The Biological Effects of 3D Resins Used in Orthodontics: A Systematic Review

Three-dimensional (3D) resin medical-dental devices have been increasingly used in recent years after the emergence of digital technologies. In Orthodontics, therapies with aligners have gained popularity, mainly due to the aggressive promotion policies developed by the industry. However, their systemic effects are largely unknown, with few studies evaluating the systemic toxicity of these materials. The release of bisphenol A and other residual monomers have cytotoxic, genotoxic, and estrogenic effects. This systematic review aims to analyze the release of toxic substances from 3D resins used in Orthodontics and their toxic systemic effects systematically. The PICO question asked was, “Does the use of 3D resins in orthodontic devices induce cytotoxic effects or changes in estrogen levels?”. The search was carried out in several databases and according to PRISMA guidelines. In vitro, in vivo, and clinical studies were included. The in vitro studies’ risk of bias was assessed using the guidelines for the reporting of pre-clinical studies on dental materials by Faggion Jr. For the in vivo studies, the SYRCLE risk of bias tool was used, and for the clinical studies, the Cochrane tool. A total of 400 articles retrieved from the databases were initially scrutinized. Fourteen articles were included for qualitative analysis. The risk of bias was considered medium to high. Cytotoxic effects or estrogen levels cannot be confirmed based on the limited preliminary evidence given by in vitro studies. Evidence of the release of bisphenol A and other monomers from 3D resin devices, either in vitro or clinical studies, remains ambiguous. The few robust results in the current literature demonstrate the absolute need for further studies, especially given the possible implications for the young patient’s fertility, which constitutes one of the largest groups of patients using these orthodontic devices.

Construction of Customized Palatal Orthodontic Devices on Skeletal Anchorage Using Biomechanical Modeling

Orthodontic implants have been developed for the implementation of skeletal anchorage and are effectively used in the design of individual orthodontic devices. However, despite a significant amount of clinical research, the biomechanical aspects of the use of skeletal anchorage have not been adequately studied. The aim of this work was to numerically investigate the stress–strain state of the developed palatal orthodontic device supported by mini-implants. Four possible options for the placement of mini-implants in the bone were analyzed. The effect of a chewing load of 100 N on the bite plane was investigated. The study was carried out using biomechanical modeling based on the finite element method. The installation of the palatal orthodontic device fixed on mini-implants with an individual bite plane positioned on was simulated. The dependence of equivalent stresses and deformation changes on the number and location of the supporting mini-implants of the palatal orthodontic device was investigated. Two materials (titanium alloy and stainless steel) of the palatal orthodontic device were also investigated. The choice of a successful treatment option was based on the developed biomechanical criteria for assessing the surgical treatment success. Application of the criteria made it possible to estimate the stability and strength of fixation of each of the considered mini-implants installation options. As a result, options for the mini-implants optimal placement were identified (the first and the fourth which provide distributed front and side support of the device), as well as the preferred material (titanium alloy) for the manufacture of the palatal orthodontic device.

Use of domestic light-cured polymer at production of removable orthodontic devices

The purpose of work was the clinical laboratory research, identification of reaction of local immunity mucous a mouth, indicators of globulins fraction on carrying within 6 months of the removable orthodontic device from domestic light-cured polymer at children. Immunoglobulins of three classes IgM, IgG, IGA and calculated values of sIgA and sc (free secretory component) were investigated. Contents sekretorny IgA (sIgA) and a free secretory component (sc) is especially important. Results were estimated by V.V. Zverev’s technique et al. (2011) [6]. Results showed that immunoglobulins changed individually at each patient within one extent of dysbiotic disorders that is connected with an initial situation of a condition of oropharynx of the child which had no considerable fluctuations within one degree of a condition of a microbiota of a mucous oropharynx of the child. The bioinertness of Nolatek photopolymer in the form of basic material of the orthodontic device is established. Light-cured domestic nanostructural polymer has high quality of the operational properties in children’s practice of clinic of orthodontics conforming to modern requirements for bioinertness, an esthetics and functionality.

Properties of Orthodontic Clear Aligner Materials - A Review

BACKGROUND Clear aligners are orthodontic devices that are transparent, a plastic used to correct malaligned teeth. Here patient wears a series of customized clear, removable aligners that gradually move the teeth to the desired position. The clear aligner system is a modern adaptation of the systems described since the middle of the 20th century, therefore there were different devices and philosophies that have led to its creation and the system has evolved a lot over the decades. Clear aligner therapy has been a part of the orthodontic practice for years, but, popularity was increased since the introduction of Invisalign appliances (Align Technology) in 1998. There are almost 27 different clear aligner products currently on offer for orthodontic treatment. Nowadays, more people prefer clear aligner treatment because it is aesthetically superior to brackets and lingual orthodontics. The superiority of clear aligners lies in their aesthetics. The optical properties of the clear aligner material play a major role in aesthetics. The rising demand among adult patients for “invisible” orthodontic treatment has led to an exponential growth in the clear aligner market. Indeed, these aligners have a low aesthetic impact, as well as being able to effectively and progressively guide the teeth into their programmed positions. They are also removable and therefore do not hamper oral hygiene maintenance, in turn reducing the risk of white spots, caries, gingivitis and periodontal disease. All the materials do not possess the same chemical composition. The properties change before and after wear. In this article, we bring out the different materials used for the manufacture of clear aligners and their various properties. KEY WORDS Clear Aligners, Optical Properties, Thermoplastic Material, Mechanical Properties

