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Intraoral Aging of 3D Printed Orthodontic Aligners

5. november 2026 oppdatert av: Azza Gamal Kamel Wafa, Alexandria University

The Effect of Intraoral Aging on 3D-Printed Aligners: A Randomized Split-Mouth Study

This study aims to bridge the gap in literature by conducting a combined evaluation of the mechanical, chemical, optical, and morphological changes of 3D-printed clear aligners manufactured from TC-85 and TA-28 resins that occur after clinical use. By analyzing aligners retrieved after two weeks of intraoral use, this research will offer critical insights into the material stability and aging behavior of the two types of 3D-printed clear aligners.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Background: Direct 3D-printing of clear aligners is emerging as a promising alternative to conventional thermoformed systems, offering enhanced precision, digital workflow efficiency, and improved material control. Among the photopolymer resins used for 3D-printed aligners, Tera Harz TC-85 and Tera Harz TA-28 have emerged as leading materials due to their reported shape-memory behavior, dimensional stability, and mechanical performance. However, despite increasing clinical adoption, limited evidence exists regarding how these two materials respond to intraoral aging, where fluctuating pH, temperature changes, salivary enzymes, and occlusal forces may alter their mechanical, optical, chemical, and surface characteristics. Understanding these changes is essential for determining the clinical reliability and long-term performance of each resin.Therefore, a demanding evaluation of post-aging changes in 3D-printed aligners is essential to determine their suitability for sustained orthodontic force delivery and to guide material selection in clinical practice. Assessing how key properties such as mechanical behavior, dimensional accuracy, surface topography, and optical characteristics evolve after intraoral exposure will provide valuable insight into material durability and clinical reliability.

Studietype

Intervensjonell

Registrering (Faktiske)

12

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Alexandria Governorate
      • Alexandria, Alexandria Governorate, Egypt, 21526
        • Department of Orthodontics, Faculty of Dentistry, Alexandria University

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 35 år (Voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Patients aged 18-35 years.
  • Mild to moderate crowding.
  • Good oral hygiene and healthy periodontium.
  • Permanent dentition with no active caries.

Exclusion Criteria:

  • Patients with systemic diseases affecting saliva or oral mucosa.
  • Smoking or alcohol consumption.
  • History of parafunctional habits.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Grunnvitenskap
  • Tildeling: Randomisert
  • Intervensjonsmodell: Crossover-oppdrag
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: TC-85 maxillary / TA-28 mandibular

Participants received a directly 3D-printed TC-85 aligner in the maxillary arch and a directly 3D-printed TA-28 aligner in the mandibular arch. Both aligners were worn simultaneously for 2 weeks (22 hours/day).

Aligner directly 3D-printed from Tera Harz TC-85 shape-memory resin [add printer, layer thickness and post-curing protocol]. Worn 22 hours/day for 2 weeks in the maxillary or mandibular arch, according to a computer-generated randomization sequence.

Eksperimentell: TA-28 maxillary / TC-85 mandibular

Participants received a directly 3D-printed TA-28 aligner in the maxillary arch and a directly 3D-printed TC-85 aligner in the mandibular arch. Both aligners were worn simultaneously for 2 weeks (22 hours/day).

Aligner directly 3D-printed from Tera Harz TA-28 shape-memory resin [same printer, layer thickness and post-curing protocol as above]. Worn 22 hours/day for 2 weeks in the maxillary or mandibular arch, according to a computer-generated randomization sequence.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in indentation hardness (HIT), measured by instrumented nanoindentation
Tidsramme: Baseline (unused aligner) and after 2 weeks of intraoral use

Indentation hardness (HIT, GPa) of directly 3D-printed TC-85 and TA-28 aligners, measured by instrumented nanoindentation using a Nano Indenter XP (MTS Systems Corporation, USA) with a Berkovich diamond indenter. Tests were displacement-controlled to a maximum depth of 2000 nm at a constant strain rate of 0.05 s-¹, with 25 indentations per specimen spaced 30 μm apart. Testing followed ISO 14577-1:2015 and data were analyzed by the Oliver and Pharr method. Retrieved aligners are compared with unused aligners printed from the same digital design.

Baseline (unused aligner) and after 2 weeks of intraoral use

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in indentation elastic modulus (EIT), measured by instrumented nanoindentation
Tidsramme: Baseline (unused aligner) and after 2 weeks of intraoral use

Indentation elastic modulus (EIT, GPa) of directly 3D-printed TC-85 and TA-28 aligners, measured by instrumented nanoindentation using a Nano Indenter XP (MTS Systems Corporation, USA) with a Berkovich diamond indenter. Tests were displacement-controlled to a maximum depth of 2000 nm at a constant strain rate of 0.05 s-¹, with 25 indentations per specimen spaced 30 μm apart. A Poisson's ratio of 0.4 was assumed. Testing followed ISO 14577-1:2015 and data were analyzed by the Oliver and Pharr method. Retrieved aligners are compared with unused aligners printed from the same digital design.

