Recent advances in orthodontic materials /certified fixed orthodontic courses by Indian dental academy

672 views

Published on


The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

Published in: Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
672
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
29
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Recent advances in orthodontic materials /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. www.indiandentalacademy.com
  3. 3. www.indiandentalacademy.com
  4. 4. Technological and material advancements in Orthodontics has made possible a constant improvement in the quality of orthodontic treatment ultimately, benefiting the patient. An analysis of the various dimensions of orthodontic advancement reveal two important truths. www.indiandentalacademy.com
  5. 5. Firstly, the biologic problems have remained singularly unchanged. New solutions to the old problems have resulted principally from advancements in orthodontic materials (Biomaterials) and their cascading end effect on appliance design and treatment strategies (Biomechanics). www.indiandentalacademy.com
  6. 6. The Problem, Treatment & The Result Biomechanics Biomaterials www.indiandentalacademy.com
  7. 7. Virtually every facet of orthodontic treatment has been changed for the better thanks to the advancement in the orthodontic material & biomechanics arena. Technique dogma will soon slip into orthodontic history !! www.indiandentalacademy.com
  8. 8. However there is still an inadequate understanding of this area by todays Orthodontists. This area has been shunned by the clinical orthodontist and by default has been the preserve of the manufacturers, the “engineer-orthodontist” and perhaps a few academicians. www.indiandentalacademy.com
  9. 9. Orthodontic material science is an emerging sub discipline of Orthodontics. The earlier we recognise and initiate efforts to foster it , the better it would be for Orthodontics. www.indiandentalacademy.com
  10. 10. The canvas is too broad to address all of the related issues, in this brief paper. This is a humble attempt in this direction within the constraints of the time allotted. www.indiandentalacademy.com
  11. 11. Have been in the market now for 3 years. How good are they ? What do we know more about them ? www.indiandentalacademy.com
  12. 12. SELF ETCHING (ACIDIC) PRIMER (SEP’s) ADHESIVE SYSTEMS An acidic primer combines the etchant with the primer in one application eg; Clearfil Liner Bond 2.( J.C.Moritta Kuraway, Japan) ie; contains both the acid (Phenyl-P) and the primer (HEMA and dimethacrylate) www.indiandentalacademy.com
  13. 13. NEWER ETCHING / BONDING SYSTEMS Self Etching Primers (systems) – (SEP’s) ( • Clearfil Liner bond V (Kuraray) • Megabond (Kuraray) • Prompt –L-Pop (Unitek-3M) • First Step (Reliance) • Transbond Plus SEP (Unitek -3M) • Ideal1 (GAC) • One up Bond F (Tokuyama) Moisture Insensitive Primers – • Assure (Reliance) • MIP (Unitek-3M) www.indiandentalacademy.com
  14. 14. Self – etching Adhesive Primer www.indiandentalacademy.com
  15. 15. www.indiandentalacademy.com
  16. 16. Self Etching Primers (Anirudh Agarwal & Jyothindra Kumar )  To determine the mean shear bond strength of orthodontic brackets bonded with an Acidic Primer System (Clearfil Liner Bond 2V) using both the light cured and the dual cure mode.  To compare the mean shear bond strength of both these materials with “Rely-a Bond”. www.indiandentalacademy.com
  17. 17. Self Etching Primers Table showing shear bond strength (MPa) Mean Minimum Maximum Std. Dev. Std. Err. 1.043 0.301 Rely-a-Bond™ 12.907 11.389 14.612 VLC Clearfil Liner Bond 2V 13.465 12.271 14.612 0.802 0.232 Dual Cure Clearfil Liner Bond 2V 13.610 11.977 14.906 0.803 0.232 www.indiandentalacademy.com
