Shear bond strength of orthodontic resins after caries infiltrant preconditioning

Objective:To investigate the influence of caries infiltrant preconditioning on the shear bond strength of orthodontic resin cements on sound and demineralized enamel.Materials and Methods:Stainless-steel brackets were bonded to sound or artificially demineralized (14 d, acidic buffer, pH 5.0) bovine enamel specimens using a resin cement or a combination of caries infiltrant preconditioning (Icon, DMG) and the respective resin cement (light-curing composite: Heliosit Orthodontic, Transbond XT, using either Transbond XT Primer or Transbond Plus Self Etching Primer; light-curing resin-modified glass ionomer cement: Fuji Ortho; or self-curing composite: Concise Orthodontic Bonding System). Each group consisted of 15 specimens. Shear bond strength was evaluated after thermo-cycling (10,000×, 5°C to 55°C) at a crosshead speed of 1 mm/min, and data were statistically analyzed by analysis of variance, Mann-Whitney test, and Weibull statistics. Adhesive Remnant Index (ARI) scores and enamel fractures were determined at 25× magnification and were statistically analyzed by regression analyses (P < .05).Results:The caries infiltrant system significantly increased the shear bond strength of Transbond XT Primer, Transbond Plus Self Etching Primer, and Fuji Ortho in sound specimens, and of all resin cements except for the Concise Orthodontic Bonding System in demineralized enamel. Overall, caries infiltrant preconditioning decreased significantly the number of enamel fractures, but it did not affect ARI scores.Conclusion:Preconditioning of sound and demineralized enamel with the caries infiltrant system did not impair but rather increased the shear bond strength of most orthodontic resin cements while decreasing the risk of enamel fracture at debonding.     

Adhesive performance of a caries infiltrant on sound and demineralised enamel

Objective

Resin infiltration is considered as a treatment option for initial caries lesions. As cavitated early lesions might require additional restorative intervention, a caries infiltrant might be also used for enamel conditioning prior to composite insertion. This study aimed to analyse the shear bond strength of a flowable composite to sound and demineralised enamel pretreated with a caries infiltrant, a conventional adhesive or a combination of both.

Methods

Flattened bovine enamel specimens (n = 120) were either demineralised (14 d, acidic buffer, pH 5) or remained untreated. Sound and demineralised specimens (each n = 20) were then treated with: (1) 35% phosphoric acid, conventional adhesive, (2) 15% hydrochloric acid, caries infiltrant or (3) 15% hydrochloric acid, caries infiltrant, conventional adhesive. Shear bond strength of a flowable composite was tested after 24 h water storage (37 °C) and statistically analysed (ANOVA, p ≤ 0.05). The mode of failure was assessed microscopically at 25× magnification.

Results

On demineralised enamel, the combination of caries infiltrant and conventional adhesive showed significantly higher shear bond strength values than the conventional adhesive alone, while both being not significantly different from group 2. No significant differences between the groups could be detected on sound specimens. A higher percentage of cohesive failures could be observed in demineralised samples of group 2 (40%) and 3 (65%), while all other specimens presented almost only adhesive failures.

Conclusion

The use of a caries infiltrant before application of a conventional adhesive did not impair bonding to sound and demineralised enamel and might be beneficial as a pretreatment in demineralised enamel.     

Fluoride bioactive glass paste improves bond durability and remineralizes tooth structure prior to adhesive restoration

