Available commercial ceramic brackets are made of alumina either monocrystalline or polycrystalline. One major drawback of these brackets is fracture during archwire torsion or tipping. Another drawback is that each type comes in one shade only: transparent or translucent. Objectives: To fabricate orthodontic brackets from different esthetic materials and evaluate their mechanical properties; to introduce extremely low profile miniature zirconia brackets and evaluate their torsional fracture strength; also, to fabricate brackets in shades comparable to natural tooth shades, and compare them to commercial ceramic brackets under different lights. Materials and Methods: CAD/CAM technology was used to mill brackets from: ParadigmTM MZ100 and LavaTM Ultimate resin composite; Mark II feldspathic porcelain; and In-Ceram® YZ zirconia. The brackets were subjected to two separate tests (torque and tipping). The average moments necessary to fracture the brackets were determined and compared to those of commercial alumina brackets, Mystique® MB and Resolve®. Also, miniature zirconia brackets were fabricated and subjected to torsion till failure. Static fatigue test was performed on standard YZ, MZ100, and Mystique brackets. Brackets were fabricated using CAD/CAM in shade A3 materials: MZ100; Lava Ultimate; and Mark II. Zirconia and alumina brackets were also fabricated and colored. Adobe Photoshop software was used to determine ΔE values between the brackets and A3 acrylic teeth from digital images taken under three different lights (daylight, fluorescent, and incandescent). The shaded brackets were compared to commercial alumina brackets: Inspire ICETM; Radiance PlusTM; Avex® CX; and Mystique® MB. Results: Standard zirconia brackets had the highest torsional and tipping strength among the tested esthetic brackets. Miniature zirconia brackets showed comparable or even statistically significantly higher resistance to archwire torsion than commercial alumina brackets. Standard zirconia brackets showed the highest survival rate of 83%. Under daylight, Radiance Plus and Lava Ultimate brackets had the smallest mean ΔE values. Lava Ultimate brackets had the smallest mean ΔE under fluorescent and incandescent light. Conclusions: Esthetic brackets can be fabricated in extremely low profile and smaller dimensions from zirconia with fracture strength comparable to the bulkier commercial alumina brackets. Also, brackets can be produced in natural tooth shades enhancing their esthetic appearance. / 2018-09-28T00:00:00Z

Orientadores: João Sarmento Pereira Neto, Simonides Consani / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-04T04:19:16Z (GMT). No. of bitstreams: 1 Lunardi_Nadia_M.pdf: 1996088 bytes, checksum: 349b61cd35911f4191f9ad6dc0b13a3f (MD5) Previous issue date: 2004 / Resumo: O objetivo desta pesquisa foi avaliar in vitro a resistência ao cisalhamento de braquetes ortodônticos metálicos submetidos a duas reciclagens consecutivas com jato de óxido de alumínio, em função de quatro tipos diferentes de materiais fixadores. A amostra consistiu de 40 incisivos bovinos para confecção dos corpos-de-prova. Quarenta braquetes metálicos edgewise, de incisivo central Ultraminitrim (Dentaurum), foram colados nos dentes bovinos com os seguintes materiais fixadores: Transbond XT, Concise, Smartbond e Fuji Orto, seguindo as instruções do fabricante. Após a colagem os corpos-de-prova foram armazenados em água destilada numa estufa a 37ºC por 24 horas e submetidos à 500 ciclos térmicos com 30 segundos em cada balho (5ºC e 55ºC). O ensaio de resistência ao cisalhamento foi realizado numa máquina Instron com velocidade de 0,5mm/min. Os braquetes removidos foram reciclados com jateamento de óxido de alumínio (50 micrômetro) e colados novamente no mesmo corpo-de-prova, utilizando os mesmos materiais fixadores. Após o segundo ensaio de resistência ao cisalhamento, os procedimentos de reciclagem, recolagem e ensaio de força foram repetidos. Os dados foram submetidos à análise de variância e ao teste de Tukey (p=0.05), aplicado para cada sistema adesivo nos diferentes tratamentos dos braquetes metálicos. Foi comprovado que reciclagens repetidas, utilizando o jateamento de óxido de alumínio, não interferem na resistência adesiva, independente do sistema adesivo empregado. Dentre os adesivos utilizados, o Transbond XT apresentou os maiores valores de resistência ao cisalhamento, independente do tratamento do braquete. Assim, concluímos que o efeito cumulativo das reciclagens não afetou a resistência ao cisalhamento de braquetes metálicos e que o efeito adesivo do material utilizado para fixação do braquete não foi alterado pelas reciclagens repetidas / Abstract: The aim of this research was to evaluate in vitro shear bond strength of metallic orthodontic brackets submitted to two consecutive recyclings with aluminium oxide air abrasion, making use of four different bond materials. The sample consisted of 40 bovine incisives. Forty metallic orthodontic edgewise brackets of central incisor Ultraminitrim (Dentaurum), were fixed in the bovine teeth with the following bonded material: Transbond XT, Concise, Smartbond and Fuji Orto, following the