Esthetic Brackets Research Articles

Mechanical properties of orthodontic wires on ceramic brackets associated with low friction ligatures

Abstract Introduction Few studies investigated the mechanical properties of orthodontic wires on ceramic brackets associated the ligatures. Objective This study aimed to compare the load-deflection of orthodontic wires with round section of 0.016” made of stainless steel (SS), nickel-titanium (NiTi) and glass fiber-reinforced polymer composite (GFRPC). Material and method Sixty specimens obtained from 10 sectioned pre-contoured arches (TP Orthodontics), were divided into 3 groups of 20 according to each type of material (1 esthetic-type wire and 2 not esthetic) and length of 50 mm. The methodology consisted of a 3-point bending test using esthetic ceramic brackets (INVU, TP Orthodontics, Edgewise, 0.022”x 0.025”) as points of support. The tensile tests were performed on a mechanical test machine, at a speed of 10 mm/min, deflection of 1 mm, 2 mm and 3 mm. Friedman’s Non Parametric Multiple comparisons test was used (P<0.05). Result The nickel-titanium wire presented smaller load/ deflection compared with stainless steel. GFRPC wires had lower strength values among all groups evaluated (P<.05). The steel wire showed permanent deformation after 3 mm deflection, NiTi wire demonstrated memory effect and the esthetic type had fractures with loss of strength. Conclusion It can be concluded that steel wires have high strength values, requiring the incorporation of loops and folds to reduce the load / deflection. NiTi and GFRPC wires produced low levels of force, however the esthetic wire was shown to fracture and break.

Assessment of Enamel Surface after Debonding of Different Types of Esthetic Brackets : An in Vitro Study

Background: Debonding orthodontic brackets and removal of residual bonding material from the enamel surface include critical steps that may cause enamel damage. The aim of the present study was to evaluate and compare the site of bond failure and enamel surface damage after debonding of three types of esthetic brackets (composite, ceramic, sapphire) bonded with light cure composite and resin-modified glass ionomer adhesive. Materials and methods: Seventy two maxillary premolars teeth were divided into three groups each group consisted of 24 teeth according to the type of brackets. Each group was subdivided into two subgroups (12 teeth for each) according to the bonding material that was used. After 7 days of bonding procedure, the brackets were debonded using specifically designed debonding device in which the brackets were debonded by a debonding pliers to simulate the actual clinical debonding procedure. Instron Universal testing was used to apply the debonding force on the debonding pliers which transferred to the bracket. The teeth and the brackets were examined with a 10X magnifying lens to evaluate the site of failure. After the removal of residual adhesive, stereomicroscope was used to evaluate enamel surface damage. Results: The most common type of bond failure was cohesive failure (Score II) in all esthetic brackets. While enamel cracks (scale I) were found to be the most type of enamel damage. Chi- square showed non-significant differences among different types of esthetic bracket bonded with same type of adhesive and between the same types of brackets (ceramic, sapphire) bonded with the two types of adhesive. On the other hand, there was significant difference between composite brackets subgroups bonded with the two adhesives. Conclusion: The bond failure mostly within the adhesive itself and higher enamel damage was resulted from mechanical debonding of these esthetic brackets.

Esthetic perception of orthodontic appliances by Brazilian children and adolescents.

ABSTRACTObjective: The objective of this present study was to understand how children and adolescents perceive esthetic attractiveness of a variety of orthodontic appliances. It also analyzed preferences according to patients' age, sex and socioeconomic status. Methods: A photograph album consisting of eight photographs of different orthodontic appliances and clear tray aligners placed in a consenting adult with pleasing smile was used. A sample of children or adolescents aged between 8 and 17 years old (n = 276) was asked to rate each image for its attractiveness on a visual analog scale. Comparisons between the appliances attractiveness were performed by means of nonparametric statistics with Friedman's test followed by Dunn's multiple comparison post-hoc test. Correlation between appliances and individuals' socioeconomic status, age, sex, and esthetic perception was assessed by means of Spearman's correlation analysis. Results: Attractiveness ratings of orthodontic appliances varied nonsignificantly for children in the following hierarchy: traditional metallic brackets with green elastomeric ligatures > traditional metallic brackets with gray elastomeric ligatures > sapphire esthetic brackets; and for adolescents, as follows: sapphire esthetic brackets > clear aligner without attachments > traditional metallic brackets with green elastomeric ligatures. The correlation between individuals' socioeconomic status and esthetic perception of a given appliance was negative and statistically significant for appliances such as the golden orthodontic brackets and traditional metallic brackets with green elastomeric ligatures. Conclusion: Metal appliances were considered very attractive, whereas aligners were classified as less attractive by children and adolescents. The correlation between esthetic perception and socioeconomic status revealed that individuals with a higher socioeconomic level judged esthetics as the most attractive attribute. For those with higher economic status, golden orthodontic brackets and traditional metallic brackets with green elastomeric ligatures were assessed as the worst esthetic option.

