This study aims to compare two types of clear orthodontic aligner materials used in dental treatment: single-layer and triple-layer thermoplastic polyurethane (TPU) aligners (MaxFlex). Clear aligners are commonly used to straighten teeth and are preferred for their comfort and aesthetic appearance. Participants will be provided with aligners and instructed to wear them for approximately 22 hours per day for 10 days. The aligners will be collected before use and after the 10-day period. The study will evaluate how the oral environment affects the properties of these materials over time. Laboratory tests will be conducted to measure mechanical properties such as strength, flexibility, and deformation, as well as to examine surface changes under a microscope. The results of this study may help improve the performance and durability of aligners and contribute to better orthodontic treatment outcomes.
Clear aligner therapy (CAT) has become an increasingly popular alternative to fixed orthodontic appliances due to its aesthetic advantages, improved patient comfort, and ease of oral hygiene maintenance. Thermoplastic materials, particularly thermoplastic polyurethane (TPU), are widely used in the fabrication of aligners due to their favorable mechanical and elastic properties. Recent advancements in aligner materials have led to the development of multilayer TPU systems designed to enhance flexibility, force delivery, and clinical performance. Triple-layer TPU aligners typically consist of a soft inner layer for patient comfort, a rigid intermediate layer for structural strength, and a flexible outer layer to improve adaptability and fit. In contrast, single-layer TPU aligners are composed of a homogeneous material and are generally more cost-effective. Despite these developments, limited evidence exists regarding the comparative behavior of single-layer and multilayer TPU materials following intraoral exposure. The oral environment, characterized by temperature fluctuations, moisture, masticatory forces, and enzymatic activity, may contribute to material degradation, potentially affecting aligner performance. This randomized controlled trial is designed to evaluate the effects of intraoral aging on the mechanical properties and surface morphology of single-layer and triple-layer TPU aligners (MaxFlex). Participants will be randomly assigned to receive one type of aligner material and will be instructed to wear the aligners for a standardized duration of 10 days (minimum 22 hours per day). Aligners will be collected at baseline (prior to intraoral use) and after the 10-day wear period. Following retrieval, samples will undergo standardized cleaning procedures before laboratory analysis. Mechanical testing will be performed using dynamic mechanical analysis to assess tensile properties, stress relaxation behavior, and creep characteristics. Surface morphology will be evaluated using scanning electron microscopy to identify features such as roughness, cracks, and voids. Additionally, Fourier transform infrared spectroscopy will be used to detect potential chemical changes in the material composition. The primary objective of this study is to compare the mechanical performance of single-layer and triple-layer TPU aligners before and after intraoral use. Secondary outcomes include evaluation of surface morphology and chemical structure changes associated with intraoral aging. The findings of this study are expected to provide insight into the durability and clinical performance of different aligner materials, which may help guide material selection and improve orthodontic treatment outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
66
Single-layer thermoplastic polyurethane (TPU) clear aligners fabricated from a homogeneous TPU sheet using thermoforming techniques. These aligners are designed to deliver orthodontic forces for tooth movement. Participants will be instructed to wear the aligners intraorally for 10 days for a minimum of 22 hours per day. The aligners will be evaluated before use and after intraoral exposure to assess changes in mechanical properties and surface morphology.
Triple-layer thermoplastic polyurethane (TPU) clear aligners composed of a multilayer structure including a soft inner layer, a rigid intermediate layer, and a flexible outer layer. These aligners are fabricated using thermoforming techniques and are designed to provide improved force delivery and adaptability. Participants will wear the aligners intraorally for 10 days for at least 22 hours per day. Pre- and post-use evaluations will be conducted to assess mechanical properties and surface morphology changes.
Akhtar Saeed Medical & Dental College
Lahore, Punjab Province, Pakistan
Effect of Oral Environment on Elastic Modulus of TPU Aligners
This outcome measures the change in elastic modulus (MPa) of thermoplastic polyurethane (TPU) orthodontic aligners following intraoral exposure. Measurements are obtained using a dynamic mechanical analyzer and compared between single-layer and multilayer TPU aligners at baseline and after two weeks of clinical use to assess changes in stiffness and material integrity.
Time frame: Baseline (0 week) and after 2 weeks of intraoral use (minimum 22 hours/day)
Effect of Oral Environment on Stress Relaxation of TPU Aligners
This outcome measures the percentage stress relaxation (%) of TPU aligners following intraoral exposure. Stress decay over time is recorded using a dynamic mechanical analyzer and compared between single-layer and multilayer TPU aligners at baseline and after two weeks to evaluate force retention capacity.
Time frame: Time Frame: Baseline (0 week) and after 2 weeks of intraoral use (minimum 22 hours/day)
Effect of Oral Environment on Creep Behavior of TPU Aligners
This outcome measures creep (% strain) in TPU aligners under constant stress conditions using a dynamic mechanical analyzer. Comparisons are made between single-layer and multilayer TPU aligners at baseline and after two weeks to assess susceptibility to permanent deformation.
Time frame: Time Frame: Baseline (0 week) and after 2 weeks of intraoral use (minimum 22 hours/day)
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