DOI QR코드

DOI QR Code

Effects of thermoforming on the physical and mechanical properties of thermoplastic materials for transparent orthodontic aligners

  • Ryu, Jeong-Hyun (Department and Research Institute for Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry) ;
  • Kwon, Jae-Sung (Department and Research Institute for Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry) ;
  • Jiang, Heng Bo (School of Stomatology, Taishan Medical University) ;
  • Cha, Jung-Yul (Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry) ;
  • Kim, Kwang-Mahn (Department and Research Institute for Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry)
  • Received : 2017.11.07
  • Accepted : 2018.05.29
  • Published : 2018.09.25

Abstract

Objective: The aim of this systematic multiscale analysis was to evaluate the effects of thermoforming on the physical and mechanical properties of thermoplastic materials used to fabricate transparent orthodontic aligners (TOAs). Methods: Specimens were fabricated using four types of thermoplastic materials with different thicknesses under a thermal vacuum. Transparency, water absorption and solubility, surface hardness, and the results of three-point bending and tensile tests were evaluated before and after thermoforming. Data were analyzed using one-way analysis of variance and Student's t-test. Results: After thermoforming, the transparency of Duran and Essix A+ decreased, while the water absorption ability of all materials; the water solubility of Duran, Essix A+, and Essix ACE; and the surface hardness of Duran and Essix A+ increased. The flexure modulus for the 0.5-mm-thick Duran, Essix A+, and eCligner specimens increased, whereas that for the 0.75-/1.0-mm-thick Duran and eClginer specimens decreased. In addition, the elastic modulus increased for the 0.5-mm-thick Essix A+ specimens and decreased for the 0.75-mm-thick Duran and Essix ACE and the 1.0-mm-thick Essix ACE specimens. Conclusions: Our findings suggest that the physical and mechanical properties of thermoplastic materials used for the fabrication of TOAs should be evaluated after thermoforming in order to characterize their properties for clinical application.