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

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

Translucency and color match with a shade guide of esthetic brackets with the aid of a spectroradiometer

ABSTRACTObjective: Since the color of esthetic brackets should match that of teeth, the aims of this study were to determine the color and translucency of esthetic brackets by means of the clinically relevant use of a spectroradiometer, and to compare the color of brackets with that of a commercial shade guide. Methods: The color of central and tie-wing regions of four plastic and four ceramic brackets was measured according to the CIE L*a*b* color scale over white and black backgrounds. Brackets were classified into five groups based on their composition. The color of Vitapan Classical Shade Guide tabs was also measured. Translucency parameter (TP) and contrast ratio (CR) were calculated to determine translucency. Results: Color differences between brackets and the shade guide tabs were 10.4 - 34.5 ∆E*ab units. TP and CR values for the central region were 16.4 - 27.7 and 0.38 - 0.58, whereas for the tie-wings they were 24.0 - 39.9 and 0.25 - 0.45, respectively. The color coordinates, TP and CR values were significantly influenced by bracket composition and brand (p < 0.05). Conclusions: Esthetic brackets investigated herein showed unacceptable color differences (∆E*ab > 5.5) compared with the shade guide tabs. Differences in the translucency of brackets by brand were within the visually perceptible range (∆CR > 0.07). Therefore, brackets showing the best matching performance for each case should be selected considering esthetic and functional demands.

Evaluating the Type of Light Transmittance in Mono Crystalline, Poly Crystalline and Sapphire Brackets- An Invitro Spectrofluorometer Study.

Most of the patients seek orthodontic treatment to improve the smile, which improves the facial profile by means of fixed appliances i.e., brackets and wires. The brackets are of different types like stainless steel and ceramic. Ceramic brackets were considered as aesthetic appliance which was divided into mono-crystalline, polycrystalline and sapphire brackets. The light transmittance might influence the degree of curing adhesive material in mono crystalline, polycrystalline and sapphire brackets. The aim of the present study was to evaluate the translucency and intensity of three different aesthetic brackets (mono crystalline, poly crystalline and sapphire ceramic brackets) and to determine their influence on shear bond strength of the brackets. The adhesive remnant index was also measured after debonding of the brackets from the tooth surface. Twenty six samples each of monocrystalline, polycrystalline and sapphire brackets (total 78 ceramic brackets) were used for the study. The bracket samples were subjected to optical fluorescence test using spectrofluorometer to measure the intensity of the brackets. Seventy eight extracted premolar teeth were procured and divided into 3 groups. The brackets were then bonded to the tooth using Transbond XT (3M Unitek) light cure composite material and cured with new light cure unit (Light Emitting Diode) of wood pecker company (400-450nm) for 30 seconds, and these samples were subjected to shear bond strength test with Instron Universal Testing Machine (UNITEK-94100) with a load range between 0 to 100 KN with a maximum cross head speed of 0.5mm/min. ARI (Adhesive Remnant Index) scores were evaluated according to Artun and Bergland scoring system using stereomicroscope at 20x magnification. The light absorption values obtained from spectrofluorometeric study were 3300000-3500000 cps for group 1 (monocrystalline ceramic brackets), 6000000-6500000 cps for Group 2 (polycrystalline ceramic brackets) and 2700000 -3000000 cps for Group 3 (sapphire ceramic brackets) i.e., Group 2 showed the highest light absorption and the least translucency followed by groups 1 and 3. Shear bond strength results were 2.4 mpa, 1.9 mpa and 3.6 mpa for groups 1,2 and 3 respectively. Superior shear bond strength was recorded in group 3 (sapphire ceramic brackets). ARI results showed that group 3 had increased bond between bracket adhesive interfaces when compared to the other 2 groups. From this study, it has been concluded that sapphire ceramic brackets (Group 3) was superior in translucency and shear bond strength followed by monocrystalline and polycrystalline ceramic brackets.