Baseline (unused aligner) and after 2 weeks of intraoral use
Change in color (ΔE₀₀, CIEDE2000), measured by UV-visible spectrophotometry
Tidsramme: Baseline (unused aligner) and after 2 weeks of intraoral use

Color of directly 3D-printed TC-85 and TA-28 aligners measured with a UV-visible spectrophotometer (V-770, JASCO Corporation, Tokyo, Japan). Each aligner was sectioned along the right central incisor-canine region, and the labial surface was positioned in a standardized manner facing the incident-light window. CIE Lab* coordinates were recorded according to ISO 11664-4:2019, and the color change between unused and retrieved aligners was calculated as ΔE₀₀ using the CIEDE2000 equation (parametric factors set to 1). Values are interpreted against 0.8 (50:50% perceptibility) and 1.8 (50:50% acceptability).

Baseline (unused aligner) and after 2 weeks of intraoral use
Change in light transmittance and absorbance (400-700 nm), measured by UV-visible spectrophotometry
Tidsramme: Baseline (unused aligner) and after 2 weeks of intraoral use

Light transmittance and absorbance of TC-85 and TA-28 aligners recorded across the visible range (400-700 nm) with a UV-visible spectrophotometer (V-770, JASCO Corporation, Tokyo, Japan) using Spectra Manager II software, after calibration according to the manufacturer's instructions. Values at 400 and 700 nm were extracted from each spectrum and compared between materials and between unused and retrieved aligners.

Baseline (unused aligner) and after 2 weeks of intraoral use
Change in aligner thickness (μm), measured by confocal laser scanning microscopy
Tidsramme: Baseline (unused aligner) and after 2 weeks of intraoral use

Thickness of TC-85 and TA-28 aligners measured by confocal laser scanning microscopy (Leica DMi8, Leica Microsystems, Wetzlar, Germany) with a 10× objective and 1.5× digital zoom under standardized imaging conditions. Standardized 4 × 4 mm specimens were taken from the labial surface of the left central incisor region. Z-stack images were reconstructed in 3D using Leica LAS AF software (version 1.1.0.12420), and thickness was calculated as the perpendicular distance between the upper and lower specimen surfaces. Each specimen was measured twice and the mean was used.

Baseline (unused aligner) and after 2 weeks of intraoral use
Change in surface roughness (Sa, Sq, Sp, Sv), measured by confocal laser scanning microscopy
Tidsramme: Baseline (unused aligner) and after 2 weeks of intraoral use

Surface roughness of the inner surface of directly 3D-printed TC-85 and TA-28 aligners, assessed on the same 4 × 4 mm specimens used for thickness measurement, imaged by confocal laser scanning microscopy (Leica DMi8, Leica Microsystems, Wetzlar, Germany). Height maps generated from the z-stacks with Leica LAS AF software were analyzed in ImageJ (National Institutes of Health, USA) with the SurfCharJ-1q plugin to calculate Sa (arithmetical mean height), Sq (root mean square height), Sp (maximum peak height) and Sv (maximum valley depth), in µm. Analysis was repeated twice per specimen and the mean was used. Identical acquisition and analysis settings were applied to all specimens.

Baseline (unused aligner) and after 2 weeks of intraoral use
Change in degree of conversion (DC), measured by ATR-FTIR spectroscopy
Tidsramme: Baseline (unused aligner) and after 2 weeks of intraoral use

Degree of conversion (%) of TC-85 and TA-28 aligners, calculated from attenuated total reflectance Fourier-transform infrared (ATR-FTIR) spectra as the reduction of the aliphatic C=C band near 1638 cm-¹ relative to, referenced to the corresponding unset resin. Retrieved aligners are compared with unused aligners.

Baseline (unused aligner) and after 2 weeks of intraoral use
Change in chemical structure, assessed by ATR-FTIR spectral analysis
Tidsramme: Baseline (unused aligner) and after 2 weeks of intraoral use

Qualitative comparison of ATR-FTIR spectra of unused and retrieved TC-85 and TA-28 aligners, focusing on the O-H/N-H stretching bands (3400-3200 cm-¹), aliphatic C-H bands (about 2920 and 2850 cm-¹), the carbonyl (C=O) band (about 1700 cm-¹) and the C-O/C-O-C region (1200-1000 cm-¹).

Baseline (unused aligner) and after 2 weeks of intraoral use

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Etterforskere

  • Hovedetterforsker: Azza Gamal Wafa, PHD, Alexandria University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. februar 2026

Primær fullføring (Faktiske)

1. april 2026

Studiet fullført (Faktiske)

1. september 2026

Datoer for studieregistrering

Først innsendt

31. oktober 2026

Først innsendt som oppfylte QC-kriteriene

5. november 2026

Først lagt ut (Faktiske)

9. november 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

9. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

5. november 2026

Sist bekreftet

1. januar 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 1223

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

UBESLUTTE

IPD-planbeskrivelse

Individual participant data will not be shared publicly because of participant confidentiality and privacy considerations. The study involves a relatively small sample, and sharing individual-level data may pose a risk of participant identification. De-identified aggregate results will be reported in the published manuscripts. Data may be made available from the corresponding author upon reasonable request, subject to institutional ethical approval and applicable data-protection requirements.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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