and Vitis orthodontic with a median of 70 cN (70–80 cN). On the contrary, the least prone to force reduction was the control group of Ormco 280 cN (275–285 cN) and RMO 280 cN (270–280 cN). Conclusions: Elastomeric chains’ force degradation could be exacerbated by the use of mouth rinses. These data could be beneficial in choosing the appropriate combination of elastomeric chain and mouthrinse for optimal results of orthodontic therapy.

Evaluation of the frictional resistance between different bracket types, archwires and ligation materials: An in-vitro study

In orthodontic treatment, brackets need to slide along the archwire to allow for alignment of the teeth. The lesser the friction between the bracket and the archwire, the easier it is to align the teeth and the lighter the forces required to make such movements. In recent years, patients’ esthetic demands have driven the field of orthodontics to find alternatives to conventional stainless steel bracket systems. While ceramic brackets meet the esthetic demands, their inferior frictional characteristics have always been an issue for orthodontists.The present in-vitro research study evaluates and compares the frictional resistance between various types of brackets, archwire materials and ligation methods. The purpose of the study was to equate the frictional resistance among 12 different groups using the universal testing machine, so as to recognize the factors involved in the in-vitro appraisal of resistance to sliding (RS) and inferring their clinical implications. In this study, 120 pre-adjusted edgewise upper central incisor brackets with MBT 0.022″ slot were used, which included 40 standard metal brackets, 40 ceramic brackets, 20 self-ligating metal brackets and 20 self-ligating ceramic brackets. 0.019″ x 0.025″ SS (stainless steel) archwires, esthetic archwires, Teflon-coated ligatures and conventional elastic modules to ligate the archwire to the brackets except in self-ligating brackets, were used. The average frictional resistance of Group A10 was the minimum succeeded by A9, A12, A4, A11, A8, A3, A7, A2, A6, A1 and A5. In the comparison of the mean frictional resistance of 12 different groups, the ANOVA test showed noticeably different frictional resistance amongst the groups (F=745.80, P&amp;#60; 0.001). Self-ligating metal bracket combinations with different archwires showed a significantly smaller magnitude of friction than self-ligating ceramic, metal and ceramic bracket combinations. Teflon-coated ligature combinations possess less friction in comparison with conventional elastomeric module combinations.

Perceptual and quantitative analysis of discoloration of orthodontic elastomeric chains by food

BackgroundThe objectives of this study were to use a digital camera to measure the discoloration of orthodontic elastomeric chains in various immersion solutions over different time periods and to determine the valid acceptability tolerances for color changes in orthodontic elastomeric chains by surveying digital photographs.MethodsOrthodontic elastomeric chains were applied to the maxillary anterior teeth of nine typodont models. The models were divided into three groups and immersed in the curry, coffee, and wine solutions. The digital images of the elastomeric modules were captured and processed using commercial software after 30 min of immersion, thrice a day, for 28 days. The differences in color changes (Delta {text{E}}), depending on the type of immersion solution and period, were analyzed using a repeated-measures analysis of variance (ANOVA) test. A web-based survey questionnaire was randomly distributed to 50 respondents for a visual analysis of the elastomeric chain discoloration. The relationship between the surveying score and Delta {text{E}} value was analyzed using Spearman’s correlation coefficient. The perceptibility and acceptability of elastomeric chain discoloration (Delta {text{E}}) based on the type of immersion solutions and periods were analyzed using a regression model.ResultsSignificant differences were observed in the discoloration of the elastomeric power chain depending on the immersion solution and period. The amount of discoloration was highest in curry, followed by coffee and wine (P < 0.05). The mean discoloration (Delta {text{E}}) continued to increase over the entire immersion period. There was a significant correlation between visual scoring and discoloration (Delta {text{E}}) over the entire period, especially in the early stages compared to the later stages (r = 0.918, P < 0.05). In 50% of the respondents, the predicted clinically unacceptable discoloration was between 4.46 and 9.98 and in 90% of the respondents, it was between 16.52 and 19.85.ConclusionsThe amount of discoloration was the highest for curry, followed by coffee and wine, and continued to gradually increase during the observation period. Significant differences were found between the color measurements obtained and the visual assessment by observers. The observers varied in their tolerance for perceptibility and acceptability for elastomeric chain discoloration based on the type of dietary media.