Evaluation of Frictional Forces between Different Aesthetic Brackets and Arch Wires during Leveling and Alignment Stage

Evaluation of Frictional Forces between Different Aesthetic Brackets and Arch Wires during Leveling and Alignment Stage

Bacterial load assessment in metallic versus esthetic brackets

Objective: To assess the bacterial load in metallic and ceramic brackets and determine which favor dental plaque retention. Material and methods: Extracted premolars divided into 2 groups and analyzed. In one group metal brackets were placed and in the other group, ceramic brackets. Results: Statistical analysis were performed and it was determined that there was no significant difference. Conclusion: The type of bracket used in the orthodontic treatment, is not a determining factor in bacteria adhesion and therefore plaque accumulation as long as proper hygiene is maintained. Key words: Ceramic brackets, metallic brackets, colony-forming unit (UFC), bacterial load.

Staining of esthetic brackets by plaque disclosing solutions

Staining of esthetic brackets by plaque disclosing solutions

Evolution of treatment mechanics and contemporary appliance design in orthodontics: A 40-year perspective.

Until the early 1970s, successful treatment with the Begg technique and the Tweed edgewise technique required tedious wire bending. The introduction of Andrews' straight wire appliance changed that, and it was one of the most significant contributions in the history of orthodontics. The straight wire appliance significantly reduced the amount of wire bending and also brought along other options in treatment mechanics. Retraction of the canines with elastic chains and ligature wires became more common. Sliding mechanics in place of closing loops became the method of space closure for a significant number of clinicians. Edgewise force levels were initially used to close spaces; however, it was soon observed that lighter forces were more effective with sliding mechanics. Along with these changes, it became apparent that compensation in the appliance was needed, depending on the type of malocclusion and particularly with varying extraction sequences. Various appliance designs were developed to accommodate changes in mechanics and force levels. These modifications improved tooth positions at the end of treatment as long as the brackets were properly placed. These major changes in appliances, force levels, and treatment mechanics can be traced back to the work of Dr Lawrence Andrews and the straight wire appliances.

Evaluation of mechanical properties of esthetic brackets.

Plastic brackets, as well as ceramic brackets, are used in various cases since they have excellent esthetics. However, their mechanical properties remain uncertain. The purpose of this study was to determine how deformation and stress distribution in esthetic brackets differ among materials under the same wire load. Using the digital image correlation method, we discovered the following: (1) the strain of the wings of plastic brackets is within 0.2% and that of ceramic and metal brackets is negligible, (2) polycarbonate brackets having a stainless steel slot show significantly smaller displacement than other plastic brackets, and (3) there is a significant difference between plastic brackets and ceramic and stainless steel brackets in terms of the displacement of the bracket wing.

Comparison of frictional resistance of esthetic and semi-esthetic self-ligating brackets