  18. 18. Self Etching Primers Bond strength of Acidic Primer System - adequate and acceptable for clinical use. No statistical difference with conventional composite resin adhesive system .Varies from 8 - 20 MPa.(In vitro-unground enamel) and 12-25.Mpa on ground human enamel. Can be used on Porcelain substrates – produces bond strengths of over 10 MPa when etched with Phosphoric acid and bonded with SEP. (Ajlouni et al 2003) A delay in bonding after SEP application further increases the bond strength ( 20 MPa at 1 minute vs 25 MPa at 10 mins – Errera et al ’03) www.indiandentalacademy.com
  19. 19. SEP: Self-etching Primer vs. Two-stage Etch and Prime system for Orthodontic Bonding: A RCT (Aljoubouri et al ’03) • Mean bonding time of brackets bonded with SEP was significantly shorter than that for the two-stage bonding system (mean difference 24.9 sec) • Bond failure rate was similar for each bonding system (SEP was 0.8% and for the two-stage etch and prime system was 1.1%. ) • Application of a self-etching primer provides no resistance to enamel demineralization as compared to a conventional sealant. (Kao et al ’03) www.indiandentalacademy.com
  20. 20. Bonding Durability of Orthodontic Brackets using SEP’s • No significant difference in shear bond strength was observed between phosphoric acid etching and self-etching primer before thermal cycling. • However, after 2000 and 5000 thermal cycles the bond strength obtained using self-etching primer was significantly higher than that with phosphoric acid etching (P<0.05). • There were no significant decrease in shear bond strengths using self-etching primer treatment after thermal cyclings (P>0.05). • Conclusion: Self-etching primer treatment produced more durable bonding of orthodontic brackets to human enamel than phosphoric acid etching. www.indiandentalacademy.com
  21. 21. SEP’s resistant to saliva contamination (S. SIRIRUNGROJYING et al ’03) • With self-etching primer treatment, saliva contamination did not cause any decrease of bond strength • Phosphoric acid etching produced more enamel fracture than self-etching primer treatment after debonding orthodontic brackets. • Field-emission scanning microscopy revealed that self-etching primer produced less dissolution of enamel surface www.indiandentalacademy.com compared with phosphoric acid.
  22. 22. Hydrophilic Primers Works in both dry and wet environments www.indiandentalacademy.com
  23. 23. Moisture Insensitive Primers (MIP) • Generally available as a primer formulation • An aqueous solution of methacrylate functionalised polyalkenoic acid copolymer and hydroxyethylmethacrylate. (Used earlier in hydrophilic dentin bonding systems). • Moisture active adhesives require the presence of water for initiating the setting reaction and will therefore fail in the dry environment. • Cyanoacrylates (Smart bond) is an example.Early www.indiandentalacademy.com reports indicate that they work adequately.
  24. 24. Zn treatment of enamel enhances bond strength & reduces decalcification (Olivier et al –’02) • Incorporation of Zn into hydroxyapatite is known to reduce plaque growth. It may be effective in resisting decalcification surrounding orthodontic brackets which is a common clinical problem • The shear strength (MPa) of the Zn-treated and control specimens were 11.31 ± 3.46 and 9.10 ± 3.94, respectively –No statistically signficant difference. www.indiandentalacademy.com
  25. 25. www.indiandentalacademy.com
  26. 26. Zn treatment of enamel • SEM, the Zn-treated surface was found to be rough and porous, characteristics conducive to mechanical bonding. EDXA revealed the incorporation of a significant amount of Zn in treated enamel. • Zn treatment of enamel, with its shear bond strength comparable to that of traditional phosphoric acid etched enamel, has the potential to be used in orthodontic bonding with possible protection against decalcification. www.indiandentalacademy.com
  27. 27. EDTA Etching ( Cehreli et al, 2000) • Evaluated the effects of 17% ethylenediaminetetraacetic acid (EDTA) and nonrinse conditioner (NRC) on enamel surface morphology and compared with traditional 37% phosphoric acid. • EDTA treatment had the least effect of all etchants tested. The SEM photographs revealed a smooth, wavelike, and reactive etched surface,while the integrity of enamel prisms was maintained www.indiandentalacademy.com
