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Tooth hemisection preserves partial tooth structure and reduces the resorption of alveolar bone. The aim of this study was to analyze the feasibility of preserving a molar after hemisection and inserting a dental implant with different prosthetic superstructures by means of finite element analysis. First, the distance between the root of the mandibular second premolar and the distal root of the first molar were measured in 80 cone beam computed tomography (CBCT) data sets. Based on these data, the lower right posterior jaw segment was reconstructed and the geometries of the appropriate implant were imported. Four models were created: (1) Hemi-1: An implant (3.7 × 9 mm) replaced the mesial root of the molar, and a single crown was placed on the implant and residual tooth. (2) Hemi-2: Two separate crowns were generated for the implant and the residual tooth. (3) Single: An implant (5.5 × 9 mm) with crown replaced the whole molar. (4) FPD: A 3-unit fixed partial denture combined the distal residual part of the molar and premolar. The results indicated that stresses in the cortical bone and strains in the majority region of the spongious bone were below the physiological upper limits. There were higher stresses in implant with the Hemi-1 and Single models, which had the same maximum values of 45.0 MPa. The FPD models represented the higher values of stresses in the teeth and strains in PDL compared to other models. From a biomechanical point of view, it can be concluded that a combination of an implant and residual molar after tooth hemisection is an acceptable treatment option. [ABSTRACT FROM AUTHOR]

The periodontal ligament is a complex tissue with respect to its biomechanical behaviour. It is important to understand the mechanical behaviour of the periodontal ligament during physiological loading in healthy patients as well as during the movement of the tooth in orthodontic treatment or in patients with periodontal disease, as these might affect the mechanical properties of the periodontal ligament (PDL). Up to now, only a limited amount of in vivo data is available concerning this issue. The aim of this study has been to determine the time dependent material properties of the PDL in an experimental in vivo study, using a novel device that is able to measure tooth displacement intraorally. Using the intraoral loading device, tooth deflections at various velocities were realised in vivo on human teeth. The in vivo investigations were performed on the upper left central incisors of five volunteers aged 21–33 years with healthy periodontal tissue. A deflection, applied at the centre of the crown, was linearly increased from 0 to 0.15 mm in a loading period of between 0.1 and 5.0 s. Individual numerical models were developed based on the experimental results to simulate the relationship between the applied force and tooth displacement. The numerical force/displacement curves were fitted to the experimental ones to obtain the material properties of the human PDL. For the shortest loading time of 0.1 s, the experimentally determined forces were between 7.0 and 16.2 N. The numerically calculated Young's modulus varied between 0.9 MPa (5.0 s) and 1.2 MPa (0.1 s). By considering the experimentally and numerically obtained force curves, forces decreased with increasing loading time. The experimental data gained in this study can be used for the further development and verification of a multiphasic constitutive law of the PDL. [ABSTRACT FROM AUTHOR]

Introduction: Our objective was to evaluate the effect of the diameter of the archwire on tooth alignment with different bracket-archwire combinations.Methods: The materials included 2 categories of orthodontic brackets (1) conventional ligating brackets (Victory Series [3M Unitek, Monrovia, Calif], Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo], and Synergy [Rocky Mountain Orthodontics]) and (2) self-ligating brackets (SmartClip [3M Unitek], a passive self-ligating bracket; Time3 [American Orthodontics, Sheboygan, Wis], an active self-ligating bracket; and SPEED [Strite Industries, Cambridge, Ontario, Canada], an active self-ligating bracket). All brackets had a nominal 0.022-in slot size. The brackets were combined with Therma-Ti 0.014-in and Therma-Ti 0.016-in titanium memory archwires (American Orthodontics). The archwires were tied to the conventional brackets with both stainless steel ligatures (0.010 in) and elastomeric rings. Each bracket-archwire combination was tested 20 times with the orthodontic measurement and simulation system built in a temperature-controlled chamber where the temperature was kept at 37°C (±1°C) during testing. The malocclusion simulated in the study represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis).Results: The incisogingival corrections achieved by the 0.014-in archwire combined with the brackets used ranged from 40% to 95%; the corrections by the 0.016-in wire were 55% to 95%. The labiolingual corrections achieved by the 0.014-in archwire combined with the brackets used ranged from 10% to 100%, and the corrections of the 0.016-in archwires ranged from 15% to 100%.Conclusions: Increasing the diameter from 0.014 to 0.016 in increased the correction achieved by up to 15% in certain bracket-archwire combinations, but it decreased the correction by up to 25% in other combinations. [ABSTRACT FROM AUTHOR]

