Maria Elena Cataldi

Clear aligners have transformed orthodontic care by providing an aesthetic, removable alternative to traditional braces. However, their significant environmental footprint, contributing to approximately 15,000 tons of plastic waste annually, poses a critical challenge. To address this issue, advancements in 4D printing have introduced “smart” aligners with shape memory properties, enabling reshaping and reducing the number of aligners required per treatment. This study focuses on ClearX aligners, an innovative 4D-printed solution aimed at extending usage duration and minimizing environmental impact. Using a comprehensive suite of tests, including morphological, optical, and mechanical evaluations conducted via scanning electron microscopy, UV-Vis spectroscopy, infrared spectroscopy, and bending and strain assessments, we evaluated the optical and mechanical stability of the ClearX material before and after thermal activation. Our results demonstrate that ClearX aligners retain their structural and functional properties after reshaping. Temporary changes in transparency, observed only under prolonged treatment durations exceeding manufacturer recommendations, are fully reversible within 12 h and do not compromise the aligner’s usability. These findings support the potential of ClearX aligners to effectively combine patient-centered, high-quality orthodontic care with sustainable practices.

Fluoride-based mouthwashes and gels are preventive measures in countering demineralization and caries but, modifying environmental acidity, can reduce the wet corrosion resistance of orthodontic alloys. To evaluate chemical stability, in vitro experiments were conducted on stainless steel and nickel–titanium wires, weighed before and after immersion in household fluorinated mouthwashes and gels, measuring weight variations and elution of metal ions from acid corrosion phenomena. Elution samples were analyzed by inductively coupled plasma mass spectrometry, detecting residual ion concentration, while surface changes were analyzed under scanning electron microscopy. Results showed stainless steel wires do not undergo significant erosion when exposed to most fluorinated mouthwashes but, at prolonged exposure, alloys elute gradually greater amounts of metals and Ni–Ti wires become more sensitive to some mouthwashes. Ions’ elution varies considerably, especially for Ni–Ti wires, if exposed to household fluorinated gels, for which significant negative values were obtained. Changes, affecting wires’ outer layer, negatively act on shiny appearance and luster, reducing corrosion resistance. Although examined orthodontic wires showed good chemical stability and low toxicity, surface corrosion from exposure to fluorinated agents was observed. Home use must be accompanied by clinician prescription and, for household dental gels, must follow manufacturers’ recommendations, ensuring prophylactic action without damaging alloys surfaces.

Bacterial adhesion to the surface of orthodontic materials is an important step in the formation and proliferation of plaque bacteria, which is responsible for enamel demineralization and periodontium pathologies. With the intent of investigating if adhesive resins used for bracket bonding are prone to bacteria colonization, the surface roughness of these materials has been analyzed, combining information with a novel methodology to observe the internal structures of orthodontic composites. Scanning electron microscopy, combined with focus ion bean micromachining and stylus profilometry analyses, were performed to evaluate the compositional factors that can influence specific pivotal properties facilitating the adhesion of bacteria to the surface, such as surface roughness and robustness of three orthodontic adhesive composite resins. To confirm these findings, contact angle measurements and bacteria incubation on resin slide have been performed, evaluating similarities and differences in the final achievement. In particular, the morphological features that determine an increase in the resins surface wettability and influence the bacterial adhesion are the subject of speculation. Finally, the focused ion beam technique has been proposed as a valuable tool to combine information coming from surface roughness with specific the internal structures of the polymers.