  28. 28. EDTA Etching • Irrespective of treatment time, NRC produced an aprismatic etch pattern, which suggested a potentially retentive morphological character. • Shorter etching time with phosphoric acid resulted in a relatively smooth enamel surface compared with longer treatments. www.indiandentalacademy.com
  29. 29. www.indiandentalacademy.com
  30. 30. Classification of Light curing Sources • Halogen Light curing Units (80’s) • High energy Laser curing systems (90’s >) • Plasma Arc Curing Units (2001 & >) • LED Curing Units (2002 & > ) www.indiandentalacademy.com
  31. 31. Halogen LC: Drawbacks Halogen bulbs have a limited effective lifetime of approximately 40-100 hours. High temperatures cause a gradual degradation of the halogen bulb, reflector, and filter, reducing the intensity of the light output and thus the unit’s effectiveness in curing composite resins. The clinical implication is that with an aging light-curing unit, adhesives will be less well cured, with poorer physical properties and an increased risk of bond failure. www.indiandentalacademy.com
  32. 32. Halogen LC: Drawbacks Dental halogen light-curing units do not reach the minimum power output specified by the manufacturers. This can be a result of improper maintenance, including failure to make a critical check of the light irradiance and to replace the filter and the halogen bulb on a www.indiandentalacademy.com regular basis
  33. 33. History Of LED in Dentistry • First suggested by: Mills, R.W.: Blue light emitting diodes—another method of light curing? Br. Dent. J. 178:169, 1995. • First report by: Fujibayashi, K.; Ishimaru, K.; Takahashi, N.; and Kohno, A.:Newly developed curing unit using blue light-emitting diodes,Dent. Jap. 34:49-53, 1998. www.indiandentalacademy.com
  34. 34. GC – E light 3M Unitek Ortholux www.indiandentalacademy.com
  35. 35. LED CURING UNITS • LEDs are semiconducting materials that transform current into light of a specific wavelength. • They are much smaller and lighter than conventional bulbs. They offer high shock resistance, as there is no filament to be damaged, and their relatively low power consumption makes them suitable for portable use in cordless devices. www.indiandentalacademy.com
  36. 36. • LEDs have lifetimes of more than10,000 hours and experience little degradation of light output over this time —a distinct advantage over halogen bulbs • LEDs require no filters to produce blue light. The spectral outputof these LEDs falls mainly within the absorption spectrum of the camphoroquinone photoinitiator (400500nm) of most dental composites. • LED sources have been found to produce a depth of cure significantly greater than that achieved with a conventional halogen light. www.indiandentalacademy.com
  37. 37. • LED sources have been found to produce a depth of cure significantly greater than that achieved with a conventional halogen light. • No significant differences in compressive strength, flexural strength, or modulus10 were found between composites polymerized with halogen units and those cured with LED units. www.indiandentalacademy.com
  38. 38. • Is the claim of adequate bond strength when using LED units borne out by in vitro / vivo evidence? www.indiandentalacademy.com
  39. 39. • Reynolds & Lalani have recommended a value of 6-8.MPa as adequate for clinically successful bonding. • Reviewing the published reports( 8 ),all studies have reported bond strengths of 6 – 16 MPa and as high as 19.9 ± 5.7 MPa (Cacciafesta –’02) • This is adequate for clinically successfull bonding. • Bond strength increases with exposure time and is a critical factor. There is a minimum exposure time. For current units it is about 10 secs or > www.indiandentalacademy.com
  40. 40. • Halogen lights still produce the highest bond strength approx – 30-40% more. • Etch – Prime –Bond (EPB) technique still produces the highest bond strength compared to One step techniques. • In terms of the initial cost the benefit is clinically not very significant. • Nevethless it is yet another way of delivering curing energy for bonding adhesives www.indiandentalacademy.com