Analysing the influence of implant splinting and its relation to different framework materials is a complex issue. The stiffness of framework materials and the overload of the implant system directly affect the final transferred load of the bone around implants. A finite element model of a long-span cementable implant-supported fixed prosthesis was created. Three materials were analysed for the framework: Titanium, gold alloy, and zirconia. The connection screws were first preloaded with 200 N. Two loading conditions were studied: The implant at the molar region was first loaded without splinting to the framework, and in the second condition, the implant was splinted to the framework. A total force of 500 N and 1000 N in 30° from the long axis of the framework were applied in buccal or distal direction on the implant system. The stresses and strains within the framework materials, implant system, and bone bed around the supporting implants were analysed. Loading the implant distally was associated with high stresses within the implant system in comparison to buccal loading. By splinting the implant, the stress in the implant system was reduced from 5393 MPa to 2942 MPa. Buccal loading of the implant was more critical than the distal loading. In the splinted condition of the implant, the stresses in the cortical bone were reduced from 570 MPa to 275 MPa. [ABSTRACT FROM AUTHOR]

The rigidity of framework materials and overload of the implant system directly affect the final transferred load of the bone around implants. The aim of the present study has been to analyse the influence of framework materials on the transferred load to the implant system and the surrounding bone. A finite element model of a long-span cementable implant-supported fixed prosthesis was created with two coping layers (gold and hybrid composite) to optimise the fitting of the prosthesis to the abutments. Three framework materials were analysed: titanium, gold alloy, and zirconia. The connection screws were first preloaded with 200 N. The framework was then loaded with 500 N vertically and at 30° to the framework long axis. Two loading conditions were considered: at the mesial and distal boundaries of the framework and at the centre of the framework. The stresses and strains within the framework materials and bone bed around the supporting implants were analysed. The region and angle of load applications showed an obvious effect on the values of the stresses and strains within the framework itself and, consequently, their distribution in the implant system and surrounding bone. A correlation of the framework material and stresses of the coping materials was observed as well. The gold framework showed acceptable values of stress within the cortical bone (92 MPa and 89 MPa with 30° loading at two points and at the centre, respectively) in comparison to titanium (92 MPa and 113 MPa) and zirconia (88 MPa and 115 MPa). [ABSTRACT FROM AUTHOR]

Summary Understanding the changes in bone density after insertion of dental implants and their relation to immediate loading is essential to achieving improvements in their survival rate. Histological investigations of the bone bed in humans are limited, which in turn hampers opportunities to deepen knowledge about the remodelling process around dental implants. The aim of the present study was to follow the change in bone density by measuring the grey values of cone beam computed tomography (CBCT) at different periods subsequent to implant insertion. The CBCTs of 20 individual immediately loaded implants were evaluated at three time points: prior to surgery, one month following, and six months after the operation. The grey values were measured at different regions around the implants. Reduction in the grey values was observed with respect to the reference values after one month and six months from implant insertion in the apical, middle, and cervical regions. No correlation was detected either between the change in grey values and drilling method or with the measured primary and secondary stabilities by Osstell ISQ instrument. Cone beam computed tomography can be used as a qualitative method to support clinical follow up and monitor the changes in bone density around implants in critical cases. [ABSTRACT FROM AUTHOR]

The bone bed around dental implants is influenced by implant and augmentation materials, as well as the insertion technique used. The primary influencing factors include the dental implant design, augmentation technique, treatment protocol, and surgical procedure. In addition to these treatment-related factors, in the literature, local and systemic factors have been found to be related to the bone stability around implants. Bone is a dynamic organ that optimises itself depending on the loading condition above it. Bone achieves this optimisation through the remodelling process. Several studies have confirmed the importance of the implant design and direction of the applied force on the implant system. Equally dispersed strains and stresses in the physiological range should be achieved to ensure the success of an implant treatment. If a patient wishes to accelerate the treatment time, different protocols can be chosen. However, each one must consider the amount and quality of the available local bone. Immediate implantation is only successful if the primary stability of the implant can be provided from residual bone in the socket after tooth extraction. Immediate loading demands high primary stability and, sometimes, the distribution of mastication forces by splinting or even by inserting additional implants to ensure their success. Augmentation materials with various properties have been developed in recent years. In particular, resorption time and stableness affect the usefulness in different situations. Hence, treatment protocols can optimise the time for simultaneous implant placements or optimise the follow-up time for implant placement. [ABSTRACT FROM AUTHOR]

Introduction A quantitative assessment of maxillary first molar distalization with and without the maxillary second molar (M2) was carried out. Methods Fifty-six cervical headgear patients undergoing fixed appliance orthodontic treatment were divided into 2 groups: before (G − M2) and after (G + M2) eruption of the maxillary second molars (ages, 11.87 ± 1.20, and 13.05 ± 1.55 years, respectively). The tightness of the dental contact point (TDCP) and the space between the second premolar and the maxillary first molar were measured at 6 levels of headgear force (0-15 N) at 3 intervals 6 months apart (T0, T1, T2). Results Relationships were found between space and TDCP, time, and presence or absence of the maxillary second molar at T1 and T2 ( P <0.001). The TDCP decreased and space increased with increase in initial headgear force. An increase in initial force beyond 6 to 9 N did not significantly increase the initial maxillary first molar distalization. The G − M2 TDCP and space measurements were similar to those of G + M2 at T2 with the eruption of the maxillary second molar. From T0 to T1, maxillary first molar distalization was greater in G − M2. In comparison with our previous headgear-alone study, initial distalization with a fully bonded appliance was reduced by 4-fold. Conclusions Headgear therapy is more effective before the eruption of the maxillary second molar. Once it erupts, the distalization pace of the maxillary first molar is reduced, but it can nevertheless be pursued at a slower pace when the maxillary second molar is present. [ABSTRACT FROM AUTHOR]

