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Recent Orthodontic Improvements

The last three decades have led to the development of numerous revolutionary orthodontics technologies. Among these are the beta titanium alloy, the Platypus Ortho Flosser, and the SureSmile. The beta titanium alloy offers increased performance when compared to other materials for certain orthodontics applications. The Platypus Ortho Flosser enables orthodontics users to floss quickly and effectively. The SureSmile uses a variety of computer-based technologies to complete orthodontic treatment more accurately and effectively. This article provides additional information on these new technologies.

Platypus Ortho Flosser

The Platypus Ortho Flosser tackles a problem frequently seen by dental hygienists in users of orthodontics. Traditional flossing is tedious and time-consuming with the archwires in place. While some specialized products are on the market to help those with orthodontics floss, many patients find these difficult to use. Threader-type flossers facilitate flossing to some degree, but are still difficult to get around the archwires and brackets. Since the majority of orthodontics users are young, they are less likely to want to spend extensive time using these difficult methods to floss (O’Hehir 2008). Most are taught how to floss, but do not wish to spend the time due to the difficulty with flossing with orthodontics (Boseker 2010).

However, dental hygiene remains of paramount importance for orthodontic patients. Lack of proper dental hygiene can lead to cavities and spotting around the brackets. Gum health can also suffer, with gum inflammation contributing to demineralization and caries lesions (O’Hehir 2008). If an orthodontics user only brushes their teeth with a toothbrush and does not floss, plaque remains between the teeth.  Orthodontics users are predisposed to increased plaque buildup as the hardware naturally traps food (Boseker 2010).

The Platypus Ortho Flosser was developed to facilitate good dental hygiene in orthodontics patients. Laura Morgan, a dental hygienist, invented the Flosser when she who saw an opportunity for innovation that would better her patients’ dental hygiene. It cuts down flossing time to roughly a minute. The flosser consists of a y-shaped piece of plastic with a floss thread connecting the two points of the plastic holder (O’Hehir 2008). The holder is made with a high-quality polymer (DentistryiQ 2013). One of the tips of the plastic holder is thin and tapers. This allows for the user to slip the thin plastic piece between their arch wire and tooth. Due to this design innovation, orthodontics user does not have to thread the floss behind the archwire at any point (O’Hehir 2008). The end of the flosser’s handle is a brush that can be used to remove additional food residue around the brackets (Goldberg et al. 2010).

In clinical studies, use of the Platypus Ortho Flosser raised the percentage of patients who regularly flossed from 3% to 85%(DentistryiQ).

SureSmile

SureSmile is an integrated treatment mechanism that uses various computer-based mechanisms to assist in orthodontics. Teeth are sprayed with a tracking film that enables computer modeling of the dental structure. This produces a computer image in 3D. The orthodontist then creates a treatment plan based on the 3D image, creating a digital target position image. The SureSmile program then calculates the archwire geometry and bracket position necessary to reach the desired position (Sachdeva 2001, 245-8).

The SureSmile computer-assisted modeling system is highly accurate. The initial scan is accurate to within 50 microns, and linear error is minimized to less than .1mm per tooth. The creation of the archwires is accurate to within 1mm, and 1˚. The bracket placement is accurate to within 25 microns, and in vivo bracket placement is accurate to within 1mm (Sachdeva 2001, 250).

The incorporation of computer –aided technology in the orthodontics process offers a number of benefits over traditional orthodontics. Initial clinical studies demonstrated decreased treatment time as compared to the control group. No conclusions have been made about the difference in the quality of treatment as compared to the control group (Sachdeva 2001, 253). When evaluated using the American Board of Orthodontics Objective Grading System (ABO OGS), SureSmile outperformed traditional orthodontic techniques. The SureSmile patients scored 4.4 points below those receiving traditional treatment. This measure represents an increase in treatment quality for 14.3% of all patients. Results were statistically significant (P<.001). Treatment time was 25% shorter on average (Saxe et al. 2010). Further clinical studies also demonstrated lower clinical treatment times. The SureSmile treatment outscored others on first-order rotation and interproximal space measurements, though it was outperformed by traditional treatments on second order root angulation (Alford et al. 2011).

Beta Titanium Alloy

Material scientists first stabilized beta titanium at room temperature in 1977 (Ross 2002). This beta titanium alloy exhibited exemplary weldability, formability, and springback (Burstone 1980).

The Beta titanium alloy was adopted for orthodontics use in the 1980s (Burstone and Goldberg 1980). This type of alloy replaced stainless steel for certain uses, as stainless steel had dominated orthodontics since the 1960s (Kusy 2002). Beta titanium alloys are superior to stainless steel in a variety of functionality trainings. Beta titanium was 1.8 times more extensible and had a 2.2 fold reduction in force per unit of displacement after thermo-mechanical treatments (Burstone 1979).  Beta titanium alloys are also superior to traditional titanium alloys. Beta titanium alloys “are capable of providing a lower modulus of elasticity, enhanced corrosion resistance, improved fabrication response, and acceptable biocompatibility when compared to established titanium alloys” (Zardiackas et al. 1996). Beta type titanium alloys have decreased rigidity as compared to traditional titanium alloys (Niinomi et al. 2002). These alloys can also be heated to variable stiffness, and are of lower cost than other materials, such as gold, that have similar properties (Kusy 2002).

In orthodontics, beta titanium alloys exhibit characteristics that make them a superior choice as an intermediate arch wire (Kusy 1981).

Bibliography

Alford, T.J. et al. 2011. “Clinical outcomes for patients finished with the SureSmile method compared with conventional fixed orthodontic therapy,” The Angle Orthodontist 81 (3): 383-388.

Boseker, J. 2010. “New Products for Orthodontic Care,” Journal of the American Orthodontic Society, 10 (5), Sept/Oct.

Burstone, CJ and AJ Goldberg. 1980. “Beta titanium: a new orthodontic alloy,” Am  Orthod. 77(2): 121-32.

DentristyiQ. No date given. Accessed 2013. “Paradise Dental flosser,” < http://www.dentistryiq.com/articles/2011/05/paradise-dental-flosser.html>.

Goldberg, J. and C. Burstone. 1979. “An Evaluation of Beta Titanium Alloys for Use in Orthodontic Appliances.” Journal of Dental Research, 58 (2): 593-599.

Kusy, R.P. 1981. “Comparison of nickel-titanium and beta titanium wire sizes to conventional orthodontic arch wire materials,” American Journal of Orthodontics 79 (6): 625-9.

Kusy, R.P. 2002. “Orthodontic Biomaterials: From the Past to the Present. The Angle Orthodontist,” 72 (6): 501-12.

Niinomi, M. et al. 2002. “Development of Low Rigidity β-type Titanium Alloy for Biomedical Applications,” Materials Transactions 43 (12): 22970-7.

O’Hehir, T. 2008. “Invention Borne of Passion,” Hygienetown Magazine, October.

Ross, J. Dryden Flight Research Center. NASA; 2002.

Sachdeva, R.C.L. 2001. “SureSmile technology in a patient-centered orthodontic practice,” Journal of Clinical Orthodontics.

Saxe, A. K., L.J. Louie, J. Mah. 2010. “Efficiency and effectiveness of suresmile,” World Journal of Orthodontics 11 (1).

Zardiackas, L.D., D. W. Mitchell, J. A. Disegi. 1996. “Characterization of Ti-15Mo Beta Titanium Alloy for Orthopaedic Implant Applications,”