  41. 41. • Does curing time length produce an intra pulpal temperature rise ? www.indiandentalacademy.com
  42. 42. • Halogen lights were found to produce a greater pulpal temperature rise – with longer curing cycles increasing iatrogenic pulpal damage risk. • LED’s tended to produce significantly lesser pulpal wall heating and had shorter cooling times. • May be related to their narrow energy spectrum. www.indiandentalacademy.com
  43. 43. PLASMA ARC CURE BONDING UNITS Apollo 95E Plasma Curing Unit www.indiandentalacademy.com
  44. 44. PLASMA ARC CURE BONDING Advantages  Overall time reduction – 2 mins for whole arch  Immediate bond strength appears to be very high  No enamel damage on debonding  Re - bonding of brackets is easy Disadvantages  Light emitted from plasma arc device is so powerful that both the operator and assistant should wear protective glasses  Additional cost of curing light www.indiandentalacademy.com
  45. 45. Exposure Time for PAC Systems • Two curing cycles of 3 seconds each can be recommended for bonding stainless steel brackets with xenon plasma arc curing lights. • Reducing curing time from 6 to 2 seconds resulted in a significant decrease in mean bond strength of premolar brackets. • Time saved is the significant advantage of plasma curing lights. www.indiandentalacademy.com
  46. 46. www.indiandentalacademy.com
  47. 47. LASER DEBONDING 1. The time spent to debond ceramic brackets is less when using lasers. Debonding forces are significantly reduced with lasers. 2. The risk of enamel damage and bracket fracture is significantly reduced with lasers. 3. The CO2 super-pulse laser is superior to normal pulse CO2 and YAG lasers. MMA resins are recommended over Bis-GMA resins. 4. The use of monocrystalline brackets is suggested over polycrystalline brackets. www.indiandentalacademy.com
  48. 48. LASER DEBONDING 5.Ceramic brackets should be irradiated and debonded one by one immediately after laser exposure. 6. The risk of pulpal damage is significantly reduced if the following are used: a. Super-pulse CO2 laser at 2 W for less than 4 seconds. b. CO2 laser (10.6 m) for 3 seconds at 3 W. c. CO2 laser (normal pulse) at 18 W for 2 seconds. www.indiandentalacademy.com
  49. 49. • Recently, the implant has been recognized as one of the useful methods for orthodontic anchorage. In cases where nonabsorbable implants are placed, it is necessary to remove them after orthodontic treatment. • An absorbable implant (FIXSORB-MX) Takiron company, Japan, poly lactic acid, with molecular weight 200,000, mini-screw-type 2.0x8.0mm has been tried as an orthodontic implant . www.indiandentalacademy.com
  50. 50. Preliminary findings • The loading of orthodontic force resulted in no mobility and deciduation in the implant • The results showed that the absorbable implant had a clinically acceptable strength when the orthodontic anchorage was applied. www.indiandentalacademy.com
  51. 51. www.indiandentalacademy.com
  52. 52. Ethyl – Cyanoacrylate material was tested as orthodontic bracket adhesive and found to have significantly higher strength than conventional composite (1991) Significant advantage – Ability to polymerize as a thin film at room temperature, without a catalyst, when pressure is applied in moist environment www.indiandentalacademy.com
  53. 53. www.indiandentalacademy.com
  54. 54. Resistance to thermocycling (Bishara et al ’03) • In dry environment it gives comparable bond strength values to single step bond resins and can be misleading. (Wiltshire ’03) • Smartbond cyanoacrylate adhesive has adequate bond strength 24 hours after initial bonding, but its strength decreases by 80% after thermocycling between 5°C and 55°C After 24 hours After thermocycling - 7.1 + 3.3 Range1.4-13.2 MPa -1.5 +1.4 Range 0.1- 6.5 MPa www.indiandentalacademy.com
  55. 55. www.indiandentalacademy.com