Introduction It has been found that controlled movement of the anterior teeth can be obtained by attaching a certain length of power arm onto an archwire in sliding mechanics. However, the impact of the archwire/bracket play on anterior tooth movement has not been clarified. The purpose of this study was to compare the effect of the power arm on anterior tooth movements with different dimensions of bracket slots and archwires. Methods A 3-dimensional finite element method was used to simulate en-masse anterior tooth retraction in sliding mechanics. Displacements of the maxillary central incisor and the archwire deformation were calculated when applying retraction forces from different lengths of power arms. Results When a 0.017 x 0.022-in archwire was engaged into the 0.018-in slot bracket, bodily movement of the incisor was obtained with 9.1-mm length of the power arm. When a 0.022-in slot system was coupled with a 0.019 x 0.025-in archwire, bodily movement was observed with a power arm length of 11.6 mm. Conclusions Archwire/bracket play has a remarkable impact on anterior tooth movement. An effective torque application to the anterior teeth becomes clinically difficult in sliding mechanics combined with power arms when the archwire/bracket play is large. [ABSTRACT FROM AUTHOR]

Introduction: The exact force systems as well as their progressions generated by removable thermoplastic appliances have not been investigated. Thus, the purposes of this experimental study were to quantify the forces and moments delivered by a single aligner and a series of aligners (Invisalign; Align Technology, Santa Clara, Calif) and to investigate the influence of attachments and power ridges on the force transfer. Methods: We studied 970 aligners of the Invisalign system (60 series of aligners). The aligners came from 30 consecutive patients, of which 3 tooth movements (incisor torque, premolar derotation, molar distalization) with 20 movements each were analyzed. The 3 movement groups were subdivided so that 10 movements were supported with an attachment and 10 were not. The patients' ClinCheck (Align Technology, Santa Clara, Calif) was planned so that the movements to be investigated were performed in isolation in the respective quadrant. Resin replicas of the patients' intraoral situation before the start of the investigated movement were taken and mounted in a biomechanical measurement system. An aligner was put on the model, the force systems were measured, and the calculated movements were experimentally performed until no further forces or moments were generated. Subsequently, the next aligners were installed, and the measurements were repeated. Results: The initial mean moments were about 7.3 N·mm for maxillary incisor torque and about 1.0 N for distalization. Significant differences in the generated moments were measured in the premolar derotation group, whether they were supported with an attachment (8.8 N·mm) or not (1.2 N·mm). All measurements showed an exponential force change. Conclusions: Apart from a few maximal initial force systems, the forces and moments generated by aligners of the Invisalign system are within the range of orthodontic forces. The force change is exponential while a patient is wearing removable thermoplastic appliances. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to determine the material composition and cell-mediated remodelling of different calcium phosphate-based bone substitutes. Osteoclasts were cultivated on bone substitutes (Cerabone, Maxresorb, and NanoBone) for up to 5 days. Bafilomycin A1 addition served as the control. To determine cellular activity, the supernatant content of calcium and phosphate was measured by inductively coupled plasma optical emission spectrometry. Cells were visualized on the materials by scanning electron microscopy. Material composition and surface characteristics were assessed by energy-dispersive X-ray spectroscopy. Osteoclast-induced calcium and phosphate release was material-specific. Maxresorb exhibited the highest ion release to the medium (P =0.034; calcium 40.25mg/l day 5, phosphate 102.08mg/l day 5) and NanoBone the lowest (P =0.021; calcium 8.43mg/l day 5, phosphate 15.15mg/l day 5); Cerabone was intermediate (P =0.034; calcium 16.34mg/l day 5, phosphate 30.6mg/l day 5). All investigated materials showed unique resorption behaviours. The presented methodology provides a new perspective on the investigation of bone substitute biodegradation, maintaining the material-specific micro- and macrostructure. [Copyright &y& Elsevier]

Introduction: The assessment of forces and moments generated by fully customized lingual appliances and their effectiveness in tooth movement were compared with conventional labial bracket systems, applied to a specific malocclusion model.Methods: Two fully customized lingual appliances (Incognito [3M Unitek, Monrovia, Calif] and WiN [DW Lingual Systems, Bad Essen, Germany]) and 2 labial bracket systems (Discovery classic and Discovery smart [Dentaurum, Ispringen, Germany]) were examined with nickel-titanium wires of different cross-sections (0.012, 0.014, 0.016, and 0.016 × 0.022-in) and 3 tooth types (canine, lateral incisor, and second premolar). Simulated movement was performed with a wire replacement as soon as forces or moments were no longer effective.Results: Lingual and labial appliances showed statistically significant differences in initial forces and moments when tested with the same cross-section wires. Statistically significant differences between the 2 lingual bracket systems were also registered. Both lingual appliances rotated the premolar less than the conventional labial appliances.Conclusions: In areas of smaller lingual interbracket distance and higher lingual slot misalignment, the tested lingual multibracket appliances showed higher forces than the labial appliances. The force difference was particularly prominent with vertically oriented lingual slots and rectangular wires. The tested lingual appliances presented difficulties in rotating the premolar. [ABSTRACT FROM AUTHOR]