Aim:The frictional resistance encountered during sliding mechanics has been well established in the orthodontic literature, and it consists of complex interactions between the bracket, archwire, and method of ligation the claim of reduced friction with self-ligating brackets is often cited as a primary advantage over conventional brackets. This study was done to compare and evaluate the frictional forces generated between fully esthetic brackets and semi-aesthetic self-ligating brackets, which are of passive form and SEM (scanning electron microscope) study of the Brackets after Frictional evaluation.Materials and Methods:Two types of self-ligating esthetic brackets, Damon clear (Ormco) made of fully ceramic and Opal (Ultradent Products, USA) and, Two types of self-ligating semi-esthetic brackets, Clarity SL (3M Unitek) and Damon 3 (Ormco) both of which are made of ceramic with metal slot. Arch wires with different dimensions and quality 17 × 25, 19 × 25 Titanium Molybdenum Alloy (TMA) and 17 × 25, 19 × 25 stainless steel that came from plain strands of wire were used for frictional comparison test. The brackets used in this study had 0.022 × 0.028 inch slot.Results:The statistical tests showed significantly smaller amount of kinetic frictional forces is generated by Damon 3 (semi-esthetic self-ligating brackets). For each wire used, Damon 3 displayed significantly lower frictional forces (P ≤ 0.05) than any of the self-ligating system, followed by Opal (fully esthetic self-ligating brackets) which generated smaller amount of frictional forces but relatively on the higher side when compared with Damon 3. Damon clear (fully esthetic self-ligating brackets) generated the maximum amount of kinetic forces with all types of wire dimensions and properties when compared to the other three types of self-ligating system. Clarity SL (semi-esthetic self-ligating brackets) generated smaller amount of frictional forces when compared with Damon clear and relatively higher amount of frictional forces when compared to Opal and Damon 3

Effect of different staining materials on color stability of sapphire brackets bonded with different types of light cure orthodontic adhesives (An in vitro study)

Background: The demand for better esthetic during orthodontic treatment has increased nowadays, so orthodontists starting using esthetic arch wires, brackets and ligatures.Tooth colored brackets were introduced in different types of materials. Sapphire ceramic brackets are one type of esthetic brackets and their color stability remains the main concern for the clinicians and patients at the same time. The present study design to evaluate the effect of three different staining materials (pepsi, black tea and cigarette smoke) on the stainability of sapphire ceramic brackets bonded with three types of light cure orthodontic adhesives which include: Resilience, Enlight and Transbond. Materials and Methods: The sample consisted of three hundred sixty sapphire brackets. The brackets were divided according to bonding materials into three groups each group consist of one hundred twenty brackets, then each subgroup farther subdivided into four groups according to the material they were immersed (distilled water, black tea, Pepsi and cigarette smoke) with thirty brackets each, then Each group with ten brackets farther subdivided according to time interval of immersion in each media into three groups one day, seven days and fourteen days at 37°C in the incubator.A UV-Visible spectrophotometer (Shimadzu, UV -1800) was used to perform a light absorption test. Results: ANOVA and LSD post Hoc tests were used to identify the significant effects of the staining materials at a significance level P ≤ 0.05.It was found that the immersion time gradually influenced the color stability of the adhesive materials with sapphire brackets with the highest activity observed at fourteen days interval. The brackets bonded with Resilience light cure adhesive are the most type affected by staining materials, then followed by the brackets bonded with Transbond and finally the brackets bonded with Enlight light cure adhesive. For the staining materials it was found that the cigarette smoke is the most powerful staining material, followed by tea and finally pepsi. Conclusions: From the above result we can conclude that the type of adhesive must take in consideration when the esthetic brackets have been used.

Immediate Replacement of an Esthetic Bracket

Immediate Replacement of an Esthetic Bracket

Frictional resistance of aesthetic brackets

The aim of this study was to evaluate and compare the static frictional forces produced by monocrystalline ceramic (sapphire) bracket and polycrystalline ceramic bracket. Materials and methods: one hindered twenty brackets/segment of archwire combinations were used, each bracket/segment of archwire combination was tested 10 times. The tests were performed in a universal testing Instron machine. The data was submitted to in depended t-test. Results: The independent sample t-tests showed a highly significant difference in the static frictional forces between monocrystalline ceramic (sapphire) bracket and polycrystalline ceramic bracket. Conclusion: According to the biomechanical result gained from the present study, the monocrystalline ceramic (sapphire) brackets produced lower static friction level than polycrystalline ceramic bracket.

