Differential Scanning Calorimetry (DSC) Analyses Of Superelastic And Nonsuperelastic Nickel-Titanium Orthodontic Wires

The purpose of this study was to determine the transformation temperatures for the austenitic, martensitic, and rhombohedral (R) structure phases in representative as-received commercial nitinol (NiTi) orthodontic wire alloys, to reconcile discrepancies among recent publications. Specimens were examined by differential scanning calorimetry (DSC) over a temperature range from approximately −170° C to 100° C, with a scanning rate of 10° C per minute. Two different pathways, with the intermediate R structure either absent or present, were observed for the transformation from martensitic to austenitic NiTi, whereas the reverse transformation from austenitic to martensitic NiTi always included the R structure. The enthalpy (ΔH) for the transformation from martensite to austenite ranged from 0.3 to 35 calories per gram. The lowest ΔH value for the nonsuperelastic Nitinol wire is consistent with a largely work-hardened, stable, martensitic microstructure in this product. The DSC results indicate that the transformation processes are broadly similar in superelastic, body-temperature shape-memory, and nonsuperelastic NiTi wires. Differences in bending properties for the NiTi orthodontic wires at room temperature and 37° C are due to the relative proportions of the metallurgical phases in the microstructures

The Reliability Of Facial Soft Tissue Landmarks With Photogrammetry

Introduction:With attention being given to the deleterious effects of radiation exposure from dental radiographs and inaccuracies in cephalometric soft tissue measurements, an alternative method of facial analysis with sufficiently reliable soft tissue landmarks should be developed. The goals of this study were threefold: (1) to define a new, low-cost method for capturing standardized frontal and sagittal facial images, (2) to determine on which photographic view that landmarks can be more reliably located, and (3) to determine which landmarks are appropriate for quantitative facial analysis. Materials and Methods:Simultaneous frontal and right sagittal facial images of 10 male and 10 female dental student subjects were captured using high-definition webcams as part of a low-cost set-up. Seventeen identical predefined facial soft tissue landmarks were located by 5 examiners on both types of images and were recorded as coordinate values. These coordinate values were used to calculate the best estimate of the true value for each landmark, mean deviation from this best estimate, and reliability in the X- and Y-axes using the Shrout-Fleiss intraclass correlation coefficient with corresponding 95% confidence intervals. Two examiners repeated the landmark location to evaluate intra-examiner reliability. Results:With a 95% confidence interval range of \u3e0.950, nose and mouth landmarks were among the most reliable landmarks on frontal and sagittal facial images. Converselyright soft tissue gonionwas one of the least reliable landmarks located in this study. In general, landmarks located by a single examiner showed greater reliability than when there were multiple examiners. Conclusions:This low-cost method yielded frontal and sagittal images sufficient for landmark identification. The magnitude of error varies between landmarks, is largest for poorly demarcated landmarks, and most had a non-circular envelope of error. Certain landmarks were more reliable on sagittal images and others were more reliable on frontal images. All landmarks had greater reliability and less mean deviation when located by a single examiner

Bonding with Self-etching Primers – Pumice or Pre-etch? An \u3cem\u3ein vitro\u3c/em\u3e Study

The purpose of this study was to compare the shear bond strengths (SBSs) of orthodontic brackets bonded with self-etching primer (SEP) using different enamel surface preparations. A two-by-two factorial study design was used. Sixty human premolars were harvested, cleaned, and randomly assigned to four groups (n = 15 per group). Teeth were bathed in saliva for 48 hours to form a pellicle. Treatments were assigned as follows: group 1 was pumiced for 10 seconds and pre-etched for 5 seconds with 37 per cent phosphoric acid before bonding with SEP (Transbond Plus). Group 2 was pumiced for 10 seconds before bonding. Group 3 was pre-etched for 5 seconds before bonding. Group 4 had no mechanical or chemical preparation before bonding. All teeth were stored in distilled water for 24 hours at 37°C before debonding. The SBS values and adhesive remnant index (ARI) score were recorded. The SBS values (±1 SD) for groups 1–4 were 22.9 ± 6.6, 16.1 ± 7.3, 36.2 ± 8.2, and 13.1 ± 10.1 MPa, respectively. Two-way analysis of variance and subsequent contrasts showed statistically significant differences among treatment groups. ARI scores indicated the majority of adhesive remained on the bracket for all four groups. Pre-etching the bonding surface for 5 seconds with 37 per cent phosphoric acid, instead of pumicing, when using SEPs to bond orthodontic brackets, resulted in greater SBSs

Do the Mechanical and Chemical Properties of Invisalign\u3csup\u3eTM\u3c/sup\u3e Appliances Change After Use? A Retrieval Analysis