manufacturer's instructions. After bonding, they were stored in distilled water in incubators at 37ºC for 24 hours and submitted to 500 thermal cycles with 30 seconds in each bath (5ºC and 55ºC). The shear bond strength was determined with an Instron universal machine with 0,5mm/min speed. The removed brackets were recycled with aluminium oxide air abrasion (50 micrometer) and bonded again in the same bovine incisive, using the same bond material. After the second shear bond strength test the recycling procedures, the rebonding and shear bond strength test were repeated. The data were submitted to Analysis of Variance and Tukey's test (p=0.05), applied for each adhesive system in different treatments of metallic brackets. It was demonstrated that repeated recyclings, using the aluminium oxide air abrasion, don't interfere in the adhesive resistance, independent of the employed bond material. Among the used bond materials, Transbond XT presented the largest resistance values of shear bond strength, independent of the treatment of the bracket. Thus, we concluded that the recycling cumulative effects didn't affect the shear bond strength of metallic orthodontic brackets and that the effect bond material used for fixation of the bracket was not altered by the repeated recyclings / Mestrado / Ortodontia / Mestre em Ortodontia

Indiana University-Purdue University Indianapolis (IUPUI) / Microabrasion with PREMA Compound (Premier Dental Product Co., King of Prussia, Penn.) has been advocated for the removal of superficial enamel stains. This procedure eliminates stains by removing a microscopic layer of enamel. The objective of this study was to determine whether the use of PREMA microabrasion prior to orthodontic bonding affects the tensile bond strength of an adhesive precoated stainless steel orthodontic bracket. Sixty noncarious extracted human premolar teeth were randomly divided into three groups of 20 and stored in 3-percent buffered formalin solution. Group I was a control group that was etched and bonded in the usual manner. Group II received PREMA Compound microabrasion immediately prior to bonding. Group III received PREMA microabrasion followed by a six-week storage period prior to bonding. After bonding, specimens were thermocycled and stored in distilled water at 37 °C for 14 days. The specimens were then loaded to failure in the tensile mode of an Instron testing machine (Instron Corp., Canton, Mass.). A stress-breaking apparatus was utilized to minimize all forces other than tensile. The data was statistically analyzed using one-way analysis of variance at the 0.05 level. No statistically significant differences were found among the three groups. From these results it was concluded that microabrasion with PREMA did not affect bond strength. Enamel microabrasion can be provided prior to orthodontic treatment without any detriment to bracket bond strength.

Indiana University-Purdue University Indianapolis (IUPUI) / Understanding the factors that increase patients susceptibility to orthodontically induced root resorption is of the utmost importance to the practicing clinician. Numerous studies have been conducted that investigated contributing and etiological factors that tend to increase the amount of external apical root resorption a patient may incur during orthodontic treatment. However, there has been little research that has attempted to determine if patients treated with different slot size orthodontic brackets exhibit the same amount of external apical root resorption. The purpose of this research was to determine if patients treated with the 0.018 x 0.025 slot size bracket and patients treated with the 0.022 x 0.028 exhibited similar amounts of external apical root resorption during orthodontic treatment. Pre and Post treatment panoramic films from 91 consecutively treated orthodontic patients from a private orthodontic practice were used for this study. Each case that was included in the study had been treated with standard edgewise brackets using the Tweed-Merrifield philosophy of treatment. Forty-three cases from the 0.018 group and 48 from the 0.022 group were obtained. Each film that was analyzed was blinded prior to measuring to minimize observer bias. Mitutoyo Digimatic® calipers accurate to the nearest tenth of a millimeter were used for obtaining tooth measurements. Measurements were made from the Cemento-enamel junction and from incisal/occlusal to most apical portion of each incisor and all first molars. Statistical analysis was performed and the results showed no significant correlation between the size of the bracket and the amount of root resorption. No significant correlations existed between the groups for patient age, time in treatment, gender, and angle classification. Statistically significant differences were noted for cases in which extraction of four bicuspids was performed. Subjects belonging to the extraction group demonstrated significantly more external apical root resorption than those in which extractions were not done. This study demonstrated that the incidence of EARR that a patient may incur during treatment is independent of the size of the slot of the orthodontic bracket.

