Susumu Nakagaki

Effect of coating on properties of esthetic orthodontic nickel-titanium wires

OBJECTIVE To determine the effect of coating on the properties of two esthetic orthodontic nickel-titanium wires. MATERIALS AND METHODS Woowa (polymer coating; Dany Harvest) and BioForce High Aesthetic Archwire (metal coating; Dentsply GAC) with cross-section dimensions of 0.016 × 0.022 inches were selected. Noncoated posterior regions of the anterior-coated Woowa and uncoated Sentalloy were used for comparison. Nominal coating compositions were determined by x-ray fluorescence (JSX-3200, JOEL). Cross-sectioned and external surfaces were observed with a scanning electron microscope (SEM; SSX-550, Shimadzu) and an atomic force microscope (SPM-9500J2, Shimadzu). A three-point bending test (12-mm span) was carried out using a universal testing machine (EZ Test, Shimadzu). Hardness and elastic modulus of external and cross-sectioned surfaces were obtained by nanoindentation (ENT-1100a, Elionix; n  =  10). RESULTS Coatings on Woowa and BioForce High Aesthetic Archwire contained 41% silver and 14% gold, respectively. The coating thickness on Woowa was approximately 10 µm, and the coating thickness on BioForce High Aesthetic Archwire was much smaller. The surfaces of both coated wires were rougher than the noncoated wires. Woowa showed a higher mean unloading force than the noncoated Woowa, although BioForce High Aesthetic Archwire showed a lower mean unloading force than Sentalloy. While cross-sectional surfaces of all wires had similar hardness and elastic modulus, values for the external surface of Woowa were smaller than for the other wires. CONCLUSIONS The coating processes for Woowa and BioForce High Aesthetic Archwire influence bending behavior and surface morphology.

Effects of bonding materials on the mechanical properties of enamel around orthodontic brackets

OBJECTIVE To determine if the enamel around orthodontic brackets is significantly altered after demineralization followed by application of adhesives with and without fluoride-releasing ability. MATERIALS AND METHODS One hundred eight noncarious human premolars were divided into six groups of 18 each and exposed to a demineralization solution. Stainless steel brackets were bonded using two conventional composite resin etch-and-rinse systems, three self-etching primer (SEP) composite resin systems, and one resin-modified glass ionomer cement (RMGIC) system. One conventional and one SEP composite resin adhesive did not have fluoride-releasing ability, which was claimed for the other four adhesives. The elastic modulus and hardness of the enamel were determined with a nanoindenter at 10 equidistant depths ranging from 1-46 µm and at four regions: control (not exposed) enamel surface, under the adhesive, and at 50 µm and 100 µm from the bracket edges. Using the Kruskal-Wallis and Mann-Whitney U-tests (P < .0125 for statistical significance), these properties were compared at different regions. RESULTS The same behavior was observed for values of elastic modulus and hardness. Significant differences were found within approximately 21 µm of the enamel surface for etching with 35% phosphoric acid or priming with SEP, but only minimal changes occurred for the SEP adhesive. Increases in near-surface elastic modulus and hardness of enamel were found with the SEP adhesive and RMGIC with fluoride-releasing ability. CONCLUSIONS Clinical use of the fluoride-releasing adhesives investigated may prevent demineralization of enamel around brackets during orthodontic treatment.

Frictional and mechanical properties of diamond-like carbon-coated orthodontic brackets