ObjectiveThe current study aimed at examining a fluoride containing bioactive glass (BiominF®) paste as a temporary filling material capable of remineralizing the demineralized enamel or dentin, and its ability to decrease a simulated dentinal fluids pressure on the resin/dentin interface, without affecting the shear bond strength of a universal bonding agent to enamel and dentin.Methods60 premolars were utilized for the acid resistance, trans-microradiography (TMR) and shear bond strength (SBS) experiments. Enamel and dentin discs were demineralized for 4 days to create a subsurface demineralized zone followed by applying BiominF® paste, 1.23% acidulated phosphate fluoride, or a temporary filling material for 24 h.30 extracted human non-carious third molars were utilized for the pulpal pressure experiment in which direct communication to the pulp chamber was created by cutting at a level approximately 1 mm below the cemento-enamel junction while the coronal enamel was ground to expose mid coronal dentin. The dentin surface was exposed to a simulated pulpal pressure. The dentin surfaces had BiominF® paste, an oxalate desensitizing agent, or temporary filling material followed by application of a universal adhesive system.ResultsOne way ANOVA showed that BiominF® paste remineralized effectively the demineralized enamel or dentin, did not affect the bond strength of the enamel and dentin surfaces to the tested adhesive system p < 0.05, and improved the acid resistance of the demineralized enamel and dentin against a secondary erosive challenge. Moreover, BiominF® paste decreased the nanoleakage expression in the dentin/adhesive interface exposed to a simulated pulpal pressure.SignificanceBiominF® paste may serve as a temporary filling material that may improve the longevity of adhesive restorations and help to conserve tooth structures by preserving the demineralized enamel and dentin form cutting during cavity preparation.     

Effect of lingual enamel sandblasting with aluminum oxide of different particle sizes in combination with phosphoric acid etching on indirect bonding of lingual brackets

Objective:To compare bond strength and bond failure location of lingual brackets indirectly bonded after lingual enamel sandblasting with 27-, 50-, and 90-µm aluminum oxide particles followed by 37% phosphoric acid etching.Material and Methods:Eighty maxillary premolars were randomly divided into four equal groups according to the method of lingual enamel surface conditioning: Group 1 (control) was etched with 37% phosphoric acid, and group 2, group 3, and group 4 were sandblasted with 27-, 50-, and 90-µm aluminum oxide particles, respectively, prior to acid etching. Lingual brackets were indirectly bonded using the same protocol and adhesive (Sondhi) in all groups. The maximum shear bond strength required to debond the brackets was measured using a testing machine, and the bond failure location was classified according to the adhesive remnant index (ARI). Analysis of variance was used to compare the mean bond strength between groups. The differences between ARI scores were evaluated using the Kruskal-Wallis test.Results:There were no statistically significant differences in mean shear bond strength or ARI scores between the four enamel-conditioning procedures.Conclusion:Lingual enamel sandblasting using different particle sizes of aluminum oxide prior to phosphoric acid etching did not increase the shear bond strength of indirectly bonded brackets and did not affect the amount of adhesive remnant on the enamel.     

Influence of caries infiltrant contamination on shear bond strength of different adhesives to dentin

Objectives

To analyze whether the contamination with a caries infiltrant system impairs the adhesive performance of etch-and-rinse and self-etching adhesives on dentin.

Materials and methods

Dentin contamination with the caries infiltrant system (Icon, DMG) was simulated by applying either hydrochloric acid (15 % HCl, Icon Etch, 15 s), the resin infiltrant (Icon infiltrant, 4 min), or both prior to the application of the respective adhesives (each group n?=?10). In the control groups, the etch-and-rinse adhesive (Optibond FL, Kerr) and the self-etching adhesive (iBOND Self Etch, Hereaus) were applied without former contamination with the infiltrant system. Additionally, the adhesive performance of the resin infiltrant alone was tested. Shear bond strength of a nano-hybrid composite was analyzed after thermocycling (5,000×, 5–55°C) of the specimens and analyzed by ANOVA/Scheffé post hoc tests (p?<?0.05) and Weibull statistics. Failure mode was inspected under a stereomicroscope at?×?25 magnification.

Results

Contamination with the resin infiltrant alone did not impair shear bond strength, while contamination with hydrochloric acid or with hydrochloric acid and the resin infiltrant reduced shear bond strength (MPa) of the adhesives (Optibond FL: 20.5?±?3.6, iBOND Self Etch: 17.9?±?2.6) significantly. Hydrochloric acid contamination increased the number of adhesive failures. The adhesive performance of the caries infiltrant system alone was insufficient.

