History of NiTinol. Ni = Nickel Ti = Titanium N = Naval O = Ordnance L = Laboratory

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2 History of NiTinol Ni = Nickel Ti = Titanium N = Naval O = Ordnance L = Laboratory NiTinol was discovered in a laboratory of the U.S. Marines in 1962 (US-Naval Ordnance Laboratory). The U.S. Marines wanted to improve their submarine boats and needed an antimagnetic metal with a high hardness and resistance against corrosion. By melting approx.. 55 % Nickel and 45 % Titanium, an alloy appeared which showed extraordinary characteristics that have not been known so far.

3 Nitinol is an alloy, which reacts to deformation like gum. Products made of this alloy show elastic properties ten times higher than steel. Properties of NiTi

4 Properties of NiTi (2) NiTi is a memory metal alloy High temperature structure: Austenit Low temperature structure: Martensit

5 Properties of NiTi (3) Resistance against corrosion and biocompatible: - although as it contains approx. 50 % Nickel - NiTi only releases very few Nickel ions - Nickel allergies during treatment with NiTi materials have not been reported

6 Victory of NiTi in Orthodontics The orthodontist Dr. Andreasen of the University of Iowa is supposed to be the inventor of NiTi in orthodontics. The first trials were performed at the beginning of the 1970ies at the university of Iowa Mid of the 1970ies the first NiTi orthodontic product was introduced under the trademark of NiTinol Activ Arch During the 1990ies modern superelastic NiTi products were marketed Performance of a so called plateau Light, physiologically ideal forces

7 Root Resorption Root resorption after 600 gmm Root resorption is an unrequested side effect of an orthodontic treatment. Irreversible shortening of the root With the kind authorisation of Prof. Dr. Sander, University Ulm

8 Root Resorption Root resorption after 100g of intrusive force With the kind authorisation of Prof. Dr. Sander, University Ulm

9 Root Resorption Experimental in-vivo study (Faltin et al., São Paulo, Brazil, 2001) Intrusion F z = -0.5 N / -1 N Lingual root torque M x = -3 Nmm / -6 Nmm With the kind authorisation of Prof. Dr. Sander, University Ulm

10 In vitro computer simulation of resorption, Sander et al.2004 Stressprofile Intrusion (50 g) With the kind authorisation of Prof. Dr. Sander, University Ulm

11 In vitro computer simulation of resorption, Sander et al.2004 Stressprofile Torque (3 Nmm) With the kind authorisation of Prof. Dr. Sander, University Ulm

12 Conclusion Prof. Dr. Sander et al By the application of treatment elements, which are already available and while developing new treatment elements, it is to be considered, that to avoid root resorption the hydrostatic pressure in PDL (Periodontal Ligament) must not exceed the capillary blood pressure.

13 Study Drescher et al Material and Methods:: The premolars of 30 patients, which are intended to be extracted, were included in the initial phase in a multi bracket aperture and extracted after the levelling with 15 th Twistflex and 14 th Sentalloy wires and registered historically. The force systems which are applied on the teeth were registered using a biomechanical measuring system and out of it, the periodontal pressure allocation is defined using a Finite Element models. Results: Root resorption can be detected on all teeth, which were examined. The maximum pressure exceeded the capillary bood pressure in many cases. The comparison between Finite Element models and histological cuts show a correlation between maximum tension in periodontal fissure and root resorptions, for Sentalloy as well as for Twixflex wires. Conclusion: The correlation between dimensions and localization of the maximum periodontal tension and root resorption confirms, that the affected forces and moments are seen as the reason for the lesions.

14 Conclusion Prof. Dr. Sander et al Summary of the two studies: To avoid root resorption especially at the initial phase of orthodontic treatment, transferred forces have to be below 50g.