Although endocrown is a successful restorative approach for endodontically treated molars, its survival rate in endodontically treated premolars with extensive loss of coronal structure has been debated. The aim of this study was to evaluate the biomechanical behavior of endodontically treated maxillary premolars restored with different lithium disilicate endocrown designs. Based on cone-beam computed tomography (CBCT) of an intact maxillary premolar, five models were designed. Model A: fiber post, core, and crown; Model B: endocrown, 5 mm pulpal extension and butt margin; Model C: endocrown, 5 mm pulpal extension and axial extension; Model D: Endocrown, 3 mm pulpal extension and butt margin; Model E: Endocrown, 3 mm pulpal extension and axial extension. The bone geometry was simplified as a cylinder of compact and trabecular bone. All models were imported into finite element analysis (FEA) software, where the base of the bone cylinder was chosen as fixed support. Axial and oblique loads of 100 N each were applied separately to each model, and static structural analysis was performed. Regardless of the design of the endocrown, the resulting von Mises stresses were far below the yield strength of the tooth structure and the flexural strength of the ceramic material. The generated von Mises stresses on the restoration decreased by 15% in the models with 3 mm pulp extension (D and E) compared to the 5-mm pulpal extension models. In addition, the resulting von Mises stresses on the tooth structure decreased also by 15% in models C and E with the axial extension compared to models B and D with the butt margin. Endocrown is a suitable restoration for endodontically treated maxillary premolars. Furthermore, reducing the depth of the pulpal extension to 3 mm with the addition of an axial extension resulted in a more favorable stress distribution within the tooth-restoration interface. [ABSTRACT FROM AUTHOR]

Objective: To compare the archwires inserted during the final stages of the orthodontic treatment with the generated moments at 0.018- and 0.022-inch brackets. Materials and Methods: The same bracket type, in terms of prescription, was evaluated in both slot dimensions. The brackets were bonded on two identical maxillary acrylic resin models, and each model was mounted on the orthodontic measurement and simulation system. Ten 0.017 x 0.025-inch TMA and ten 0.017 x 0.025-inch stainless steel archwires were evaluated in the 0.018- inch brackets. In the 0.022-inch brackets, ten 0.019 x 0.025-inch TMA and ten 0.019 x 0.025-inch stainless steel archwires were measured. A 15° buccal root torque (+15°) and then a 15° palatal root torque (-15°) were gradually applied to the right central incisor bracket, and the moments were recorded at these positions. A f-test was conducted to compare the generated moments between wires within the 0.018- and 0.022-inch bracket groups separately. Results: The 0.017 x 0.025-inch archwire in the 0.018-inch brackets generated mean moments of 9.25 Nmm and 14.2 Nmm for the TMA and stainless steel archwires, respectively. The measured moments in the 0.022-inch brackets with the 0.019 x 0.025-inch TMA and stainless steel archwires were 6.6 Nmm and 9.3 Nmm, respectively. Conclusion: The 0.017 x 0.025-inch stainless steel and ß-Ti archwires in the 0.018-inch slot generated higher moments than the 0.019 x 0.025-inch archwires because of lower torque play. This difference is exaggerated in steel archwires, in comparison with the β-Ti, because of differences in stiffness. The differences of maximum moments between the archwires of the same cross-section but different alloys were statistically significant at both slot dimensions. [ABSTRACT FROM AUTHOR]