Discoloration of stretched colored elastomeric modules : An in vivo study.

As the demands on esthetic orthodontic devices continue to increase, discoloration of colored elastomeric modules is still a concern for patients and orthodontics. Thus, we performed an in vivo study evaluating discoloration of stretched colored elastomeric modules (i.e., white, gray, and pink). In all, 90elastomeric modules of three different colors (white, gray and pink; 30elastics from each color) were placed around brackets. The elastomeric modules were distributed and arranged randomly in the patients' four dental quadrants, and were removed after 1, 2, and 4weeks. Color measurements were made before and after insertion into each patient's mouth. Digital images were taken with the camera of amobile phone (iPhoneX, Cupertino, CA, USA), and the variations in color were characterized using the Commission Internationale del'Eclairage (CIE) color space system (L*a*b*) offered by Photoshop (Adobe, San Jose, CA, USA). Analysis of variance (ANOVA) and least significant difference (LSD) tests were used for statistical analyses. The white elastomeric modules were most prone to discoloration, followed by the pink and then finally by the gray colored modules. The amount of discoloration resulting from arandom diet practiced by the patients increased gradually (but was not significant) for all elastomeric modules studied and reach apeak after 2weeks for the white and gray elastomeric modules, while discoloration of the pink elastomeric modules plateaued after 1week. Colored elastomeric modules (e.g., white, gray, and pink) discolor to variable degrees over time. Thus, patients should be advised that the consumption of food and drinks may result in discoloration of the elastomeric modules.

A Novel Coating of Biosynthesized Silver Nanoparticles on Orthodontic Elastomeric Ligatures

Background: Fixed orthodontic appliances especially with orthodontic elastomeric ligatures can increase the risk for development of white spot lesions, which are often irreversible. Due to their huge surface area, silver nanoparticles are effective antimicrobials. Green synthesis employs the use of plant extracts such as Clove and Cardamom which possesses antimicrobial, antiinflammatory and antioxidant properties. Aim: This study aims to discover a novel approach to coat orthodontic elastomeric modules or ligatures with biosynthesized silver nanoparticles using clove and cardamom as plant extract. Materials and methods: Aqueous extract of cardamom and clove was prepared. Biosynthetic silver nanoparticles were synthesised by reacting silver nitrate ions with clove and cardamom extract (as bioreductant). Using a magnetic stirrer and a hot plate, silver nanoparticles (AgNPs) were synthesised directly on orthodontic elastomeric ligatures. Characterization of silver nanocoated elastomeric ligatures was done using Scanning Electron Microscope (SEM) and Energy Dispersive X-ray Spectroscopy (EDX). Results: At the end of third day formation of AgNPs were reported by color shifting from orange-red to dark brown. Reducing silver ions to AgNPs, as shown by UV-vis spectroscopy, generated a peak at 462 nm. SEM and EDX confirms the presence of elemental silver on silver nanocoated elastomeric ligatures. Conclusion: An innovative coating technique incorporating magnetic stirrer along with a hot plate allows for the efficient coating of biosynthesized silver nanoparticles on orthodontic elastic ligatures. The SEM and EDX results indicate the structural integrity of the Ag nanoparticles on the biosynthetically produced orthodontic elastic ligatures is enhanced.

The Effect of Elastic and Metallic Ligation Methods on the Unloading Forces for Three Different Types of Nickel-Titanium Archwires Inserted Into Metallic Brackets: An In-vitro Study.

