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Original Article

Fracture Characteristics of Fiber Reinforced Composite


Bars Used To Form Rigid Orthodontic Anchorage Units
F. Heravi 1~, SM. Moazzami 2, S. Tahmasbi 3
1
Assistant Professor, Department of Orthodontics, School of Dentistry, Mashad University of Medical Sciences, Mashhad, Iran
2
Assistant Professor, Department of Operative Dentistry, School of Dentistry, Mashad University of Medical Sciences,
Mashhad, Iran
3
Assistant Professor, Department of Orthodontics, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran

Abstract:
Objective: The aim of this study was to evaluate fracture characteristics of rigid two-
tooth segments splinted with fiber reinforced composite (FRC), with and without
application of simulated masticatory forces.
Material and Methods: In this experimental study, 80 extracted maxillary bicuspids
were joined in pairs from the buccal aspect using FRC. The specimens were divided
into two groups. In group A, the fracture load of FRC was measured. The 20 specimens
of group B were initially loaded in a chewing simulator machine for 4×105 cycles to
simulate a two-year chewing period. Samples that withstood these loads were assessed
for fracture load. The results were compared using student t-test. Stereomicroscopic
evaluation of fracture areas was performed to determine the fracture pattern.
Results: None of the specimens in group B failed during application of simulated
masticatory forces, meaning that the survival rate was 100%. Mean (standard deviation)
of fracture loads in groups A and B were 195.80 (14.345) and 190.57 (24.027),
respectively. No significant difference was found in mean fracture loads between the
~
Corresponding author:
two groups. The overall fracture pattern was similar in both groups.
F Heravi, Department of Ortho- Conclusions: FRC bars demonstrated sufficient durability to withstand chewing forces
dontics, School of Dentistry, within the chewing simulation period. The fracture loads were higher than the mean
Mashhad University of Medical mastication forces and remained almost unchanged after application of these forces.
Sciences, Mashhad, Iran.
heravif@mums.ac,ir
Key Words: Fiber reinforced composites; Fracture load; Masticatory forces
Received: 28 May 2006
Accepted: 27 September 2006 Journal of Dentistry, Tehran University of Medical Sciences, Tehran, Iran (2007; Vol: 4, No.2)

INTRODUCTION clinical study, Rose et al [8] found that retai-


Fiber reinforcement was introduced to clinical ners made of plasma-treated woven polyethy-
dentistry for the first time in the 1960s, when lene ribbons remained in place for approxi-
investigators attempted to reinforce polymeth- mately 11.5 months.
yl-methacrylate dentures with glass or carbon Fallis and Kusy [9] introduced a novel esthetic
fibers [1,2]. It has recently been shown that glass fiber-reinforced composite wire for
crowns, bridges and posts made of FRC can be specific purposes with reasonable patient
used successfully in dental practice and they acceptance and structural integrity.
possess adequate flexural modulus [3], flexural Burstone and Kuhlberg [10] presented a new
strength [3,4] and fracture strength [5,6]. clinical use of FRC to make an esthetic con-
Initial application of FRC in orthodontics was necting bar utilized as an adjunct for active
limited to bonded lingual retainers [7]. In a tooth movement. In this application, teeth were

2007; Vol. 4, No. 2 53


Journal of Dentistry, Tehran University of Medical Sciences Heravi et al.