Conclusion

The contamination with the caries infiltrant system impaired the shear bond strength of conventional dental adhesives.

Clinical relevance

Contamination of the caries infiltrant system on dentin should be avoided due to the detrimental effect of hydrochloric acid etching.     

Effects of CO2 laser debonding of a ceramic bracket on the mechanical properties of enamel

Objective:To investigate the effects of CO₂ laser debonding of a ceramic bracket on the mechanical properties of tooth enamel.Materials and Methods:Fifty-three human premolars were used in this study. The temperature changes of cross-sectioned specimens during laser irradiation were monitored with an infrared thermographic microscope system. Different laser output settings (3, 4, 5, and 6 W) were compared. The shear bond strength of brackets after laser irradiation was measured for specimens bonded with a conventional etch and rinse adhesive or with a self-etching adhesive, and the adhesive remnant index score was calculated. The hardness and elastic modulus of cross-sectioned enamel after laser irradiation were investigated by the nanoindentation test. Data were compared by one-way and two-way analysis of variance, followed by the Scheffé test.Results:The temperature of enamel increased by about 200°C under CO₂ laser irradiation with a relatively high output (5 and 6 W), and a temperature increase of about 100°C to 150°C was seen under laser irradiation with a low output (3 and 4 W). The bracket shear bond strength decreased under all laser irradiation conditions. The hardness and elastic modulus of enamel were not affected by CO₂ laser debonding.Conclusion:CO₂ laser debonding may not cause iatrogenic damage to enamel.     

SHEAR BOND STRENGTH OF METALLIC BRACKETS: INFLUENCE OF SALIVA CONTAMINATION

Objective:

To evaluate the influence of saliva contamination on shear bond strength and the bond failure pattern of 3 adhesive systems (Transbond XT, AdheSE and Xeno III) on orthodontic metallic brackets bonded to human enamel.

Material and Methods:

Seventy-two permanent human molars were cut longitudinally in a mesiodistal direction, producing seventy-two specimens randomly divided into six groups. Each system was tested under 2 different enamel conditions: no contamination and contaminated with saliva. In T, A and X groups, the adhesive systems were applied to the enamel surface in accordance with manufacturer''s instructions. In TS, AS and XS groups, saliva was applied to enamel surface followed by adhesive system application. The samples were stored in distilled water at 37°C for 24 h, and then tested for shear bond strength in a universal testing machine (Emic, DL 2000) running at a crosshead speed of 1 mm/min. After bond failure, the enamel surfaces were observed under an optical microscope at 40x magnification.

Results:

The control and contaminated groups showed no significant difference in shear bond strength for the same adhesive system. However, shear bond strength of T group (17.03±4.91) was significantly higher than that of AS (8.58±1.73) and XS (10.39±4.06) groups (p<0.05). Regarding the bond failure pattern, TS group had significantly higher scores of no adhesive remaining on the tooth in the bonding area than other groups considering the adhesive remnant index (ARI) used to evaluate the amount of adhesive left on the enamel.

Conclusion:

Saliva contamination showed little influence on the 24-h shear bond strength of orthodontic brackets.     

In vitro effect of a resin infiltrant on different artificial caries-like enamel lesions

