Advances in orthodontic clear aligner materials

Bichu, Yashodhan M.; Alwafi, Abdulraheem; Liu, Xiaomo; Andrews, James R.; Ludwig, Björn; Bichu, Aditi Y.

doi:10.1016/j.bioactmat.2022.10.006

Cited by 79 publications

(99 citation statements)

References 130 publications

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“…A great interest surrounds the use of 3D printing technologies to produce dental aligners and retainers [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…The review of the literature revealed that aligners and retainers represent the currently most studied 3D-printed orthodontic appliances. Claimed advantages of 3D-printed aligners in comparison with thermoformed ones are greater accuracy and shortening of the supply chain, and reduction in costs, as the production of physical models can be avoided [ 25 ]. Moreover, the thermoforming procedure has been reported to adversely affect the mechanical and esthetic properties of the aligners [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Claimed advantages of 3D-printed aligners in comparison with thermoformed ones are greater accuracy and shortening of the supply chain, and reduction in costs, as the production of physical models can be avoided [ 25 ]. Moreover, the thermoforming procedure has been reported to adversely affect the mechanical and esthetic properties of the aligners [ 25 ]. In addition, 3D printing produces less waste, thus presenting as a more sustainable process.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, 3D printing produces less waste, thus presenting as a more sustainable process. Additionally, 3D printing theoretically enables the production of aligners with customized thickness and the control of thickness across the arch, thus influencing the mechanical properties of the aligners [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, the authors did not disclose the specific materials that were used for printing; they only reported that the materials were recommended by the manufacturer of each printer. It was also reported that both SLA [ 23 ] and DLP [ 25 ] printers produce thicker aligners compared to the digital design.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Clinically Relevant Properties of 3D Printable Materials for Intraoral Use in Orthodontics: A Critical Review of the Literature

et al. 2023

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The review aimed at analyzing the evidence available on 3D printable materials and techniques used for the fabrication of orthodontic appliances, focusing on materials properties that are clinically relevant. MEDLINE/PubMed, Scopus, and Cochrane Library databases were searched. Starting from an initial retrieval of 669 citations, 47 articles were finally included in the qualitative review. Several articles presented proof-of-concept clinical cases describing the digital workflow to manufacture a variety of appliances. Clinical studies other than these case reports are not available. The fabrication of aligners is the most investigated application of 3D printing in orthodontics, and, among materials, Dental LT Clear Resin (Formlabs) has been tested in several studies, although Tera Harz TC-85 (Graphy) is currently the only material specifically marketed for direct printing of aligners. Tests of the mechanical properties of aligners materials lacked homogeneity in the protocols, while biocompatibility tests failed to assess the influence of intraoral conditions on eluents release. The aesthetic properties of 3D-printed appliances are largely unexplored. The evidence on 3D-printed metallic appliances is also limited. The scientific evidence on 3D printable orthodontic materials and techniques should be strengthened by defining international standards for laboratory testing and by starting the necessary clinical trials.

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“…A great interest surrounds the use of 3D printing technologies to produce dental aligners and retainers [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Clinically Relevant Properties of 3D Printable Materials for Intraoral Use in Orthodontics: A Critical Review of the Literature

et al. 2023

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Construction of Zwitterionic Coatings with Lubricating and Antiadhesive Properties for Invisible Aligner Applications

Wei,

Deng,

Guo

et al. 2024

Macromol. Rapid Commun.

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Invisible aligners have been widely used in orthodontic treatment but still present issues with plaque formation and oral mucosa abrasion, which can lead to complicated oral diseases. To address these issues, hydrophilic poly(sulfobetaine methacrylate) (polySBMA) coatings with lubricating, antifouling, and anti‐adhesive properties have been developed on the aligner materials (i.e., polyethylene terephthalate glycol, PETG) via a simple and feasible glycidyl methacrylate (GMA)‐assisted coating strategy. Poly(GMA‐co‐SBMA) was grafted onto the aminated PETG surface via the ring‐opening reaction of GMA (i.e., “grafting to” approach to obtain G‐co‐S coating), or a polySBMA layer was formed on the GMA‐grafted PETG surface via free radical polymerization (i.e., “grafting from” approach to obtain G‐g‐S coating). The G‐co‐S and G‐g‐S coatings significantly reduced the friction coefficient of PETG surface. Protein adsorption, bacterial adhesion, and biofilm formation on the G‐co‐S‐ and G‐g‐S‐coated surfaces were significantly inhibited. The performance of the coatings remained stable after storage in air or artificial saliva for 2 weeks. Both coatings demonstrated good biocompatibility in vitro and did not cause irritation to the oral mucosa of rats in vivo over 2 weeks. This study proposed a promising strategy for the development of invisible aligners with improved performance, which is beneficial for oral health treatment.This article is protected by copyright. All rights reserved

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Effect of thermomechanical aging on force system of orthodontic aligners made of different thermoformed materials

Elshazly,

Keilig,

Nang

et al. 2024

J Orofac Orthop

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Purpose The aim was to investigate the effect of aging by thermocycling and mechanical loading on forces and moments generated by orthodontic clear aligners made from different thermoplastic materials. Methods A total of 25 thermoformed aligners made from 5 different materials, i.e., Essix ACE® and Essix® PLUS™ (Dentsply Sirona, Bensheim, Germany), Invisalign® (Align Technology, San Jose, CA, USA), Duran®+ (Iserlohn, Germany), Zendura™ (Fremont, CA, USA), underwent a 14-day aging protocol involving mechanical loading (a 0.2 mm vestibular malalignment of the upper left second premolar [tooth 25]) and thermocycling in deionized water (temperature range 5–55 °C). The 3D forces/moments exerted on tooth 25 of a resin model were measured at three time points: before aging (day 0), after 2 days and after 14 days of aging. Results Before aging, extrusion–intrusion forces were 0.6–3.0 N, orovestibular forces were 1.7–2.3 N, and moments as mesiodistal rotation were 0.3–42.1 Nmm. In all directions, multilayer Invisalign® exhibited the lowest force/moment magnitudes. After aging, all materials showed a significant force/moment decay within the first 2 days, except Invisalign® for orovestibular and vertical translation. However, following thermomechanical aging, Duran®+ and Zendura™ aligners had equivalent or even higher vestibular forces (direction of mechanical load). Conclusion Thermomechanical aging significantly reduced forces and moments during the first 48 h. Multilayer aligner materials exhibit lower initial forces and moments than single-layer ones, and were less influenced by aging. Material hardening was observed after subjecting some of the aligner materials to mechanical loading. Thus, orthodontists should be aware of possible deterioration of orthodontic aligners over time. This work also sheds light on how material selection impacts the mechanical behavior of aligners and may provide valuable guidance regarding optimal timing for the aligner changing protocol.

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Advances in orthodontic clear aligner materials

Cited by 79 publications

References 130 publications

Clinically Relevant Properties of 3D Printable Materials for Intraoral Use in Orthodontics: A Critical Review of the Literature

Clinically Relevant Properties of 3D Printable Materials for Intraoral Use in Orthodontics: A Critical Review of the Literature

Construction of Zwitterionic Coatings with Lubricating and Antiadhesive Properties for Invisible Aligner Applications

Effect of thermomechanical aging on force system of orthodontic aligners made of different thermoformed materials

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