  56. 56. Glass Polyphosphonate Cement (Diamond® Kemdent®, Associated Dental Products Limited, Swindon, UK) • Glass Polyphosphonate cements have recently been introduced for use in restorative dentistry. • The claimed advantages of glass polyphosphonates over conventional glass polyalkenoate cements are: – A rapid set, a high compressive strength,and a low solubility. – The latter is said to result in a less unpleasant taste, a common complaint by patients when cementing bands with glass polyalkenoate cement. www.indiandentalacademy.com
  57. 57. -Saliva resistant snap-set -Chemical set -Adhesive to Dentine and Enamel -Fluoride release -Radiopaque -7 aesthetic shades -Class leading mechanical properties give Diamond up to 50% higher compressive strength than conventional glass www.indiandentalacademy.com ionomer cements
  58. 58. Evaluation of glass polyphosphonate cement in orthodontic banding (J. R. Clark, A. J. Ireland and M. Sherriff - EJO ’03) • After 6 months of active treatment the overall failure rate for bands cemented with Diamond® in this study was 4.8 per cent, same as that with a conventional GIC. • 50% of the patients showed better acceptance of the polyphosphonate cement • It would seem that glass polyphosphonate cements maybe used for orthodontic banding. www.indiandentalacademy.com
  59. 59. www.indiandentalacademy.com
  60. 60. Contemporary Metal lined Ceramic Brackets How Good are They ? (especially when we pay 600% more than SS Brackets and 25% more than Ceramic brackets for them!!) www.indiandentalacademy.com
  61. 61. ………..the aesthetics of ceramics, and the strength & surface properties of metal all in one bracket !! www.indiandentalacademy.com
  62. 62. Clarity - SS Inserted Ceramic bracket Gold reinforced ceramic brackets Luxi ™ contains an 18-karat (75%) gold insert,which is similar in composition to high-quality gold crown and bridge alloys. www.indiandentalacademy.com
  63. 63. Aspire & Inspire ASPIRE GOLD - KERAMIK BRACKET -mit Gold-Sliding-Guide F O R E S TA D E N T ® Illusion + Orthorganisers www.indiandentalacademy.com
  64. 64. Inspire - Ormco Mystique-Ceramic-glazed slot (GAC) www.indiandentalacademy.com
  65. 65. www.indiandentalacademy.com
  66. 66. www.indiandentalacademy.com
  67. 67.  G .I - Clarity (Ceramic -SS insert)- Unitek 3M  G .II – Luxi (Ceramic - gold insert) - RMO  G.III – Aspire (Ceramic- gold insert)- Forestadent  G.IV – Illusion + (Ceramic-Silver) – Ortho Organiser  G.V - Classic – Polycarbonate-Gold insert – American Ortho  G.VI- Elation (Polycarbonate –SS insert)- GAC  G. VII - Spirit MB – Polycarbonate – SS insert – Ormco  G.VIII- Inspire (Monocrystalline – Ceramic)- Ormco  G. IX- Mystique – Glazed Slot – Ceramic - GAC  G. X- Gemini – SS brackets ( gold standard) – Unitek 3M www.indiandentalacademy.com
  68. 68. Parameters  Frictional characteristics using stainless steel arch wire - .016 x .022 dimension  Shear bond strength (bonding with Rely – a – Bond) www.indiandentalacademy.com
  69. 69. Results - Kinetic Friction Brackets Mean ± SD of µK 50 grams Clarity (SS) 0.71 ± 0.02 Luxi 0.45 ± 0.03 (Cer-Gold) Aspire (Cer-Gold) 0.399 + 0.14 Illusion + (Cer-silver) 0.196 + 0.015 Inspire (M.C.Cer) 0.497 + 0.069 Mystique (PC Glazed) 0.318 + 0.042 Gemini SS 0.69 ±0.04 www.indiandentalacademy.com
  70. 70. Results – Kinetic Friction Brackets Mean ± SD of µK 100 grams Clarity 0.50 ± 0.015 Luxi 0.26 ± 0.008 Aspire 0.246 + 0.069 Illusion Plus 0.11 + 0.011 Inspire 0.311 + 0.083 Mystique 0.233 + 0.035 Stainless Steel 0.44 ± 0.016 www.indiandentalacademy.com
  71. 71. Slot Surface Topography - SEM Normal Luxi (with gold insert) – porous. Clarity (Steel insert) – relatively smoother surface with uniform distribution of cracks. After frictional evaluation. Luxi – severe wear of slot material. Clarity – horizontal lines visible, smooth surface maintained. www.indiandentalacademy.com
  72. 72. Slot Surface Topography - SEM Unused Clarity Bracket slot – x 1000 Unused Clarity Bracket slot – x 5000 www.indiandentalacademy.com
  73. 73. Slot Surface Topography - SEM Mystique – Unused Bracket slot- 25x Mystique – Unused Bracket slot – 1000x www.indiandentalacademy.com
