Welcome to PracticeUpdate! We hope you are enjoying access to a selection of our top-read and most recent articles. Please register today for a free account and gain full access to all of our expert-selected content.
Already Have An Account? Log in Now
Effect of Salbutamol Sulphate Inhalation on the Surfaces of Orthodontic Archwires
TAKE-HOME MESSAGE
- This study showed that exposure to the salbutamol sulphate inhalation solution used to treat asthma significantly increased the surface roughness of β-titanium (β-Ti) and copper–nickel–titanium (NiTi) archwires compared with that of stainless steel (StSt) and NiTi archwires, in which deteriorating surface changes were undetected. The frictional forces of β-Ti and copper–NiTi archwires exposed to salbutamol sulphate were significantly increased compared with those of StSt and NiTi archwires.
- Smooth archwire surfaces reduce unwanted friction during sliding mechanics. The authors recommend using StSt archwires for patients with asthma receiving salbutamol sulphate inhalation therapy and careful monitoring with frequent archwire changes if β-Ti archwires are employed.
abstract
This abstract is available on the publisher's site.
Access this abstract nowOBJECTIVES
This study aimed to compare the surface roughness and friction of different orthodontic archwires after exposure to salbutamol sulphate inhalation, an anti-asthmatic medication.
METHODS
Orthodontic archwires (stainless-steel [StSt], nickel-titanium [NiTi], beta-titanium [β-Ti], and copper-NiTi [Cu-NiTi]) were equally divided into two groups. The exposed groups were subjected to 20 mg salbutamol sulphate for 21 days and kept in artificial saliva. The control groups were only kept in artificial saliva. Surface changes were visualized using scanning electron microscopy (SEM). The average surface roughness (Ra) was evaluated using atomic force microscopy (AFM), and friction resistance forces were assessed using a universal testing machine. Statistical analyses were performed using t-tests and ANOVA followed by post hoc tests.
RESULTS
Salbutamol sulphate did not change the surface roughness of StSt and NiTi archwires (p > .05). However, the change in the surfaces of β-Ti and Cu-NiTi archwires was significant (p < .001). The frictional forces of exposed StSt, NiTi, and Cu-NiTi archwires did not change (p > .05). However, the frictional forces of β-Ti archwires increased significantly after exposure to salbutamol sulphate (p = .021). Brushing with fluoride after exposure to salbutamol sulphate increased the frictional forces of β-Ti only (p = .002).
CONCLUSIONS
Salbutamol sulphate inhalation significantly affected the surface texture of β-Ti and Cu-NiTi orthodontic archwires and increased the friction of β-Ti archwires. These deteriorating effects were not detected on the surface of StSt and NiTi archwires. Therefore, we suggest that β-Ti and copper titanium archwires should be used cautiously in individuals under salbutamol sulphate inhalation treatment.
Additional Info
Disclosure statements are available on the authors' profiles:
The effect of salbutamol sulphate inhalation (an anti-asthmatic medication) on the surfaces of orthodontic Archwires
Orthod Craniofac Res 2024 Jun 01;27(3)447-454, MA Alemran, MA Abbassy, AS Bakry, DH Alsaggaf, TS Abu Haimed, KH ZawawiFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This interesting in vitro study compared surface roughness and friction changes among four orthodontic archwires (stainless steel, nickel–titanium [NiTi], β-titanium [β-Ti], and copper–NiTi) after exposure to salbutamol sulphate. The exposed groups were treated with 20 mg of salbutamol sulphate for 21 days and kept in artificial saliva, whereas the control groups were kept only in artificial saliva. Significant surface changes occurred in β-Ti and copper–NiTi archwires, with significantly increased friction in β-Ti archwires after salbutamol exposure. The authors recommended using stainless steel archwires for sliding mechanics and careful monitoring of β-Ti archwires with frequent archwire changes for patients with asthma undergoing salbutamol sulphate inhalation therapy.
Given the frequency of patients with asthma using salbutamol inhalers who visit orthodontic clinics, replicating this in vitro study with an in vivo study would be valuable to confirm the findings. This is particularly relevant, given the trend toward longer intervals between orthodontic appointments and archwire changes.
In addition to potential archwire modifications caused by the medication, other concerns are also significant. Patients with asthma often experience xerostomia owing to the prolonged use of steroid-containing inhalers, increasing their risk of decalcification and periodontal issues. Strict oral hygiene is essential to mitigate these risks during orthodontic therapy.
Although earlier studies suggested a higher risk of external apical root resorption (EARR) in patients with asthma, a recent systematic review found no significant difference compared with a control group.1 However, increased frictional forces could be linked to the elevated risk of EARR reported in some studies.
Until more research is available, it remains essential to identify patients with asthma and consider the potential implications during orthodontic treatment.
Reference