Indiana University-Purdue University Indianapolis (IUPUI) / New products are frequently developed for bonding brackets. This continuum brings about incessant studies attempting to prove or disprove their value. The need to compare the results of bond failure studies is made difficult if not impossible by the variation of published testing methods. The purpose of this study is to compare the differential effects of thermocycling, as a lab protocol, on three debonding techniques, shear-peel, tension, and torsion when using a traditional orthodontic resin adhesive. A standard orthodontic resin, Transbond™ XT (3M Unitek, Monrovia, CA) was used to bond 102 flattened 0.018-inch stainless steel brackets (3M Unitek) to flattened bovine incisors. Two step acid etching and priming (37 % phosphoric acid gel and Transbond MIP Primer, 3M Unitek) was used to prepare the enamel for bonding. During bonding, the resin thickness was held consistent. The bonding was accomplished under controlled temperature and humidity. Half of the samples were thermocycled prior to debonding. The samples were debonded in shear-peel, tension, and torsion. The data showed no significant differences between thermocycling and nonthermocycling in shear-peel or torsion, but in tension the thermocycling group had a statistically significant higher failure load. Overall, was a trend toward increased bond strength in the thermocycled group. The increase is likely the result of continued polymerization during thermocycling. The statistical difference that is noted in tension is thought to be due to the location of the highest stress being in the center of the resin pad. This would be the location of the least initial polymerization. The use of thermocycling as a lab protocol during bracket failure studies in shear-peel and torsion is not necessary when using traditional orthodontic resin.

Indiana University-Purdue University Indianapolis (IUPUI) / The search for an orthodontic bonding adhesive that has chemical adhesion to enamel and releases fluoride into the oral environment has led to experimentation with glass ionomer cements. This study compared the tensile bond strength of eight different orthodontic bracket base designs in vitro and assessed the amount of adhesive remaining on the bracket pad after debonding. Each bracket base design included in this study had unique characteristics warranting their inclusion. The groups contained brackets with 60, 80, and 100 gauge mesh pads; 100 gauge mesh sandblasted pads; perforated metal bases; Micro-Lock™ photo-etched bases; Dyna-Lock™ integral bracket/bases; and ceramic silane-coated bracket pads. Groups contained 20 to 22 specimens that were bonded to bovine incisor teeth embedded in a self-curing acrylic block that could be held in the testing machine. Pre-encapsulated glass ionomer cement (Ketac-Fil™) was the experimental adhesive. The adhesive was mixed according to the manufacturer's instructions in a dental amalgamator. The specimens were thermocycled between water oaths of 15°C and 55°C. The specimens spent 30 seconds in each bath for a total of 2,500 cycles and were stored in a humidor until debonding. After 14 days, the specimens were subjected to a tensile force using an Instron mechanical testing machine until failure occurred. The Micro-Loc™ photo-etched base had significantly higher mean tensile bond strength (p<0.05) than all other brackets tested. The ceramic brackets were unable to be tested due to the extremely weak bond strength which did not allow preparation of the samples for debonding. Following debonding, the percentage of adhesive remaining attached to the bracket base was determined using a grid in the ocular of a light microscope. In general, the site of bond failure involved the base/adhesive interface. The Dyna-Lock™ integral bracket/base and 80 gauge mesh base had a greater mean percent of adhesive remaining attached to the base. (Dyna-Lock™ 45 percent and 80 gauge mesh 43 percent vs. all other < 20 percent.) The results indicate that the bracket base design can influence the bond strength when GIC is used as an orthodontic adhesive and suggests that development of GIC with increased fracture toughness might increase bond strength.

