Objectives: To investigate and compare the characteristics of commonly used types of traditional and heat-activated initial archwire by plotting their load/deflection graphs and quantifyin...

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Load deflection characteristics and force level of nickel titanium initial archwires.

Metallic biomaterials have been extensively used in orthodontics throughout history. Gold, stainless steel, cobalt-chromium alloys, titanium and its alloys, among other metallic biomaterials, have been part of the orthodontic armamentarium since the twentieth century. Metals and alloys possess outstanding properties and offer numerous possibilities for the fabrication of orthodontic devices such as brackets, wires, bands, ligatures, among others. However, these materials have drawbacks that can present problems for the orthodontist. Poor friction control, allergic reactions, and metal ionic release are some of the most common disadvantages found when using metallic alloys for manufacturing orthodontic appliances. In order to overcome such weaknesses, research has been conducted aiming at different approaches, such as coatings and surface treatments, which have been developed to render these materials more suitable for orthodontic applications. The purpose of this paper is to provide an overview of the coating and surface treatment methods performed on metallic biomaterials used in orthodontics.

https://www.mdpi.com/2079-6412/3/1/1/pdf/1

Coating and Surface Treatments on Orthodontic Metallic Materials

Thermodynamic nickel-titanium (NiTi) wires have become increasingly popular. The relationship between the temperature variation within the mouth and the force level delivered is, however, far from elucidated. The aim of this study was to evaluate the influence of possible intraoral temperature differences on the forces exerted by seven commercially available 0.019 x 0.025 inch NiTi archwires. As mouth temperature ranges from 33 to 37 degrees C most of the time, all wires were tested at five different temperatures between 30 and 40 degrees C in an orthodontic wire-testing device, a so-called Force System Identification (FSI) apparatus, placed in a climate chamber. In the FSI a two-bracket system using self-ligating Damon brackets simulated first order displacements up to 4 mm. At each temperature five samples of each archwire brand were tested. The following variables from the activation/deactivation curves were calculated: force and displacement at the yield point, maximum force level, total energy up to maximum displacement, energy loss after deactivation, force and displacement at the beginning and at the finish of the plateau, and the slope of the plateau. Any statistically significant differences in these variables for the different brands and temperature levels were analysed using one-way analysis of variance. The results showed that: (1) The behaviour of all wires was different. (2) Copper NiTi40 showed the lowest and the most constant force level, followed by NeoSentalloy 200 g. On the other hand, these wires may not work properly in mouth breathers as no forces were exerted below 35 degrees C. (3) If the use of superelastic characteristics and low force levels are the reasons for utilizing rectangular NiTi wires, austenitic NiTi wires should be avoided.

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How does temperature influence the properties of rectangular nickel-titanium wires?

SUMMARY The aim of this study was to investigate the mechanical properties of superelastic and thermal nickel–titanium (NiTi) archwires for correct selection of orthodontic wires. Seven different NiTi wires of two different sizes (0.014 and 0.016 inches), commonly used during the alignment phase, were tested. A three-point bending test was carried out to evaluate the load–deflection characteristics. The archwires were subjected to bending at a constant temperature of 37°C and deflections of 2 and 4 mm. Analysis of variance showed that thermal NiTi wires exerted significantly lower working forces than superelastic wires of the same size in all experimental tests (P < 0.05). Wire size had a significant effect on the forces produced: with an increase in archwire dimension, the released strength increased for both thermal and superelastic wires. Superelastic wires showed, at a deflection of 2 mm, narrow and steep hysteresis curves in comparison with the corresponding thermal wires, which presented a wide interval between loading and unloading forces. During unloading at 4 mm of deflection, all wires showed curves with a wider plateau when compared with 2 mm deflection. Such a difference for the superelastic wires was caused by the martensite stress induced at higher deformation levels. A comprehensive understanding of mechanical characteristics of orthodontic wires is essential and selection should be undertaken in accordance with the behaviour of the different wires. It is also necessary to take into account the biomechanics used. In low-friction mechanics, thermal NiTi wires are to be preferred to superelastic wires, during the alignment phase due to their lower working forces. In conventional straightwire mechanics, a low force archwire would be unable to overcome the resistance to sliding.

Load-deflection characteristics of superelastic and thermal nickel-titanium wires.