ObjectivesA resin infiltrant was employed for the treatment of active white spot lesions due to its ability to penetrate into the enamel pores and prevent the progression of the lesion. However, limited information is available about its mechanical effect on different artificial enamel lesions as well as on its resistance to further demineralization. Therefore, this study aimed to evaluate the effects of the Icon® infiltrant on different artificial caries-like enamel lesions and its resistance to new acid challenges.DesignArtificial lesions were produced in bovine enamel using three different protocols (demineralization/remineralization cycling, DE-RE; 8% methylcellulose gel, MC; and methyl ethyl diphosphonate solution, MHDP; n = 13). The specimens were treated with Icon® and subjected to a new acid challenge using DE-RE cycling. The surface and cross-sectional hardness were evaluated in sound, demineralized, treated and further demineralized enamel areas. Data were statistically analyzed using ANOVA and Tukey’s test (p < 0.05).ResultsAll of the demineralizing protocols produced subsurface artificial caries lesions. The infiltrant was able to partially recover the surface hardness and prevent further surface hardness loss in enamel previously demineralized using the DE-RE and MHDP protocols. In regard to cross-sectional hardness, no positive effect was found.ConclusionsThe effect of the infiltrant depends on the type of lesion created in vitro, and its action is limited to the lesion surface.     

Effects of remineralization procedures on shear bond strengths of brackets bonded to demineralized enamel surfaces with self-etch systems

Objective:To compare the effects of different remineralization procedures on the surface roughness of teeth, shear bond strengths (SBSs), and Adhesive Remnant Index scores of self-etching primer (SEP) used to bond orthodontic brackets to previously treated demineralized enamel surfaces.Materials and Methods:A total of 140 extracted human premolar teeth were randomly divided into seven equal groups. Group I was the control group. A demineralization procedure was performed in the other six groups. A remineralization procedure was performed before bonding by using casein phosphopeptide-amorphous calcium phosphate, fluoride, a microabrasion mixture (18% hydrochloric acid-fine pumice), a microabrasion agent, and resin infiltration in groups III to VII. Brackets were bonded using a self-etching primer/adhesive system. The specimens were tested for SBS. The roughness and morphology of the enamel surfaces were analyzed using profilometer and scanning electron microscopy. Data were analyzed with analysis of variance, Tukey, and G-tests at the α  =  .05 level.Results:Significant differences were found in the SBS values among the seven groups (F  =  32.69, P  =  .003). The lowest SBS value was found in group II (2.62 ± 1.46 MPa). No significant differences were found between groups I, III, and VII, between groups III and IV, or between groups V and VI. The differences in the roughness values were statistically significant among the groups (P  =  .002).Conclusions:Remineralization procedures restore the decreased SBS of orthodontic brackets and decrease surface roughness caused by enamel demineralization. SEPs provide clinically acceptable SBS values for bonding orthodontic brackets to previously treated demineralized enamel surfaces.     

Can demineralized enamel surfaces be bonded safely?

Objective. To evaluate and compare the effects of enamel demineralization, microabrasion therapy and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on the shear bond strength (SBS) of orthodontic brackets bonded to enamel surfaces and enamel color. Materials and methods. Eighty freshly extracted human maxillary premolar teeth were allocated to one of the four groups. Brackets were bonded directly to non-demineralized enamel surfaces in Group I (control group), directly to the demineralized enamel surfaces in Group II, to demineralized enamel surfaces after CPP-ACP application in Group III and to demineralized enamel surfaces after microabrasion therapy in Group IV. The samples were stored in water for 24 h at 37°C and then underwent thermocycling. The SBS in megapascals (MPa) was determined by a shear test with 0.5 mm/min crosshead speed and failure types were classified with modified adhesive remnant index scores. The data were analyzed with one-way analyses of variance (ANOVA), Tukey and chi-square tests at the α = 0.05 level. Results. Significant differences were found among the four groups (F = 21.57, p < 0.01). No significant difference was found between Group I and III (17.12 ± 2.84 and 15.08 ± 3.42 MPa, respectively) or between Group III and IV (12.82 ± 2.64 MPa). The lowest SBS value was determined in Group II (5.88 ± 2.12 MPa). Enamel demineralization, microabrasion therapy and CPP-ACP application affected enamel color significantly. Conclusion. CPP-ACP application and microabrasion therapy are able to increase the decreased SBS of orthodontic brackets because of enamel demineralization.     

