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The future of Orthodontics going backwards with a fancy vehicle. EOS. Theodore Eliades. Episode 81. April 8th 2021

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Hosted by
Farooq Ahmed

 

Join me as i summarise Professor Theador’s lecture at the EOS, looking at 3 new technologies

1.     Aligners

2.     3D printed materials

3.     New technologies which have not been used in orthodontics

 

1.     Aligners

 

Aligner way of engaging tooth

·      Distortion and re-assert shape, plastic aligners molecular chain – stiffer material

·      Greater force generation

 

Mechanical properties

Small variation between aligners – stiff material which has low strain properties

·      Hardness 100N/mm = high force

·      Elastic: index 34-40% = Strain / stretch prior to permanent deformation

·      Creep: identifies permanent deformation over time / force relaxation 2.2-3.7%

 

Evidence of aligners

·      Accuracy of aligner 47%

·      PAR aligners less improvement that fixed , Odds 0.3 Gu 2017

·      ABO worse occlusal outcomes with ABO compared to fixed SR Papageorgiou 2020

 

Attachments – more predictable

·      Reduced advantages over fixed as bonding now required

·      Larger area of enamel bonding than fixed

o   Large surface area to volume ratio

§  Greater surface are exposed than conventional bracket

·      Difficulty in removing

o   Extensive aerosol

·      Snaggy fit: Complicates the aging profile of attachments inducing attrition / wear

o   Wear to resin composite

·      Composite resin hardness 3-7 x hardness of aligner material, enamel 3-5 x hardness of composite – differential roughness

 

What is missing with aligners?

·      Independent trials – outcome of treatment duration

·      Hazard assessment – release of factors and harm

 

2.     3D printing

1.     Polymers

2.     Alloys

 

3D printing material polymer

·      For aligners

·      Material able to maintain hardness after 1 week

·      Possible release of hardness material

 

3D printing of alloys

·      SS 30-40 years of properties

·      For 3D printing change of material to Co-Cr : Unknown corrosion of ageing Co-Cr

·      Cobalt, carcinogenic, respiratory sensitiser

 

3D printing may be more practical and cost effectiveness, however we need to establish release properties, corrosion

 

 

3.     New technologies which have not been used in orthodontics

 

·      Biomimetic adhesives

o   Living  / pretending Greek word material

·      Mussel model

o   Sticky glue muscles use to bond to rock / wood

o   Reversible adhesive Muscle / Gecko – Patient University of south western USA for orthodontic use

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