Dental Biomaterials from the past to the present by: Albert Mikko Hizon & Chai C. Santiago

Brief History

The French and the English dominated the earliest contributions to the field of Orthodontics. In 1723 Fauchard invented the expansion arch and gave the first comprehensive discussion of appliances. In 1819 Delabarre introduces the wire crib, and this marked the birth of contemporary orthodontics. Brief History

In 1865 Kingsley advocates plates as retaining devices.

Early Developments

Dental bands Dental clasps Ligature Dental wire

Early developments Gold, platinum, silver, steel, gum rubber, vulcanite and, occasionally, wood, ivory, zinc, copper, brass were used to form loops, hooks, spurs, and ligatures. 14- to 18-karat Gold was usually used for wires, bands, clasps, ligatures, and spurs.

Period of stagnation

Dental practitioners learned that gold alloys have deficiencies too. Gold was too expensive already. Stainless steel became available. In 1933, Archie Brusse gave a table clinic on the first complete stainless steel system at the American Society of Orthodontists (ASO). Period of stagnation

In 1937 Acrylic’s were discovered and replaced gold wires. In the 1940’s acrylic materials were being polymerized into plates by reacting dough made from methyl methacrylate monomer (MMA) and acrylic powder under heat and pressure. By 1946, 98% of all denture bases were constructed with the use of acrylics.

Stainless steel gained prominence as the soft brass ligature wire is now replaced by an mm (0.01in) soft stainless steel wire. To close this age, a man named Michael G. Buonocore proposed the use of a 30-second, 85% phosphoric acid etch to enhance bonding of acrylic materials to enamel surfaces. Period of stagnation

The rise of the dental industry

By the 1960’s, gold was universally abandoned in favor of stainless steel. Advantages of using stainless steel: a.The force per unit activation of stainless steel is greater than that of gold. b.By being smaller in size, stainless steel material were regarded as being more esthetic than gold materials. c.Stainless steels possess an excellent corrosion resistance, work- hardening, and a very low frictional magnitude.

In the1960’s: –Bracket bands are disappearing as the bonded miniature bracket appears – thereby disrupting the beginning of esthetic orthodontics. –Cobalt-chromium alloys were introduced. These alloys contained not only cobalt, chromium, and molybdenum but also large amounts of nickel and iron. These alloys are available in four different tempers and are heat treatable. –Nitinol was discovered. This product has the lowest modulus for any cross section and has the most extensive deactivation (range) capabilities. The rise of the dental industry

In the 1970’s elastics of all sorts find their niches in the orthodontic professions. Independent of whether elastomerics are made from ester- or ether-based polyurethanes, they possess real limitations with respect to the force retention, color fastness, and odor prevention. Coatings of polytetrafluoroethylene or Teflon are made to reduce friction. By 1986, two “superelastic” alloys are offered – a Japanese NiTi and a Chinese NiTi. These are active austenitic alloys that form stress-induced martensite.

In 1977 the beta phase of titanium was stabilized at room temperature thus producing the titanium- molybdenum alloy. This beta-titanium alloy has a modulus closest to that of traditional gold along with good springback, formability, and weldability. During this point, dental practitioners had to decide how to compare all the different types of materials. With the use of equations, tables and other mathematical based figures, the practitioners could already compare one wire with the other in terms of its three properties: stiffness, strength, and range. The rise of the dental industry

Reported Properties of alloys during the 20 th Century MaterialYoung’s modulus Yield Strength (Mpa) Tensile Strength (Mpa) Brass to 18-karat gold Nickel Silver Stainless Steel Cobalt chromium CP-Titanium (α+β)Ti NiTi-M NiTi-A β-Titanium Titanium-niobium

Current trends in the dental industry

69% of adults ages 35 to 44 have lost at least one permanent tooth to an accident, gum disease, a failed root canal, or tooth decay. By age 74, 26% of adults have lost all of their permanent teeth. Did you know that..

As we enter the 20 th century we learn that what’s more important is not making things smaller but making them look, feel and function like a real teeth. Nowadays, the most common dental operation is the Tooth replacement. Current trends in the dental industry

Attractive appearance Cuts down healthy teeth Bone loss under bridge Attractive appearance Full chewing function Prevents bone loss

The most common type of a dental implant is a titanium screw that is anchored into the jawbone where it serves as post for a custom-made tooth crown. Once the crown is in place, you may not be able to tell it apart from your natural teeth. Titanium dental implants have been placed extensively since the 1970s. Titanium offers the benefit of being lightweight and strong, and is not rejected by the body (biocompatible). It is the most widely used metal in orthopedic joint replacement and dental implants. Current trends in the dental industry

The implant is placed in the bone below the gum tissue. A temporary abutment may be placed on the implant until the healing phase is complete. A cosmetic temporary crown can often be made to fill the missing space. After healing, the abutment is attached to the implant. It will hold a custom-made crown that the dental laboratory will mold and match to your existing teeth. In the final step, the custom crown is cemented onto the abutment. The tooth has been replaced without disturbing the healthy teeth next to it and bone loss has been eliminated.

We've sure come a long way from the wrap- around "metal mouth" -- and that's something we can all smile about!

Sources 1.R. Kusy, PhD. Orthodontic Biomaterials: From the past to the present, pg