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Farklı teflon kaplı estetik tellerin fiziksel ve mikrobiyolojik özelliklerinin incelenmesi / Evaluation of the physical and microbiological properties of teflon coated arch wires

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Abstract
The lack of esthetic appearance of the orthodontic appliances is one of the greatest concerns for orthodontic patients. The negative perception sometimes causes the patient to give up or postpone the treatment process. A number of esthetic approaches have been introduced such as lingual technique or esthetic brackets to minimize the metallic profile of the fixed devices. The esthetic brackets are used in combination with esthetic arch wires often coated with Teflon hiding the polished metallic surface. However, peeling of the coating material over time results in rough surfaces that are suitable sites for plaque accumulation. Plaque accumulation can lead to periodontal diseases, caries and white spot lesions, and the surface roughness of the esthetic arch wires reduce the performance of sliding mechanics, mechanical strength, color stability, friction, and the success of the treatment mechanics. The aim of this study was to evaluate the surface roughness, microbial plaque retention, and discoloration of round and rectangular cross-sectional Teflon coated arch wire from three different manufacturers in the market. Our study was performed in two stages, in vivo and in vitro conditions. The physical and microbiological characteristics of the Teflon coated 0.016-inch and 0.016 x 0.022-inch arch wire of 3 different manufacturers ((EverWhite (American Orthodontics, Sheboygan, USA), Titanol Cosmetic (Forestadent, Pforzheim, Germany), Proflex (G&H Orthodontics, Franklin, USA)) were examined. Initial (T0) and secondary surface roughness and color change data were collected following 28 days of clinical exposure (T1). Biofilm formation and microbiological properties between the groups were evaluated. As received and retrieved samples from each kind of wire were analyzed. Atomic force microscobe (Brand: NT-MDT Model: Netweaver Solaris) was used to analyze surface roughness. The specimens were prepared by cutting 5 mm from the flat ends of the archwire. Surface roughness values of arch wires are calculated using the software supported by the AFM. In each group, surface topography was evaluated using the average surface roughness (Ra) parameter. The average surface roughness values in all study groups are significantly higher than the initial average (p<0,005). All bacteria were removed from the study samples for investigating the effects of the peeling on bacterial adhesion. Wire samples were incubated in in vitro medium conditions and S. mutans was assesed in terms of colony forming unit (cfu). The amount of S. mutans adhesion of 0.016 x 0.022-inch cross-sectional Proflex wires was significantly lower than the initial average (p = 0.002). The amount of S. mutans adhesion of 0.016-inch cross-sectional Titanol Cosmetic wires was statistically significantly higher than the initial average (p = 0.004). There was no statistically significant difference between the initial mean value of S. mutans bacteria adhesion of 0.016-inch section size Proflex, 0.016 X 0.022-inch section size Titanol Cosmetic, 0.016-inch and 0.016 X 0.022-inch section size Everwhite wires (p>0,005). No statistically significant difference was found between the mean surface roughness values of round wires after 28 days use (p = 0.25). Statistically significant difference was found between S. mutans adhesion measurement values (p = 0,002). It has been determined that the significance is caused by the difference between Proflex and EverWhite; The S. mutans adhesion values in EverWhite wires were found to be high at significantly higher levels than Proflex archwires (p=0,001). There was no statistically significant difference between the mean surface roughness values of rectangular wires and S. mutans adhesion values after 28 days use (p = 0,617 and p = 0,051). It has been found that rectangular sectioned EverWhite archwires showed high bacterial adhesion at statistically significant level from Titanol Cosmetic archwires. Color measurement was performed using VITA Easyshade Compact (VITA Zahnfabrik, Bad Sackingen, Germany, Model DEASYC220) spectrophotometer. No statistically significant difference was found between the color measurement values of the groups. According to the NBS values, a clinically noticeable color change was observed in the Titanol Cosmetic and EverWhite wires, whereas a more remarkable color change was observed in the Proflex wires. In conclusion, we found that the surface roughness values measured with the AFM device were not related to the amount of S. mutans adhesion. Point measurements made with the AFM device were considered to be inadequate alone to make a deduction for all surface topography of the arch wires. All the three different brands of archwires showed clinically noticeable color change.
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Description
Thesis (dentistry)--Bezmialem Vakıf University, Faculty of Dentistry, Department of Orthodontics, Istanbul, 2018
Keywords
Diş Hekimliği = Dentistry, Estetik ortodontik ark teli, Teflon kaplı ark teli, Yüzey pürüzlülüğü : Surface roughness
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