Introduction: The force applied to the teeth is a variable of orthodontic treatment that can be controlled. Poor control of the applied force can lead to adverse biologic effects as well as undesirable tooth movements. The selected archwire-bracket combination is a primary determining factor in the force level applied to a tooth during orthodontic treatment. The aim of this research was to use an experimental biomechanical setup to measure forces generated during complex orthodontic tooth movements with various archwire-bracket combinations. Methods: The materials consisted of 3 types of 0.022-in slot orthodontic brackets: (1) conventional brackets (Victory Series [3M Unitek, Monrovia, Calif] and Mini-Taurus [Rocky Mountain Orthodontics, Denver, Colo]), (2) self-ligating brackets (SmartClip [3M Unitek] and Time3 [American Orthodontics, Shegoygan, Wis]), and (3) a conventional low-friction bracket (Synergy [Rocky Mountain Orthodontics]); and 4 archwire types: (1) 0.012-in stainless steel (3M Unitek), (2) 0.0155-in coaxial (Advanced Orthodontics [Näpflein, Düsseldorf, Germany]), (3) 0.012-in Orthonol (Rocky Mountain Orthodontics), and (4) 0.012-in Thermalloy (Rocky Mountain Orthodontics). Stainless steel ligatures and elastomeric rings were used. The materials were used in different combinations in a simulated malocclusion that represented a maxillary central incisor displaced 2 mm gingivally (x-axis) and 2 mm labially (z-axis). Results: The lowest forces were measured when the brackets were combined with either the coaxial or the Thermalloy archwires; the forces ranged from 3.4 ± 0.2 to 0.7 ± 0.1 N in the x-axis direction, and from 4.5 ± 0.3 to 0.5 ± 0.1 N in the z-axis direction. The highest forces were measured in combination with stainless steel archwires; the forces ranged from 6.3 ± 0.3 to 3.0 ± 0.1 N in the x-axis direction, and from 6.3 ± 0.3 to 1.7 ± 0.1 N in the z-axis direction. Conclusions: We recommend 0.0155-in coaxial and 0.012-in Thermalloy archwires for leveling and alignment. Elastomeric rings, when used with conventional brackets, increased the force applied to the teeth. [Copyright &y& Elsevier]

Abstract: The aim of this study has been to systematically evaluate the loading behaviour of a novel pre-fabricated chair-side SFI-Bar® bar system supported by two implants using finite element (FE) analysis. Two series of FE models were created of the bar placed on two idealised implants and embedded in idealised bone segments using CAD data. In the first series, the inter-implant distance varied from 10 to 26mm; the second series consisted of a bar with a fixed implant distance of 26mm and varying horizontal fitting inaccuracy from 0.0 to 0.3mm. The bar was loaded vertically at 500 N. In all simulations, the regions with the greatest amount of stress were concentrated on the connecting elements of the bar and the bar itself. A slight increase in stress was observed with decreasing inter-implant distance. With a non-zero fitting inaccuracy, no clear correlation was observed between the amount of play and the stress distribution in the system. For a perfect fit, an obvious increase in stress was found in the implant and strain in the implant bed. With respect to the excessive static loading performed in our simulations and the resulting loading behaviour, we conclude that the SFI-Bar is a system suitable for clinical application. [Copyright &y& Elsevier]

Summary: The survival of dental implants, in particular immediately loaded implants, critically depends on the biomechanical properties of the bone bed surrounding them. In experimental animal investigations of immediately loaded implants the initial stability, implant design as well as stress and strain distributions in the surrounding bone have been extensively studied. It was the aim of this study to investigate the biomechanical properties of the reindeer antler used as a bony tissue surrounding dental implants, in particular the Young''s modulus, Poisson''s ratio, and further numerical parameters such as mesh density, friction models and the corresponding frictional coefficients and relative velocities for establishing a novel animal model that can be used in the numerical analyses of experimentally investigated antler specimens. The sensitivity of the investigated parameters was analysed based on the close correlation of numerical and experimental results. No obvious influence of the frictional coefficient and/or relative velocity was observed on the implant displacement using a finite element model. Moreover, nearly identical numerical and experimental results were observed for two kinds of implants concerning implant deflection in the x-axis and implant rotation around the y-axis. [Copyright &y& Elsevier]

Summary: Aims: To compare the reaction of the alveolar bone to the preservation of the extraction socket by Bio-Oss Collagen with and without combination of implant treatment. To evaluate whether early implant insertion 8–10weeks thereafter could be a suitable time point for long term bone stability around the implant. Methods: A total of 25 patients were divided into three groups: The first group (seven patients) received Bio-Oss Collagen after extraction and 8–10weeks later an implant, the second group (eight patients) received only Bio-Oss Collagen without implantation thereafter, while the third group was considered as a control (eleven patients), where the sockets healed without any treatment. The change in the vertical bone level of the alveolar crests were measured from panoramic radiographs and statistically analysed. Results: Bone level change was significantly less for Group 1 than Group 3 (P <0.001), while was not significantly different for Group 2 and Group 3 (P =0.23). However, the rate of bone level change per year was statistically smaller for Group 1 compared to Group 3 (P =0.019) and as well as for Group 1 than for Group 2 (P =0.003), whereas the change per year was not significantly different for Group 2 vs. Group 3 (P =0.122). Conclusion: Bone level preservation of extraction sockets using Bio-Oss Collagen with implantation is significantly better compared to using Bio-Oss Collagen only and untreated sockets. Implant insertion 8–10weeks after extraction is a suitable time point after socket augmentation. [ABSTRACT FROM AUTHOR]