Aim: To investigate the mechanical and chemical alterations of Invisalign appliances after intraoral aging. Materials and methods: Samples of Invisalign appliances (Align Technology, San Jose, California, USA) were collected following routine treatment for a mean period of 44±15 days (group INV), whereas unused aligners of the same brand were used as reference (group REF). A small sample from the central incisors region was cut from each appliance and the buccal surface was analysed by attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy (n = 5). Then the appliances were cut (n = 25) and embedded in acrylic resin, ground/polished in a grinding polishing machine, and the prepared surfaces were subjected to Instrumented Indentation Testing under 4.9 N load. Force-indentation depth curves were recorded for each group and the following parameters were calculated according to ISO 14577-1; 2002 specification: indentation modulus (E IT), elastic to total work ratio also known as elastic index (ηIT), Martens Hardness (HM), and indentation creep (C IT) The mean values of the mechanical properties were statistically analysed by unpaired t-test (a = 0.05). Results: ATR-FTIR analysis confirmed the urethane based structure of the appliances, without important chemical differences attributed to the aging process. INV group showed significantly lower E IT (REF: 2466±20, INV: 2216±168MPa), HM (REF: 119±1, INV: 110±6 N mm−2) and higher ηIT (REF: 40.0±0.3, INV: 41.5±1.2%), and C IT (REF: 3.7±0.2 INV: 4.0±0.1%). The increase in ηIT indicates that INV is a more brittle than REF, whereas the increase in C IT, a decrease in creep resistance. Conclusion: Despite the lack of detectable chemical changes, intraoral aging adversely affected the mechanical properties of the Invisalign appliance

Bonding with Self-etching Primers – Pumice or Pre-etch? An \u3cem\u3ein vitro\u3c/em\u3e Study

The purpose of this study was to compare the shear bond strengths (SBSs) of orthodontic brackets bonded with self-etching primer (SEP) using different enamel surface preparations. A two-by-two factorial study design was used. Sixty human premolars were harvested, cleaned, and randomly assigned to four groups (n = 15 per group). Teeth were bathed in saliva for 48 hours to form a pellicle. Treatments were assigned as follows: group 1 was pumiced for 10 seconds and pre-etched for 5 seconds with 37 per cent phosphoric acid before bonding with SEP (Transbond Plus). Group 2 was pumiced for 10 seconds before bonding. Group 3 was pre-etched for 5 seconds before bonding. Group 4 had no mechanical or chemical preparation before bonding. All teeth were stored in distilled water for 24 hours at 37°C before debonding. The SBS values and adhesive remnant index (ARI) score were recorded. The SBS values (±1 SD) for groups 1–4 were 22.9 ± 6.6, 16.1 ± 7.3, 36.2 ± 8.2, and 13.1 ± 10.1 MPa, respectively. Two-way analysis of variance and subsequent contrasts showed statistically significant differences among treatment groups. ARI scores indicated the majority of adhesive remained on the bracket for all four groups. Pre-etching the bonding surface for 5 seconds with 37 per cent phosphoric acid, instead of pumicing, when using SEPs to bond orthodontic brackets, resulted in greater SBSs

Salivary inflammatory biomarkers during initial orthodontic tooth movement

BACKGROUND: Orthodontic tooth movement is a complex process involving a number of inflammatory and anabolic/catabolic pathways. Further, successful treatment depends on proper timing of orthodontic measures with regard to patient’s growth spurt. Saliva analysis has emerged as a non-invasive collection method to track biomarkers relevant to both tooth movement biology and growth prediction. The aim of the present study was to analyze changes in tooth movement and assess relationships with salivary levels of alkaline phosphatase, IGF-1, TGF-β1, testosterone, BMP-2, BMP-4, and BMP-9t. METHODS: Twenty seven healthy patients (17 females, 10 males) with a mean age of 13.3 years, undergoing orthodontic treatment with a non-extraction treatment plan were selected for the study. Height, weight, and other demographic features were recorded; maxillary and mandibular alginate impressions were obtained, and 10 mL saliva samples were taken at the initial visit (T0), after 4 weeks (T1), 3 months (T2), and then at 3-month intervals (T3, T4, T5). Casts were made from alginate impressions. Little’s Irregularity Index, intercanine widths, intermolar widths, arch lengths, and tooth widths were measured. Saliva samples were analyzed for the concentrations of alkaline phosphatase, IGF-1, TGF-β1, testosterone, BMP-2, BMP-4, and BMP-9 by multiplex immunoassay and/or ELISA. Data were analyzed using correlation coefficients and ANOVA. RESULTS: Over the six timepoints, there were statistically significant changes in the level of testosterone (p < 0.05) and Little’s Irregularity Index (p < 0.01), with the most significant changes occurring at the beginning of treatment (T0 to T1). Statistically significant correlations (p < 0.05) were observed between testosterone and height/weight, intercanine width and intermolar width, BMP-4 and intercanine/intermolar width, alkaline phosphatase and testosterone, alkaline phosphatase and TGF-β1, and among the BMPs. CONCLUSION: The changes in Little’s Irregularity Index reflects successful progress of the orthodontic treatment. The correlations observed among the various salivary concentrations suggest a number of further directions for study

3D-printing techniques in a medical setting : a systematic literature review

Background: Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. Methods: Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. Results: 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. Conclusion: 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D- printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis

Fracture of the tibial baseplate in bicompartmental knee arthroplasty

Introduction. Bicompartmental knee arthroplasty (BKA) addresses combined medial and patellofemoral compartment osteoarthritis, which is relatively common, and has been proposed as a bridge between unicompartmental and total knee arthroplasty (TKA). Case Presentation. We present the case report of a young active man treated with BKA after unsuccessful conservative therapy. Four years later, loosening with fracture of the tibial baseplate was identified and the patient was revised to TKA. Discussion. Although our case is only the second fractured tibial baseplate to be reported, we believe that the modular titanium design, with two fixation pegs, is too thin to withstand daily cyclic loading powers. Light daily routine use, rather than high-impact sports, is therefore advised. Failures may also be related to the implant being an early generation and known to be technically complex, with too few implant sizes. We currently use TKA for the treatment of medial and patellofemoral compartment osteoarthritis