Effects of different pre-treatment methods on the shear bond strength of orthodontic brackets to demineralized enamel

Objective. To compare the effects of different treatment methods used for the enamel damage, on the shear bond strength (SBS) and fracture mode of orthodontic brackets. Materials and methods. Freshly-extracted 140 premolars were randomly allocated to seven groups: Group I was considered as the control of other groups. The remaining groups were exposed to demineralization. In group II, brackets were directly bonded to the demineralized enamel surface. CPP-ACP paste (GC Tooth Mousse), fluoride varnish (Bifluorid 12), microabrasion with a mixture prepared with 18% hydrochloric acid and fine pumice powder, microabrasion with an agent (Opalustre) and resin infiltrant (Icon®) were applied in Groups III, IV, V, VI and VII, respectively. The specimens were tested for SBS and bond failures were scored according to the Adhesive Remnant Index (ARI). Analysis of variance and Tukey tests were used to compare the SBS of the groups. ARI scores were compared with G-test. The statistical significance was set at p < 0.05 level. Results. Statistically significant differences were found among seven groups (F = 191.697; p < 0.001). The SBSs of groups I (mean = 18.8 ± 2.0 MPa) and VII (mean = 19.1 ± 1.4 MPa) were significantly higher than the other groups. No statistically significant difference was found between groups IV (mean = 11.5 ± 1.2 MPa) and V (mean = 12.6 ± 1.5 MPa). The differences in ARI scores of the groups were statistically significant (p < 0.01). Conclusions. All demineralization treatment methods improve bonding to demineralized enamel. Resin infiltrant application after demineralization showed similar bond strength values as intact enamel.     

Orthodontic bracket bonding without previous adhesive priming: A meta-regression analysis

Objective:To determine the consensus among studies that adhesive resin application improves the bond strength of orthodontic brackets and the association of methodological variables on the influence of bond strength outcome.Materials and Methods:In vitro studies were selected to answer whether adhesive resin application increases the immediate shear bond strength of metal orthodontic brackets bonded with a photo-cured orthodontic adhesive. Studies included were those comparing a group having adhesive resin to a group without adhesive resin with the primary outcome measurement shear bond strength in MPa. A systematic electronic search was performed in PubMed and Scopus databases.Results:Nine studies were included in the analysis. Based on the pooled data and due to a high heterogeneity among studies (I²  =  93.3), a meta-regression analysis was conducted. The analysis demonstrated that five experimental conditions explained 86.1% of heterogeneity and four of them had significantly affected in vitro shear bond testing. The shear bond strength of metal brackets was not significantly affected when bonded with adhesive resin, when compared to those without adhesive resin.Conclusions:The adhesive resin application can be set aside during metal bracket bonding to enamel regardless of the type of orthodontic adhesive used.     

Caries infiltrant combined with conventional adhesives for sealing sound enamel in vitro

Objective:To test the null hypothesis that combining low-viscosity caries infiltrant with conventional adhesive resins would not improve sealing of sound enamel against demineralization in vitro.Materials and Methods:Bovine enamel discs (N  =  60) with diameter of 3 mm were randomly assigned to six groups (n  =  10). The discs were etched with 37% phosphoric acid for 30 seconds and treated with resins of different monomer content forming the following groups: (1) Icon (DMG), (2) Transbond XT Primer (3M ESPE), (3) Heliobond (Ivoclar Vivadent), (4) Icon + Transbond XT Primer, and (5) Icon + Heliobond. Untreated etched samples served as the negative control. Specimens were subjected to demineralization by immersion in hydrochloric acid (pH 2.6) for 80 hours. Calcium dissolution into the acid was assessed by colorimetric analysis using Arsenazo III method at 16-hour intervals. Groups presenting high protection against demineralization were subjected to further acidic challenge for 15 days with calcium measurements repeated at 24-hour intervals. Data were analyzed by Kruskal-Wallis test and Mann-Whitney U-test.Results:Untreated specimens showed the highest amount of demineralization. Icon and Transbond XT primer decreased the mineral loss significantly compared to the control. Heliobond performed significantly better than both Icon and Transbond XT primer. Combination of Icon both with Transbond XT primer or Heliobond served as the best protective measures and maintained the protective effect for the additional 15-day acidic challenge.Conclusions:Within the limitations of this in vitro study, it could be concluded that the use of low-viscosity caries infiltrant prior to application of the tested conventional adhesives increases their protective effect against demineralization.     