Keywords

References

  1. Martorelli M, Gerbino S, Giudice M, Ausiello P. A comparison between customized clear and removable orthodontic appliances manufactured using RP and CNC techniques. Dent Mater 2013;29:e1-10.
  2. Ogaard B, Rolla G, Arends J. Orthodontic appliances and enamel demineralization. Part 1. Lesion development. Am J Orthod Dentofacial Orthop 1988;94:68-73. https://doi.org/10.1016/0889-5406(88)90453-2
  3. Featherstone J. Dental caries: a dynamic disease process. Aust Dent J 2008;53:286-91. https://doi.org/10.1111/j.1834-7819.2008.00064.x
  4. Joffe L. Invisalign: early experiences. J Orthod 2003; 30:348-52. https://doi.org/10.1093/ortho/30.4.348
  5. Shalish M, Cooper-Kazaz R, Ivgi I, Canetti L, Tsur B, Bachar E, et al. Adult patients' adjustability to orthodontic appliances. Part I: a comparison between Labial, Lingual, and $Invisalign^{TM}$. Eur J Orthod 2012;34:724-30. https://doi.org/10.1093/ejo/cjr086
  6. Kesling HD. The philosophy of the tooth positioning appliance. Am J Orthod Oral Surg 1945;31:297-304. https://doi.org/10.1016/0096-6347(45)90101-3
  7. Sheridan JJ. The Readers' Corner. 2. What percentage of your patients are being treated with Invisalign appliances? J Clin Orthod 2004;38:544-5.
  8. Nahoum H. The vacuum formed dental contour appliance. N Y State Dent J 1964;9:385-90.
  9. Ponitz RJ. Invisible retainers. Am J Orthod 1971;59:266-72. https://doi.org/10.1016/0002-9416(71)90099-6
  10. Melkos AB. Advances in digital technology and orthodontics: a reference to the Invisalign method. Med Sci Monit 2005;11:PI39-42.
  11. Cassetta M, Altieri F, Pandolfi S, Giansanti M. The combined use of computer-guided, minimally invasive, flapless corticotomy and clear aligners as a novel approach to moderate crowding: a case report. Korean J Orthod 2017;47:130-41. https://doi.org/10.4041/kjod.2017.47.2.130
  12. Boyd RL, Miller RJ, Vlaskalic V. The Invisalign system in adult orthodontics: mild crowding and space closure cases. J Clin Orthod 2000;34:203-12.
  13. Kravitz ND, Kusnoto B, BeGole E, Obrez A, Agran B. How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. Am J Orthod Dentofacial Orthop 2009;135:27-35. https://doi.org/10.1016/j.ajodo.2007.05.018
  14. Lagravere MO, Flores-Mir C. The treatment effects of Invisalign orthodontic aligners: a systematic review. J Am Dent Assoc 2005;136:1724-9. https://doi.org/10.14219/jada.archive.2005.0117
  15. Barone S, Paoli A, Razionale AV, Savignano R. Computer aided modelling to simulate the biomechanical behaviour of customised orthodontic removable appliances. IJIDeM 2016;10:387-400.
  16. Hahn W, Zapf A, Dathe H, Fialka-Fricke J, Fricke-Zech S, Gruber R, et al. Torquing an upper central incisor with aligners--acting forces and biomechanical principles. Eur J Orthod 2010;32:607-13. https://doi.org/10.1093/ejo/cjq007
  17. Simon M, Keilig L, Schwarze J, Jung BA, Bourauel C. Forces and moments generated by removable thermoplastic aligners: incisor torque, premolar derotation, and molar distalization. Am J Orthod Dentofacial Orthop 2014;145:728-36. https://doi.org/10.1016/j.ajodo.2014.03.015
  18. Li X, Ren C, Wang Z, Zhao P, Wang H, Bai Y. Changes in force associated with the amount of aligner activation and lingual bodily movement of the maxillary central incisor. Korean J Orthod 2016;46:65-72. https://doi.org/10.4041/kjod.2016.46.2.65
  19. Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. Angle Orthod 2015;85:881-9. https://doi.org/10.2319/061614-436.1
  20. Dupaix RB, Boyce MC. Finite strain behavior of poly (ethylene terephthalate)(PET) and poly (ethylene terephthalate)-glycol (PETG). Polymer 2005;46:4827-38. https://doi.org/10.1016/j.polymer.2005.03.083
  21. Fang D, Zhang N, Chen H, Bai Y. Dynamic stress relaxation of orthodontic thermoplastic materials in a simulated oral environment. Dent Mater J 2013;32:946-51. https://doi.org/10.4012/dmj.2013-131
  22. Lombardo L, Martines E, Mazzanti V, Arreghini A, Mollica F, Siciliani G. Stress relaxation properties of four orthodontic aligner materials: A 24-hour in vitro study. Angle Orthod 2017;87:11-8. https://doi.org/10.2319/113015-813.1
  23. Ryokawa H, Miyazaki Y, Fujishima A, Miyazaki T, Maki K. The mechanical properties of dental thermoplastic materials in a simulated intraoral environment. Orthod Waves 2006;65:64-72. https://doi.org/10.1016/j.odw.2006.03.003
  24. Min S, Hwang CJ, Yu HS, Lee SB, Cha JY. The effect of thickness and deflection of orthodontic thermoplastic materials on its mechanical properties. Korean J Orthod 2010;40:16-26. https://doi.org/10.4041/kjod.2010.40.1.16
  25. Kwon JS, Lee YK, Lim BS, Lim YK. Force delivery properties of thermoplastic orthodontic materials. Am J Orthod Dentofac Orthop 2008;133:228-34;quiz 328.e1. https://doi.org/10.1016/j.ajodo.2006.03.034
  26. Ahn HW, Kim KA, Kim SH. A new type of clear orthodontic retainer incorporating multi-layer hybrid materials. Korean J Orthod 2015;45:268-72. https://doi.org/10.4041/kjod.2015.45.5.268
  27. International Organization for Standardization (ISO). ISO 20795-2:2013 Dentistry-base polymers--Part 2: orthodontic base polymers. Geneva: ISO; 2013.
  28. Azhikannickal E, Bates PJ, Zak G. Laser light transmission through thermoplastics as a function of thickness and laser incidence angle: experimental and modeling. J Manuf Sci Eng 2012;134:061007. https://doi.org/10.1115/1.4007619
  29. Kattan M, Dargent E, Ledru J, Grenet J. Straininduced crystallization in uniaxially drawn PETG plates. J Appl Polym Sci 2001;81:3405-12. https://doi.org/10.1002/app.1797
  30. Zhang N, Bai Y, Ding X, Zhang Y. Preparation and characterization of thermoplastic materials for invisible orthodontics. Dent Mater J 2011;30:954-9. https://doi.org/10.4012/dmj.2011-120
  31. Gardner GD, Dunn WJ, Taloumis L. Wear comparison of thermoplastic materials used for orthodontic retainers. Am J Orthod Dentofacial Orthop 2003;124:294-7. https://doi.org/10.1016/S0889-5406(03)00502-X
  32. Alexandropoulos A, Al Jabbari YS, Zinelis S, Eliades T. Chemical and mechanical characteristics of contemporary thermoplastic orthodontic materials. Aust Orthod J 2015;31:165-70.
  33. Kohda N, Iijima M, Muguruma T, Brantley WA, Ahluwalia KS, Mizoguchi I. Effects of mechanical properties of thermoplastic materials on the initial force of thermoplastic appliances. Angle Orthod 2013; 83:476-83. https://doi.org/10.2319/052512-432.1
  34. Brazel CS, Rosen SL. Fundamental principles of polymeric materials. 3rd ed. London: John Wiley; 2010. p. 53.
  35. Elkholy F, Schmidt F, Jager R, Lapatki BG. Forces and moments applied during derotation of a maxillary central incisor with thinner aligners: an in-vitro study. Am J Orthod Dentofacial Orthop 2017;151:407-15. https://doi.org/10.1016/j.ajodo.2016.08.020