One of the unique properties of the nickel-titanium (NiTi) archwires is the release of light continuous forces with a wide range of activation, which is affected by the method of ligating the wire to the bracket. Both elastomeric modules and metallic ligatures are the most common components to ligate the archwire to the bracket. This study aimed to evaluate the effect of elastomeric versus metallic ligatures on the released forces of three types of rectangular 0.016- by 0.022-inch NiTi wires. This investigation evaluated three different situations of ligating the NiTi archwires to metallic brackets. The produced forces by these wires were evaluated using a modified three-point bending test (a universal testing machine: Testometric 350M®, Instron, Lincoln Close, Rochdale, England). A 0.022-inch slot-size premolar bracket was used for this investigation with zero torque and zero angulation (Master Series®, American Orthodontics, Sheboygan, USA). The first situation involved no ligation to the metallic brackets using three types of NiTi wires, whereas the second situation (the elastic ligation) involved the use of colored elastomeric modules with a 0.045-inch inner diameter and a 0.115-inch outer diameter (Color Ligatures®, American Orthodontics, Sheboygan, USA) to ligate the archwire into the metallic bracket's slot. In the third situation (metallic ligation), stainless steel metallic ligatures with a 0.012-inch (Preformed Ligature Wire®, American Orthodontics, Sheboygan, USA) were used to perform the ligation. The employed NiTi wires were 0.016 x 0.022-inch in diameter (American Orthodontics®, Sheboygan, Wisconsin, USA), and they were of three different types: (1)the superplastic wires (NT3-SE®), the thermally activated wires at 25°C (Thermal Ti-D®), and the thermally activated wires at 35°C (Thermal Ti-Lite®). The thermally activated wires at 35°C (Thermal Ti-Lite®) recorded the lowest force levels for the three ligation methods, while the highest result appeared with the superelastic type (NT3-SE®) and the thermally activated type at 25°C (Thermal Ti-D®) which showed a varied force for different ligation methods. Regarding the three different NiTi wires used, the elastic and metallic ligation increased the force levels for the superelastic type (NT3-SE®) over non-ligation by 50% and 110%, respectively, whereas the elastic ligation raised only the forces for the thermal types (Thermal Ti-D®and Thermal Ti-Lite®) by 75% and 22%, respectively. Both thermally activated types (Thermal Ti-D®and Thermal Ti-Lite®) released forces in the elastic ligation method greater than that of the metallic method by 125% and 20%, respectively. The elastic ligation method raised the unloading forces in comparison with the non-ligation for all tested archwires, whereas the metallic ligation method raised the released forces for the superelastic type (NT3-SE®) and decreased those related to the activated types (Thermal Ti-D®, Thermal Ti-Lite®)due to the increased friction and the instability of the crystalline structure. Only the heat-activated type at 35°C (Thermal Ti-Lite®) reflected the unique properties of the NiTi wires in producing light continuous forces with a wide range of activations regardless of the type of ligation.

An In - vivo study to evaluate the force decay of three different orthodontic elastomeric ligatures.

Abstract: Background: In vitro studies conducted under simulated oral environment under estimated the force decay of elastomeric ligatures. There are only few invivo studies that are reported evaluating the force decay of elastomeric ligatures. Aim &amp; Objectives: The aim of this in-vivo study was to evaluate the force decay of three different clear elastomeric ligature modules stretched over the lower incisor brackets intra orally over three different time periods at 24 hrs, 7 days and 21 days by comparing it with the force levels evaluated at as received conditions . Materials and methods: Ten patients undergoing fixed orthodontic treatment with Roth Prescription, 0.022" slot preadjusted edgewise stainless steel brackets with aligning and levelling completed and 0.019" x 0.025" SS arch wire placed passively in the lower arch were included in the study. The three types of elastomeric ligature modules formed the three study groups [Group I: Molded“O” (Ormco, USA),Group II: Alastik (3M Unitek, USA)&amp;Group III: Uni-stick (American orthodontics, USA)] Each group was assigned with a specific lower incisor in each patient and the respective modules were used in the teeth during the study period. The force levels required to stretch the modules to a predetermined length of 4.1mm were evaluated at 4 different time intervals at 0 hour (as received), 24, 7 days, and 21 days after intra-oral use using a universal testing machine (Instron model 1112, Instron Corp.). The mean force values and standard deviations for all the groups at each time period. The mean percentage of force decay between time periods for each study group was calculated. One way ANOVA followed by Post hoc Tukey HSD was performed for within the group and between group comparisons. Paired T test was done for pairwise comparisons. (P value≤ 0.05) Results: The mean force level recorded were high at the base line level with as received modules before inserting into the patients mouth for all the three study groups. The mean force level was 766.50 ± 3.659 gms, 650.50±2.759 gms and 594 .10 ± 4.630 gms for group I, II &amp; III respectively in the as received condition. The percentage of force decay was 32.94 % at 24 hrs and 69.85% at 7 days and 79.31% at 21 days for Group I. A force decay of 31.36%, 70.76% and 79.83% from the base line value was noted in group II at the same time intervals. In Group III The force decay rate at 24 hrs, 7 days and 21 days were 33.29%, 66.10% and 77.12% respectively. One way ANOVA for within group and between group comparison showed a significant difference between the force levels recorded at different time intervals within and between all the three study groups. Post Hoc Tukey HSD revealed a significant difference between the three groups at all the time intervals tested except at 7 days and 21 days where the force levels exerted by the group II and Group III samples were not significantly different. Paired sample T test for pairwise comparison of force exerted between different time intervals in all the three groups revealed a significant difference. Conclusion: Group I clear modules exhibited significantly high mean force and less force decay compared to other groups at all four time intervals tested. The elastomeric modules exhibited significant force decay after 24 hours, 7days and 21 days of intra-oral use except at 7 days and 21 days where the force levels exerted by the group II and Group III samples were not significantly different. The forces at the end of three weeks of intra oral use appeared to be insufficient for effective torquing effect and severe rotational corrections in all the three study groups and hence changing modules sfter three weeks may be beneficial in those cases

