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Cytotoxicity and Endocrine Disruption in Materials Used for Removable Orthodontic Retainers: A Comprehensive Review
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This review evaluated the safety of materials used in removable orthodontic retainers, including traditional plastics, 3D-printed resins, and newer composites. While most materials were found to be generally safe in the short term, some released bisphenol-type chemicals (known hormone disruptors), and long-term endocrine effects have not been adequately studied. The review also notes that single-use thermoplastic retainers contribute to microplastic pollution, raising environmental sustainability concerns.
Objective: To evaluate the cytotoxicity and endocrine-disrupting potential of materials used in removable orthodontic retainers. Methods: A literature search (2015-2025) covered in vitro cytotoxicity, estrogenicity, in vivo tissue responses, and clinical biomarkers in PMMA plates, thermoplastic foils, 3D-printed resins, PEEK, and fiber-reinforced composites. Results: Thirty-eight in vitro and ten clinical studies met inclusion criteria, identified via a structured literature search of electronic databases (2015-2025). Photopolymer resins demonstrated the highest cytotoxicity, whereas thermoplastics and PMMA exhibited predominantly mild effects, which diminished further following 24 h water storage. Bisphenol-type compound release was reported, but systemic exposure remained below regulatory limits. No statistically significant mucosal alterations or endocrine-related effects were reported in clinical studies. Conclusions: Retainer materials are generally biocompatible, though data on long-term endocrine effects are limited. Standardized biocompatibility assessment protocols are necessary to enable comparative evaluation across diverse orthodontic materials. Single-use thermoplastics contribute to microplastic release and pose end-of-life management challenges, raising concerns regarding environmental sustainability.
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Comprehensive Review of Cytotoxic and Endocrine-Disrupting Effects of Materials Used in Removable Orthodontic Retainers
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Researchers reviewed 48 studies published between 2015 and 2025 to assess cytotoxic and hormone-disrupting effects of materials commonly used in removable orthodontic retainers, including PMMA plates, thermoplastic foils, 3D-printed resins, PEEK, and fiber-reinforced composites, evaluating both laboratory and clinical evidence.
Toxicological and Endocrine Impacts of Materials in Removable Orthodontic Retainers: A Systematic Review
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This systematic review examined potential cytotoxicity and endocrine-disrupting effects of materials used in removable orthodontic retainers, analyzing 48 studies (38 in vitro, 10 clinical) published between 2015 and 2025 covering PMMA plates, thermoplastic foils, PEEK, fiber-reinforced composites, and 3D-printed photopolymer resins.
The Biological Effects of 3D Resins Used in Orthodontics: A Systematic Review
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This systematic review found that 3D-printed orthodontic resins release bisphenol A and other residual monomers with demonstrated cytotoxic, genotoxic, and estrogenic effects, though few studies have evaluated systemic toxicity in patients. The release of these substances is influenced by printing parameters, post-processing, and material composition. Bisphenol A is also a key chemical of concern in microplastic research, as it leaches from degrading plastic particles and acts as an endocrine disruptor.
Biocompatibility and Safety of Orthodontic Clear Aligners and Thermoplastic Retainers: A Systematic In Vitro Review (2015–2025)
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This systematic review examined whether orthodontic clear aligners and retainers release harmful chemicals or microplastics in the mouth. While most products met safety standards, some materials did release detectable levels of bisphenol A and other chemicals, especially during initial wear and after aging, raising questions about long-term oral exposure.
Microplastics and nanoplastics in clinical dentistry and orthodontics: leaching, health implications, and future directions: a narrative review
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