Laboratory evaluations on thermal debonding of ceramic brackets.

The purpose of this laboratory study was to define the working parameters and physiological safety and efficacy of the Dentaurum Ceramic Debonding Unit. Extracted mandibular incisors were utilized because of their low thermal mass and low heat sensitivity. The teeth were embedded in plastic and placed on a turning force measuring apparatus. An electrothermal element was placed in the pulp chamber (filled with a conducting paste). The thermoelement temperature was registered on y-t recorder as was the turning momentum required to remove the ceramic brackets with the Dentaurum Ceramic Debonding Unit. Ceramic brackets from GAC (Allure III), Unitek (Transcend) and Dentaurum (Fascination) using one and two component adhesives (Monolok, Concise), were tested. Scanning electron microscopic views taken after debonding showed predictable (and favorable) adhesive failure at the bracket base/resin interface. No enamel damage was demonstrated. All brackets were removable under three seconds with a clinically reproducible turning force of 85-100 Nmm allowing for intrapulpal temperature increases under the 5 degrees C biocompatible threshold. The Dentaurum Ceramic Debonding Unit provided a safe, reliable, efficient modality of removing ceramic brackets while maintaining a physiologically acceptable rise in pulpal temperature without damage to tooth enamel or pulpal tissue.     

An in vitro evaluation of a metal reinforced orthodontic ceramic bracket

The objectives of the present study were to measure and compare the bond strength and failure sites of a currently available ceramic bracket (Transcend 3M-Unitek) with the new metal reinforced ceramic bracket (Clarity 3M-Unitek) and to evaluate the amount of composite left on the tooth using the Adhesive Remnant Index in the teeth that were debonded with pliers recommended for this purpose. In addition, the presence or absence of enamel damage after debonding was also assessed. One hundred and twenty extracted premolar teeth were divided into 4 groups of 30 each. Two groups of 30 teeth had Transcend 6000 brackets bonded, and the other 2 groups had Clarity brackets bonded. Shear bond strength was carried out on 30 Transcend 6000 brackets and 30 Clarity brackets, whereas the other 2 groups of 30 teeth bonded with Transcend 6000 and Clarity brackets were debonded with debonding pliers recommended by the manufacturer of both ceramic brackets. The mean shear bond strength of the Clarity brackets was 13.27 MPa, whereas that of the Transcend 6000 was 21.19 MPa. Both brackets failed mostly at the bracket-adhesive interface (75%), indicating a possible reduction of the chances of enamel damage. Six of the premolars, bonded with Transcend 6000 brackets and debonded with the plier, showed an increase in the number or length of enamel cracks as evaluated by an optical microscope (Micro-Vu); one premolar, bonded with Clarity brackets and debonded with the pliers, showed an increased enamel crack length. Gross enamel damage, assessed by enamel dislodgment, was not evident in any specimen. Results of this study suggest that the new metal reinforced ceramic bracket (Clarity) may be recommended for clinical use because of its acceptable shear bond strength and possible reduced chances of enamel damage during bracket removal.     

Histologic investigation of the human pulp after thermodebonding of metal and ceramic brackets.

Twenty-five human permanent teeth scheduled for extraction for orthodontic reasons were used to study the effect of thermodebonding on the pulp tissue. One week before brackets were removed the teeth were bonded with either metal or ceramic brackets, with two alternative adhesives. For debonding, three different techniques were used: (1) debonding of ceramic brackets warmed up indirectly by resistance heating of a metallic bow applied to the bracket slot, (2) debonding of metal brackets warmed up directly by inductive heating of the bracket itself, and (3) debonding of ceramic brackets warmed up indirectly by inductive heating of metallic plier tips, applied to the mesial and distal bracket surfaces. Teeth with metal brackets removed without heat by squeezing the wings together served as a control group. The teeth were extracted 24 hours after debonding and subjected to a light microscopic study after histologic preparation and staining. In addition, the location of adhesive remnants was evaluated. While the thermodebonding of metal brackets worked properly and without any obvious pulp damage, there were problems related to the thermodebonding of ceramic brackets: (1) if more than one heating cycle was necessary, several teeth showed localized damage of the pulp with slight infiltration of inflammatory cells, (2) bracket fractures occurred frequently, and enamel damage could be shown, and (3) often with Transbond (Unitek/3M, Monrovia, Calif.) as the adhesive, more than one heating cycle was necessary for bracket removal, and thus patients complained about pain.     