This study investigated the effects of a diamond-like carbon (DLC) coating on frictional and mechanical properties of orthodontic brackets. DLC films were deposited on stainless steel brackets using the plasma-based ion implantation/deposition (PBIID) method under two different atmospheric conditions. As-received metal brackets served as the control. Two sizes of stainless steel archwires, 0.018 inch diameter and 0.017 × 0.025 inch cross-section dimensions, were used for measuring static and kinetic friction by drawing the archwires through the bracket slots, using a mechanical testing machine (n = 10). The DLC-coated brackets were observed with a scanning electron microscope (SEM). Values of hardness and elastic modulus were obtained by nanoindentation testing (n = 10). Friction forces were compared by one-way analysis of variance and the Scheffé test. The hardness and elastic modulus of the brackets were compared using Kruskal-Wallis and Mann-Whitney U-tests. SEM photomicrographs showed DLC layers on the bracket surfaces with thickness of approximately 5-7 μm. DLC-coated brackets deposited under condition 2 showed significantly less static frictional force for the stainless steel wire with 0.017 × 0.025 inch cross-section dimensions than as-received brackets and DLC-coated brackets deposited under condition 1, although both DLC-coated brackets showed significantly less kinetic frictional force than as-received brackets. The hardness of the DLC layers was much higher than that of the as-received bracket surfaces. In conclusion, the surfaces of metal brackets can be successfully modified by the PBIID method to create a DLC layer, and the DLC-coating process significantly reduces frictional forces.

Effect of the quantity and quality of cortical bone on the failure force of a miniscrew implant

This study examined the influence of the quantity and quality of cortical bone on the failure force of miniscrew implants. Twenty-six titanium alloy miniscrew implants (AbsoAnchor) 1.4mm in diameter and 5 or 7 mm long were placed in cross-sectioned maxillae (n = 6) and mandibles (n = 20) of human cadavers. Computed tomography imaging was used to estimate the cortical bone thickness and bone mineral density [total bone mineral density (TBMD, values obtained from cortical bone plus trabecular bone); cortical bone mineral density (CBMD, values obtained from only cortical bone)]. Maximum force at failure was measured in a shear test. Nanoindentation tests were performed to measure the hardness and elastic modulus of cortical bone around the miniscrew implants. The mean failure force of miniscrew implants placed in mandibles was significantly greater than that for implants in maxillae, and the bone hardness of mandibles was significantly greater than that of maxillae. The length of miniscrew implants did not influence the mean failure force in monocortical placement in the mandible. Cortical bone thickness, TBMD, CBMD, and bone hardness were significantly related to the mean failure force. CBMD was related to the mechanical properties of cortical bone. In conclusion, the quantity and quality of cortical bone greatly influenced the failure force of miniscrew implants.

Effect of immediate loading on the biomechanical properties of bone surrounding the miniscrew implants.

The aim of this study was to investigate the effect of immediate loading on the biomechanical properties of bone surrounding a miniscrew implant. Forty titanium alloy miniscrew implants were placed on the buccal side of the maxillae and mandibles in four beagle dogs. Twelve pairs of miniscrew implants were immediately loaded with approximately 150 g of continuous force using nickel-titanium coil springs and the remaining 16 implants were left unloaded for 8 weeks. Nanoindentation testing was performed (peak load 10 mN) and the hardness and elastic modulus were calculated. Two series of indentations (in cortical and trabecular bone) for both the compression and tension sides were made. For each site, five indentations were placed approximately 25 μm from the implant-bone interface and 250 μm from the screw thread. The mean hardness and elastic modulus were generally higher in mandibles than maxillae and were higher in cortical bone than in trabecular bone. The trabecular bone near the implant-bone interface on the compression side was significantly harder than that at other locations in trabecular bone. In conclusion, this is the first study that has investigated the biomechanical properties of bone surrounding a miniscrew implant under immediate loading using nanoindentation testing. The mechanical properties of bone surrounding a miniscrew implant may be influenced by immediate loading.

Bracket bond strength and cariostatic potential of an experimental resin adhesive system containing Portland cement