Background: Although enamel matrix derivative (EMD) has been shown to promote periodontal regeneration, it is unknown whether the actions of EMD are modulated by occlusal loading. This in vitro study was performed to investigate whether biomechanical forces regulate the response of periodontal ligament (PDL) cells to EMD. Methods: Human PDL cells were treated with EMD in the presence and absence of cyclic tensile strain (CTS) of various magnitudes for ≤14 days. Synthesis of transforming growth factor (TGF)-β1, vascular endothelial growth factor (VEGF), growth factor receptors, collagen, and runt-related transcription factor 2- (RUNX2), cell numbers and adhesion, wound fill rate, and calcium accumulation were analyzed by real-time polymerase chain reaction, enzyme-linked immunosorbent assay, a wound healing assay, and alizarine red S staining. Results: Wound fill rate, cell numbers and adhesion, and expression of TGF-β1, VEGF, collagen, and RUNX2 were significantly increased by EMD. In the presence of CTS, the EMD-induced effects were significantly reduced. The inhibition of the EMD-upregulated VEGF expression by CTS was blocked by a specific inhibitor of nuclear factor-kappa B signaling. Moreover, CTS downregulated receptors for growth factors involved in the actions of EMD. CTS also antagonized significantly the EMD-induced calcium deposition. Conclusions: These in vitro findings suggest that the beneficial actions of EMD on PDL cell functions critical for periodontal regeneration are jeopardized by biomechanical loading. Clinical studies should clarify whether protection of teeth against occlusal forces in the early healing stage may positively affect the outcome of regenerative therapy with EMD. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this article was to assess the effect of wire adaptation on the lingual surfaces of mandibular anterior teeth with 3 types of lingual retainers on the development of vertical and labiolingual forces. Methods: Ten retainers (canine to canine) were constructed from each of the following wires: Wildcat 0.0195-in heat-treated 3-strand twist-flex wire (GAC, Bohemia, NY); Penta-one 0.0215-in 6-strand as received; and Penta-one 0.0215-in 6-strand after heat treatment at 350°C for 4 minutes (both, Masel Orthodontics, Carlsbad, Calif). The retainers were bonded on each tooth of an acrylic resin model, and the model was installed in the Orthodontic Measurement and Simulation System. The vertical and labiolingual forces generated were measured for wire displacements up to 0.2 mm in 0.02-mm increments. Results: Wire displacement of 0.2 mm exerted forces as high as 1 N on the teeth. In the vertical direction, the highest force levels were recorded for the as-received Penta-one 0.0215-in and the lowest from its heat-treated counterpart. In the horizontal plane, the as-received Penta-one 0.0215-in exerted the highest forces. Conclusions: The forces recorded from the lingual retainer wires during 0.2-mm simulated intrusion-extrusion and buccal-lingual movements might generate high forces that exceed 1 N and be large enough to produce unwanted tooth movement during retention. The only significant determinant of the generated forces was the amount of wire displacement and not the type of wire used in this study. [ABSTRACT FROM AUTHOR]

The introduction of nickel-titanium (NiTi) wires has revolutionized the field of orthodontics by delivering light continuous forces over a wider range of displacements than the traditional stainless-steel wires. Over the years improvements in NiTi wire manufacturing and composition have been introduced; however, the claimed wire capabilities are not always easy to verify in the clinical setting. We aim at presenting an overview of the use and applications of NiTi alloys in orthodontics. The implications of the metallurgical and mechanical properties and intraoral aging of the wires in their clinical application is discussed. Finally, time variants of orthodontic therapy duration with the use of NiTi and alternative arch wires are presented, and the clinical implication of superelasticity is analyzed. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to investigate the torque capabilities of conventional and self-ligating brackets by using the finite element method. Methods: Three types of brackets were selected: self-ligating Hanson Speed (Strite Industries, Cambridge, Ontario, Canada) and Damon MX (Ormco, Glendora, Calif), and conventionally ligated Discovery (Dentaurum, Pforzheim, Germany). All brackets had a 0.022-in slot size. From the maxillary left incisor to the maxillary right canine, 4 brackets were included in the finite element models generated. Torque of 20° was applied to the maxillary right incisor with 0.46 × 0.64 mm2 (0.018 × 0.025 in) and 0.48 × 0.64 mm2 (0.019 × 0.025 in) archwires. Three kinds of wire alloys were used: stainless steel, titanium molybdenum, and nickel titanium. For the conventional Discovery brackets, 2 types of ligation were modeled: elastic and stainless steel wire ligatures. The torque angle/torque moment characteristics in the simulated movement were calculated by using the MSC.Marc/Mentat 2005 FE software package (MSC Software Corporation, Santa Ana, Calif). Results: The torque angle/torque moment curves seemed to be dominated by the characteristics of the wire. The change of wire dimension increased the torque moments less than the change of wire alloy (125% increase for a 0.48 × 0.64 mm2 instead of a 0.46 × 0.64 mm2 stainless steel wire, and 220% for a 0.46 × 0.64 mm2 stainless steel instead of a nickel-titanium wire). The combined change of the wire alloy and wire dimension resulted in a 600% increase for a 0.48 × 0.64 mm2 stainless steel instead of a 0.46 × 0.64 mm2 nickel-titanium wire.The play of the 0.46 × 0.64 mm2 wires was about 9.0°, and the play of the 0.48 × 0.64 mm2 wires was about 7.5°, with slightly more play for the Damon. The ligation effect of Discovery brackets with elastic and stainless steel ligatures could be compared with the behavior of the Damon. The Speed showed different behavior, with the lowest torquing moments and the smallest torque play. Conclusions: Improving the adaptation of torque movements to the biomechanical reactions of the periodontium is best done by proper selection of both wire dimension and wire alloy. The effect of the bracket system is of minor importance, with the exception of brackets with an active clip (eg, Speed), which had the least play and the lowest torquing moments of all the wires. [Copyright &y& Elsevier]