BOND STRENGTH AND MORPHOLOGY OF ENAMEL USING SELF-ETCHING ADHESIVE SYSTEMS WITH DIFFERENT ACIDITIES

Objectives:

To assess the bond strength and the morphology of enamel after application of self-etching adhesive systems with different acidities. The tested hypothesis was that the performance of the self-etching adhesive systems does not vary for the studied parameters.

Material and methods:

Composite resin (Filtek Z250) buildups were bonded to untreated (prophylaxis) and treated (burcut or SiC-paper) enamel surfaces of third molars after application of four self-etching and two etch-and-rinse adhesive systems (n=6/condition): Clearfil SE Bond (CSE); OptiBond Solo Plus Self-Etch (OP); AdheSe (AD); Tyrian Self Priming Etching (TY), Adper Scotchbond Multi-Purpose Plus (SBMP) and Adper Single Bond (SB). After storage in water (24 h/37°C), the bonded specimens were sectioned into sticks with 0.8 mm² cross-sectional area and the microtensile bond strength was tested at a crosshead speed of 0.5 mm/min. The mean bond strength values (MPa) were subjected to two-way ANOVA and Tukey''s test (α=0.05). The etching patterns of the adhesive systems were also observed with a scanning electron microscope.

Results:

The main factor adhesive system was statistically significant (p<0.05). The mean bond strength values (MPa) and standard deviations were: CSE (20.5±3.5), OP (11.3±2.3), AD (11.2±2.8), TY (11.1±3.0), SBMP (21.9±4.0) and SB (24.9±3.0). Different etching patterns were observed for the self-etching primers depending on the enamel treatment and the pH of the adhesive system.

Conclusion:

Although there is a tendency towards using adhesive systems with simplified application procedures, this may compromise the bonding performance of some systems to enamel, even when the prismless enamel is removed.     

Effect of ozone gas on the shear bond strength to enamel

Ozone is an important disinfecting agent, however its influence on enamel adhesion has not yet been clarified.

Objective:

Evaluate the influence of ozone pretreatment on the shear strength of an etch-and-rinse and a self-etch system to enamel and analyze the respective failure modes.

Material and Methods:

Sixty sound bovine incisors were used. Specimens were randomly assigned to four experimental groups (n=15): Group G1 (Excite^® with ozone) and group G3 (AdheSE^® with ozone) were prepared with ozone gas from the HealOzone unit (Kavo^®) for 20 s prior to adhesion, and groups G2 (Excite^®) and G4 (AdheSE^®) were used as control. Teeth were bisected and polished to simulate a smear layer just before the application of the adhesive systems. The adhesives were applied according to the manufacturer''s instructions to a standardized 3 mm diameter surface, and a composite (Synergy D6, Coltene Whaledent) cylinder with 2 mm increments was build. Specimens were stored in 100% humidity for 24 h at 37º C and then subjected to a thermal cycling regimen of 500 cycles. Shear bond tests were performed with a Watanabe device in a universal testing machine at 5 mm/min. The failure mode was analyzed under scanning electron microscope. Means and standard deviation of shear bond strength (SBS) were calculated and difference between the groups was analyzed using ANOVA, Kolmogorov-Smirnov, Levene and Bonferroni. Chi-squared statistical tests were used to evaluate the failure modes.

