Degradation of the Strength of Elastomeric Chains Exposed to Energy Drinks in a Simulated Oral Environment

Abstract

Objective

This study was conducted to evaluate the degradation of strength in memory elastomeric chains after repeated exposure to different energy drinks under simulated oral cavity conditions.

Methods

The study included 180 memory elastomeric chains from three commercial brands. Their initial strength was measured at six time points after daily immersion in energy drinks. A descriptive analysis was performed, and the assumptions of repeated-measures ANOVA were verified. ANOVA was then applied to evaluate the variation in strength according to brand and immersion solution, followed by Tukey’s post-hoc test (p<0.05).

Results

The decrease in strength of various brands of elastomeric chains intensified over time, following a similar decay pattern. The elastomeric chains lost approximately 46% of their initial strength after 28 days of immersion in an energy drink, compared to a loss of 43% in the control group. Among the manufacturers evaluated, one group exhibited the greatest resistance to force degradation.

Conclusion

Considering the effects of manufacturer, duration, and type of energy drink, exposure to these beverages significantly accelerates force degradation in elastomeric chains. These findings support limiting the consumption of energy drinks during orthodontic treatment or selecting materials with greater resistance to force degradation.

Introduction

Elastomeric chains (ECs) are some of the main devices for the application of force in contemporary orthodontics and are widely used in procedures such as space closure and canine traction. Manufactured predominantly from polyurethane, these chains offer significant clinical advantages, including their low cost and ease of use and manipulation independent of patient cooperation.1,2 However, these advantages are offset by a progressive and significant loss of applied force, a phenomenon inherent to the viscoelastic nature of the material, which can compromise biomechanical efficiency and the predictability of orthodontic treatment, particularly given that orthodontic therapy relies on the application of light, continuous, and controlled forces is essential to achieve efficient and biologically safe tooth movement; therefore, force degradation may directly affect treatment outcomes and duration. When exposed to the oral environment, elastomeric chains (ECs) initially exhibit elastic deformation, followed by irreversible plastic deformation, which results in a progressive decrease in strength over time. This loss of mechanical performance necessitates periodic replacement avoid functional inactivation of the material. This constitutes a recurring challenge in orthodontic clinical practice and a critical factor in the control of treatment biomechanics.3

In this context, the effectiveness of orthodontic treatments depends largely on the ability of mechanical devices to maintain stable, continuous, and biologically compatible forces over time.4–6 However, numerous studies have shown that the elastic materials used in orthodontics undergo a progressive loss of strength, a phenomenon attributed mainly to water absorption and interaction with salivary components, processes that induce modifications in the molecular structure of the polymer and alter its mechanical behavior.7–12 Additionally, previous research has demonstrated that exposure to chemical agents such as mouthwashes and acidic beverages can significantly influence the mechanical properties and force stability of elastomeric chains, highlighting the importance of evaluating different intraoral environments.13,14

In addition to the intrinsic factors of the oral environment—such as saliva, moisture, and pH variations—patients’ dietary habits play a significant role in the degradation of the mechanical properties of ECs.5,6 In this regard, the consumption of energy drinks has shown a sustained increase in recent years, especially among adolescents and young adults, an age group with a high prevalence of orthodontic treatment.15 This is particularly relevant given that this population is more likely to consume highly acidic and carbonated beverages during orthodontic therapy.

Studies have reported that energy drinks can accelerate the loss of strength of ECs, an effect attributed mainly to their acidic pH (~2.5–4.0) and high content of sugars and additives, as well as the presence of other bioactive components, such as caffeine.9,16 These components have also been described to negatively affect other orthodontic materials by promoting enamel erosion, demineralization, and weakening of bracket adhesion, in addition to causing stains and discoloration of the appliances.17

It has been documented that conventional occlusal clamps can lose between 40% and 60% of their initial strength during the first week of use, compromising tooth movement control and treatment efficiency.18 In response to this limitation, memory ECs were developed to provide a more sustained release of force, maintaining approximately 60% of their initial force after 28 days.19 Compared to conventional chains—which show reductions of around 50% in the first seven days—memory chains show significantly less degradation, close to 20%, allowing for reduced replacement frequency and improved biomechanical control of orthodontic treatment.1 These materials are designed to exhibit enhanced elastic recovery and improved resistance to force decay, making them a promising alternative in clinical orthodontics.

