Orthodontic magnets. A study of force and field pattern, biocompatibility and clinical effects

Abstract

Magnetic forces have been incorporated into orthodontic mechanics during recent years. However, the biocompatibility of magnet alloys and the possible risk of harmful or unusual reactions in tissues exposed to static magnetic fields have been characterized as inconsistent and often contradictory. It has also been questioned whether magnetic forces have significant advantages over traditional mechanics. The present series of studies aimed to analyse the force and field properties, the biocompatibility and the clinical effects of rare earth magnets as well as to compare the efficiency of tooth movement between magnets and another force system. Samarium-cobalt magnets for molar distalization were tested in experimental models for force and field properties. The cytotoxicity of different magnet alloys (rare earth types) as well as of clinically used and recycled magnets was assessed by two in vitro methods, the millipore filter method and an extraction method. The effect of static magnetic fields on human gingival tissue and dental pulp was examined histologically for alterations in cell pattern and cell morphology. The effects of using repelling samarium-cobalt magnets for simultaneous distalization of maxillary first and second molars were analysed in individuals with Class II malocclusion. The efficiency of molar distalization was also intra-individually compared between repelling magnets and superelastic NiTi-coils in individuals with Class II malocclusion and deep bite. The magnet forces decreased approximately with the reciprocal square of the separation distance between the magnets. No fatigue of force over time could be seen. The static magnetic fields were weak and had a limited extent and the flux density dropped exponentially in all directions with increased distance from the magnets, implying a small exposure area when the magnets are used clinically. Rare earth magnets showed good biocompatibility, particularly coated magnets. However, uncoated samarium-cobalt magnets showed significant cytotoxicity. It was also found that stainless-steel-coated samarium-cobalt magnets could be recycled with maintained good biocompatibility. After exposure to static magnetic fields, normal clinical and histological conditions in the human gingival tissue and normal histological features in the human dental pulp were found. Repelling magnets were effective in producing maxillary molar distalization but some side effects like anchorage loss and molar tipping were found. The superelastic coils were shown to be even more efficient than the repelling magnets for maxillary molar distalization in individuals with Class II malocclusion and deep bite.