OBJECTIVE To determine if a new experimental resin-based material containing Portland cement (PC) can help prevent enamel caries while providing adequate shear bond strength (SBS). MATERIALS AND METHODS Brackets were bonded to human premolars with experimental resin-based adhesive pastes composed of three weight rations of resin and PC powder (PC 30, 7:3; PC 50, 5:5; PC 70, 3:7; n  =  7). Self-etching primer (SEP) adhesive (Transbond Plus) and resin-modified glass ionomer cement (RMGIC) adhesive (Fuji Ortho FC Automix) were used for comparison. All of the bonded teeth were subjected to alternating immersion in demineralizing (pH 4.55) and remineralizing (pH 6.8) solutions for 14 days. The SBS for each sample was examined, and the Adhesive Remnant Index (ARI) score was calculated. The hardness and elastic modulus of the enamel were determined by a nanoindenter at 20 equidistant depths from the external surface at 100 µm from the bracket edge. Data were compared by one-way analysis of variance and a chi-square test. RESULTS PC 50 and PC 70 showed significantly greater SBS than Fuji Ortho FC Automix, although Transbond Plus showed significantly greater SBS than other bonding systems. No significant difference in the ARI category was observed among the five groups. For specimens bonded with PC 50 and PC 70, the hardness and elastic modulus values in most locations were equivalent to those of Fuji Ortho FC Automix. CONCLUSIONS Experimental resin-based bonding material containing PC provides adequate SBS and a caries-preventive effect equivalent to that of the RMGIC adhesive system.

Effects of CO2 laser irradiation combined with fluoride application on the demineralization, mechanical properties, structure, and composition of enamel

We investigated the effects of CO2 laser irradiation combined with acidulated phosphate fluoride (APF) application on the demineralization of enamel. APF gel was applied to the buccal enamel of human premolars and CO2 laser was applied. After the specimens were immersed in demineralization solution for 72 h, they were subjected to depth-dependent micro-CT and nanoindentation analyses. Micro-X-ray diffraction and X-ray photoelectron spectroscopy were performed to analyze the surfaces. Some surface regions of the enamel in specimens that were laser-irradiated with low output and APF-treated showed significantly higher values of MD and hardness than specimens treated with APF alone. A higher fluoride concentration in the enamel surface was observed in specimens treated with CO2 laser irradiation plus APF gel application. In conclusion, CO2 laser irradiation with low output is preferable to improve acid resistance.

Effectiveness of methods for detaching orthodontic implants likely to fracture upon rotational torque – an animal study

Orthodontic implants may fracture at the cortical bone level upon rotational torque. The impacted fragment can be detached by a range of methods, which are all more or less time‐consuming and injurious to the cortical bone. The aim of this study was to compare three different methods for detaching an orthodontic implant impacted in cortical bone. Health Sciences University of Hokkaido animal ethics committee approved the study protocol. Orthodontic titanium‐alloy (Ti‐6Al‐4 V) implants were placed bilaterally on the buccal side of the mandible of beagle dogs. Subsequently, the implants were detached using either a low‐speed handpiece with a round bur, alternatively by use of a low‐power or a high‐power ultrasonic instrument. In the first experiment, 56 orthodontic implants were placed into the dissected mandible from 7 animals. The methods for detachment were compared with respect to time interval, as well as associated undesirable bone loss as appraised by use of cone‐beam computed tomography. In experiment two, 2x2 implants were placed bilaterally in the mandible of 8 animals and subsequently detached by manual rotational torque, and the described three methods for detachment. The implant socket was investigated histologically as a function of removal method immediately after removal, and after 1, 3 and 8 weeks and contrasted with the healing of the socket of the implant that was detached by manual rotational torque. Statistical significance was appraised by the use of non‐parametric Kruskal‐Wallis one‐way analysis of variance. The method using the low‐power ultrasonic required significantly longer removal time versus the two other methods, i.e. high‐power ultrasonic and low‐speed handpiece with a round bur (p < 0.02). The amount of undesirable bone loss was substantially larger with low‐speed handpiece with a round bur compared to the two ultrasonic methods (p < 0.05). Bone formation after 3 weeks of healing was more complete following the use of low or high‐power ultrasonic instrument in comparison with a low‐speed handpiece rotary instrument method. Orthodontic implants likely to fracture upon rotational torque or impacted fractured fragments should be detached preferably with an ultrasonic instrument, because of less associated bone loss and more rapid bone healing compared to the use of a low‐speed handpiece rotary instrument.