Aim: To compare the 0.018-inch and 0.022-inch conventional pre-adjusted orthodontic bracket slot systems in terms of the effectiveness of levelling and alignment stage of orthodontic treatment. Design: Prospective, multi-centre randomised clinical trial. Setting: This was undertaken in the secondary care hospital environment in Tayside NHS in the United Kingdom. Subjects and methods: One hundred and five orthodontic patients were randomly allocated to treatment with either the 0.018-inch bracket slot (n= 52) and 0.022-inch bracket slot (n=53) Victory conventional pre-adjusted bracket systems (3M Unitek). The patients were treated in three centres in secondary care hospitals Tayside NHS, United Kingdom. The levelling and alignment stage of treatment was assessed from the start of treatment until the ligation of the working archwire for each bracket slot system (0.016x0.022 stainless steel for the 0.018-inch group and 0.019x0.025 stainless steel for the 0.022-inch group). Periapical radiographs were taken before the start of treatment and after 9 months in treatment for the maxillary central incisors to assess orthodontically-induced inflammatory root resorption (OIIRR). The “Smiles better” questionnaire was completed by the participants at 6 months from the start of treatment. Primary outcome measures: The duration of the levelling and alignment stage of orthodontic treatment in the maxillary and mandibular arches. Secondary outcome measures: The number of scheduled appointments for the levelling and alignment stage of orthodontic treatment in the maxillary and mandibular arches, OIIRR at 9 months from the start of treatment using periapical radiographs and patient perception of wearing orthodontic appliances. Results: The data from 92 patients (mean age 19.55 years) were analysed after the completion of their levelling and alignment stage of orthodontic treatment. An ANOVA test showed no statistically significant difference in the duration or number of scheduled appointments for the levelling and alignment stage in the maxillary and mandibular arches between the two appliance groups. Non-parametric statistical test showed no statistically significant difference in the severity of OIIRR and patient perception of wearing orthodontic appliances between the two study groups except for the soreness of teeth, where more patients in the 0.022-inch group experienced significant teeth soreness than the 0.018-inch group. Multiple regression analysis determined that 49.6% of the variance in the duration of levelling and alignment duration for the maxillary arch can be explained by five factors: alignment of ectopic tooth, scheduled appointment intervals, gender, bracket slot size system and the number of failed scheduled visits. For the mandibular arch, 50.8% of the variance in the levelling and duration of alignment can be explained by three factors: scheduled appointment intervals, arch irregularity and the number of debonded brackets. Conclusions: There is no difference in the effectiveness of the levelling and alignment stage of orthodontic treatment between the 0.018-inch or 0.022-inch conventional bracket slot systems except for the soreness of teeth.

Magister Chirurgiae Dentium - MChD (Orthodontics) / The aim of the study is to compare the frictional resistance generated between two types of self-ligating brackets; Smart-Clip Metal SL (3M Unitek) and Damon Clear SL (Ormco), with conventional stainless steel brackets, Victory Series (3M Unitek) when coupled with various stainless steel and nickel-titanium archwires. Materials and Methods: All brackets had a 0.022" slot and tested using three archwires: 0.016" nickel-titanium, 0.019 x 0.025" nickel-titanium and 0.019 x 0.025" stainless steel archwires. Friction was evaluated for the upper right quadrant of the typodont. For each testing procedure, new brackets and archwire was employed to eliminate the influence of wear. Results: The mean results showed that the Smart-Clip self-ligating brackets generated significantly lower friction than both the Damon Clear self-ligating brackets and Victory Series brackets. However, the analysis of the various bracket-archwire combinations displayed that Damon Clear SL brackets generated the lowest friction when tested with 0.016" round nickeltitanium archwire and significantly higher friction than Smart-Clip and Victory Series brackets when tested with 0.019 x 0.025" stainless steel rectangular archwires. All brackets showed higher frictional forces as the wire size increased. Clinical relevance: The production of high levels of friction during orthodontic sliding mechanics presents a clinical challenge to the orthodontists. The generation of high levels of friction may reduce the effectiveness of the mechanics, decrease tooth movement efficiency and further complicate anchorage control. The amount of friction is variable in the orthodontic system and can be altered somewhat by the orthodontist's choices.

