Although only a small percentage of orthodontic systematic reviews was registered a priori in PROSPERO, registered reviews were of higher quality than nonregistered reviews.
The purpose of this study was to evaluate the enamel colour changes associated with bonding of brackets with a no-mix (one-phase) adhesive resin (Unite) and a glass-ionomer adhesive (GC Fuji Ortho). Thirty recently extracted premolars were used in the investigation. Black rectangular pieces of adhesive tape with a 3-mm diameter window were used to standardize the enamel surface intended for analysis. The teeth were divided into two groups of 15 teeth each, brackets (Starfire TMB) were bonded with the two adhesives, and the enamel surfaces were colourimetrically evaluated at three time intervals: (a) before bonding (baseline), (b) following debonding and cleaning, and (c) after artificial photo-ageing for 24 hours. The CIE colour parameters (L*, a*, b*) were recorded and averaged for each material, interval group, and the corresponding colour differences (delta E) were calculated. The results were statistically analysed using two-way ANOVA repeated measures, and Scheffé multiple range test at alpha = 0.05 level of significance. All differences noted exceeded the threshold for clinical detection (delta E = 3.7). The highest differences were recorded for the baseline-debonding interval for both adhesives used. No difference was found with respect to delta E between etching-mediated and no etching-mediated bonding implying that the debonding cleaning process involving adhesive grinding may be more invasive relative to acid etching with regard to enamel colour alterations.
The purpose of this study was to assess quantitatively the roughness of the enamel surface following debonding using two resin removal methods. The enamel surface of 30 premolar crowns was covered with black tape with a 3 mm window on the middle buccal third to standardize the area of analysis. The initial enamel surfaces were subjected to profilometry, registering four roughness parameters (Ra, Rq, Rt and Rz). The brackets were bonded to the plaster-embedded enamel surfaces with a chemically cured, no-mix adhesive, and debonded after 1 week. Resin removal in half of the specimens was performed with an eight-bladed carbide bur, and in the other half with an ultra-fine diamond bur, both attached to a high speed hand piece; a second profilometric measurement was made after resin removal. Finishing of all surfaces was achieved with Soflex discs and a third registration of roughness followed. The duration of each resin removal protocol was also recorded. The results were analysed with two-way ANOVA and the Newman-Keuls test with the two resin grinding modes and the three intervals serving as discriminating variables (n = 15). For the duration results, a one-way ANOVA was used. Significant differences (P < 0.05) were observed with respect to enamel roughness parameters between the two resin grinding methods used, while there was no consistent roughness-reducing effect of finishing with Soflex discs. Resin removal with a diamond bur was achieved in approximately half the time compared with the eight-bladed bur. The increase in most roughness variables induced by the debonding procedures was not reversed at the end of the finishing stage, regardless of the resin removal protocol used, suggesting an irreversible effect on enamel texture.
The purpose of this article is to examine the soundness of conventional orthodontic bonding assessment methods. A classification of bond strength studies is proposed with the testing environment (in vivo, in vitro, and ex vivo), loading mode (shear, tensile, and torsion), and bonding substrate (enamel, restorative, and prosthetic materials) serving as discriminating variables. Inconsistencies throughout the various stages of research protocols are analysed. These include the following: tooth selection, storage, and preparation; bonding; testing; and data analysis with regard to the clinical applicability of the reported information, as well as the scientific integrity of the testing procedure. Contradictory models may partially account for the considerable variability noted for reported bond strength values of different orthodontic bonding systems. Such discrepancies may also explain the conflicting evidence reported on the failure characteristics of the components of the bonding system in different trials examining the efficacy of nominally identical materials. A novel approach to study the fatigue life of materials is proposed to understand the processes occurring prior to bond failure. Mock research data manipulation is also utilized to illustrate the correct statistical treatment of findings, and recommendations for future research are made to ensure scientific soundness and clinical applicability of data.
The objectives of this study were to investigate the structure of Invisalign appliances (Align Technology, Santa Clara, Calif) after intraoral exposure, and to qualitatively and quantitatively characterize the substances leached from the aligners after accelerated in vitro aging. Samples of Invisalign appliances were randomly selected from 10 patients before intraoral placement and after retrieval, and the prepared specimens were subjected to (1) bright-field optical reflection microscopy to study the surface morphology; (2) Fourier transform infrared microspectroscopy to characterize the in vivo changes in molecular composition induced on appliance surfaces, (3) scanning electron microscopy and energy dispersive X-ray microanalysis to identify the elemental composition of integuments formed on the surface, and (4) Vickers hardness (HV 200) testing. Another set of reference and retrieved appliances was subjected to artificial aging for 2 weeks, and the extracts were subjected to gas chromatography-mass spectroscopy. The retrieved appliances demonstrated substantial morphological variation relative to the as-received specimens involving abrasion at the cusp tips, adsorption of integuments, and localized calcification of the precipitated biofilm at stagnation sites. Buccal segments of retrieved appliances showed an increase in hardness, which might be attributed to mastication-induced cold work; however, the clinical implication of this effect on mechanotherapy is unknown. In vitro aged and retrieved appliances were found to leach no traceable amount of substances in an ethanol aging solution.
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