The effect of whitening toothpastes on polyurethane and silicone orthodontic clear ligatures: A clinical study.

This study aimed to verify the effects of bleaching toothpaste on colour stability, elastic properties, surface topography between aesthetic polyurethane and silicone elastomeric ligatures from different brands. Elastomeric ligatures tested were: 1-Mini Single Case Ligature Stick (RMO-polyurethane); 2-Ligature "S" Shaped Dispenser (RMO-Silicone); 3-Sany-tie (GAC-translucent polyurethane); and 4-Sili-tie (GAC-translucent silicone). The ligatures were randomly assigned from the brackets of canines and lower incisors of 40 patients. The study had two phases of 30days in which a different toothpaste was used, followed by a washout period of 30days. After each phase, ligatures were submitted to colour checking, tensile strength, and SEM. The average of the ultimate tensile strength (m=2.59; DP=0.014) was higher in the control ligatures if compared to the tested ones (m=2.24; DP=0.014). There were no statistically significant differences between toothpastes regarding the type of ligature. Also, no interaction was observed between toothpastes in ligature's ultimate tensile strength and strain. The type of toothpaste did not minimize colour changes. In conclusion, there was no difference in colour stability and elastic properties between polyurethane or silicone aesthetic elastomeric modules. Whitening toothpastes had no impact on ligatures performance after 30days in the oral cavity.

Effect of antimicrobial agents on the oral microflora in patients undergoing fixed orthodontic therapy-An ex vivo comparative analysis.

Aim:To evaluate and compare the efficacy of Ozonated Olive Oil Gel, Chlorhexidine gel, and Amflor (Fluoridated) mouthwash on reducing the count of Streptococcus mutans and Lactobacillus in patients undergoing fixed orthodontic therapy evaluated at different time intervals.Methods:Sixty patients undergoing orthodontic treatment were randomly divided into three groups (n = 20) based on antimicrobial agents used (Group 1: Ozonated olive oil gel; Group 2: Chlorhexidine gel; Group 3: Fluoridated mouthwash). Elastomeric modules from brackets were collected at T0 (Fresh samples) and T1 (2nd week) and T2 (4th week) for assessment of the microbial growth. These collected modules were cultured and evaluated for the presence of Streptococcus Mutans and Lactobacilli and numbers of colonies were counted at each interval. Data obtained was subjected to statistical analysis using SPSS software (Version 20.0). Level of significance was kept at 5%. Intra-group and inter-group comparison between pretreatment, 2nd week and 4th week was done for each group using Wilcoxon signed rank test and Mann–Whitney U test.Results:There was presence of Streptococcus Mutans and Lactobacilli during orthodontic treatment which progressively increased from To to T1 and then declined from T1 to T2. The colony counts were maximum for Fluoridated mouthwash and least for Chlorhexidine and the results were statistically significant (P < 0.05).Conclusion:All three antimicrobial agents used were effective against Streptococcus mutans and Lactobacillus. Chlorhexidine proved to be more efficacious whereas Fluoridated mouthwash proved to be least effective against both Streptococcus mutans and Lactobacillus bacteria.