Digital (R)Evolution: Open-Source Softwares for Orthodontics

Among the innovations that have changed modern orthodontics, the introduction of new digital technologies in daily clinical practice has had a major impact, in particular the use of 3D models of dental arches. The possibility for direct 3D capture of arches using intraoral scanners has brought many clinicians closer to the digital world. The digital revolution of orthodontic practice requires both hardware components and dedicated software for the analysis of STL models and all other files generated by the digital workflow. However, there are some negative aspects, including the need for the clinician and technicians to learn how to use new software. In this context, we can distinguish two main software types: dedicated software (i.e., developed by orthodontic companies) and open-source software. Dedicated software tend to have a much more user-friendly interface, and be easier to use and more intuitive, due to being designed and developed for a non-expert user, but very high rental or purchase costs are an issue. Therefore, younger clinicians with more extensive digital skills have begun to look with increasing interest at open-source software. The aim of the present study was to present and discuss some of the best-known open-source software for analysis of 3D models and the creation of orthodontic devices: Blue Sky Plan, MeshMixer, ViewBox, and Blender.

Uncovering and Autonomous Eruption of Palatally Impacted Canines—A Case Report

The impaction of permanent maxillary canine is a common clinical occurrence, and it is observed in 2% of patients who require orthodontic treatment. This case report describes a new orthodontic-surgical approach through the use of CO2 laser, for the exposure of the palatally impacted canines. A 13-year-old female referred to our observation to make an orthodontic examination because of the maxillary primary canines’ persistence in upper arch. Orthopanoramic X-ray showed impaction of both permanent maxillary canines. The family history revealed that the patient’s mother had the same orthodontic problem. Cone Beam Computer Tomography (CBCT) was requested to plan the surgical-orthodontic treatment. Surgical exposure of the impacted canines was performed using a CO2 laser and subsequent periodontal pack application. No orthodontic devices were applied for impacted teeth traction on dental arch. Canines’ movement was monitored at 1, 8 and 16 weeks post-surgery with photo and intraoral scanner CS3500 (CS3500®, Carestream Health, Atlanta, GA, USA). When canine crowns were completely erupted on palatal side, the alignment in the arch with indirect bonding technique was performed. Complete disimpaction of canine crowns was obtained in only four months. As reported in the literature, this case confirms that impacted canines’ exposure to CO2 laser has advantages if compared with traditional surgery: no bleeding during and after the procedure, decontaminant effect on the surgical area, no suture, and a fast spontaneous eruption. Conclusions: The pre-orthodontic uncovering and autonomous eruption of palatally impacted maxillary canines provides simplified, predictable, and more aesthetic outcomes. Furthermore, a significant positive factor is that there is no need to carry out the orthodontic traction of the impacted element, undoubtedly better compliance by the patient during the next alignment phase with the fix orthodontic appliance.

Disinclusion of Palatally Impacted Canines with Surgical and Photobiomodulating Action of a Diode Laser: Case Series

Background: The permanent maxillary canine is the most impacted tooth after third molars. There are many possible surgical techniques to approach impacted canines. The literature reports that high-intensity laser therapies (HILTs) can be used for opercolectomy of an impacted tooth. The aim of this study is to propose a new orthodontic-surgical approach using a laser for the disinclusion of palatally impacted canines. Methods: Nine patients presented maxillary primary canine persistence in the dental arch. Orthopanoramic X-ray and cone beam computed tomography (CBCT) showed the impaction of permanent maxillary canines. Surgical exposure was performed using a diode laser (Raffaello, DMT, Lissone, Italy, 980 nm + 645 nm). No orthodontic devices were applied for impacted tooth traction. Canine movement was monitored at 1, 8, 16 weeks post-surgery with photos and a CS3500 intraoral scanner (Carestream Dental, Atlanta USA) to evaluate their autonomous eruption. Results: No complications were observed. In all the cases, complete disimpaction of the treated canines was obtained in only four months. Conclusions: Impacted canine exposure with a diode laser has many advantages if compared with traditional surgery. The pre-orthodontic exposure and autonomous eruption of impacted canines provided simplified and predictable outcomes. The absence of traction and the reduced time for orthodontic treatment increased compliance during the orthodontic alignment.

THE ROLE OF ORTHODONTIC CARE IN THE COMPLEX REHABILITATION OF GLOSSECTOMY PATIENTS

n recent years, Russia has seen an increase in the incidence of malignant tumors of the mouth and throat, including tongue cancer. Surgical methods of treatment of cancer of such localization have a crippling character and inevitably lead to disruption of a number of vital functions, including the development of tooth-jaw deformities, which further deteriorates the quality of life of such patients. Timely prescription of orthodontic devices for prophylactic and therapeutic purposes allows to prevent the development of tooth jaw abnormalities and deformities, as well as to treat the already developed pathology.

Effect of non-removable orthodontic devices on the condition of solid dental tissues

We carried out the analysis of solid dental tissue among 50 patients at different stages of orthodontic treatment using brace systems made of materials, which are used most often in the process of bite correction. We determined the hygiene index (OHI-S), saliva buffer capacity and its immunoreactive properties, caries intensity to explain the development of demineralization. We conducted the study using ligature and self-ligating ceramic and metal brace systems. The examination revealed a clear tendency to imbalance in the local immune response of the body, deterioration of hygienic status in patients during the period of noted orthodontic treatment, as well as noticeable changes in the structure of solid tooth tissues. There is a noticeable development of pathological processes depending on the duration of treatment, and then a regressive effect in relation to hygienic deviations in tracking the retinal period. These studies have proved the pathogenetic effect of edgewise technology, mainly ligature representatives, on the general state of the oral cavity, including the body as a whole, which leads to the importance of the introduction of permanent preventive hygienic events and the implementation of treatment in conjunction with dental doctors of other directions.