Nd：YAG激光去除陶瓷托槽对兔牙髓组织的影响

目的应用Nd：YAG激光,观察在不同功率、时间等参数下,激光照射辅助去除陶瓷托槽后兔牙髓的组织学变化。方法选择新西兰长耳白兔20只,将其4颗前牙作为实验用牙齿,常规黏结陶瓷托槽。左上前牙机械去黏结,作为对照组;其余3颗牙齿采用激光去黏结,右上前牙激光能量为3 W、3 s（A组）,左下前牙能量为2 W、5 s（B组）,右下前牙能量为5 W、2 s（C组）。去黏结后5 min、1 d、3 d、1周和1月后处死动物,每次处死4只,拔除前牙,制作兔牙髓组织切片。结果与对照组相比,经不同能量激光照射后5 min,兔牙髓组织均出现轻度毛细血管扩张。1 d后,A、B组出现中度毛细血管扩张;C组除有中度毛细血管扩张外,还伴有少量炎细胞浸润。3 d后,B组牙髓症状消失;A组牙髓症状减轻,仍有轻度毛细血管扩张;C组有毛细血管扩张、出血,并伴有炎细胞浸润。1周后,A组毛细血管扩张减轻,基本恢复正常;C组症状仍很明显。1月后,A组牙髓症状消失,C组仍有轻度毛细血管扩张。结论采用能量为3 W、3 s的Nd：YAG激光去除陶瓷托槽,兔牙髓组织不会出现不可逆的组织学变化。     

Heat generated by grinding during removal of ceramic brackets

When ceramic brackets fracture during treatment or at the time of debonding, it may become necessary to remove residual fragments by grinding with a handpiece. However, the grinding of ceramic surfaces may generate temperatures high enough to have detrimental effects on dental pulp. Intrapulpal temperature measurements were made on extracted teeth during bracket grinding with a small thermocouple probe fixed to the pulpal wall subjacent to the bracket position. These measurements were then compared with established threshold temperatures that have been reported to cause pulpal pathosis. We removed 122 ceramic brackets (A-Company Starfire, GAC Allure, and Unitek Transcend) from eight extracted teeth by grinding with high-speed diamond burs or low-speed green stones, both with and without air or water coolant. It was determined that low-speed grinding without coolant resulted in a significant (p less than 0.001) increase in pulp chamber temperature for all three types of brackets. Neither high-speed nor low-speed grinding during bracket removal caused a rise in pulp chamber temperature when combined with air or water coolant.     

Bond strength and debonding characteristics of a new ceramic bracket

INTRODUCTION: The purposes of this study were to evaluate the shear bond strength of a new collapsible monocrystalline bracket (Inspire, Ormco, Orange, Calif) and compare it with another collapsible ceramic bracket (Clarity, 3M Unitek, Monrovia, Calif) and a metal bracket; to examine the modes of failure after shear bond strength testing; and to observe the tooth surface after debonding the ceramic brackets with pliers. METHODS: One hundred extracted human premolars were selected for bonding. Three types of brackets and 2 orthodontic adhesives (Transbond XT, 3M Unitek; and Enlight, Ormco) were used. After bonding, all samples were placed in a distilled water bath at 37 degrees C for 24 hours. The shear bond strength of 60 samples was measured, and the remaining 40 samples with ceramic brackets were debonded with pliers. RESULTS: No statistically significant differences in bond strengths among the different combinations of brackets and adhesives were found (P > .05). The mode of failure after debonding by either shear bond strength testing or with pliers was predominantly at the bracket/adhesive interface in all groups. Enamel and bracket fractures were noted in 2 and 5 of 20 samples for Inspire, and 1 and 0 of 20 samples for Clarity after debonding with pliers. CONCLUSIONS: Bond strength and mode of failure of Inspire were similar to those of Clarity, but the risk of bracket fracture after debonding for Inspire was greater.     