Despite the existing evidence on the effects of saliva, mouthwashes, and acidic beverages on conventional elastomeric chains, the specific impact of energy drinks—characterized by their unique chemical composition—on memory elastomeric chains remains insufficiently explored.13,14

Despite these advantages, specific scientific evidence on the effect of energy drinks on elastomeric chains under conditions simulating the oral environment remains limited. This knowledge gap justifies the need for research aimed at evaluating the impact of energy drinks on these frequently used clinical materials.

Therefore, the aim of this study was to evaluate the degradation of strength in memory elastomeric chains after repeated exposure to different energy drinks under simulated oral cavity conditions. It was hypothesized that ECs exposed to energy drinks would experience a greater loss of strength compared to those not exposed (control group). The results of this study provide evidence that can help optimize clinical decision-making, promote healthy dietary habits in patients, and contribute to the development of orthodontic materials with greater resistance to adverse oral conditions.

Materials and Methods

Elastomeric Chains

This study used 180 short segments of gray memory elastomeric chains, which were selected for their frequent clinical use in orthodontics. Specimens were obtained from the same commercial lots of three internationally recognized brands and were randomly assigned to three groups based on the brand: C1 (TP Orthodontics Inc., La Porte, IN, USA), C2 (Ormco Corporation, Orange, CA, USA), and C3 (American Orthodontics, Sheboygan, WI, USA). This grouping was established to evaluate potential inter-brand variations in the mechanical behavior of elastomeric chains.

Energy Drinks and Control Solution

Two widely consumed energy drinks were evaluated: Beverage A (V220, Pichincha, Ecuador) and Beverage B (Red Bull, Red Bull GmbH, Fuschl am See, Salzburg, Austria). These drinks were selected based on their high availability in local and international markets, their popularity among consumers, and the differences in their chemical composition, particularly in the content of caffeine, sugars, and acidic additives—components potentially involved in the degradation of orthodontic materials. Artificial saliva was used both as a control to simulate the baseline conditions of the oral environment and for storing the samples during the experimental period. The artificial saliva was prepared using a standard formulation containing NaCl (0.4 g/L), KCl (0.4 g/L), CaCl₂·2H₂O (0.795 g/L), NaH₂PO₄·2H₂O (0.78 g/L), Na₂S·9H₂O (0.005 g/L), and urea (1 g/L), with a pH adjusted to 7.0.

Equipment

The following equipment was used for measurement and experimental control: a digital dynamometer (Digital Force Gauge, model ZMF-500 N, Imada Inc., Northbrook, IL, USA), with an accuracy of ±0.2% of full scale ±1 digit and a resolution of 0.1 N; an incubation oven (Memmert, Schwabach, Bavaria, Germany); and a pH meter (BOECO, Hamburg, Germany). Prior to data collection, all measuring devices were calibrated according to the manufacturer’s instructions to ensure measurement accuracy.

Methods

Study Design

An in vitro experimental study was conducted under controlled laboratory conditions. Artificial saliva was used to simulate the oral environment and evaluate the mechanical behavior of the ECs under standardized conditions.

Ethical Considerations

This in vitro experimental study did not involve human participants, biological samples, identifiable data, or animals. The study protocol was reviewed and classified as exempt by the Research Ethics Committee of Universidad Católica de Cuenca, Ecuador (Approval code: CEISH-UCACUE-120-2024), as it involved exclusively commercially available orthodontic materials and laboratory-based mechanical testing procedures.