15 Poster German Ortho Meeting 2006: Is there an ideal first arch for levelling? Conclusion: NiTi twisted wire and NiTi wire are suitable to reduce forces to a physiologically acceptable level

16 Order No. Maxillary Order No. Maxillary BioStarter - BioTorque archwires Order No. Mandibular Diameter Inch Force g 0, g 0, g 0, g 0,016 Order No. Mandibular Force Dimensions (Inch) g.016" x.016" g.016" x.022" g.018" x.025" BioStarter round 0.010" - for particularly sensitive patient BioTorque square and rectangular wires Efficiency for all dimensions

17 BioStarter THE INTELLIGENT SHAPE MEMORY EFFECT BioStarter is thermo-activated wire BioStarter archwires get their characteristics from a specially composed metal alloy. Due to the composition of this alloy the forces of the archwire vary depending on the surrounding temperature, which may be influenced by e.g. food and drink. Force level at 37 C drops with a decreasing temperature. All changes in the forces are reversible and lead over the duration of the orthodontic treatment to intermittent levelling of the teeth.

18 Surface Condition Forestadent Competitor

19 Wire comparison Biostarter Competitor

20 SEM-Scanning Electron Microscopy With the kind authorisation of Prof. Dr. Sander, University Ulm

21 With the kind authorisation of Prof. Dr. Sander, University Ulm

22 Competitor O With the kind authorisation of Prof. Dr. Sander, University Ulm

23 Forestadent-Biostarter With the kind authorisation of Prof. Dr. Sander, University Ulm

24 3D Surface of a new NiTi wire (Laser Scan and scanning force microscopy* * The surface roughness and friction of NiTi orthodontic wires in clinical use Geserick M et al., Department of Orthodontics and Pediatric Dentistry, University of Basel*

25 3D Surface of a used NiTi wire after 4 weeks of oral exposure* * The surface roughness and friction of NiTi orthodontic wires in clinical use Geserick M et al., Department of Orthodontics and Pediatric Dentistry, University of Basel*

26 Friction [N] Forestadent NiTI Forestadent River Finish Neo Sentalloy Neo Sentalloy IONGUARD * The surface roughness and friction of NiTi orthodontic wires in clinical use Geserick M et al., Department of Orthodontics and Pediatric Dentistry, University of Basel*

27 friction [N] Low Force Low Force River Finish Neo Sentalloy Neo Sentalloy IONGUARD * The surface roughness and friction of NiTi orthodontic wires in clinical use Geserick M et al., Department of Orthodontics and Pediatric Dentistry, University of Basel*

28 Conclusion of the study: The measurements show that the friction of superelastic NiTi wires with chemically or mechanically treated surfaces ie. ion implantation or special polishing techniques is significantly improved. However all NiTi wires should be discarded after 4 weeks of intraoral use due to an increase in friction during use. * The surface roughness and friction of NiTi orthodontic wires in clinical use Geserick M et al., Department of Orthodontics and Pediatric Dentistry, University of Basel*

29 Features: Wide range of forces available Extremely flexible, thermoactive NiTi alloy with efficient force expression for faster treatment Shape Memory Effect: Martensitic shape memory with thermoactive force changes, e.g. pain sensitive patient Unique surface treatment of archwire reduces friction up to 30% BioStarter for patients with periodontally compromised patients BioTorque : Square and rectangular wire for the application of precise and gentle forces even during torquing

30 4 months Patient B, courtesy of Dr. Cacciafesta, Pavia, Italy

31 Patient B, courtesy of Dr. Cacciafesta, Pavia, Italy

32 Patient AC, courtesy of Dr. Cacciafesta, Pavia, Italy, 7 months of treatment

33 Patient MG, courtesy of Dr. Cacciafesta, Pavia, Italy at start of treatment

34 Patient MG, courtesy of Dr. Cacciafesta, Pavia, Italy with Biostarter 0.010

35 Patient MG, courtesy of Dr. Cacciafesta, Pavia, Italy with Biostarter 0.010

36 Patient MG, courtesy of Dr. Maijer, Canada with Biostarter 0.010

37 Patient MG, courtesy of Dr. Maijer, Canada with Biostarter 0.010

38 BioStarter. BioTorque. The intelligent and comfortable technology from Forestadent.

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