Idealized force decay of orthodontic elastomeric chains follows Nutting Equation

AbstractThe force decay of orthodontic elastomeric modules has been of considerable interest since these biomechanical force‐generating appliances were introduced five decades ago. Two mathematical approaches, a power‐law equation and a Maxwell–Weichert model, have been used by previous investigators to predict the in vitro force degradation under idealized conditions. In this study, the principal sensor approach had the test specimen being strained continuously using a digital force gauge. Test specimens of 13 products from 8 manufacturers were stretched to 25 mm and tested in an artificial saliva at 37°C in both the as‐received condition and after 24 h conditioning. Measurements for specimens strained continuously on the digital force gauge were compared with intermittent measurements for other specimens transferred to this gauge after 19.2 h ageing on a stretching rack, the approach in most past studies. Force data at equally spaced logarithmic time points, normalized to initial force and induced strain, were used to present degradation curves for individual products. Nonlinear regression analyses were used to fit both mathematical models to each product and conditioning state. Statistical analyses show that the power‐law equation (historically the Nutting equation) provides a more accurate prediction of idealized in vitro force decay for the elastomeric products.

Novel Metal Auxiliary (Device) to Prevent Cross-contamination of Elastomeric Modules

Emerging and prevalent infectious pose a significant threat to all stakeholders in the orthodontic office, namely, treating orthodontists, clinical assistants, and the patients. Due diligence must be applied to prevent further transmission of disease and infections. The elastomeric modules are one of the most frequent components of the fixed appliance. This clinical aid puts forth a novel clinical tip to prevent cross-contamination of and from elastomeric modules.

Ligation ties in orthodontics

During fixed orthodontic treatment, ligation method refers to the means by which an archwire is held inside the bracket. It can also be used to move the tooth in a particular direction depending on the type of ligature used and its method of ligation. Ligation can be done using stainless steel ligatures or elastomeric modules, or more recently, ligation methods have been designed and built directly into the bracket. Metal or elastic ligatures are used for this purpose, and the way they are tied affects tooth movement. Because of their design, twin brackets can be tied in a large variety of ways. Knowing how to use all the bracket's resources makes for better and faster treatment results. Elastic ligature may be a substitute for the wire ligatures in most situations. In various treatment mechanics, ligation ties are modified to accomplish variable tooth movement or to maintain arch form integrity during finishing of an orthodontic case. This article will highlight different ligation methods used in different bracket systems and their indications as well.

Stem cells in orthodontics and dentofacial orthopedics: Current trends and future perspectives

A simple overview of daily orthodontic practice involves use of brackets, wires and elastomeric modules. However, investigating the underlying effect of orthodontic forces shows various molecular and cellular changes. Also, orthodontics is in close relation with dentofacial orthopedics which involves bone regeneration. In this review, current and future applications of stem cells (SCs) in orthodontics and dentofacial orthopedics have been discussed. For craniofacial anomalies, SCs have been applied to regenerate hard tissue (such as treatment of alveolar cleft) and soft tissue (such as treatment of hemifacial macrosomia). Several attempts have been done to reconstruct impaired temporomandibular joint. Also, SCs with or without bone scaffolds and growth factors have been used to regenerate bone following distraction osteogenesis of mandibular bone or maxillary expansion. Current evidence shows that SCs also have potential to be used to regenerate infrabony alveolar defects and move the teeth into regenerated areas. Future application of SCs in orthodontics could involve accelerating tooth movement, regenerating resorbed roots and expanding tooth movement limitations. However, evidence supporting these roles is weak and further studies are required to evaluate the possibility of these ideas.

