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Objectives: To investigate and quantify forces generated by three-dimensional-printed aligners made of shape memory polymers (four-dimensional [4D] aligner).Methods: Clear X v1.1 material was used in this study. On a custom-made typodont model, correction of maxillary central incisor (tooth 21) malposition by 4D aligners with thicknesses of 0.8 and 1.0 mm was measured by superimposition of subsequent scans. Maximum deflection forces generated by foil sheet specimens were measured at different temperatures in three-point bending (3-PB) tests. In a biomechanical system (orthodontic measurement and simulation system [OMSS]), forces generated on movements of tooth 21 by the 4D aligners were measured at different temperatures.Results: 4D aligners succeeded to achieve a significant tooth movement (2.5 ± 0.5 mm) on the typodont, with insignificant difference between different thicknesses. In the 3-PB test, the maximum deflection forces measured at 20, 30, 37, 45, and 55°C, were 3.8 ± 1.1, 2.5 ± 0.9, 1.7 ± 0.6, 1.0 ± 0.4, and 0.5 ± 0.4 N, respectively. Forces delivered on palatal displacement of tooth 21 at 37, 45, and 55°C by 0.8-mm aligners were 0.3 ± 0.1, 0.2 ± 0.1, and 0.7 ± 0.2 N, respectively, whereas those by 1.0-mm aligners were 0.3 ± 0.1, 0.3 ± 0.1, and 0.6 ± 0.2 N, respectively. A good concordance with movement on the typodont model was shown in OMSS.Conclusion: An initial study of 4D-printed aligner shows its ability to move a tooth by biocompatible orthodontic forces, after a suitable thermal stimulus within the oral temperature range.

Bioactive glasses (BGs) are being increasingly considered for numerous biomedical applications. The loading of natural compounds onto BGs to increase the BG biological activity is receiving increasing attention. However, achieving efficient loading of phytotherapeutic compounds onto the surface of bioactive glass is challenging. The present work aimed to prepare novel amino-functionalized mesoporous bioactive glass nanoparticles (MBGNs) loaded with the phytotherapeutic agent Boswellia sacra extract. The prepared amino-functionalized MBGNs showed suitable loading capacity and releasing time. MBGNs (nominal composition: 58 wt% SiO2, 37 wt% CaO, 5 wt% P2O5) were prepared by sol-gel-modified co-precipitation method and were successfully surface-modified by using 3-aminopropyltriethoxysilane (APTES). In order to evaluate MBGNs loaded with Boswellia sacra, morphological analysis, biological studies, physico-chemical and release studies were performed. The successful functionalization and loading of the natural compound were confirmed with FTIR, zeta-potential measurements and UV-Vis spectroscopy, respectively. Structural and morphological evaluation of MBGNs was done by XRD, SEM and BET analyses, whereas the chemical analysis of the plant extract was done using GC/MS technique. The functionalized MBGNs showed high loading capacity as compared to non-functionalized MBGNs. The release studies revealed that Boswellia sacra molecules were released via controlled diffusion and led to antibacterial effects against S. aureus (Gram-positive) bacteria. Results of cell culture studies using human osteoblastic-like cells (MG-63) indicated better cell viability of the Boswellia sacra-loaded MBGNs as compared to the unloaded MBGNs. Therefore, the strategy of combining the properties of MBGNs with the therapeutic effects of Boswellia sacra represents a novel, convenient step towards the development of phytotherapeutic-loaded antibacterial, inorganic materials to improve tissue healing and regeneration.

