INDIAN DENTAL ACADEMY

Leader in continuing dental education

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Guided by:
Dr.(Mrs.) P.V.Hazarey
Prof. And Head
Presented by:
Madhvi Bhardwaj
Postgraduate student
Sharad Pawar Dental College
Datta Meghe Institute of Medical Sciences, Wardha

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Introduction
As overhead costs rise, orthodontists are continually
searching for ways to reduce costs.

The newer orthodontic wires display an excellent
combination of strength resiliency and low-load
deflection rates.

Beta-titanium (TMA) three times while NiTi usually
two times more expensive than stainless steel wires.
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It is unlikely that orthodontist will discontinue their
use due to their relatively high price.

Hence, the challenge is to make more cost effective
use of these wires.

Sterilization and reuse of the more expensive
orthodontic wires is one option.

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During finishing stage of treatment when lower
grade wires may be reused in the same patient

Also one can recycle and reuse the same wire in
different patient
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When considering the reuse of orthodontic
wires, it is important to:
Evaluate the effect of sterilization on the
physical properties of wires
Eliminate the risk of cross infection
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AIM AND OBJECTIVES
To evaluate the effects of sterilization on the tensile
strength of Nickel- Titanium, TMA and Stainless steel
wires.

To compare the effects of three different methods of
sterilization methods on the tensile strength of Nickel-
Titanium, TMA and Stainless steel wires.
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Materials
Wires used:
5 samples of each
0.016 (round) and 0.016X0.022 (rectangular)
TMA (Ortho organizer)

0.016 (round) and 0.016X0.022 (rectangular)
Nickel Titanium (Libral Traders)

0.016 (round) and 0.016X0.022 (rectangular)
Stainless Steel wires (Libral Traders)
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Control group: The used wires were
ultrasonically cleaned and air dried
but was not processed through
different sterilization procedures.

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Experimental group: The used wires
were ultrasonically cleaned and air
dried and was processed through
different sterilization procedures.
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Equipments used for sterilizations:







HOT AIR OVEN
STEAM AUTOCLAVE
BIOCLENZ SOLUTION
(2% GLUTERALDEHYDE)
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Universal testing machine:
For measuring the ultimate tensile strengths of the
wires


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Method
Part 1:
The different types of sterilization methods used
on three types of wires:

Dry heat sterilization: Hot air oven was used at
320to 340F (160 to 171C) for a period of 1 to 2
hours.

Autoclaving: Used at 250 F (121 C) at 15 psi for
15 minutes or 270 F (132 C) at 30 psi.

Cold sterilization: 2% Glutaraldehyde was used for
a duration of 10 minutes and upto 10 hours of time.
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Part 2 :
Determining the effects of repeated sterilization
on tensile strengths of 0.016 and 0.016X
0.022 TMA, Nickel -Titanium and Stainless
steel wires.

All wires were tested using a Universal Tensile
Testing Machine (Model No. 1.3 D) with a load
cell capacity of 2500 N having a least count of
50 N.


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The machine consisted of two movable fixtures so
as to tightly grip the wire specimen in place when
the test is being performed and the speed of the
machine was kept at a constant rate of 1mm/min.

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Table 1 Ultimate Tensile strength of stainless steel wire(0.016
round)
Sterilization cycles
Sterilization Method
Dry heat Autoclave Cold
0 1237 85 1211 85 1087 48
1 1282 57 1251 84 1091 38
5 1212 95 1238 180 1088 47
F- value*
p-level
8.06
NS
2.95
NS
2.01
NS
Comparison
Between
Cycles
(0-1)
NS --- ---
(0-5)
NS --- ---
(1-5)
NS --- ---
Observation and Results
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Sterilization Method
Sterilization cycles
Dry heat

Autoclave


Cold

0 1855. 33 26. 39 1840. 27 5. 53 1797. 29 17. 36
1 1825. 44 30. 97 1832. 12 5. 40 1794. 75 19. 82
5 1849. 71 20. 42
1835. 32
19. 15
1776. 80 19. 62
F- value*
p-level
1. 82
0. 20
NS, p>0. 05
0. 59
0. 56
NS, p>0. 05
1. 73
0. 21
NS, p>0. 05
(0-1)
0. 21
NS, p>0. 05
0. 54
NS, p>0. 05
0. 97
NS, p>0. 05
(0-5)
0. 93
NS, p>0. 05
0. 79
NS, p>0. 05
0. 24
NS, p>0. 05
Comparison
Between
Cycles
(1-5)
0. 34
NS, p>0. 05
0. 90
NS, p>0. 05
0. 32
NS, p>0. 05

Table 2 : Ultimate Tensile strength of stainless steel
wire (0.016 x 0.022inch)
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Dry heat sterilization, Autoclaving and
Cold sterilization did not affect the
tensile strength of round and rectangular
Stainless steel wires.