connected by FRC to form anchorage or extracted maxillary bicuspids with normal


movement units and attachments such as anatomy were collected and stored in a normal
brackets, tubes and hooks were directly bon- saline solution (sodium chloride, 0.9%). Forty
ded to the FRC as needed (Fig. 1). Although plastic cylinders (25mm in diameter×20mm in
this design can not be used in all stages of height) and self curing polymethyl metha-
comprehensive orthodontic treatment, its great crylate (PMMA) resin (Acropars, Iran) were
advantages such as simplicity, esthetics, bio- used for mounting the teeth in pairs. The size
compatibility, obviating the need for a full set- and shape of all premolars were similar and
up and reducing the need for bonded attach- each pair was positioned in full proximal
ments and wires, make it a good candidate for contact so that their marginal ridges were in
partial or adjunctive orthodontic treatment. In full contact and their central grooves aligned.
this application, bonding and fracture charac- To create an artificial PDL, the roots were
teristics of FRC under masticatory forces covered with a 0.1-0.2 mm-thick layer of
would be of great importance. polysiloxane impression material (Speedex,
Meiers [11] and Freudenthaler [12] showed a Coltene, Switzerland), before mounting to
good bond strength of FRC to enamel and an allow for physiologic tooth movement under
excellent bonding of orthodontic attachments masticatory forces [15]. Measurements were
to FRC, respectively. made using a thickness gauge (Iwanson
On the other hand, a problem with rigid caliper, Hu Friedy Mfg. co, Chicago, Ill).
connection of teeth is independent physiologic The buccal surfaces were cleaned with a brush
tooth movement during function in contrast to and pumice powder, then etched with 35%
the inherent brittleness and rigidity of compo- phosphoric acid (Ultra-Etch, USA) for 20
sites. Thus the results of clinical reports on seconds, rinsed for 10 seconds and dried. To
direct splinting of dental segments with com- limit and unify the etched areas in all teeth, a
posite were consistently discouraging, demon- 2.5×4 mm rectangle was punched in PVC tape
strating breakage or fracture of the adhesive and fitted on the center of the buccal surfaces
within a few weeks or months [13,14] . before etching.
Addition of fibers to composites has improved A thin layer of bonding resin (Excite, Ivoclar-
their flexural properties to an extent that has Vivadent Inc, Liechtenstein) was applied and
made FRC a good candidate even for prostho- cured with a light curing unit (Astralis-7, Ivo-
dontic bridges [3,4]. clar-Vivadent Inc, Liechtenstein) at low power
Different bonding locations and loading condi- mode (LOP,400 mW/cm2) for 20 seconds, fol-
tions have been reported for FRC when used lowed by application of the composite (Tetric-
for splinting teeth from the buccal aspect; Ceram, Ivoclar- Vivadent Inc, Liechtenstein).
therefore further investigation is required in A 3-mm-wide and 12-mm-long reinforcement
this field strip (Ribbond; Ribbond Inc, Seattle, Wash-
The aim of the present study was to determine ington) was saturated with a bonding agent
if FRC bars joining adjacent teeth would
remain intact under forces simulating a 2-year
period of intraoral function. The influence of
simulated masticatory forces on the fracture
characteristics of FRC bars was also evaluated.

MATERIALS AND METHODS


In this in vitro study, 80 intact and recently Fig. 1: FRC used to form an anchor unit.

54 2007; Vol. 4, No. 2


Heravi et al. Fracture Characteristics of Orthodontic Anchorage Units

(Excite, Ivoclar-Vivadent Inc, Liechtenstein) dental area (Fig. 2). The blade was positioned
and firmly adapted onto the underlying com- exactly in the mid point, between the teeth to
posite and enamel surface according to the apply similar flexural forces on each tooth.
manufacturer’s instructions. By this approach, The specimens in Group B were placed in a
maximal contact along with a minimal thick- chewing simulator machine operated for 4×105
ness of composite was obtained. Ribbond is a cycles at 14 N loads with a frequency of 3 Hz
commonly used and commercially available and duration of 0.2 seconds. This was equiva-
FRC and was therefore employed in the lent to two years of mastication [16] (Fig. 3).
present study. Any excess composite express- After mechanical loading, all samples were
ed outside the strip was removed. evaluated for bond failure or fracture. The
Next, a thin layer of flowable composite ratio of intact teeth to the total number of
(Tetric-Flow, Ivoclar-Vivandent Inc, Liechten- specimens was considered as the survival rate.
stein) was applied on the fiber/composite com- Intact specimens were then evaluated for
bination, and cured with the same unit at high fracture load similar to group A, and data was
power (HIP, 750 mW/cm2) for 40 seconds recorded in Newton. The results were statis-
from the buccal aspect of each tooth. tically analyzed and compared between the
The procedure was repeated for all teeth, resul- two groups using Student t-test.
ting in 40 specimens, each consisting of 2 Fracture pattern was evaluated by a stereo-
teeth splinted with FRC. microscope (Olympus SZH10, Tokyo, Japan)
After 24 hours storage in normal saline, the at ×10 magnification and classified into 4
samples were randomly divided into two equal categories [11]:
groups. In group A, fracture load of FRC was 1) Adhesive failure at the enamel surface when
measured with a universal testing machine more than 75% of the enamel was exposed.
(Instron corp, Canton, Mass) at a crosshead 2) Cohesive failure in the composite material
speed of 5 mm/min. The specimens were between FRC and the enamel surface when
oriented in the positioning jig, so that the blade more than 75% of the composite was exposed
of the crosshead loaded the FRC bar vertically, on both fractured surfaces.
on the mid point of the FRC bar in the inter- 3) Adhesive failure at the FRC interfaces when
more than 75% of FRC was exposed on one of
the fractured surfaces.