Objective: To evaluate the comparative intrusive forces and torquing moments in the sagittal plane generated during anterior intrusion using different incisor intrusion mechanics in the maxillary and mandibular anterior teeth. Materials and Methods: Five wire specimens were used for each of the following intrusive arches: non-heat-treated, 0.016 × 0.016-inch blue Elgiloy utility arch, 0.017 × 0.025-inch TMA utility arch, and 0.017 )< 0.025-inch TMA Burstone intrusion arch. The wires were constructed according to the specifications given by their inventors and were inserted on bracketed dental arches on Frasaco models, segmented mesial to the canines. Simulated intrusion from 0.0-1 .5 mm was performed on the Orthodontic Measurement and Simulation System (OMSS), and forces and moments were recorded at 0.1 mm vertical displacement increments. All measurements were repeated five times for each specimen, and maximum values recorded at 1.5 mm for all wires were used for all statistical evaluations. The data were analyzed with two-way analysis of variance (ANOVA) with forces and moments serving as the dependent variables, separately, and wire type and jaw as the independent variables. Post hoc multiple comparisons were performed using the Tukey test (.05 error rate). Results: The 0.017 × 0.025-inch TMA Burstone intrusion arch exerted the lowest intrusive forces, followed by the 0.017 × 0.025-inch TMA utility and the 0.016 × 0.016-inch blue Elgiloy utility arch. The lowest anterior moment in the sagittal plane in this experiment was generated from the 0.017 × 0.025-inch TMA Burstone intrusion arch. Conclusions: The intrusive forces, as well as the generated moments, were always higher in the mandible, where significant differences were observed among the configurations tested. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to examine whether nickel-titanium (Ni-Ti) archwires cause an increase of nickel concentration in the saliva of 18 orthodontic patients to estimate the possible risk of these archwires in patients who have nickel hypersensitivity. Methods: Saliva samples were collected before orthodontic treatment, after placement of the bands and brackets, 2 weeks later and before placing the Ni-Ti archwires, immediatelly after placing the Ni-Ti archwires, 4 weeks after placing the wires, and 8 weeks after placing the wires. Results: By using mass spectrometry, no statistically significant differences were found in the nickel concentrations in the samples taken without appliances, in those obtained 2 weeks after placement of the bands and brackets, and 4 and 8 weeks after placement of the archwires. Samples taken immediately after placement of the bands and brackets and the Ni-Ti archwires showed slight but significant increases in nickel concentration of 78 and 56 μg per liter, respectively, compared with the pretreatment value of 34 μg per liter. Conclusions: Nickel leaching occurred after placement of the bands and brackets and after placement of the Ni-Ti archwires, associated with an increase of the nickel ion concentration in the patient''s saliva. This effect decreased within 10 weeks. [Copyright &y& Elsevier]

Objective: To assess comparatively the magnitude of moments generated during rotational correction from different bracket systems during the late leveling and alignment stage of orthodontic treatment. Materials and Methods: The three types of brackets assessed were Orthos2 (ORMCO, Glendora, CA), Damon2 (ORMCO), and In Ovation-R (GAC, Bohemia, NY). The brackets were bonded on replicas made of resin from models constructed from an aligned patient's mandibular arch, and a 0.014- x 0.025-inch CuNiTi (ORMCO) wire was inserted. Orthodontic rotational correction was simulated on the Orthodontic Measurement and Simulation System from -5° to +5° rotation in 0.25° increments on the distal and mesial direction. The moments generated at each increment of rotation throughout the full rotation path were statistically analyzed using a two-way analysis of variance and Tukey test at the .05 level of significance. Results: Both bracket type and direction of rotation showed an effect on moment magnitude. The highest moment (27.2 Nmm) was observed for the Damon2 bracket assigned to its noncompliant slot wall door. Higher moments were found during distal premolar rotation. The In Ovation-R showed a magnitude of moment in the range of 9.0 Nmm in the same direction, whereas conventional brackets presented the lowest moments (5.0 Nmm). Conclusions: A wide variation in magnitude of moments exerted by self-ligating and conventional brackets is noted in the simulated rotational correction of teeth, which relates to the geometry of the dental arch, the tooth position, and the rigidity of the closing component of the bracket slot. [ABSTRACT FROM AUTHOR]

