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Intraoral ageing of aligners and attachments: Adverse effects on clinical efficiency and release of biologically-active compounds

  • Theodore Eliades (Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich) ;
  • George Eliades (Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens)
  • Received : 2024.05.07
  • Accepted : 2024.05.14
  • Published : 2024.07.25

Abstract

The clinical application of aligners is accompanied by the ageing of the polymer appliances and the attachments used, which may result in inefficiency in reaching the predicted range of tooth movement, and release of compounds and microplastics in the oral cavity as a result of the friction, wear and attrition of the aligner and composite attachment. The purpose of this review is to present the mechanism and effects of in vivo ageing; describe the hydrolytic degradation of aligners and enzymatic degradation of composite attachments; examine the ageing pattern of aligners in vivo, under actual clinical scenarios; and identify a link to the discrepancy between predicted and actual clinical outcome. Lastly, strategies to deal with three potentially critical issues associated with the use of aligners, namely the necessity of weekly renewal, the dissimilar mechanical properties of aligner and attachment resulting in wear and plastic deformation of the aligner, and the development of integuments and biofilms with microbial colonization of the appliance, are discussed.

Keywords

Acknowledgement

Parts of the text of the first section and the Figure 1 of this article derive from the chapter Eliades G, Eliades T, Vavuranakis M. General aspects of biomaterial surface alterations following exposure to biologic fluids. In: Eliades G, Eliades T, Brantley WA, Watts DC, eds. Dental materials in vivo: aging and related phenomena. Chicago: Quintessence Publishing Co.; 2003. p. 3-22 and are reproduced with permission.

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