Sample Size

The sample size was determined using a two-proportion comparison test two-media comparison test, referencing the variability and mean differences reported in previous in vitro studies.17 The calculation considered a confidence level of 95%, a statistical power of 80%, a 1 precision, and a variance of 1.33 resulting in 20 20 elastomeric chain specimens per group with a total of 180 samples included in the study.

Experimental Randomization

The 180 specimens were randomly assigned to three groups based on the manufacturer: C1, C2, and C3. The immersion solutions included two types of energy drinks (beverage A and beverage B) and a control (artificial saliva).

Randomization was performed using a computer-generated random sequence to minimize allocation bias. Twenty samples were allocated to each manufacturer/immersion solution combination, ensuring a homogeneous distribution and comparability between groups, thereby strengthening the internal validity of the study. The sample size was consistent with previous in vitro studies, such as that reported by Martínez et al20 who evaluated 180 ECs and documented significant strength losses between brands.

Pilot Test

Prior to the main experiment, a pilot test was carried out using independent specimens that were not included in the final study sample. A total of 18 elastomeric chain specimens (10% of the total sample; two ECs per group) were used to train the research team in the handling of the dynamometer, incubation oven, and pH meter, as well as to standardize the measurement procedures.

Sample Preparation

The ECs were segmented into four-link units, cut from the sixth link, while leaving one link free at each end. For activation, a custom template with pins spaced 30 mm apart was used, corresponding to 50% activation of the initial elastomeric chain length.21

Immersion and Storage Protocol

The chains were immersed once daily in the corresponding energy drink for 120 seconds. Afterward, the samples were rinsed with distilled water to remove residue and simulate the effect of saliva in the oral cavity. Although this approach allows for standardization of the experimental conditions, it is acknowledged that distilled water does not fully replicate the buffering capacity and dynamic cleansing properties of natural saliva. For the duration of this 28-day study, all ECs were stored in artificial saliva at 37 °C.21–23

Force Measurement

The force released by the ECs was recorded in Newtons (N) at six-time intervals: T1 on day 0 (initial), T2 at 24 hours, T3 on day 7, T4 on day 14, T5 on day 21, and T6 on day 28, according to the experimental protocol illustrated in Figure 1. These times were selected based on usual clinical protocol, in which the ECs are replaced approximately every four weeks.10,22

Figure 1.

Experimental design for measuring strength degradation in elastomeric chains (ECs).

During each measurement, the chains were maintained at a constant length of 30 mm, corresponding to the spacing of the template pins. After each measurement, the dynamometer was zeroed, ensuring the accuracy of the readings. At the end of each measurement day, the chains were remounted, maintaining the same pin spacing (Figure 1).

All measurements were performed by a single trained and calibrated operator to minimize inter-operator variability.

Bias Control

A blinded observer design was not applied; however, standardized data measurement and recording procedures were implemented, and all assessments were performed under identical experimental conditions to minimize variability and the risk of bias.

Statistical Analysis

A descriptive analysis was performed, calculating the mean and standard deviation of the EC strength according to the evaluation time and immersion solution. Data normality was verified using the Shapiro–Wilk test, and the Greenhouse-Geisser test was used for sphericity test (variances of the differences) on elastomeric chains groups. Baseline force values were compared between groups to assess initial equivalence.

For inferential analysis, a two-way repeated measures Analysis of variance (ANOVA) was applied (beverage × time), evaluating the main effects and interactions. ANOVA is a robust test and does not affect the type I error. Additionally, the factor “brand” (C1, C2, C3) was included in the analysis to evaluate its effect and interaction with solution and time. Tukey’s HSD post hoc test was used for comparisons between groups. The significance level was set at p < 0.05. The main effect of the time factor and beverages was estimated using the R-squared.

