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A spectroscopic study on orthodontic aligners: First evidence of secondary microplastic detachment after seven days of artificial saliva exposure

The Science of The Total Environment 2023 55 citations ? Citation count from OpenAlex, updated daily. May differ slightly from the publisher's own count.
Vincenzo Quinzi, Giulia Orilisi, Flavia Vitiello, Valentina Notarstefano, Giuseppe Marzo, Giovanna Orsini

Summary

Researchers investigated whether clear orthodontic aligners release microplastics when exposed to artificial saliva over seven days. The study found evidence of microplastic detachment from aligners made by multiple manufacturers, representing the first documentation of secondary microplastic release from these dental devices. The findings raise questions about potential microplastic ingestion by the millions of people who use clear aligners.

Body Systems
Study Type In vitro

Clear orthodontic aligners have recently seen increasing popularity. The thermoplastic materials present several advantages, even if it is known that all plastic products can be subjected to environmental and mechanical degradation, leading to the release of microplastics (MPs). Their ingestion could cause oxidative stress and inflammatory lesions. This study aims to evaluate the potential detachment of MPs by clear aligners due to mechanical friction simulated with a 7-day protocol in artificial saliva. The study was performed on orthodontic clear aligners from different manufacturers: Alleo (AL); FlexiLigner (FL); F22 Aligner (F22); Invisalign® (INV); Lineo (LIN); Arc Angel (ARC), and Ortobel Aligner (OR). For each group, two aligners were immersed in artificial saliva for 7 days and stirred for 5 h/day, simulating the physiological teeth mechanical friction. After 7 days, the artificial saliva was filtered; then, filters were analyzed by Raman Microspectroscopy (RMS) and Scanning Electron Microscopy (SEM), respectively to chemically identify the polymeric matrix and to measure the number and size of the detected MPs. RMS spectra revealed that AL, FL, LIN, ARC, and OR aligners were composed by polyethylene terephthalate, while F22 and INV ones by polyurethane. SEM analysis showed that the highest number of MPs was found in ARC and the lowest in INV (p < 0.05). As regards MPs' size, no statistically significant difference was found among groups, with most MPs ranging from 5 to 20 μm. Noteworthy, a highly significant correlation (p < 0.0001) was highlighted between the distribution of MPs size and the different typologies of aligners. This in vitro study highlighted for the first time the detachment of MPs from clear aligners due to mechanical friction. This evidence may represent a great concern in the clinical practice since it could impact human general health.

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