Cited by

  1. Development of a DLP 3D printer for orthodontic applications vol.38, pp.None, 2018, https://doi.org/10.1016/j.promfg.2020.01.187
  2. Mechanical Characterization of Thermoplastic Aligner Materials: Recommendations for Test Parameter Standardization vol.2019, pp.None, 2019, https://doi.org/10.1155/2019/8074827
  3. Thickness of orthodontic clear aligners after thermoforming and after 10 days of intraoral exposure: a prospective clinical study vol.20, pp.1, 2018, https://doi.org/10.1186/s40510-019-0289-6
  4. Effects of Carbonated Drinks on Mechanical Properties of Three Types of Thermoplastic Aligner Materials: An In vitro Study vol.54, pp.2, 2018, https://doi.org/10.1177/0301574219892421
  5. Safety Considerations for Thermoplastic-Type Appliances Used as Orthodontic Aligners or Retainers. A Systematic Review and Meta-Analysis of Clinical and In-Vitro Research vol.13, pp.8, 2020, https://doi.org/10.3390/ma13081843
  6. Thermoplastic Disks Used for Commercial Orthodontic Aligners: Complete Physicochemical and Mechanical Characterization vol.13, pp.10, 2020, https://doi.org/10.3390/ma13102386
  7. Mechanical Properties of Thermoplastic Polymers for Aligner Manufacturing: In Vitro Study vol.8, pp.2, 2018, https://doi.org/10.3390/dj8020047
  8. Micro-computed tomography evaluation of general trends in aligner thickness and gap width after thermoforming procedures involving six commercial clear aligners: An in vitro study vol.51, pp.2, 2021, https://doi.org/10.4041/kjod.2021.51.2.135
  9. Direct 3D Printing of Clear Orthodontic Aligners: Current State and Future Possibilities vol.14, pp.7, 2021, https://doi.org/10.3390/ma14071799
  10. Micro computed tomography evaluation of Invisalign aligner thickness homogeneity vol.91, pp.3, 2018, https://doi.org/10.2319/040820-265.1
  11. The force effects of two types of polyethylene terephthalate glyc-olmodified clear aligners immersed in artificial saliva vol.11, pp.1, 2018, https://doi.org/10.1038/s41598-021-89425-8
  12. Dynamic mechanical and thermal properties of clear aligners after thermoforming and aging vol.22, pp.1, 2018, https://doi.org/10.1186/s40510-021-00362-8
  13. Color Stability, Chemico-Physical and Optical Features of the Most Common PETG and PU Based Orthodontic Aligners for Clear Aligner Therapy vol.14, pp.1, 2018, https://doi.org/10.3390/polym14010014
  14. Thermal and mechanical characterization of thermoplastic orthodontic aligners discs after molding process vol.126, pp.None, 2018, https://doi.org/10.1016/j.jmbbm.2021.104991