Discoloration of Aesthetic Bracket by Mouth Washes

Discoloration of Aesthetic Bracket by Mouth Washes

Staining of esthetic brackets by plaque disclosing solutions

Aim: To evaluate the staining of esthetic orthodontic brackets by plaque disclosing solutions. Methods: Two types of brackets manufactured by GAC/DENTSPLY® were evaluated: ceramic (n=30) and polycarbonate (n=30). The brackets were divided into 6 groups. Two control groups (n=6) were immersed in absolute ethanol: GI - ceramic brackets and GII - polycarbonate brackets. Four experimental groups (n=12) were immersed in different plaque disclosing solutions: GIII (ceramic brackets) and GIV (polycarbonate brackets) were immersed in Replak®; GV (ceramic brackets) and GVI (polycarbonate brackets) were immersed in Replasul “S”®. Relative quantitative analysis of the influence of plaque disclosing tablets on bracket staining was performed using reflectance spectrophotometry of stain deposition. Exploratory analysis of the data was performed using Analysis of Variance (ANOVA) in a 2x2 factorial setup (bracket x immersion) with additional treatments (controls). Results: The results demonstrated that the ceramic brackets presented the highest amount of staining when Replasul “S”® was used (pd”0.05). However, when Replak® was used, no statistically significant difference was found in comparison with the control group (p>0.05). For polycarbonate brackets, staining was detected for both disclosing solutions (p>0.05). Conclusions: The disclosing solutions caused stain formation on polycarbonate brackets and, under the tested conditions, use of Replak® on ceramic brackets did not cause staining.

Comparison of friction among low-friction ligation, conventional ligation and self ligation with conventional stainless steel and esthetic brackets – an in vitro study

BackgroundAmong the numerous factors affecting friction between the bracket-archwire interface, the method of ligation is one of the most important. A number of ways have been proposed to reduce this friction, including self-ligating brackets and more recently Slide™ (Leone SpA, Firenze, Italy) low-friction ligatures. This study aims to compare the frictional forces generated by three different ligation methods; conventional ligation, self ligation and Slide low-friction ligation, using metallic and ceramic brackets. Materials and methodsThree models with 10 aligned brackets (standard, self-ligating and ceramic) were used with conventional and low-friction ligatures to study the frictional resistance generated with 0.016″ Nitinol (NiTi) and 0.019 × 0.025″ Stainless steel (SS) wires. ResultsConventional ligation produced the greatest friction regardless of wire or bracket combination used. With smaller round wires, the self-ligating system exhibited less friction than low-friction ligation and with higher dimension archwires it exhibited greater friction. Slide low-friction ligatures were able to reduce the friction of ceramic brackets in a similar way to stainless steel brackets. ConclusionSlide low-friction ligatures produced a reduction in friction with both metallic and ceramic brackets to a level comparable to that of self-ligating brackets.

Liquid crystalline epoxy nanocomposite material for dental application

Novel liquid crystalline epoxy nanocomposites, which exhibit reduced polymerization shrinkage and effectively bond to tooth structures, can be applied in esthetic dentistry, including core and post systems, direct and indirect restorations, and dental brackets. The purposes of this study were to investigate the properties of liquid crystalline epoxy nanocomposites including biocompatibility, microhardness, and frictional forces of bracket-like blocks with different filler contents for further clinical applications. In this study, we evaluated liquid crystalline epoxy nanocomposite materials that exhibited various filler contents, by assessing their cell activity performance using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and their microhardness with or without thermocycling. We also evaluated the frictional force between bracket-like duplicates and commercially available esthetic bracket systems using Instron 5566. The liquid crystalline epoxy nanocomposite materials showed good biocompatibility. The materials having high filler content demonstrated greater microhardness compared with commercially available bracket materials, before and after the thermocycling treatment. Thus, manufacturing processes are important to reduce frictional force experienced by orthodontic brackets. The microhardness of the bracket-like blocks made by our new material is superior to the commercially available brackets, even after thermocycling. Our results indicate that the evaluated liquid crystalline epoxy nanocomposite materials are of an appropriate quality for application in dental core and post systems and in various restorations. By applying technology to refine manufacturing processes, these new materials could also be used to fabricate esthetic brackets for orthodontic treatment.

Comparison of Friction among Low-friction Ligation, Conventional Ligation and Self-ligation with Conventional-Stainless Steel and Esthetic Brackets: An in vitro Study

Comparison of Friction among Low-friction Ligation, Conventional Ligation and Self-ligation with Conventional-Stainless Steel and Esthetic Brackets: An in vitro Study