Bacterial Adhesion Differentiation Between 3 Non-conventional Elastomeric Modules

Bacterial Adhesion Differentiation Between 3 Non-conventional Elastomeric Modules

The Microflora Diversity and Profiles in Dental Plaque Biofilms on Brackets and Tooth Surfaces of Orthodontic Patients

Objective: Fixed orthodontic appliances may influence the oral environment through accumulation of plaque, decreased plaque pH, and increased gingival inflammation. These changes in the oral cavity can potentially lead to periodontal disease, demineralization, and other infectious diseases. Materials and Methods: To investigate the changes in biofilm throughout the initial 2 weeks, we placed a stainless steel bracket on the upper second premolar and collected plaque samples on the bracket and on the tooth surface at different time points (0, 24, 48 h and 1 and 2 weeks) and plated on tryptic soy agar blood agar plate, and kept at 37°C in an anaerobic chamber for 5 days to determine the CFUs of bacteria. At the end of 2 weeks, we removed the bracket and elastomeric module, and we isolated genomic DNA from the bacterial biofilm for identification of bacteria by 16S rRNA PCR analysis. We also analyzed the morphology of biofilm on the bracket by scanning electron microscope. Results: Our results show that the bacterial biofilm was significantly increased on the bracket in all the subjects, whereas on the tooth surface, the CFUs were not significantly increased. PCR assay showed that biofilm on orthodontic brackets from all subjects showed colonization by Streptococcus gordonii, Porphyromonas gingivalis and Streptococcus mutans were observed on some of the subjects after 48 h, whereas Aggregatibacter actinomycetemcomitans biofilm was observed in all the time points except 24 h. Conclusion: This study demonstrated that both periodontal and cariogenic bacterial biofilms were formed on the bracket as early as 24 h.

Various methods of ligation ties

During fixed orthodontic treatment, ligation is used to keep the arch wire in the slot of the bracket. It can also be used to move the tooth in a particular direction depending upon the type of ligature used and its method of ligation. Ligation can be done using Stainless steel (SS) ligatures or elastomeric modules. SS ligature wire provides secured tie of arch wire to bracket slot, lesser friction and slower rate of force decay compared to elastomeric modules. Elastomeric modules are easier to place and take lesser chair side time. Elastic ligature does not have sharp edges and they exert lesser force on the bracket. So, they are preferred in those situations where there is higher tendency for debonding of brackets. Elastic ligature may be a substitute for the wire ligatures in most situations. In various treatment mechanics ligation ties are modified to accomplish variable tooth movement or to maintain arch form integrity during finishing of an orthodontic case. This article will highlight different ligation ties used in different bracket systems and their indications as well. Keywords: Ligation Ties, Stainless steel Ligation, Elastic modules, Rotation ties.

Evaluation and Comparison of Two Different Mouthwashes on Frictional Resistance Between Orthodontic Bracket and Archwire: An in Vitro Study

Aims: This study aimed to evaluate and compare the effect of tea tree oil (TTO) mouthwash and chlorhexidine (CHX) mouthwash on frictional resistance. Settings and Design: In vitro. Materials and Methods: In total, 60 extracted premolars were mounted on a custom-made acrylic fixture. These 60 premolars were randomly divided into 3 groups of 20 each, on which 0.022″ × 0.028″ slot MBT stainless steel brackets were bonded and 0.019″ × 0.025″ rectangular stainless steel wire was ligated with an elastomeric module. The 3 groups included a control group where the samples were immersed in artificial saliva and 2 experimental groups immersed in 0.2% CHX and TTO mouthwash, respectively, for 1.5 hours. Postimmersion static frictional resistance was evaluated on a universal testing machine at crosshead speed of 0.5 mm/min. Statistical Analysis Used: Tukey’s post hoc procedure. Results: This study showed a statistically significant difference in the frictional resistance between saliva and CHX groups and CHX and TTO groups ( P &lt; .05). No statistically significant difference was observed between saliva and TTO groups ( P &gt; .05). The frictional resistance was more in the CHX mouthwash group than in the TTO mouthwash group. Conclusions: Frictional resistance was lesser in the TTO mouthwash than in the CHX mouthwash. Based on this result, TTO mouthwash can be used instead of CHX mouthwash as an oral hygiene aid in patients with orthodontic treatments.