Evaluation of modifying the bonding protocol of a new acid-etch primer on the shear bond strength of orthodontic brackets

The purpose of the study was to evaluate the shear bond strength of orthodontic brackets when light curing both the self-etch primer and the adhesive in one step. Fourty eight teeth were bonded with self-etch primer Angel I (3M/ESPE, St Paul, Minn) and divided into three groups. In group I (control), 16 teeth were stored in deionized water for 24 hours before debonding. In group II, 16 teeth were debonded within half-an-hour to simulate when the initial archwires were ligated. In group III, 16 additional teeth were bonded using exactly the same procedure as in groups I and II, but the light cure used for 10 seconds after applying the acid-etch primer was eliminated, and the light cure used for 20 seconds after the precoated bracket was placed over the tooth. This saved at least two minutes of the total time of the bonding procedure. The teeth in this group were also debonded within half-an-hour from the time of initial bonding. The teeth debonded after 24 hours of water storage at 37 degrees C had a mean shear bond strength of 6.0 +/- 3.5 MPa, the group that was debonded within half-an-hour of two light exposures had a mean shear bond strength of 5.9 +/- 2.7 MPa, and the mean for the group with only one light cure exposure was 4.3 +/- 2.6 MPa. Light curing the acid-etch primer together with the adhesive after placing the orthodontic bracket did not significantly diminish the shear bond strength as compared with light curing the acid-etch primer and the adhesive separately.     

Development of an easy-debonding orthodontic adhesive using thermal heating

We produced experimentally a new bonding material that consisted of a mixture of a base resin (4-META/MMA-TBB resin adhesive) and thermoexpandable microcapsules for safe, easy debonding. Microcapsules in the base resin would start expansion at 80 degrees C, leading to a remarkable decrease in bond strength. Stainless steel brackets were bonded to bovine permanent mandibular incisors using bonding materials containing the microcapsules at different contents. After thermal cycling or heating, the shear bond strength of the brackets was measured. Shear bond strength of the bonding materials containing 30-40 wt% microcapsules decreased to about one-third or one-fifth that of the base resin on heating. Heating the brackets for eight seconds increased the temperature in the pulp chamber by 2 degrees C, which should not induce pulp damage. Results obtained suggested that the new bonding material should prove useful for removing brackets easily at the time of bracket debonding without any pain or enamel cracks, while maintaining the bonding strength during active orthodontic treatment.     

The effect of repeated bonding on the shear bond strength of a composite resin orthodontic adhesive

One of the problems clinicians face during treatment is bracket failure. This is usually the result either of the patient's accidentally applying inappropriate forces to the bracket or of a poor bonding technique. As a result, a significant number of teeth have to be rebonded in a busy orthodontic practice. The purpose of this study was to evaluate the effect of repeated bonding on the shear bond strength of orthodontic brackets. Fifteen freshly extracted human molars were collected and stored in a solution of 0.1% (wt/vol) thymol. The teeth were cleaned, polished, and etched with a 37% phosphoric acid gel. The brackets were bonded with the adhesive and light cured for 20 seconds. The teeth were sequentially bonded and debonded 3 times with the same composite orthodontic adhesive. At each time, all 15 teeth were debonded within a half hour after bonding to simulate the clinical condition at which a newly bonded bracket is attached to the arch wire. The results of the analysis of variance comparing the shear bond strength at the 3 debonding attempts indicated the presence of no significant differences among the 3 groups (P = .104). However, when the overall change in shear bond strength within each tooth was evaluated between debonding sequences 1 and 3, 10 teeth had a significant (P = .001) decrease (mean +/- SD, -4.6+/-2.5 MPa) in bond strength, whereas 5 teeth had a significant (P = .02) increase (mean +/- SD, 2.8+/-1.6 MPa). The present findings indicated that in general, the highest values for shear bond strength were obtained after the initial bonding. Rebonded teeth have significantly lower and inconsistent shear bond strength; ie, bond strength may further decrease or increase after the second debonding, and the changes in bond strength may be related to the changes in the morphologic characteristics of the etched enamel surface as a result of the presence of adhesive remnants.     