Additionally, the percentage of force loss relative to the initial force was calculated using the following formula: Force Loss (%) = [(F₀ − F_t) / F₀] × 100, where F₀ corresponds to the initial force (day 0) and F_t corresponds to the force recorded in each interval. The analysis was performed in terms of both absolute residual force (N) and the percentage of force lost, allowing for a more comprehensive interpretation of the mechanical behavior of the ECs. Tables were created in Microsoft Excel^® 2024, and statistical processing and graph generation were performed in SPSS^® version 25.0.

Results

The average initial strength of the chains and the strength after being placed in the immersion solutions at different study time points were measured. Table 1 shows the mean and standard deviation of the initial strength, which were 8.018±1.744, 5.739±0.398, and 6.140±0.326 for the memory ECs groups C1, C2, and C3, respectively.

Table 1.

Mean and Standard Deviation of Force Decay (N) in Elastomeric Chains Across the Tested Immersion Solutions at Each Study Time Point

		T1	T2	T3	T4	T5	T6
Elastomeric chain	C1	8.018 ± 1.744	7.594 ± 0.988	6.878 ± 1.551	6.227 ± 0.955	5.577 ± 0.076	5.009 ± 0.708
	C2	5.739 ± 0.398	4.999 ± 0.572	4.417 ± 0.611	4.053 ± 0.561	3.645 ± 0.446	3.188 ± 0.450
	C3	6.140 ± 0.326	5.322 ± 0.426	4.719 ± 0.512	4.120 ± 0.462	3.537 ± 0.378	3.116 ± 0.426
	p	<0.001*	<0.001*	<0.001*	<0.001*	0.004*	0.025*
Immersion solutions	Control	6.871 ± 1.694	6.455 ± 1.468	6.066 ± 1.551	5.407 ± 1.527	4.526 ± 1.453	4.032 ± 1.371
	Beverage A	6.489 ± 1.313	5.572 ± 1.274	4.788 ± 1.148	4.298 ± 0.974	3.894 ± 0.863	3.524 ± 0.831
	Beverage B	6.536 ± 1.278	5.889 ± 0.937	5.160 ± 0.819	4.950 ± 0.789	4.339 ± 0.729	3.757 ± 0.721
	p	0.287	<0.001*	<0.001*	<0.001*	0.004*	0.025*

Note: Data are presented as mean ± SD. Repeated-measures ANOVA test. *p < 0.05 was considered statistically significant.

Abbreviations: SD, standard deviation.

After being placed in the immersion solutions, the average initial strength was 6.871±1.694 f or the control group, 6.489±1.313 for chains immersed in Beverage A, and 6.536±1.278 for chains immersed in Beverage B.

Repeated-measures ANOVA showed that the chain brand had a statistically significant effect on the strength remaining over time (p < 0.001), particularly at times T1 to T4. Furthermore, a statistically significant interaction was identified between immersion solution and evaluation time (p < 0.001), indicating that the strength degradation pattern differs depending on the immersion solution.

There was a significant main effect of time intervals (p<0.001) with 84.1% (η² =0.841) of the decline in strength of the elastomeric chains over time explained by this effect. Furthermore, the interaction between time and immersion solutions was also statistically significant (p<0.001) with 9% (η² =0.090) explaining the degradation of the strength of the elastomeric chains (Table 2).

Table 2.

Interaction Between Immersion Solutions and Resistance Degradation of Elastomeric Chains Across Six-Time Intervals

Test	Origin	Type III Sum of Squares	df	Mean Square	F	p	R-Squared
Greenhouse-Geisser	Time	1056.181	2.694	391.996	934.979	<0.001*	0.841
	Time × Immersion solutions	19.778	5.389	3.670	8.754	<0.001*	0.090
	Error (Time)	1999.945	476.903	0.419

Note: Greenhouse-Geisser correction was applied. *p < 0.05 was considered statistically significant.

Abbreviation: df: degrees of freedom.

