Flávio de Mendonça Copello

Purpose: To evaluate the effect of cigarette smoke on esthetic brackets. Methods: Four commercial brackets ( n = 112), Ceramic ^® , Composite ^® , PolySafira ^® , and Zetta ^® were exposed for 21 consecutive days to cigarette smoke. The control group consisted of each bracket material maintained in artificial saliva and not exposed to cigarette smoke. Linear surface roughness was measured before and after exposure using optical profilometry, and surface morphology was qualitatively characterized by scanning electron microscopy (SEM) after the exposure period. Subsequently, the brackets were subjected to an acidogenic challenge in a multispecies biofilm with 2% sucrose. After 48 h, biofilm viability was assessed (CFU/mL), and the culture medium pH was analyzed. The data were analyzed using the Kruskal–Wallis test followed by the Mann–Whitney U test with Bonferroni correction, and a paired t -test ( p < .05). Results: Zetta ^® showed the greatest increase in Ra (+0.27 µm), and Ceramic ^® exhibited a slight increase (+0.06 µm). Composite ^® and PolySafira ^® demonstrated a reduction in Ra values ( p < .05). Composite ^® accumulated the highest amount of viable biofilm (6.44 × 10 ⁴ CFU/mL), whereas Ceramic ^® presented the lowest (3.56 × 10 ⁴ CFU/mL). All groups showed a significant pH reduction after biofilm formation, with Composite ^® demonstrating the most pronounced acidification (pH 6.5–5.2) and Ceramic ^® the least (pH 6.8–5.9). Conclusions: Cigarette smoke exposure adversely affected surface characteristics and acidogenic potential in esthetic orthodontic brackets. Ceramic ^® showed lower biofilm accumulation and less pronounced surface roughness changes, while PolySafira ^® showed stable surface behavior, and Zetta ^® and Composite ^® were more susceptible to surface alterations and biological challenges.

Objectives: This study aims to evaluate the impact of cigarette smoke on Invisalign ^® aligners in surface roughness, bacterial adherence rates, pH changes and multispecies biofilm formation after exposure. Materials and Methods: Seventy-two flat samples of growth (G1), sterility (G2), saliva (G3), and smoke (G4) groups were exposed to artificial saliva, and G4 underwent 21 cycles of smoke. Linear roughness (Ra) and average depth (Rz) were assessed before and after saliva (G3.1) and smoke (G4.1) exposure. Independent and paired t-tests compared measurements over 5 days of evaluation [biofilm, microorganisms (CFU/mL), pH, and volumetric surface roughness (Sa)], measurements were taken before (T0) and after (T1) exposure to saliva and cigarette smoke. Results: Increased roughness post-exposure to cigarette smoke Ra (p = 0.003) and Rz (p = 0.014) in G4.1 at T1 (p = 0.046), and higher roughness over time (Ra: 0.139 ± 0.007; Rz: 0.741 ± 0.026), unlike G3.1 (Ra: 0.122 ± 0.002; Rz: 0.616 ± 0.021). G1 had the highest CFU (8.57 × 108), significantly higher than the G4.2 (5.33 × 108) and G3.2 (2 × 108). From 24 to 96 h, pH in G4.2 (5.75) and G1 (4.45) showed slight decreases, G2 (6.76) and G3.2 (6.35) increased. G1 had the highest Sa (48.97 ± 14.19), compared to G2 (4.27 ± 1.14), G3 (7.60 ± 4.28), and G4 (13.98 ± 8.18). Conclusions: Cigarette smoke exposure elevated surface roughness and enhanced bacterial adherence on aligners. Clinical Relevance: Reinforce smoking cessation and strict oral hygiene protocols for aligner-wearing patients. In vivo studies are warranted to confirm these findings.

Aim: This study assessed the optical properties of aligner surfaces post-cigarette smoke exposure. Design: In-vitro experimental study. Setting: Laboratory analysis of clear aligners subjected to cigarette smoke exposure at Federal University of Rio de Janeiro, Brazil. Methods: A total of 20 plastic pieces from the labial surfaces of upper central incisors of Invisalign ^® clear aligners were randomly divided into a control group (CG) and an experimental group (EG). The specimens were divided equally (n = 10): CG, stored in artificial saliva at 37°C ± 1°C for 14 days; and the EG, exposed to cigarette smoke using a sealed acrylic device with 10 cigarettes per cycle for 20 cycles. A spectrophotometer was used to evaluate changes in colour and light transmittance based on CIELab* colour parameters. Measurements were taken before (T0) and after (T1) exposure. The total colour difference (∆E) and National Bureau of Standards (NBS) were calculated. T-tests were used for comparisons at a significance level of 0.05. Results: Statistically significant colour changes ( P < 0.05) were observed at T1 in the EG (luminosity [L*] = 77.20 ± 3.33; difference along green-red axis [a*] = −1.57 ± 0.02; and difference along blue-yellow axis [b*] = 6.74 ± 0.55) compared to the CG. The mean ∆E* value at T1 was significantly higher in the EG (14.27 ± 2.72) compared to the CG (2.39 ± 0.56; P = 0.002). Light transmittance decreased significantly after cigarette smoke exposure (CG = 68.396 ± 8.683; EG = 59.538 ± 5.089; P = 0.012). Conclusions: Cigarette smoke exposure significantly altered the optical properties of clear orthodontic aligners, affecting both colour and light transmittance.

Objective: This pilot study aims to compare virtual treatment setups provided by four different clear aligner companies, to assess how variations in features might impact treatment planning. Methods: Initial records of 10 patients were submitted to Invisalign®, ClearCorrect®, 3M™ Clarity™, and Spark™. Standardized case prescriptions ensured comparable treatment plans across companies. Comparisons focused on the number of aligners, number of attachments, interproximal reduction per arch, vertical movement of maxillary central incisors, final canine and molar relationships, intercanine and intermolar widths, and expansion or constriction of these widths. Results: Among the companies, significant differences were found in the number of aligners (p = 0.003), number of attachments (p< 0.001), and final canine relationship (p = 0.013). No statistical differences were observed for the other variables. ClearCorrect® prescribed the fewest number of aligners and attachments, while 3M™ Clarity™ prescribed the most. ClearCorrect® and Spark™ showed deficiencies in planning for bilateral canine Class I relationship. Conclusions: The unique characteristics of each aligner company result in distinct approaches to treating the same patient, highlighting both areas of discrepancy and consistency in virtual treatment setups.

Background: This case report describes the clinical management of a traumatic palatal ulcer, a complication associated with mini-implant-assisted rapid maxillary expansion (MARPE). Case Report: A 13-year-old female patient with maxillary constriction underwent MARPE treatment using a custom acrylic expander anchored by four mini-implants. Despite proper planning and device design, the patient missed her first follow-up appointment and continued activations, resulting in tissue inflammation and embedding of the device. Upon examination, swelling and displacement of the cement were observed, necessitating device removal. The traumatic ulcer was treated with chlorhexidine gel, paracetamol, and a soft diet. Complete recovery was achieved within one month. A second expander was then designed and installed, with more frequent monitoring and improved hygiene protocols. This approach led to successful expansion without complications. This case highlights the importance of precise treatment planning, proper mini-implant selection, and regular follow-ups in MARPE therapy. It also emphasizes the need for patient compliance and effective hygiene measures to prevent complications. Conclusions: The successful management of the traumatic ulcer demonstrates that prompt action and consideration of cost-effective treatment options can lead to positive outcomes in addressing MARPE-related complications.