激光辅助去托槽后牙面再染色的实验研究

目的评价激光辅助去托槽后牙面再染色的程度。方法选取南京市挹江门社区卫生服务中心2014年1月至2016年1月收集的因正畸需要而拔除的30颗健康前磨牙为研究对象,将牙齿随机分成A、B、C 3组:A组采用激光、矽粒子去托槽,B组采用去托槽钳、矽粒子进行去托槽,C组采用去托槽钳、碳钨钻、矽粒子进行去托槽。结果 C组操作时间较B组明显缩短,与A组相比差异不大。去除托槽后,对三组釉质损失量进行统计,三组间两两对比,差异显著,C组牙釉质损失量与A、B相比明显增多。B组去除托槽后和着色处理后牙面的L*值,与粘结托槽前相比显著下降;与粘结托槽前和去托槽后相比,C组着色处理后L*值显著增加。与粘结托槽前相比,去除托槽后,C组a*值显著下降;着色处理后,三组a*值均显著上升。A、B、C组的b*值,着色处理后显著上升。着色处理后,B组△b*值比A组显著正向移动。经扫描电镜显示,激光辅助去托槽后牙釉质表面损伤较小,色泽未见明显变化。结论激光辅助去除正畸托槽及残留剂的之法效果较好,对牙面影响较小,操作时间符合临床习惯,不易引起牙面再染色,具有临床应用推广价值。     

机械法去除国产陶瓷托槽安全性的研究

目的使用去托槽钳去除两种底板设计的国产多晶体氧化铝陶瓷托槽,评价对牙齿安全性的影响。方法选择离体上、下颌各15颗双尖牙,随机分为3组。实验组为国产沟槽底板（3条横沟）和网格底板（3×3网格）陶瓷托槽,对照组为临床常用多晶体氧化铝陶瓷托槽（Crystaline IV）。使用37%液体磷酸和京津釉质粘接剂分别粘接上述3种托槽,在0.9%生理盐水中室温保存24h。使用去托槽钳及WDW3050型微机控制电子万能试验机龈向施加剪切力,检测去除强度、粘接剂残留指数（ARI）及托槽断裂个数,并以立体显微镜评价釉质表面损伤情况。结果国产沟槽底板、网格底板陶瓷托槽及Crystaline IV的去除强度分别为18.49±4.00MPa、17.89±4.13MPa和17.62±4.51MPa,三者间无显著性差异。主要去除部位均在粘接剂内部,托槽断裂个数分别为7个、7个和6个。各有一颗使用国产沟槽底板陶瓷托槽和Crystaline IV的牙齿在立体显微镜下发现明显的釉质缺损。结论对于唇面呈弧形的牙体,使用去托槽钳龈向施加剪切力去除国产多晶体氧化铝陶瓷托槽时,去除强度大,易发生托槽断裂,且可能并发釉质剥脱,并不是理想方法。     

Shear peel bond strengths of esthetic orthodontic brackets.

Anecdotal reports of bracket fracture and tooth damage associated with the use of certain esthetic orthodontic brackets have been reported in the literature. With the advent of new esthetic orthodontic brackets, the need has arisen to test the claims of the manufacturers. The objectives of this study were to determine: (1) shear peel bond strengths (SPBS) of various debonded orthodontic brackets, (2) SPBS of these rebonded esthetic brackets with and without use of silane, and (3) fracture sites of all groups examined. Seventy-five noncarious human premolar teeth were randomly divided into five groups (A through E). The teeth were cleaned, stored in 70% ethyl alcohol, and mounted for testing in the Instron machine. The following brackets were bonded to the teeth with Ortho-Concise bonding resin: (A) metal brackets, (B) Silkon brackets, (C) Transcend 2000 brackets, (D) debonded Transcend 2000 brackets, and (E) debonded silanized Transcend 2000 brackets. After wet storage at 37 degrees C for 7 days, the SPBS of brackets were recorded, and fracture sites observed. There were statistically significant differences between the SPBS of metal brackets when compared with the Transcend 2000 and the Silkon brackets. These groups exhibited clinically acceptable SPBS. Debonded silanized Transcend 2000 brackets showed clinically unacceptable SPBS. Fracture sites of metal and Transcend 2000 brackets were resin-bracket, whereas Silkon brackets fracture sites were predominantly resin-enamel.     

Comparison of the debonding characteristics of two innovative ceramic bracket designs.