Results:

Mean bond strength values and failure modes were as follows: G1- 26.85±6.18 MPa (33.3% of adhesive cohesive failure); G2 - 27.95±5.58 MPa (53.8% of adhesive failures between enamel and adhesive); G3 - 15.0±3.84 MPa (77.8% of adhesive failures between enamel and adhesive) and G4 - 13.1±3.68 MPa (36.4% of adhesive failures between enamel and adhesive).

Conclusions:

Shear bond strength values of both adhesives tested on enamel were not influenced by the previous application of ozone gas.     

Protection of sound enamel and artificial enamel lesions against demineralisation: Caries infiltrant versus adhesive

Objective

To compare the protective potential of a conventional adhesive, a caries infiltrant and a combination of both against acidic challenge in vitro.

Methods

One-hundred-and-fifty discs from bovine lower central incisors were fabricated. Seventy-five samples remained untreated, whereas the other half was subjected to a demineralisation process (14 days, acidic buffer, and pH 5) to create artificial enamel lesions. Specimens were then radioactively irradiated, and each 15 sound and demineralised specimens were treated with a caries infiltrant (Icon, DMG), an unfilled adhesive (Heliobond, IvoclarVivadent) or a combination of infiltrant and adhesive. Specimens treated with the adhesive followed by a flowable composite (TetricEvoFlow, IvoclarVivadent) served as positive control, while untreated specimens served as negative control. All samples were then subjected to lactic acid for 3 weeks at pH 4. Loss of apatite was determined using the radiochemical method of liquid scintillation. Data were statistically analysed by Kruskal–Wallis-test, one-way ANOVA and Scheffe's post hoc tests (p ≤ .05).

Results

In both sound enamel and artificial caries lesions, untreated specimens showed the highest rate of apatite loss, whereas enamel treated with the adhesive and the flowable composite showed almost complete protection surface against dissolution. The caries infiltrant, the adhesive and the combination of both were able to decrease enamel dissolution, but the adhesive and the combination of adhesive and infiltrant were more effective than the infiltrant alone.

Conclusion

Within the limitations of this in vitro study, the application of an adhesive (alone or in combination with the caries infiltrant) is more effective to protect enamel dissolution than the infiltrant alone.     

Bond strength and interfacial morphology of orthodontic brackets bonded to eroded enamel treated with calcium silicate–sodium phosphate salts or resin infiltration

Objective:To investigate the shear bond strength (SBS) of orthodontic brackets bonded to eroded enamel treated with preventive approaches and to examine the enamel/bracket interfaces.Materials and Methods:Ninety-one brackets were bonded to seven groups of enamel samples: sound; eroded; eroded+treated with calcium silicate–sodium phosphate salts (CSP); eroded+infiltrated by ICON^®; eroded+infiltrated by ICON^® and brackets bonded with 1-month delay; eroded+infiltrated by an experimental resin; and eroded+infiltrated by an experimental resin and brackets bonded with 1-month delay. For each group, 12 samples were tested in SBS and bond failure was assessed with the adhesive remnant index (ARI); one sample was examined using scanning electron microscopy (SEM).Results:Samples treated with CSP or infiltration showed no significant differences in SBS values with sound samples. Infiltrated samples followed by a delayed bonding showed lower SBS values. All of the values remained acceptable. The ARI scores were significantly higher for sound enamel, eroded, and treated with CSP groups than for all infiltrated samples. SEM examinations corroborated the findings.Conclusions:Using CSP or resin infiltration before orthodontic bonding does not jeopardize the bonding quality. The orthodontic bonding should be performed shortly after the resin infiltration.     

Effect of enamel protective agents on shear bond strength of orthodontic brackets

Background

This paper aimed to study the effect of two enamel protective agents on the shear bond strength (SBS) of orthodontic brackets bonded with conventional and self-etching primer (SEP) adhesive systems.