  74. 74. Slot Surface Topography - SEM Unused Aspire Bracket slot – 25x Unused Aspire Bracket slot-5000x www.indiandentalacademy.com
  75. 75. Slot Surface Topography - SEM Inspire- Unused Bracket slot -25x Inspire-Unused Bracket slot – 1000x www.indiandentalacademy.com
  76. 76. Clarity bracket – 5000 x magnification Before Frictional Evaluation After Frictional Evaluation www.indiandentalacademy.com
  77. 77. Luxi – 5000 x magnification Before frictional evaluation After frictional evaluation www.indiandentalacademy.com
  78. 78. Aspire - 5000x magnification Before frictional evaluation After frictional evaluation www.indiandentalacademy.com
  79. 79. Inspire - 1000x magnification Before frictional evaluation After frictional evaluation www.indiandentalacademy.com
  80. 80. Mystique - 1000x magnification Before frictional evaluation After frictional evaluation www.indiandentalacademy.com
  81. 81. www.indiandentalacademy.com
  82. 82. www.indiandentalacademy.com
  83. 83. www.indiandentalacademy.com
  84. 84. Look At the striations in the slot www.indiandentalacademy.com
  85. 85. www.indiandentalacademy.com
  86. 86. www.indiandentalacademy.com
  87. 87. Frictional Characteristics Tidy’s protocol was followed Coefficient of kinetic friction was calculated Values obtained were tabulated and entered into SPSS Ver.10 Mean, SD were calculated Student ‘t’ test performed www.indiandentalacademy.com
  88. 88.  Shear bond strength. Instron universal testing machine was utilized. Occlusal gingival load applied to the bracket – produces shear force. Values recorded in Newtons – by the computer attached to the machine. www.indiandentalacademy.com
  89. 89. Mean shear bond strength. Group I Clarity Mean ± SD 13.09 ± 0.214 Group II Luxi Group III Gemini 12.69 ± 0.51 12.68 ± 0.69 Minimum 12.84 12.09 11.36 Maximum 13.41 13.20 13.20 •Statistical Evaluation - Comparison of Group II and group III brackets – no statistical significance. Group I and Group III – significant at 0.01 level. Group I and Group II – significant at 0.01 level. www.indiandentalacademy.com
  90. 90. Mean shear bond strength. Aspire Inspire Mystique Mean ± SD 4.396 ± 1.18 7.023 ± 1.901 4.997± 2.023 Minimum 3.49 5.26 3.44 Maximum 5.31 8.78 6.55 www.indiandentalacademy.com
  91. 91. Mean shear bond strength - MPa Mean Minimum Maximum 13.09 ± 0.214 12.84 13.41 12.69 ± 0.51 12.09 Gemini 12.68 ± 0.69 11.36 13.20 Aspire 4.396 ± 1.18 3.49 5.31 Illusion + 12.423 + 2.12 8.48 13.87 5.26 8.78 Clarity Luxi Inspire Mystique 7.023 ± 1.90 4.997± 2.02 3.44 www.indiandentalacademy.com 13.20 6.55
  92. 92. Bases of Luxi & Clarity Luxi Base x 25 Clarity Base x 25 www.indiandentalacademy.com
  93. 93. Bracket base surface topography – SEM Evaluation Clarity – bracket base – 500 x Luxi – bracket base – 500x www.indiandentalacademy.com
  94. 94. Bases of Inspire and Mystique Inspire bracket base- 25 x Mystique bracket base – 25 x www.indiandentalacademy.com
  95. 95. Bracket base surface topography – SEM Evaluation Inspire bracket base – 500x Mystique bracket base – 500x www.indiandentalacademy.com
  96. 96. Bases of Aspire Aspire base -25 x Aspire bracket base – 500x www.indiandentalacademy.com
  97. 97. Stereomicroscopic Evaluation (Proximal) Mystique bracket Inspire bracket Aspire bracket www.indiandentalacademy.com
  98. 98. How Good are they ? Frictional characteristics of metal inserted ceramic brackets generally is comparable to or better than stainless steel brackets. www.indiandentalacademy.com
  99. 99. Summary Shear bond strength of metal inseted ceramic brackets are very close to that of stainless steel. Polycarbonate slotted brackets show much lower values Mystique and Aspire also show very low values www.indiandentalacademy.com
  100. 100. Metal inserted POLY CARBONATE BRACKETS www.indiandentalacademy.com
  101. 101. Reinforced Polycarbonate Brackets BLONDE™ Glass-reinforced composite polymer bracket IMAGE™ SOLO™ The Bio-Esthetic Single System www.indiandentalacademy.com
  102. 102. Spirit MB: Polymeric/ SS (Ormco) Elation: Polymeric/steel (GAC) www.indiandentalacademy.com