Table 3 shows a comparison of the means and standard deviations of strength decline among the three ECs groups across all test solutions and evaluation times. The results show a progressive and statistically significant decrease in strength in all groups over the 28 days of the study (p<0.001), regardless of the type of chain or solution evaluated.

Table 3.

Mean and Standard Deviation of Residual Force in Elastomeric Chains According to Brand, Immersion Solution, and Evaluation Time

		T1	T2	T3	T4	T5	T6
Control	C1	8.650 ± 0.231	8.428 ± 0.087	8.167 ± 0.084	7.462 ± 0.086	6.493 ± 0.081	5.837 ± 0.093
	C2	5.702 ± 0.231	5.228 ± 0.087	4.734 ± 0.084	4.195 ± 0.086	3.574 ± 0.081	3.108 ± 0.093
	C3	6.264 ± 0.231	5.709 ± 0.087	5.297 ± 0.084	4.567 ± 0.086	3.512 ± 0.081	3.153 ± 0.093
	p	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*
Beverage A	C1	7.703 ± 0.231	7.210 ± 0.087	6.249 ± 0.084	5.543 ± 0.086	4.983 ± 0.081	4.519 ± 0.093
	C2	5.668 ± 0.231	4.522 ± 0.087	3.830 ± 0.084	3.575 ± 0.086	3.369 ± 0.081	3.085 ± 0.093
	C3	6.098 ± 0.231	4.984 ± 0.087	4.287 ± 0.084	3.777 ± 0.086	3.329 ± 0.081	2.969 ± 0.093
	p	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*
Beverage B	C1	8.093 ± 0.231	7.146 ± 0.087	6.219 ± 0.084	5.677 ± 0.086	5.254 ± 0.081	4.671 ± 0.093
	C2	5.848 ± 0.231	5.249 ± 0.087	4.690 ± 0.084	4.392 ± 0.086	3.992 ± 0.081	3.374 ± 0.093
	C3	6.059 ± 0.231	5.273 ± 0.087	4.572 ± 0.084	4.018 ± 0.086	3.771 ± 0.081	3.228 ± 0.093
	p	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*

Notes: Data are presented as mean ± SD. p-values correspond to comparisons among elastomeric chain brands within each immersion solution and evaluation time point using repeated-measures ANOVA across T1–T6. *p < 0.05 was considered statistically significant.

Abbreviation: SD: standard deviation.

Within the memory ECs group, the highest rate of strength loss compared to the control group at any time was related to Beverage A. In contrast, C1 was the most stable elastomer over time, undergoing less strength degradation.

After four weeks of evaluation, the group of ECs immersed in Beverage A lost 41% of their initial strength, compared to 33% in the control group and 39% in chains immersed Beverage B, with the differences being statistically significant (p<0.001).

Figure 2 shows the percentages of strength loss for group C2, which were similar across the solutions evaluated; however, chains immersed in Beverage A showed a slight increase in degradation, reaching 46%, compared to chains in the other immersion solutions. C3, in contrast, showed the highest percentage of strength degradation, with a 51% loss after immersion in Beverage A, compared to 49% in the control group and 46% after immersion in Beverage B. Additionally, the strength values showed a greater decrease during the first day. This is a well-known phenomenon in elastomers, where a sharp initial decrease is followed by a lower subsequent rate of strength degradation.6,18

Figure 2.

Percentage of force degradation according to elastomeric chain brand.

Regarding the control group maintained in artificial saliva, all brands of ECs showed a progressive decrease in strength, albeit of a smaller magnitude, compared to the chains immersed in energy drinks. Likewise, the results show that Beverage A induced a more pronounced degradation in strength than Beverage B, regardless of the commercial brand evaluated.

Figure 3 presents a graphical comparison of the force degradation pattern of the three types of elastomeric chains evaluated across the different immersion solutions over time. Overall, all groups showed a progressive decrease in residual force during the 28-day experimental period, with the most pronounced reduction occurring during the first 24 hours. The degradation pattern varied according to both brand and immersion solution, with chains exposed to Beverage A generally showing greater force loss, while C1 maintained higher residual force values across most evaluation time points. This visual pattern supports the statistical findings regarding the influence of time, immersion solution, and brand on elastomeric chain force degradation.