O objetivo do trabalho foi avaliar a resistência ao cisalhamento de bráquetes ortodônticos cerâmicos com base de retenção química e mecânica, colados com diferentes compósitos e irradiados com laser de CO2. Foram utilizados 120 pré-molares humanos hígidos, suas coroas foram incluídas em resina acrílica e as faces vestibulares planificadas e polidas com lixas d\'água até exposição de 5mm esmalte. Posteriormente, as raízes dos dentes foram incluídas em tubos de PVC também com resina acrílica de forma que a face vestibular ficasse perpendicular à base do tubo. Os 120 corpos de prova foram divididos em 8 grupos (n=15), sendo 2 controles e 6 experimentais. Nos grupos 1 e 2 (controles) o compósito utilizado para colagem foi o Transbond XT, sendo que no grupo 1 foi colado o bráquete cerâmico Mystique (retenção mecânica) e no grupo 2 o bráquete cerâmico Fascination (retenção química). Nos grupos experimentais 3, 4 e 5 foi colado o bráquete Mystique com os compósitos Transbond XT, Concise e Z250, respectivamente. Nos grupos 6, 7 e 8 foi colado o bráquete Fascination com os mesmos compósitos dos grupos 3, 4 e 5, na mesma sequência. Nos grupos experimentais, após a colagem, os bráquetes foram irradiados com laser de CO2 com 10W de potência por 3 segundos e pulso de 0,01 segundo. Imediatamente após a irradiação foi realizado o teste de resistência ao cisalhamento da colagem em máquina universal de ensaios mecânicos (Emic DL 500) à velocidade de 0,5 mm/minuto. Após o teste, as superfícies avaliadas por meio do Índice de Remanescente Adesivo (IRA) e submetidas à Microscopia Eletrônica de Varredura (MEV) para investigação de eventuais fraturas. Os dados de resistência ao cisalhamento foram submetidos à Análise de Variância ANOVA e posteriormente teste de Tukey. O teste de Mann-Whitney foi utilizado para a avaliação do IRA. Os resultados mostraram que os grupos experimentais apresentaram valores de resistência ao cisalhamento menores quando comparados aos controle (p 0,05). O bráquete Mystique (retenção mecânica) apresentou valores maiores de resistência ao cisalhamento e o compósito Z 250 foi o que apresentou menor força de adesão após irradiação com laser de CO2. Os grupos 5 e 8 foram os que apresentaram maior média do IRA e para todas as superfícies avaliadas o modo de fratura mais prevalente foi a fratura adesiva . Concluiu-se que o laser de CO2 foi eficaz como auxiliar na descolagem de bráquetes cerâmicos de retenção química e mecânica. / The objective of this study was to evaluate the shear strength of the ceramic orthodontic brackets based in chemical and mechanical restraint, bonded with different composites and irradiated with CO2 laser was evaluated. Healthy human premolars (120) were used and their crowns were embedded in acrylic resin and the buccal surfaces flattened and polished with sandpaper until exposure of 5 mm of enamel. Subsequently, the roots of the teeth were included in PVC pipes also with acrylic resin so that the labial surface was perpendicular to the base of the pipe. The 120 samples were divided into 8 groups (n = 15), 2 being the control groups and 6, the experimental groups. In groups 1 and 2 (controls) the composite used for bonding was Transbond XT. Group 1 was glued to the ceramic bracket Mystique (by mechanical retention) and the group 2, with ceramic bracket Fascination (by chemical restraint). In the experimental groups 3, 4 and 5 Mystique brackets were glued with Transbond XT, Concise and Z250, respectively. In groups 6, 7 and 8 the Fascination bracket were glued with the same composites of groups 3, 4 and 5 and in the same sequence. In the experimental groups, after bonding, the brackets were irradiated with CO2 laser with 10W of power for 3 seconds and per pulse 0.01 seconds. Immediately after irradiation shear strength tests were performed on shear bonding with mechanical universal testing machines (Emic DL 500) at a speed of 0.5 mm/minute. After testing, the surfaces were evaluated using the Adhesive Remnant Index (ARI) and submitted to scanning electron microscopy (SEM) to investigate possible fractures. The shear strength data were subjected to analysis of variance with ANOVA and Tukey test later. The Mann-Whitney test was used to evaluate the ARI. The results showed that experimental groups showed lower shear strength values, comparing to the control groups (p 0.05). The bracket Mystique (mechanical retention) showed higher shear strength values and the Z 250 composite showed the lowest adhesion strength after irradiation with CO2 laser. Groups 5 and 8 presented the highest average of IRA and for all the surfaces that were evaluated the most prevalent fracture mode was the adhesive one. It was concluded that the CO2 laser was effective as an aid in bracket debonding of ceramic with chemical and mechanical retention.

