Objectives To analyse the sliding resistance of a modern 3D-printed polymer bracket combined with different archwire types and to compare the results with conventionally used polymeric, ceramic and metal brackets. It was of further interest which bracket-archwire combination could be best qualified for clinical use. Materials and methods The sliding behaviour was tested using an orthodontic measurement and simulation system (OMSS) for the use of two bracket types of the polymer, ceramic and metal group in combination with a 0.016 inch × 0.022 inch and 0.017 inch × 0.025 inch archwire of nickel-titanium (NiTi), titanium-molybdenum alloy (TMA) and stainless steel. Six bracket types were combined with six different archwire types and compared to each other. Results The sliding resistance showed significant differences between various the bracket-archwire complexes. The combination of 3D-printed polymer brackets with both steel archwire cross-sections showed the least values of sliding resistance (average 23–29%), while the combination of ceramic brackets with TMA archwires presented the highest (average 47%). Conclusions The present study could show that modern 3D-printed bracket materials can have similar or even better mechanical properties than conventional ones regarding sliding resistance. Although the combination of bracket and archwire material is decisive for low sliding resistance values, the selection of the bracket material seems to have a greater influence than the selection of the archwire material or its cross section. Clinical relevance It might be possible in future to combine aesthetic and biomechanical requirements for aesthetic brackets by using 3D-printing technology.
Objectives As part of orthodontic treatment, air polishing is routinely used for professional tooth cleaning. Thus, we investigated the effects of static powder polishing on sliding behaviour and surface quality of three different bracket materials (polymer, ceramic, metal), including a 3D-printed bracket. Methods Two bracket types of each material group were polished with an air-polishing device using sodium bicarbonate. Exposure times were set at 10, 20, and 60 s; the application distance was 5 mm. The force loss due to sliding resistance was tested with an orthodontic measurement and simulation system (OMSS) using a 0.016 inch × 0.022 inch stainless steel archwire. Untreated brackets served as control. Polishing effects and slot precision were evaluated using an optical digital and scanning electron microscope. Results Sliding behaviour and slot precision differed significantly between and within the groups. Prior to polishing, polymer brackets showed the least force loss, ceramic brackets the highest. With progressive polishing time, the resistance increased significantly with titanium brackets (26 to 37%) and decreased significantly with steel brackets (36 to 25%). Polymer brackets showed the smallest changes in force loss with respect to polishing duration. Slot precision showed the largest differences between material groups and was primarily manufacturer-dependent with hardly any changes due to the polishing time. Conclusion Powder polishing can positively or negatively affect the sliding properties of the bracket–archwire complex but is more dependent on the bracket–archwire material combination (i.e., manufacture-dependent slot precision). For titanium brackets, resistance only increased after 60 s of polishing. For ceramic brackets, effective reduction was observed after 10 s of polishing. Polymer brackets, including the 3D-printed brackets, showed better sliding properties than ceramic or metal brackets even after polishing for 60 s. Removal of plaque and dental calculus should lead to a noticeable improvement of the sliding properties and outweighs structural defects that may develop.
Objective: Intermaxillary elastics, anchored skeletally, represent a promising concept for treatment in adolescent patients with skeletal Class III anomalies. A challenge in existing concepts is the survival rate of the miniscrews in the mandible or the invasiveness of the bone anchors. A novel concept, the mandibular interradicular anchor (MIRA) appliance, for improving skeletal anchorage in the mandible, will be presented and discussed. Clinical case: In a ten-year-old female patient with a moderate skeletal Class III, the novel MIRA concept, combined with maxillary protraction, was applied. This involved the use of a CAD/CAM-fabricated indirect skeletal anchorage appliance in the mandible, with interradicularly placed miniscrews distal to each canine (MIRA appliance), and a hybrid hyrax in the maxilla with paramedian placed miniscrews. The modified alt-RAMEC protocol involved an intermittent weekly activation for five weeks. Class III elastics were worn for a period of seven months. This was followed by alignment with a multi-bracket appliance. Discussion: The cephalometric analysis before and after therapy shows an improvement of the Wits value (+3.8 mm), SNA (+5°), and ANB (+3°). Dentally, a transversal postdevelopment in the maxilla (+4 mm) and a labial tip of the maxillary (+3.4°) and mandibular anterior teeth (+4.7°) with gap formation is observed. Conclusion: The MIRA appliance represents a less invasive and esthetic alternative to the existing concepts, especially with two miniscrews in the mandible per side. In addition, MIRA can be selected for complex orthodontic tasks, such as molar uprighting and mesialization.
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