Objective: To compare as-received copper-nickel-titanium (CuNiTi) archwires to those used in patients by means of differential scanning calorimetry (DSC). Also, the thermal or phase properties of 27°C, 35°C, and 40°C CuNiTi archwires were studied to ascertain if their properties match those indicated by the manufacturer. Materials and Methods: Six wires of 27°C, 35°C, and 40°C CuNiTi were tested as-received, and six each of the 27°C and 35°C wires were examined after use in patients for an average of approximately 9 and 7 weeks, respectively. Segments of archwire were investigated by DSC over the temperature range from −100°C to 150°C at 10°C per minute. Results: There were no significant differences between as-received and clinically used 27°C and 35°C wires for all parameters (heating onset, endset, and enthalpy and cooling onset, endset, and enthalpy), except the 27°C wires exhibited a significant decrease in the heating enthalpy associated with the martensite-to-austenite transition after cli...

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Thermal Analysis of As-received and Clinically Retrieved Copper-nickel-titanium Orthodontic Archwires

The objective of the study was to investigate the load/deflection characteristics of three commercially available thermally active nickel-titanium orthodontic archwires using a standard nickel-titanium archwire as a control. The thermally active wires were Regency Thermal, Orthoform, and Eurotherm and the control was Memory. Round 0.4 mm and rectangular 0.4 x 0.56 mm wires were subjected to 2 and 4 mm of deflection in a water bath at temperatures of 20, 30, and 40 degrees C and forces were measured in three-point bend and phantom head situations. Analysis of variance revealed that, irrespective of the test set up and wire type, wire size had a significant effect (P < 0.001) on the forces produced. An increase in size from 0.4 mm round to 0.4 x 0.56 mm rectangular wire approximately doubled the force values for a given deflection. The effect of wire deflection on the force values varied according to the test system, forces being much higher in the phantom head tests than in the beam tests. In the beam tests, an increase in wire deflection from 2 to 4 mm had no significant effect on the forces exerted, but in the phantom head tests the forces produced by each wire at 4 mm deflection were four to five times greater than those at 2 mm deflection. Each of the thermally active wires produced less force that the non-thermally active wire. However, there was a large variation between the three types of thermally active wire. In the beam tests each 10 degrees C rise in temperature from 20 to 40 degrees C had a highly significant effect on the force produced by each thermoelastic wire (P < 0.001). In the phantom head tests there were significant force increases between 20 and 30 degrees C (P < 0.001), but between 30 and 40 degrees C the forces did not change significantly.

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The load/deflection characteristics of thermally activated orthodontic archwires

Failure of eruption of the maxillary permanent incisor teeth usually presents in the mixed dentition between the ages of 7 and 9 years. Missing and unerupted maxillary incisors can be regarded as unattractive and have a potentially negative impact on facial and dental aesthetics. The presence of a supernumerary tooth (or odontoma) is commonly responsible for failed eruption or impaction of the permanent maxillary incisors. The primary objective of this trial is to investigate the success of eruption associated with maxillary incisor teeth that have failed to erupt because of a supernumerary tooth in the anterior maxilla.This protocol describes an interventional multicentre two-arm randomised clinical trial. Participants meeting the eligibility criteria will be randomised (unrestricted equal participant allocation [1:1]) to either space creation with an orthodontic appliance, removal of the supernumerary tooth and application of direct orthodontic traction or space creation with an orthodontic appliance, removal of the supernumerary tooth and monitoring. The primary outcome of this trial is to determine the prevalence of successfully erupted maxillary central permanent incisors at 6 months following removal of the supernumerary tooth. Secondary outcome measures include (1) the effect of initial tooth position (assessed radiographically) on time taken for the tooth to erupt, (2) time taken to align the unerupted tooth to the correct occlusal position, (3) gingival aesthetics and (4) changes in the self-reported Oral Health Related-Quality of Life (OHRQoL) (pre-and post-treatment).There is a lack of high-quality robust prospective studies comparing the effectiveness of interventions to manage this condition. Furthermore, the UK national clinical guidelines have highlighted a lack of definitive treatment protocols for the management of children who present with an unerupted maxillary incisor due to the presence of a supernumerary tooth. The results of this trial will inform future treatment guidelines for the management of this condition in young children.ISRCTN Registry ISRCTN12709966 . Registered on 16 June 2022. 

/pdf/study-protocol-for-the-management-of-impacted-maxillary-qcb44mfb.pdf

Farnaz Parvizi

Papers

The load/deflection characteristics of thermally activated orthodontic archwires

Study protocol for the management of impacted maxillary central incisors: a multicentre randomised clinical trial: the iMAC Trial