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. 2016 Sep-Oct;21(5):53-57.
doi: 10.1590/2177-6709.21.5.053-057.oar.

Color changes of esthetic orthodontic ligatures evaluated by orthodontists and patients: a clinical study

Edilene Kawabata  1 , Vera Lucia Dantas  1 , Carlos Brito Kato  2 , David Normando  3
Affiliations

Color changes of esthetic orthodontic ligatures evaluated by orthodontists and patients: a clinical study

Edilene Kawabata et al. Dental Press J Orthod. 2016 Sep-Oct.

Abstract
in English, Portuguese

Objective:: To evaluate in vivo changes in the color of esthetic elastomeric ligatures from different manufacturers.

Methods:: Four widely used commercial brands of elastomeric ligatures were selected and used in 20 adult patients in a split-mouth design. The ligatures were evaluated by orthodontists and patients in a double-blind manner on the day the ligatures were placed (T0) and 30 days after intraoral exposure (T1) by means of a system of staining scores. Groups were compared by Friedman test with p < 0.05.

Results:: Orthodontists and patients reported similar staining scores (p > 0.05). Results showed that all brands underwent significant staining when exposed to the intraoral environment. Modular-crystal MorelliTM (Sorocaba, SP, Brazil) showed the highest degree of staining with the median reaching the maximum value (3); while the other brands (3M UnitekTM, American OrthodonticsTM and GAC DentsplyTM) showed the median equal to 1 (p < 0.001). A large individual variability in the degree of staining was also found for all brands.

Conclusions:: All four brands of esthetic ligatures showed significant staining, which appeared to be more pronounced for the MorelliTM brand. Changes in color of the elastomeric ligatures were perceived similarly by patients and orthodontists. The industry needs to improve the color stability of esthetic ligatures.

Objetivo:: avaliar, in vivo, as alterações na cor de elastômeros estéticos de diferentes fabricantes.

Métodos:: quatro marcas comerciais de elastômeros amplamente utilizados foram selecionadas e utilizadas em 20 pacientes adultos, por meio desse estudo com delineamento do tipo boca dividida. As ligaduras foram avaliadas por ortodontistas e pacientes, com método duplo-cego, no dia que as ligaduras foram instaladas (T0) e após 30 dias em exposição ao meio intrabucal (T1), atribuindo escores ao manchamento dessas. Os grupos foram comparados pelo teste de Friedman, com p < 0,05.

Resultados:: os ortodontistas e pacientes relataram escores semelhantes de manchamento (p > 0,05). Os resultados mostraram que todas as marcas analisadas apresentaram alterações significativas na coloração, quando foram expostas ao ambiente intrabucal. O modelo Modular-cristal (Morelli, Sorocaba/SP, Brasil) mostrou o maior grau de manchamento, com a mediana atingindo o valor máximo (3), enquanto nas outras marcas (3M Unitek, American Orthodontics e GAC Dentsply) a mediana foi igual a 1 (p < 0,001). Também se verificou uma grande variabilidade individual no grau de manchamento, para todas as marcas.

Conclusões:: Todas as quatro marcas de elastômeros estéticos mostraram manchamento significativo, que pareceu ser mais pronunciado para a marca Morelli. As alterações de cor nos elastômeros foram percebidas de forma semelhante pelos pacientes e pelos ortodontistas. Assim, a indústria precisa melhorar a estabilidade de cor dos elastômeros estéticos.

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Figures

Figure 1
Figure 1. Random distribution by quadrant: M = MorelliTM, GAC = GACTM, AO = American OrthodonticsTM, 3M = 3M UnitekTM.
Figure 2
Figure 2. Box-plot of medians and IQR of the scores assigned to the four brands according to orthodontists' and patients' assessment (T1-T0).
Figure 3
Figure 3. Change in color of the ligatures before (A) and after exposure to the intraoral environment for 30 days (B): note that whereas the ligatures manufactured by GACTM, 3MTM and American OrthodonticsTM show a pattern of less staining and are similar to each other, the ligature manufactured by MorelliTM exhibits a more pronounced pigmentation.
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