• The finite element method is a valuable method for understanding the biomechanics of aligners. • Trimming line design of orthodontic aligners has a key role in force transmission. • Extended straight aligner trimming line improves control of tooth movement. • Properly designed thin aligners offer enhanced efficiency and comfort. • Aligners present a higher likelihood of uncontrolled tipping than bodily movement. A finite element model was used to investigate the effect of different designs and thicknesses of orthodontic aligner margins on their biomechanical behavior. A three-dimensional data set of an upper jaw was imported into the 3-matic software. The upper right central incisor tooth (Tooth 11) was separated from the remaining model, and its periodontal ligament and surrounding bone were designed. Aligners were designed with four different trimming lines (scalloped, straight, scalloped extended, straight extended), each with four different thicknesses (0.3, 0.4, 0.5, and 0.6 mm). The models were imported into a finite element package (Marc/Mentat). A linear elastic constitutive material model was applied. A facial 0.2 mm bodily malalignment of tooth 11 was simulated. The maximum resultant force was in the range of 1.0 N to 2.2 N. The straight trimming designs deliver higher resultant forces compared with scalloped trimming designs. Increasing the aligner thickness and/or extending the aligner edge beyond the gingival line leads to an increase in the resultant force. All designs showed an uneven distribution of the normal contact forces over the tooth surface with a predominant concentration toward the cervical third and distal third, particularly with the extended trimming designs. All designs showed uncontrolled tipping of the tooth. Based on the current model outcomes, the use of a straight extended trimming line design for aligners is favored because of its positive impact on force distribution and, consequently, the control of tooth movement. These findings provide aligner companies and orthodontists a valuable biomechanical evidence and guidance to enhance control over tooth movement and therefore optimize treatment outcomes. This can be achieved by trimming the edges of aligners with a straight extended design and selecting the appropriate aligner thickness. [ABSTRACT FROM AUTHOR]

As an innovative approach to overcome the rate-limiting staging of conventional aligners, using shape memory polymers (SMPs) as aligners’ materials was investigated in this in vitro study. The ability of SMPs to shape recover and consequently move tooth, upon appropriate stimuli, was evaluated on a typodont model before clinical application. The study design was to achieve 1.9 mm correction movement of an upper central incisor by one aligner after multiple steps/activation. A custom-made aligned typodont model with a movable upper central incisor was scanned. Using an orthodontic software and a 3D printer, resin-models were generated. Seven aligners of ClearX sheets (SMPs) were fabricated by thermoforming on the resin aligned model. Each aligner was tested for repositioning of the central incisor in the typodont model. The model was scanned after each step and the corrective movement was measured through the superimposition of scans. Results showed that the total correction efficiency of the SMPs’ aligner was ≈93% (1.76 mm). The corrective movement was 0.94 ± 0.04 mm after the reforming step, 0.66 ± 0.07 mm after the first activation step, and 0.15 ± 0.10 mm after the second activation step. It was concluded that aligners made of SMPs could have a promising future-use in orthodontic aesthetic treatment.

Although several natural plants and mixtures have been known and used over the centuries for their antibacterial activity, few have been thoroughly explored in the field of dentistry. Thus, the aim of this study was to enhance the antimicrobial activity of a conventional glass ionomer cement (GIC) with natural plant extracts. The effect of this alteration on the bond strength and film thickness of glass ionomer cement was evaluated and related to an 0.5% chlorohexidine modified GIC. Olive leaves (Olea europaea), Fig tree (Ficus carica), and the leaves and roots of Miswak (Salvadora persica) were used to prepare an alcoholic extract mixture. The prepared extract mixture after the evaporation of the solvent was used to modify a freeze-dried glass ionomer cement at three different extracts: water mass ratios 1:2, 1:1, and 2:1. An 0.5% chlorhexidine diacetate powder was added to a conventional GIC for the preparation of a positive control group (CHX-GIC) for comparison. The bond strength to dentine was assessed using a material-testing machine at a cross head speed of 0.5 mm/min. Failure mode was analyzed using a stereomicroscope at 12× magnification. The cement film thickness was evaluated in accordance with ISO standard 9917-1. The minimum number of samples in each group was n = 10. Statistical analysis was performed using a Kruskal–Wallis test followed by Dunn’s post hoc test for pairwise comparison. There was a statistically insignificant difference between the median shear bond strength (p = 0.046) of the control group (M = 3.4 MPa), and each of the CHX-GIC (M = 1.7 MPa), and the three plant modified groups of 1:2, 1:1, 2:1 (M = 5.1, 3.2, and 4.3 MPa, respectively). The CHX-GIC group showed statistically significant lower median values compared to the three plant-modified groups. Mixed and cohesive failure modes were predominant among all the tested groups. All the tested groups (p < 0.001) met the ISO standard of having less than 25 µm film thickness, with the 2:1 group (M = 24 µm) being statistically the highest among all the other groups. The plant extracts did not alter either the shear bond strength or the film thickness of the GIC and thus might represent a promising additive to GICs.