Introduction: Our aim in this study was to comparatively assess the forces generated from conventional and self-ligating bracket systems during the late leveling and alignment stage, specifically for first- and second-order movement. Methods: Three types of brackets were selected: Orthos2 (Ormco, Glendora, Calif), Damon2 (Ormco), and In Ovation-R (GAC, Bohemia, NY). The brackets were bonded on resin replicas constructed from a model of an aligned mandibular arch, and a 0.014 × 0.025-in copper-nickel-titanium wire (Ormco) was placed. First- and second-order corrections—buccolingual and intrusion-extrusion movements—were simulated on the orthodontic measurement and simulation system. A 2-mm displacement was applied on the x-axis and a 1-mm displacement on the z-axis, both in 0.1-mm intervals; 5 repetitions were performed for each wire-bracket-interval combination, and new brackets and archwires were used for each trial. The forces generated by manipulation of the bracket in the 2 directions were recorded directly with the orthodontic measurement and simulation system software and were statistically analyzed with 2-way ANOVA, with bracket and displacement as the discriminating variables. Group differences were further analyzed with the Tukey post-hoc comparisons test with the family error rate set at the 0.05 level. Results: In the first-order correction, the direction showed a significant effect on force magnitude, with inward (lingual) movement having lower force levels for the In Ovation-R. No significant difference was found between the Damon2 and the conventional appliance for this movement. In the second-order model, no difference was noted between the 2 self-ligating brackets in magnitude of force, but the conventional bracket showed higher force levels, which accounted for 20%, or 1 N, of the increase in magnitude. The effect of the direction of displacement (intrusion vs extrusion) on force variation did not produce a significant effect. Conclusions: The forces generated by first- and second-order corrections in self-ligating appliances do not show a consistent pattern and depend on the wire, the direction of movement, and the design of the ligating component. [Copyright &y& Elsevier]

Introduction: The purpose of this study was to investigate the effect of intraoral aging on the force applied during engagement of a wire into the slot of active self-ligating brackets. Methods: Two types of brackets were used: Speed (Speed System Orthodontics, Cambridge, Ontario, Canada) and In Ovation-R (GAC, Bohemia, NY). Ten as-received and 10 retrieved maxillary incisor brackets collected after full treatment for at least 15 months (range, 15-19 months) were included in each bracket group. The brackets were mounted on the orthodontic measurement and simulation system, and the spring was subjected to tensile stress, which induced deformation of up to 1.5 mm, with a custom-made jig and laboratory configuration at body temperature. On the loading portion of the loading-unloading curve of clips, the slope was fitted a first-degree equation curve, to determine the stiffness/deflection rate of the clip. The results of slopes and ranges were analyzed with a 2-sample t test at the .05 level of significance, with aging as the discriminating variable. Results: No difference was found between as-received and used brackets with respect to force exerted by the spring in 1 bracket group, whereas the other group showed extensive relaxation after use; neither group had permanent deformation. The consistency of the initial force levels varied significantly in each bracket group. Conclusions: The initial force levels and the effect of intraoral conditions on the stiffness of the clip seem to vary between products, with potential implications for the archwire engagement into the bracket slot and associated mechanotherapy. [Copyright &y& Elsevier]

Introduction: The aim of this study was to characterize intraorally fractured nickel-titanium (Ni-Ti) archwires, determine the type of fracture, assess changes in the alloy’s hardness and structure, and propose a mechanism of failure. Methods: Eleven Ni-Ti SE 200 and 19 copper-Ni-Ti (both, Ormco, Glendora, Calif) intraorally fractured archwires were collected. The location of fracture (anterior or posterior), wire type, cross section, and period of service before fracture were recorded. The retrieved wires and brand-, type-, and size-matched specimens of unused wires were subjected to scanning electron microscopy to assess the fracture type and morphological variation of fracture site of retrieved specimens, and to Vickers hardness (HV200) testing to investigate the hardness of as-received and in-vivo fractured specimens. Fracture site distribution was statistically analyzed with the chi-square test (α = 0.05), whereas the results of the hardness testing were analyzed with 2-way ANOVA with state (control vs in-vivo fractured) and composition (Ni-Ti SE vs copper-Ni-Ti) serving as discriminating variables and the Student-Newman-Keuls test at the 95% confidence level. Results: The fracture site distribution showed a preferential location at the midspan between the premolar and the molar, suggesting that masticatory forces and complex loading during engagement of the wire to the bracket slot and potential intraoral aging might account for fracture incidence. All retrieved wires had the distinct features of brittle fracture without plastic deformation or crack propagation, whereas no increase in hardness was observed for the retrieved specimens. Conclusions: Most fractures sites were in the posterior region of the arch, probably because of the high-magnitude masticatory forces. Brittle fracture without plastic deformation was observed in most Ni-Ti wires regardless of archwire composition. There was no increase in the hardness of the intraorally exposed specimens regardless of wire type. This contradicts previous in-vitro studies and rules out hydrogen embrittlement as the cause of fracture. [Copyright &y& Elsevier]