Figure 3.

Strength reduction in elastomeric chains C1, C2, and C3 over time according to immersion solution. Mean residual force values are shown for each elastomeric chain brand across the six evaluation time points: T1, baseline; T2, 24 hours; T3, 7 days; T4, 14 days; T5, 21 days; and T6, 28 days. Columns represent the elastomeric chain brands C1, C2, and C3, while rows represent the immersion solutions: control, Beverage A, and Beverage B. The numerical indicators inside the boxes correspond to the mean residual force values, expressed in Newtons (N) and rounded to the nearest whole number, for each brand, immersion solution, and time point. The trend lines indicate the progressive force decay observed during the 28-day experimental period.

Table 4 shows a comparative analysis of the commercial brands immersed in each solution; statistically significant differences were evident in most of the evaluated periods (T1-T6). In the control group, highly significant differences (p<0.05) were identified between the three brands at virtually all time points, demonstrating that even without exposure to external agents, the materials exhibit distinct mechanical behaviors in terms of strength retention.

Table 4.

Pairwise Comparison of p-values for Force Decay Among Elastomeric Chain Brands Over Time According to Immersion Solution

			Control	Beverage A	Beverage B
T1	C1	C2	<0.001*	<0.001*	<0.001*
		C3	<0.001*	<0.001*	<0.001*
	C3	C1	<0.001*	<0.001*	<0.001*
		C2	0.258	0.360	0.777
T2	C1	C2	<0.001*	<0.001*	<0.001*
		C3	<0.001*	<0.001*	<0.001*
	C3	C1	<0.001*	<0.001*	<0.001*
		C2	<0.001*	0.010	0.962
T3	C1	C2	<0.001*	<0.001*	<0.001*
		C3	<0.001*	<0.001*	<0.001*
	C3	C1	<0.001*	<0.001*	<0.001*
		C2	<0.001*	0.006	0.485
T4	C1	C2	<0.001*	<0.001*	<0.001*
		C3	<0.001*	<0.001*	<0.001*
	C3	C1	<0.001*	<0.001*	<0.001*
		C2	0.016	0.259	0.003
T5	C1	C2	<0.001*	<0.001*	<0.001*
		C3	<0.001*	<0.001*	<0.001*
	C3	C1	<0.001*	<0.001*	<0.001*
		C2	0.868	0.940	0.081
T6	C1	C2	<0.001*	<0.001*	<0.001*
		C3	<0.001*	<0.001*	<0.001*
	C3	C1	<0.001*	<0.001*	<0.001*
		C2	0.952	0.683	0.304

Note: Pairwise comparisons were performed using Tukey’s post hoc test. *p < 0.05 was considered statistically significant.

In the group evaluated with Beverage A, significant differences were identified between brands in most of the comparisons performed. However, at later time points, particularly between T4 and T6, some comparisons between C2 and C3 did not reach statistical significance, suggesting a tendency towards similar behavior between these two brands as strength degradation progresses. Despite this, brand C1 maintained significant differences compared to C2 and C3 at most of the evaluated time points.

In the group evaluated with Beverage B a pattern comparable to that observed with Beverage A was identified: most comparisons between brands were statistically significant, although at several later time points, the differences between C2 and C3 did not reach significance (p>0.05). This indicates that with exposure to this beverage, the brands’ mechanical behaviors tend to converge as the strength progressively decreases. Again, C1 showed significant differences from the other two brands at most time points.

Overall, the results show that the chain brands exhibited distinct mechanical behaviors from the beginning and throughout the evaluation period, with C1 showing the most differentiated pattern, while C2 and C3 tended to become more similar at late time points, especially under exposure to energy drinks.

