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Color changes of nanocomposites used for clear aligner attachments: an in vitro study

Farbveränderungen von für Clear-Aligner-Attachments verwendeten Nanokompositen: eine In-vitro-Studie

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Abstract

Purpose

The purpose of this study was to compare the color changes of two different nanocomposites used for two different designs of clear aligner attachments.

Methods

In all, 120 human premolars were embedded in 12 upper dental models with 10 premolars in each model. Models were scanned and attachments were digitally designed. Conventional attachments (CA) were prepared for the first six models and optimized multiplane attachments (OA) were prepared for the other six models with packable composite (PC) on the right quadrant and flowable composite (FC) on the left quadrant of each model. The models were subjected to 2000 thermal cycles at 5 °C/55 °C and then consecutively immersed in the five different staining solutions each for 48 h to simulate external discoloration. Color measurements were taken with a spectrophotometer. Color changes (∆E*ab) of the attachments before and after immersion were compared with the Commission Internationale de l’Éclairage L*a*b* (CIELAB) color space approach.

Results

When ∆E*ab values were examined, no significant difference was observed between the groups according to the attachment type (P > 0.05). After the coloration process, the flowable composite group showed less coloration than the packable composite group for both attachment designs (P < 0.05). Color difference values after the staining procedure were significantly higher in the CA-PC and OA-PC groups compared to the CA-FC and OA-FC groups (P < 0.05).

Conclusion

Color change of the packable nanocomposite was more pronounced than that of the flowable nanocomposite for both attachment designs. Therefore, clear aligner attachments created using flowable nanocomposite can be recommended, especially in the anterior region where esthetics are important for the patient.

Zusammenfassung

Zielsetzung

Ziel dieser Studie war es, die Farbveränderungen zweier verschiedener Nanokomposite zu vergleichen, die für 2 unterschiedliche Designs von Clear-Aligner-Attachments verwendet werden.

Methoden

Insgesamt wurden 120 menschliche Prämolaren in 12 Oberkiefermodelle eingebettet, die jeweils 10 Prämolaren enthielten. Die Modelle wurden gescannt und die Attachments wurden digital entworfen. Für die ersten 6 Modelle wurden konventionelle Attachments (CA) und für die anderen 6 Modelle optimierte Multiplane-Attachments (OA) mit stopfbarem Komposit (PC) auf dem rechten Quadranten und fließfähigem Komposit (FC) auf dem linken Quadranten jedes Modells angefertigt. Die Modelle wurden 2000 thermischen Zyklen bei 5 °C/55 °C unterzogen und dann 48 Stunden lang nacheinander in die 5 verschiedenen Färbelösungen getaucht, um externe Verfärbungen zu simulieren. Die Farbmessungen wurden mit einem Spektralphotometer durchgeführt. Die Farbveränderungen (∆E*ab) der Aufsätze vor und nach dem Eintauchen wurden mit dem Farbraumverfahren der Commission Internationale de lʼÉclairage L*a*b* (CIELAB) verglichen.

Ergebnisse

Bei der Untersuchung der ∆E*ab-Werte wurde kein signifikanter Unterschied zwischen den Gruppen je nach Attachmenttyp festgestellt (p > 0,05). Nach dem Färbeverfahren zeigte die Gruppe mit fließfähigem Komposit bei beiden Geschiebeformen eine geringere Färbung als die Gruppe mit stopfbarem Komposit (p > 0,05). Die Farbdifferenzwerte nach dem Färbeverfahren waren in den Gruppen CA-PC und OA-PC signifikant höher als in den Gruppen CA-FC und OA-FC (p > 0,05).

Schlussfolgerung

Die Farbveränderung des stopfbaren Nanokomposits war bei beiden Attachment-Designs stärker ausgeprägt als die des fließfähigen Nanokomposits. Daher können Clear-Aligner-Attachments, die mit fließfähigem Nanokomposit hergestellt werden, empfohlen werden, insbesondere im Frontzahnbereich, wo die Ästhetik für den Patienten wichtig ist.

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Acknowledgements

The authors thank Prof. Neslihan Arhun for her unwavering support at every stage of this study. The authors would also like to thank Orthero® Aligner Company and assistance from Aydın Dinkkulak in this study.

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Authors and Affiliations

  1. Private practice, Ankara, Turkey

    Serhat Özsoy DDS-PhD &  Ömür Polat-Özsoy

  2. Department of Orthodontics, Faculty of Dentistry, Başkent University, Yukarıbahçelievler Mah. 82. Sokak No:26, 06490, Bahçelievler Ankara, Turkey

    Hande Pamukçu Assistant Professor & Ece Mersan Ateş PhD candidate

  3. Department of Orthodontics, Faculty of Dentistry, İzmir Tınaztepe University, Aydoğdu Mah. 1267/1 Sokak No:4, Buca, İzmir, Turkey

    Ömür Polat-Özsoy

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  1. Serhat Özsoy DDS-PhD
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  4. Ece Mersan Ateş PhD candidate
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Contributions

All authors contributed to the study design and conception. Sample preparation, data collection, and analysis were performed by S. Özsoy, H. Pamukçu, and E.M. Ateş. The first draft was written by S. Özsoy, H. Pamukçu, and Ö. Polat-Özsoy and all authors commented on previous versions of manuscript. All authors read and approved the final manuscript.

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Correspondence to Hande Pamukçu Assistant Professor.

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Conflict of interest

S. Özsoy, H. Pamukçu, Ö. Polat-Özsoy and E.M. Ateş declare that they have no competing interests.

Ethical standards

This study was approved by Baskent University Institutional Review Board (project no: D‑KA 22/02) and supported by Baskent University Research Fund. Written informed consent from the patients who donated their teeth was collected at the beginning of the study.

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Özsoy, S., Pamukçu, H., Polat-Özsoy, Ö. et al. Color changes of nanocomposites used for clear aligner attachments: an in vitro study. J Orofac Orthop 84 (Suppl 3), 266–275 (2023). https://doi.org/10.1007/s00056-023-00461-7

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