  103. 103. Comparative Evaluation of Metal inserted Plastics Brackets (Sushil Kumar & Jyothindra Kumar – 2003) Group I - Classic (Urethane with gold insert) Group II – Elation (Polycarbonate/PET with SS insert) Group III – Spirit MB (Ceramic reinforced Polycarbonate/ with SS insert) Group IV - Gemini (SS brackets – used as gold standard) www.indiandentalacademy.com
  104. 104. Elation (Polycarbonate/PET with SS insert) produced significantly higher frictional resistance than all three brackets. All three plastic brackets demonstrated shear bond strength lower than stainless steel brackets. www.indiandentalacademy.com
  105. 105. Kinetic Friction-Classic, Elation, Spirit MB & Gemini (SS wire) Brackets Mean + S.D of µK 50 grams Classic (Gold Inserted) 0.1965 + 0.0388 Elation (SS Inserted) 0.36578** + 0.1263 Spirit MB (SS Inserted) 0.1792 + 0.0747 Gemini (Conventional SS) 0.2259 + 0.0932 100 grams Classic (Gold Inserted) 0.1154 + 0.0260 Elation (SS Inserted) 0.2972** + 0.0841 Spirit MB (SS Inserted) 0.1060 + 0.0415 Gemini (Conventional SS) 0.1512 + 0.0279 www.indiandentalacademy.com **- Highly significant
  106. 106. Kinetic Friction-Classic, Elation, Spirit MB & Gemini (NiTi wire) Brackets Mean + S.D of µK 50 grams Classic (Gold Inserted) 0.2930 + 0.0197 Elation (SS Inserted) 0.5287** + 0.0906 Spirit MB (SS Inserted) 0.3282 + 0.0795 Gemini (Conventional SS) 0.3829 + 0.0790 100 grams Classic (Gold Inserted) 0.1744 + 0.0197 Elation (SS Inserted) 0.3986** + 0.0530 Spirit MB (SS Inserted) 0.1986 + 0.0629 Gemini (Conventional SS) 0.2397 + 0.0404 www.indiandentalacademy.com **- Highly significant
  107. 107. Elation- Stereomicroscopic Evaluation es Elation Why do significantly show r Friction? highe www.indiandentalacademy.com
  108. 108. Stereomicroscopic Evaluation (Proximal) Classic bracket Spirit MB bracket www.indiandentalacademy.com
  109. 109. Bracket slot surface topography – SEM Evaluation Classic bracket - 25 x www.indiandentalacademy.com bracket slot - 5000 x Classic bracket slot - 1000 x Classic
  110. 110. Classic - 5000x magnification Before frictional evaluation www.indiandentalacademy.com After frictional evaluation (SS) After frictional evaluation (NiTi)
  111. 111. Bracket base surface topography – SEM Evaluation Elation bracket - 25 x Elation bracket slot - 5000 x www.indiandentalacademy.com
  112. 112. Elation - 5000x magnification Before frictional evaluation www.indiandentalacademy.com After frictional evaluation (SS) After frictional evaluation (Niti)
  113. 113. Bracket base surface topography – SEM Evaluation Spirit MB bracket - 25 x Spirit MB bracket slot - 5000 x www.indiandentalacademy.com
  114. 114. Spirit MB - 5000x magnification Before frictional evaluation www.indiandentalacademy.com After frictional evaluation (SS) After frictional evaluation (NiTi)
  115. 115. Mean shear bond strength (MPa). Classic Elation (Gold (SS Inserted) Inserted) Spirit MB (SS Inserted) Gemini (Conv. SS) Mean ± SD 3.105 ± 0.9326 3.2033 ± 1.5022 2.962 ± 0.4316 12.676** ± 0.5491 Minimum 2.033 1.26 2.372 11.36 Maximum 4.216 5.52 3.752 13.20 www.indiandentalacademy.com **- Highly significant
  116. 116. Bracket base surface topography – SEM Evaluation Classic base – 25 x Spirit MB base – 25x Elation base25x www.indiandentalacademy.com
  117. 117. Bracket base surface topography – SEM Evaluation Classic base – 500 x Spirit MB base – 25x Elation base25x www.indiandentalacademy.com
  118. 118. Low Friction Ligatures Super Slick Ties – TP Labs (Metafasix) Sili Ties – GAC www.indiandentalacademy.com
  119. 119. Comparison of Kinetic FrictionSuper Slick ties & Dispense-A- Stix ( Leander & Jyothindra Kumar, ’01) Super Slick ties showed a 11-15% reduction in the overall friction when used in sliding mechanics. This is clinically signficant. www.indiandentalacademy.com
  120. 120. Comparison of Super Slick & Sili ties (Webb et al ’04) • TP SS ties showed a lower force decay rate compared to Sili ties when stretched for 6 hrs. • There is a significant difference in the brand, and the coating material. www.indiandentalacademy.com
  121. 121. www.indiandentalacademy.com

×