Discussion

The oral environment is a dynamic setting in which multiple physicochemical and biomechanical variables capable of altering the mechanical behavior of orthodontic biomaterials converge. In this context, the decrease in force in orthodontic appliances occurs progressively under constant tension, and the limited capacity of these materials to maintain a stable force during their clinical period of use is also evident. This instability is clinically relevant, as it can translate into uncontrolled variations in the magnitude of tooth movement, which depend on both the brand and the exposure time, potentially compromising the efficacy and provisional nature of orthodontic treatment.24,25

The results obtained are primarily related to three factors affecting the degradation of dental appliances: the brand of the appliance, the evaluation time, and the oral environment, which was simulated through exposure to immersion solutions. These findings are consistent with those in existing studies, which documented significant differences in the mechanical behavior of dental appliances both between products from the same manufacturer and between different manufacturers.9,20,25–27

There are various configurations of ECs, depending on the technology used in their manufacture. These include conventional and memory ECs. Regarding the brand, the results show that C1 exhibited the greatest strength stability over time, while C2 and C3 showed similar degradation patterns. These findings are consistent with those reported by Aldrees et al,28 who indicate that strength degradation is not uniform among ECs of different brands, suggesting a direct influence of the manufacturer on their mechanical behavior. These findings are consistent with those reported by Masoud et al29 and by Kochenborger et al6 in their 21-day study, who observed significant differences in force degradation between the evaluated elastomeric chains. Taken together, these results support the clinical recommendation of Dehghani et al9 to consider material strength stability when selecting ECs, especially in patients with dietary habits that may accelerate elastomer degradation.

Regarding the chemical environment, several authors have proposed that the decrease in strength in elastomeric materials has an inverse relationship with the pH of the oral medium; however, this association should not be interpreted as a linear or isolated phenomenon.30,31 In the pilot test of this study, pH values of 2.63 and 2.98 were recorded in Beverage A and Beverage B, respectively, which could explain, at least in part, the greater loss of strength observed in the chains exposed to these beverages. These findings are consistent with those reported by Khaleghi32 who demonstrated a critical degradation of strength in ECs subjected to acidic environments. In addition to pH, other factors such as the concentration of preservatives, pigments, chlorides, and phosphates, along with temperature, could significantly contribute to strength degradation. Dehghani et al9 showed that soft drinks produced a notable loss of strength in the evaluated chains, reaching the highest degradation values at 28 days, attributed to its combination of acidity, phosphoric acid, and sugars.

Additionally, Pithon et al21 noted that the consumption of carbonated beverages can reduce the rate of tooth movement, associating this effect with the influence of sugars on bone metabolism.

When comparing the different immersion solutions, Beverage A induced the greatest loss of strength across all the chain brands evaluated, surpassing both Beverage B and the control group with artificial saliva. This pattern coincides with that reported by Abbass et al16 who observed significant differences in force degradation depending on the type of beverage at the end of four weeks. In particular, they found that carbonated, sugar-sweetened beverages caused greater degradation than others. This aligns with the reported findings, where Beverage A was more detrimental than Beverage B.

Furthermore, the degree of strength loss was greater in their study, which can be attributed to the number of daily immersions of the chains in energy drinks. Therefore, the importance of consumption frequency can be inferred: the more frequently acidic drinks are ingested, the greater the cumulative degradation of elastic strength.

Although Beverage A did show significant differences compared to the control group in this study, these findings do not coincide with those reported by Leão et al10 who, evaluated the behavior of intermaxillary elastics and concluded that the chemical nature of different beverages did not influence the percentage of strength degradation over time. This discrepancy between the two studies could be attributed to the difference in the type of material evaluated (continuous stretch chains versus intermaxillary elastics), as well as to variations in the composition, polymer structure, and mechanical behavior of each type of elastomer. This suggests that although intermaxillary elastics may be less sensitive to the chemical components of beverages, continuous stretch chains do exhibit greater susceptibility, especially to beverages with more aggressive characteristics, such as energy drinks.