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Table 3 Ultimate Tensile strength of Nickel -
Titanium wire ( 0.016 round)
Sterilization cycles
Sterilization Method
Dry heat Autoclave Cold
0 1226 11 1226 11 1226 11
1 1382 60 1366 54 1222 15
5 1364 31 1382 29 1234 14
F- value*
p-level
32.2
S,p<.01
28.6
S,p<.01
1.06
NS
Comparison
Between
Cycles
(0-1)
P<.01 P<.01 ---
(0-5)
P<.01 P<.01 ---
(1-5)
NS NS ---
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Sterilization Method
Sterilization cycles
Dry heat

Autoclave


Cold

0 1748. 92 20. 64 1746. 45 23. 42 1748. 92 20. 64
1 1836. 36 21. 68 1826. 71 21. 47 1768. 31 0. 27
5 1758. 79 17. 02 1844. 98 21. 68 1748. 26 1. 75
F- value*
p-level
28. 99
0. 00
S, p<0. 05
27. 83
0. 00
S, p<0. 05
4. 53
0. 30
NS
(0-1)
0. 00
S, p<0. 05
0. 00
S, p<0. 05
0. 06
NS, p>0. 05
(0-5)
0. 71
NS, p>0. 05
0. 00
S, p<0. 05
0. 99
NS, p>0. 05
Comparison
Between
Cycles
(1-5)
0. 00
S, p<0. 05
0. 42
NS, p>0. 05
0. 05
NS, p>0. 05


Table 4 : Ultimate Tensile strength of Nickel Titanium(
0.016 x 0.022 inch)
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Dry heat sterilization significantly increased the
tensile strength of both round and rectangular Nickel -
Titanium wires after one cycle.

Autoclaving increased the tensile strength of
rectangular and round Nickel -Titanium wires.

Cold sterilization did not affect the tensile strength of
both round and rectangular Nickel -Titanium wires.
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Table 5 Ultimate Tensile strength of TMA wire (0.016 round)
Sterilization cycles
Sterilization Method

Dry heat Autoclave Cold

0 1087 48 1087 48 1087 48

1 1282 57 1251 84 1091 38

5 1212 95 1238 180 1088 47

F- value*
p-level
8.06
S,0.01
2.95
S,0.02
0.01
NS,0.2

Comparison
Between
Cycles
(0-1)
S --- ---
(0-5)
S S ---
(1-5)
NS NS ---
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Sterilization Method
Sterilization cycles
Dry heat

Autoclave


Cold

0 1673. 53 20. 64 1866. 02 16. 83 1773. 53 20. 64
1 1840. 89 22. 70 1823. 73 21. 26 1766. 03 4. 87
5 1672. 03 33. 65 1878. 45 21. 89 1792. 68 22. 11
F- value*
p-level
68. 12
0. 00
S, p<0. 05
10. 15
0. 003
S, p<0. 05
3. 01
0. 08
NS, p>0. 05
(0-1)
0. 00
S, p<0. 05
0. 01
S, p<0. 05
0. 78
NS, p>0. 05
(0-5)
0. 90
NS, p>0. 05
0. 60
NS, p>0. 05
0. 24
NS, p>0. 05
Comparison
Between
Cycles
(1-5)
0. 00
S, p<0. 05
0. 003
S, p<0. 05
0. 08
NS, p>0. 05

Table 6 : Ultimate Tensile strength of TMA (0.016 x
0.022 inch)
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Dry heat sterilization significantly increased the
tensile strength of both round and rectangular
Beta-Titanium wires after one cycle.

Autoclaving also increased the tensile strength of
in case of round and rectangular Beta-Titanium
wires

Cold sterilization did not affect the tensile
strength of both round and rectangular Beta-
Titanium wires.
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Statistical analysis showed that with the comparison
between the cycles no significant differences were
found in the tensile strength of wires between zero
cycle and five cycles of sterilization but increases
after one cycle of sterilization.
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Discussion
The purpose of present study was to
examine the effect of repeated cycles
of different methods of sterilizations
on tensile strength of round and
rectangular (0.016 and 0.016X
0.022 ) Beta Titanium, Nickel
Titanium, and Stainless steel wires.
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Tensile strength was chosen as the parameters
as it has a direct impact on the clinical use of
wire.

If a wires tensile strength decreases it is more
prone to breakage, which may cause a problem
for both the patient and the orthodontist

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It can be concluded that sterilization of Beta
Titanium and Nickel Titanium wires with dry
heat or autoclave produces an increase in their
tensile strength.

The decrease in tensile strength of stainless steel
wires produced by autoclave or dry heat
sterilization may not present a clinical problem
since only few Orthodontists reuse these wires.
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Conclusion
Whether or not recycling is a practical method of
reducing orthodontic overhead cost

The results of this study suggest that Orthodontists
who choose to recycled Nickel Titanium, TMA or
Stainless steel arch wires do not need to be
concerned about reducing the wires ultimate tensile
strength by sterilization procedures.

Instead, tensile strength increases in case of Nickel-
Titanium and TMA wires
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