Fig. 2: Location of cross head and force application for


the measurement of fracture load. Fig. 3: Teeth under simulated masticatory forces.

2007; Vol. 4, No. 2 55


Journal of Dentistry, Tehran University of Medical Sciences Heravi et al.

4) Cohesive failure within the FRC when more bond failure under these forces. Therefore it
than 75% of FRC was exposed on both frac- appears that FRC connecting bars have suffi-
tured surfaces. cient flexural properties and durability. Fallis
and Kusy in a short-term clinical study found
RESULTS no fracture in fiber reinforced composite wires
None of the specimens in Group B showed used for retainers [9]; but in another report, the
bond failure or fracture after mechanical survival time of lingual orthodontic retainers
loading. In other words, a 100% survival rate made by FRC was only 11.5 months [8]. These
was encountered in Group B. investigations were conducted on lingual retai-
Means (standard deviations) of fracture loads ners and are not comparable to the current
in groups A and B were 195.80 N (14.345) and study. This is due to the fact that force appli-
190.57 N (24.027), respectively. cation on the buccal surfaces of posterior
Student t-test showed no significant difference segments is completely different from those
in mean fracture loads between the two groups applied on the lingual surfaces of lower
(P > 0.05). anterior teeth.
Figure 4 presents the distribution of different We tried to assess fracture strength of FRC
fracture patterns in the two groups. The overall bars under chewing forces. According to
fracture pattern was similar in both groups and Freilich et al [4], these forces are completely
occurred in the following order: on the enamel different from those applied by orthodontic
surface, the FRC interface and on the com- appliances or delivered to the brackets attach-
posite material between the FRC and enamel ed to the FRCs by elastics or archwires.
surface. No fracture was observed within the Mean values for fracture load of FRC bars,
FRC. with and without application of masticatory
forces were 195.8 N and 190.57 N, respect-
DISCUSSION tively (P>0.05).
Anchorage units or units for active tooth Various studies have described different ave-
movement can be formed by rigidly joining rage forces during mastication; for example,
dental segments using fiber reinforced bars amounts of 14 [16], 45 [17] and 120 N [18]
[12]. This study was designed to test the have been reported in the literature. It is
efficacy of fiber-reinforced bars when used for
anchorage reinforcement or segmental tooth
movement.
Previous reports on FRC restorations have
demonstrated sufficient fracture strength and
favorable durability of FRC fixed partial
dentures under chewing forces [6]. However
no similar study seems to have evaluated the
survival rate of splinted posterior segments
made by FRC.
In the present investigation, none of the speci-
Groups
men developed fracture under simulated masti-
catory forces. This means that, despite the fact Fig. 4: Distribution of fracture pattern in two groups; 1)
Adhesive failure at the enamel surface; 2) Cohesive
that all teeth could have independently moved failure in the composite material between FRC and
within their artificial PDLs, the FRC connec- enamel surface; 3) Adhesive failure at the FRC inter-
ting bars did not show evidence of fracture or face; 4) Cohesive failure within the FRC.

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Heravi et al. Fracture Characteristics of Orthodontic Anchorage Units

conceivable that FRC bars used for connecting and encouragement.


teeth can tolerate such forces. On the other
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