Physical and chemical changes of clear aligners after thermoforming and intraoral exposure

Objectives: This study assessed the physical and chemical changes of clear aligners after thermoforming and intraoral exposure. Material and Methods: This ex vivo study evaluated raw sheets, thermoformed sheets, and aligners used for 2 weeks from two commercial brands of Erkodur and Shinseki (n = 8 in each group). The surface hardness (by the Vickers hardness test), thickness (by a digital caliper), and glass transition temperature (Tg) (by differential scanning calorimetry) of the specimens were measured, and they underwent X-ray diffraction (XRD) to assess their degree of crystallinity and attenuated total reflectance-Fourier-transform infrared spectroscopy (ATR-FTIR) for analysis of their molecular composition. Data were analyzed by one-sample, paired and independent t-tests, and Mann-Whitney U and Wilcoxon signed-rank tests (alpha = 0.05). Results: The XRD and ATR-FTIR spectra of Erkodur and Shinseki aligners matched those of polyethylene terephthalate glycol polymer and did not change after thermoforming or intraoral exposure. Unlike intraoral exposure (P > 0.05), thermoforming significantly decreased the hardness of both brands of aligners (P < 0.05). Intraoral exposure significantly decreased the thickness of Erkodur aligners at some points and significantly increased the thickness of Shinseki aligners (P < 0.05). Thermoforming significantly decreased the Tg of both brands of aligners (P < 0.05). Intraoral exposure significantly decreased the Tg of Erkodur and increased the Tg of Shinseki aligners (P = 0.000). Conclusion: Erkodur and Shinseki aligners showed high chemical and structural stability after thermoforming and 2 weeks of intraoral exposure. However, thermoforming affected the thermal and physical properties of both brands of aligners. Erkodur aligners had higher dimensional stability than Shinseki aligners.