O objetivo desse trabalho foi avaliar as alterações nas ranhuras dos bráquetes após uso clínico e o seu impacto na alteração da força de atrito. Para isso foi realizada uma revisão sistemática da literatura, e um estudo prospectivo comparando os níveis de atrito antes e depois do uso clínico dos bráquetes, assim como comparando dois diferentes materiais para jateamento profilático. A revisão sistemática avaliou 7 artigos que cumpriram os devidos critérios de inclusão, a partir de busca eletrônica realizada em diversas bases de dados, sem limitações quanto a data e o idioma. Foram avaliados quanto a qualidade metodológica, e ao risco de viés de acordo com uma versão modificada do checklist de Donws and Black. 6 dos 7 artigos apresentaram resultados com aumento significativo da força de atrito após o bráquete ser submetido ao uso clínico. O segundo estudo do presente trabalho se trata de um estudo prospectivo in-vivo, ao qual 16 pacientes, submetidos a tratamento ortodôntico com bráquetes metálicos convencionais, compuseram 3 grupos de acordo com o protocolo de controle profilático realizado nos bráquetes de 2ºs pré-molares (Grupo 1 - pacientes submetidos à profilaxia com jateamento à base de bicarbonato de sódio; Grupo 2 pacientes submetidos à profilaxia com jateamento à base de glicina; Grupo 3 pacientes não foram submetidos à profilaxia profissional) Os bráquetes foram posteriormente removidos da cavidade oral e submetidos a ensaios de força de atrito, além de análise qualitativo da rugosidade superficial por microscopia eletrônica de varredura. O grupo controle (GC) para comparação foi constituído por bráquetes novos não submetidos à exposição em cavidade bucal. O teste de ANOVA seguido pelo teste Tukey foram utilizados para avaliar as diferenças entre os 4 grupos (GC, G1, G2 e G3). Os grupos de bráquetes usados apresentaram aumento da força de atrito, porém apenas o grupo que não foi realizado jateamento profilático a cada consulta (G3), apresentou diferença estatisticamente significante em relação ao Grupo Controle. Não houve diferença estatisticamente significante também quando comparados os dois diferentes materiais utilizados para o jateamento profilático. / The aim of this study was to evaluate the changes in bracket slots after clinical use and their impact on friction force. It is composed by a systematic review of the literature and a prospective study comparing the friction levels before and after the clinical use, as well as comparing two different materials for prophylactic blasting. The systematic review evaluated 7 articles that satisfied the inclusion criteria, based on electronic searches conducted in several databases, without limitations regarding publication year or language. The methodological quality and risk of bias were assessed according to a modified version of the Donws and Black checklist. 6 of the 7 articles presented significant increase in the friction force on retrieved brackets, after clinical use. The second study of the present study is a prospective in-vivo study which 16 patients were submitted to orthodontic treatment, divided in 3 groups according to the protocol of prophylactic control performed in brackets (Group 1 - patients submitted prophylaxis with sodium bicarbonate blasting, Group 2 - patients submitted to prophylaxis with glycine-based blasting, Group 3 - patients were not submitted to professional prophylaxis) Brackets were later removed from the oral cavity and subjected to friction force tests, in addition to qualitative analysis of surface roughness by scanning electron microscopy. The control group (CG) for comparison consisted of as received brackets (brand new brackets). The ANOVA test followed by the Tukey test were used to evaluate the differences between the 4 groups (GC, G1, G2 and G3). The retrieved groups presented an increase on friction force, but only the group that did not perform prophylactic blasting every appointment (G3) presented a statistically significant difference in comparison to the Control Group. There was no statistically significant difference also when comparing the two different materials used for prophylactic blasting.