Dual Stimuli-Responsive Orthodontic Aligners: An In Vitro Study.

Aligner therapy for orthodontic tooth movement is gaining importance in orthodontics. The aim of this contribution is to introduce a thermo- and water-responsive shape memory polymer (SMP), which could lay the foundation for a new type of aligner therapy. The thermal, thermo-mechanical, and shape memory properties of thermoplastic polyurethane were studied by means of differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA), and various practical experiments. The glass transition temperature of the SMP relevant for later switching was determined to be 50 °C in the DSC, while the tan δ peak was detected at 60 °C in the DMA. A biological evaluation was carried out using mouse fibroblast cells, which showed that the SMP is not cytotoxic in vitro. On a digitally designed and additively manufactured dental model, four aligners were fabricated from an injection-molded foil using a thermoforming process. The aligners were then heated and placed on a second denture model which had a malocclusion. After cooling, the aligners were in a programmed shape. The movement of a loose, artificial tooth and thus the correction of the malocclusion could be realized by thermal triggering the shape memory effect, at which the aligner corrected a displacement with an arc length of approximately 3.5 mm. The developed maximum force was separately determined to be about 1 N. Moreover, shape recovery of another aligner was realized within 20 h in 37 °C water. In perspective, the present approach can help to reduce the number of orthodontic aligners in therapy and thus avoid excessive material waste.