Cytotoxicity Clinical Trial
Official title:
The Biological Effects of Commercial Orthodontic Miniscrews on the Oral Investing Tissue
The use of miniscrew implants as an anchorage device in orthodontics has gained a widespread acceptance in recent years. There prevailed use has been attributed to its ease in insertion and removal at a relatively low cost with no need to wait for a long time between miniscrew insertion and force application. In this regard; clinical studies have suggested that miniscrew implants may provide stable anchorage during the orthodontic treatment without requiring patient cooperation. These studies proved many successful applications in orthodontics involving; retraction of anterior teeth, correction of open bites, distalization, mesialization, and intrusion of teeth
The use of miniscrew implants as an anchorage device in orthodontics has gained a widespread
acceptance in recent years. There prevailed use has been attributed to its ease in insertion
and removal at a relatively low cost with no need to wait for a long time between miniscrew
insertion and force application. In this regard; clinical studies have suggested that
miniscrew implants may provide stable anchorage during the orthodontic treatment without
requiring patient cooperation. These studies proved many successful applications in
orthodontics involving; retraction of anterior teeth, correction of open bites,
distalization, mesialization, and intrusion of teeth.
In dentistry, various materials are used in implant systems. The implant material must be
nontoxic, biocompatible, mechanically sufficient, and having high tension and corrosion
resistance. Commercially pure titanium (cp Ti) is the most used material in prosthetic
implants because of its; high biocompatibility, high corrosion resistance in body fluids, not
allergic, high specific strength, and low elastic modulus when compared with other metallic
biomaterials.
On the other hand, orthodontic miniscrew implants are smaller than conventional prosthetic
implants and should resist high orthodontic loads. These factors contribute to the possible
fracture of cp Ti miniscrew implants during placement, use, and removal. To avoid such
fracture, Ti alloy implants, composed with aluminum (6Al) and vanadium (4V), (Ti-6Al-4V), for
adding strength and fatigue resistance than cp Ti, are required. Unfortunately, this alloy
has a low corrosion resistance and can result in corrosion of the orthodontic miniscrew
implants in body fluids.
Any metal or alloy implanted in the human body is a potential source of toxicity. In an oral
envelope, miniscrew implants are exposed to a number of potentially destructive physical and
chemical agents. Evaluation the potential of conventional dental implants to release metallic
ions into the body have been done. However, little attention has been given to metallic ion
released from orthodontic miniscrew implant systems and the potential toxicity of these
released metal on oral tissues. The concern about this has been limited to orthodontic
brackets and wires.
One of the studies concerned with the biocompatibility of different metals used in vivo of
different fixed orthodontic appliances and evaluating the presence of metal ions in oral
mucosa cells, their potential cytotoxicity, and genotoxic effects. This study concluded that
nickel and cobalt metals released from fixed orthodontic appliances could induce DNA damage
in oral mucosa cells.
Literature review in this topic listed an expanding area of articles dealing with orthodontic
miniscrews. The in vivo studies of cytotoxic effect of metal ions released from orthodontic
miniscrew implants in body fluids are limited compared to in vitro studies.
In view of the above review of literature, it will be of great value in clinical orthodontics
to investigate the biological effect of commercial orthodontic miniscrew implants on the oral
investing tissue.
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