The results show that the evaluated ECs were unable to maintain constant force release throughout the observation period. The greatest strength degradation occurred on the first day, followed by a considerably lower rate of degradation over the next four weeks. This is consistent with the findings of Torres et al33 who concluded that although the initial force exerted by the chains on the teeth is sufficient, changes occurring after 21 days can render it insufficient. These results contrast with those of Kumar et al,30 whose data were not statistically significant over the 28-day study period. Therefore, the orthodontist should educate the patient on scheduling regular appointments for optimal results and recommend avoiding energy drinks while wearing braces.

Melo et al21 noted that artificial saliva can induce greater strength degradation in elastomeric prostheses than that caused by various beverages, a statement that does not agree with the findings of the present study. This observation partially coincides with the results obtained, as it confirms that the simulated oral environment is a determining factor in strength loss. In addition, the systematic review by Andhare et al34 indicated that the strength loss recorded in in vivo studies is greater than that observed in in vitro models, suggesting that saliva components and the dynamic conditions of the oral environment significantly influence the progressive decrease in the elasticity of elastomeric materials.

Although this study’s in vitro design allowed precise control of the experimental variables, the findings do not fully reproduce clinical conditions, which limits their direct extrapolation to daily orthodontic practice. The behavior of ECs in the oral environment may be influenced by several factors not replicated in the experimental design, including salivary flow and buffering capacity, temperature fluctuations, oral microbiota, enzymatic activity, masticatory forces, intermittent stretching, oral hygiene habits, individual dietary patterns, and variations in the frequency and duration of contact between the elastomeric chains and the ingested beverages. Therefore, the magnitude of force degradation observed under laboratory conditions may differ from that occurring in vivo, where exposure to energy drinks is usually intermittent and modulated by the cleansing and neutralizing effects of saliva.

Consequently, future research should focus on conducting in vivo or in situ studies in patients who regularly consume energy drinks to confirm the clinical relevance of the observed findings. Furthermore, the implementation of automated measurement systems and the use of more precise equipment are recommended to optimize the reproducibility of the results. Similarly, it would be pertinent to evaluate other types of elastomers, such as ECs of different pigmentations or intermaxillary elastics, as well as to compare sugar-sweetened and sugar-free energy drinks, with the aim of isolating the specific effect of their various components. These lines of research will expand existing knowledge and strengthen evidence-based clinical decision-making.

Conclusion

Elastomeric chains exposed to energy drinks suffered significantly greater strength degradation than those kept in a neutral environment, confirming that consumption of these beverages can compromise the orthodontic force applied. The results also demonstrated brand- and beverage-specific differences, suggesting that material composition, manufacturing characteristics, and the chemical properties of the immersion solution may influence the resistance of elastomeric chains to force decay.

From a clinical perspective, these findings support the recommendation to limit the consumption of highly acidic energy drinks during orthodontic treatment, particularly when elastomeric chains are used for space closure or tooth movement control. However, because this study was conducted under controlled in vitro conditions, the results should be interpreted with caution and should not be directly extrapolated to all clinical scenarios. In the oral environment, factors such as salivary flow, buffering capacity, oral hygiene, dietary habits, masticatory forces, and the frequency and duration of beverage exposure may modify the degree of force degradation.

Therefore, while the present findings provide useful evidence for clinical decision-making and patient counseling, further in vivo and in situ studies are needed to confirm the real impact of energy drink consumption on elastomeric chain performance during orthodontic treatment.

Funding Statement

The work was funded by the Universidad Católica de Cuenca, Cuenca, Ecuador, and is anchored to the research project called: “Evaluación mecánica y antimicrobiana del quitosano agregado en adhesivos ortodóncicos. Estudio in vitro”, approved under code PIC5P23-55.

Disclosure

The authors declare no conflicts of interest regarding the publication of this article.