Methods

The two protective agents used were resin infiltrate (ICON) and Clinpro; the two adhesive systems used were self-etching primer system (Transbond Plus Self Etching Primer + Transbond XT adhesive) and a conventional adhesive system (37% phosphoric acid etch + Transbond XT primer + Transbond XT adhesive ). Sixty premolars divided into three major groups and six subgroups were included. The shear bond strength was tested 72 h after bracket bonding. Adhesive remnant index scores (ARI) were assessed. Statistical analysis consisted of a one-way ANOVA for the SBS and Kruskal-Wallis test followed by Mann-Whitney test for the ARI scores.

Results

In the control group, the mean SBS when using the conventional adhesive was 21.1 ± 7.5 MPa while when using SEP was 20.2 ± 4.0 MPa. When ICON was used with the conventional adhesive system, the SBS was 20.2 ± 5.6 MPa while with SEP was 17.6 ± 4.1 MPa. When Clinpro was used with the conventional adhesive system, the SBS was 24.3 ± 7.6 MPa while with SEP was 11.2 ± 3.5 MPa. Significant differences in the shear bond strength of the different groups (P = .000) was found as well as in the ARI scores distribution (P = .000).

Conclusion

The type of the adhesive system used to bond the orthodontic brackets, either conventional or self-etching primer, influenced the SBS, while the enamel protective material influenced the adhesive remnant on the enamel surface after debonding.     

Effect of adhesion boosters on indirect bracket bonding

Objective:To determine the influence of two adhesion boosters on shear bond strength and on the bond failure location of indirectly bonded brackets.Materials and Methods:Sixty bovine incisors were randomly divided into three groups (n  =  20), and their buccal faces were etched using 37% phosphoric acid. In group 1 (control), brackets were indirectly bonded using only Sondhi adhesive. In groups 2 and 3, the adhesion boosters Enhance Adhesion Booster and Assure Universal Bonding Resin, respectively, were applied before bonding with Sondhi. Maximum bond strength was measured with a universal testing machine, and the location of bond failure was evaluated using the Adhesive Remnant Index (ARI). One-way analysis of variance followed by the Tukey test (P < .05) was used to compare the shear bond strength among groups, and the differences in ARI scores were evaluated using the Kruskal-Wallis test (P < .05). The Pearson correlation coefficient was calculated to determine whether there was any correlation between bond strength and ARI scores.Results:The mean shear bond strength in group 3 was significantly higher (P < .01) than in the other groups. Evaluation of the locations of bond failure revealed differences (P < .05) among the three groups. There was a moderate correlation between bond strength and ARI scores within group 3 (r  =  0.5860, P < .01).Conclusion:In vitro shear bond strength was acceptable in all groups. The use of the Assure adhesion booster significantly increased both the shear bond strength of indirectly bonded brackets and the amount of adhesive that remained on the enamel after bracket debonding.     

Bond strength of self-adhesive resin cements to tooth structure

Objectives

The aim of this study was to evaluate the strength of the bond between newly introduced self-adhesive resin cements and tooth structures (i.e., enamel and dentin).

Methods

Three self-adhesive cements (SmartCem2, RelyX Unicem, seT SDI) were tested. Cylindrical-shaped cement specimens (diameter, 3 mm; height, 3 mm) were bonded to enamel and dentin. Test specimens were incubated at 37 °C for 24 h. The shear bond strength (SBS) was tested in a Zwick Roll testing machine. Results were analyzed by one-way ANOVA and t-test. Statistically significant differences were defined at the α = 0.05 level. Bond failures were categorized as adhesive, cohesive, or mixed.

Results

The SBS values ranged from 3.76 to 6.81 MPa for cements bonded to enamel and from 4.48 to 5.94 MPa for cements bonded to dentin (p > 0.05 between surfaces). There were no statistically significant differences between the SBS values to enamel versus dentin for any given cement type. All cements exhibited adhesive failure at the resin/tooth interface.

Conclusions

Regardless of their clinical simplicity, the self-adhesive resin cements examined in this study exhibit limited bond performance to tooth structures; therefore, these cements must be used with caution.