Effect of Charcoal, Probiotic, and Chlorhexidine Mouthwashes on Mechanical Properties and Surface Characterization of Ceramic-Coated Nickel-Titanium Orthodontic Arch Wires: A Comparative In-Vitro Study

Abstract

Aim and objectives: To determine the impact on the mechanical properties and surface features of ceramic-coated nickel-titanium (CC-Ni-Ti) archwires when subjected to charcoal, probiotic, and chlorhexidine mouthwashes in in vitro conditions.

Materials and methods: Eighty samples of 25 mm were cut from the posterior end of preformed maxillary 0.016'' CC-Ni-Ti super elastic archwires (Koden Company, USA) and distributed into four equal groups. Each group of wires was immersed in artificial saliva (Wet Mouth Mouthwash, ICPA Health Products Ltd., India) (control), charcoal mouthwash (Hello activated charcoal extra freshening mouthwash, Hello Products LLC, USA), probiotic mouthwash (Perfora, Probiotic Rinse, India), and 0.2% chlorhexidine gluconate mouthwash (Sensorange, Orange Biotech, Pvt., Ltd., India) (experimental groups) for 90 min at 37 °C. All samples were taken out of their respective solutions and washed with distilled water prior to testing. A three-point bending test was performed on 15 samples from each group using a universal testing device. During the loading and unloading of the archwires, the yield strength (YS), flexural modulus of elasticity (E), and spring back ratio (YS/E) were calculated. The remaining five wires from each group were observed under the scanning electron microscope (SEM) for surface topography evaluation.

Results: The mean differences of loading YS, E, and YS/E between chlorhexidine and charcoal are 302.91 MPa, 4.28 GPa, and 0.0004, whereas unloading values are 172.32 MPa, 4.16 GPa, and 0.0003, respectively, with a statistical significance of <0.001 in terms of YS and E. The mean differences of loading YS, E, and YS/E between charcoal and probiotic are 305.36 MPa, 4.54 GPa, and 0.0005, whereas unloading values are 173.77 MPa, 3.66 GPa, and 0.0003, respectively, with a statistical significance of <0.001 in terms of YS and E. The mean differences of loading YS, E, and YS/E between chlorhexidine and probiotic are 2.45 MPa, 0.26 GPa, and 0.00007, whereas unloading values are 1.44 MPa, 0.49 GPa, and 0.0000533, respectively, with no statistical significance of >0.001 in terms of YS, E, and YS/E. Surface topography alteration was clearly appreciated in the charcoal and probiotic mouthwash groups compared to charcoal mouthwash.

Conclusions: Loading and unloading of 0.016" ceramic-coated nickel-titanium archwires showed an increase in mechanical properties except for the spring back ratio on exposure to chlorhexidine, probiotic, and charcoal mouthwashes. Chlorhexidine and probiotic mouthwashes had a higher yield strength and flexural modulus of elasticity in comparison with charcoal mouthwash and artificial saliva on 0.016" ceramic-coated nickel-titanium archwires. More corrosive changes were seen on 0.016" ceramic-coated nickel-titanium archwires when immersed in chlorhexidine, followed by probiotic and charcoal mouthwashes.

Keywords: ceramic-coated nickel-titanium archwire; charcoal mouthwash; chlorhexidine gluconate mouthwash; mechanical properties; probiotic mouthwash; surface topography.

Figure 1. Surface topography of ceramic-coated nickel-titanium archwires exposed to artificial saliva.

Figure 2. Surface topography of ceramic-coated nickel-titanium archwires exposed to charcoal mouthwash.

Figure 3. Surface topography of ceramic-coated nickel-titanium archwires exposed to probiotic mouthwash.

Figure 4. Surface topography of ceramic-coated nickel-titanium archwires exposed to chlorhexidine mouthwash.