Two new ceramic brackets-one designed with a metal-lined arch wire slot and the other with an epoxy resin base-have been recently introduced. The new brackets are thought to combine the esthetic advantages of ceramics and the functional advantages of debonding metal brackets. The purpose of this study was to compare the following: 1) the shear bond strength of the 2 brackets, and 2) the bond failure location when the brackets are debonded with pliers. Sixty-one Clarity (3M Unitek) collapsible ceramic brackets and 66 MXi (TP Orthodontics, Inc) brackets were bonded to the teeth with the same bonding system. The Zwick Universal Test Machine (Zwick Gm bH & Co) was used to determine the shear bond strength force levels needed to debond the brackets. The appropriate pliers also were used to debond both types of brackets to determine the mode of bond failure that will be encountered clinically. After debonding, all the teeth and brackets were examined with 10x magnification. Any adhesive that remained after the bracket removal was assessed according to the Adhesive Remnant Index. The findings indicated that the shear bond strength of the Clarity ceramic brackets was significantly greater than that of the MXi ceramic brackets. However, both brackets exhibited forces that were adequate for clinical use. The Adhesive Remnant Index scores for both the shear test and the plier debonding indicated a similar bond failure pattern when the 2 ceramic brackets were compared with each other. This suggests that, when these brackets are debonded with the Weingart (Ormco) and ETM (Ormco) pliers, there was a greater tendency for most of the adhesive to remain on the enamel surface. In conclusion, the most efficient method to debond the MXi ceramic bracket is by placing the blades of the ETM 346 pliers between the bracket base and the enamel surface. On the other hand, the most efficient method of debonding the Clarity bracket is by using the Weingart pliers and applying pressure to the tiewings. When the 2 ceramic brackets were debonded as recommended here, most of the residual adhesive remained on the enamel surface, a pattern similar to the one observed previously with metal brackets. The failure at the bracket-adhesive interface decreases the probability of enamel damage but necessitates the removal of more residual adhesive after debonding.     

The shear bond strengths of stainless steel orthodontic brackets bonded to teeth with orthodontic composite resin and various fissure sealants

Enamel decalcification (whitened areas) around orthodontic brackets during therapy is a well-recognized problem. If a fissure sealant could be used to isolate the enamel and yet withstand debonding of the bracket during therapy, this problem might be overcome. The objective of this in vitro study was to determine (1) the shear bond strengths of stainless steel orthodontic brackets bonded to teeth with an orthodontic bonding resin together with a primary coating of various fissure sealants and (2) the fracture sites of these debonded samples. Forty noncarious human canine teeth were divided into four groups of 10 teeth each. In group A, the brackets were bonded to the buccal surfaces of the prepared teeth with a macrofilled orthodontic composite resin only. In groups B, C, and D, the brackets were similarly bonded, except that the teeth were first treated with a fissure sealant--group B having a light-cured unfilled clear fissure sealant, group C having a light-cured microfilled fissure sealant, and group D having a chemically cured opaque fissure sealant. After storage at 37 degrees C for 24 hours, the brackets were subjected to a shear force in an instron machine, and the fracture strengths were recorded, together with the sites of fracture.(ABSTRACT TRUNCATED AT 250 WORDS)     

Influence of self-etchant application time on bracket shear bond strength

OBJECTIVE: To determine the influence of self-etching primer (SEP) application time on the shear bond strength of orthodontic brackets. MATERIALS AND METHODS: Forty human molars were cleaned, mounted, and randomly divided into two groups. The same SEP, adhesive, and brackets were used in both groups. Twenty teeth were conditioned following the manufacturers' recommendations by rubbing the SEP on the enamel surface for 3 to 5 seconds. The remaining 20 teeth were conditioned using the same SEP, but the application time was increased to 15 seconds. The teeth were debonded within half an hour following initial bonding using a universal testing machine. After debonding, the amount of residual adhesive remaining on the tooth was determined. Student's t-test was used to compare the shear bond strength (SBS) of the two groups, and the chi2 test was used to compare the Adhesive Remnant Index (ARI) scores for the two adhesive systems. RESULTS: The mean SBS of the brackets bonded to the teeth subjected to the SEP for 3 to 5 seconds was 8.0+/-4.6 MPa and was not significantly different (t=-0.69, P=.494) from the SBS of the brackets bonded using a 15-second SEP application time (x=8.9+/-3.4 MPa). The comparisons of the ARI scores between the two groups (chi2=2.16) indicated that bracket failure mode was not significantly different (P=.340) for both groups, and most failures were at the bracket-adhesive interface. CONCLUSION: The present findings indicate that increasing the SEP application from 3 to 5 seconds to 15 seconds does not result in a significant increase in SBS.     

Thermal debracketing of orthodontic resins

Ten commercial brands of orthodontic bonding materials representing three modes of delivery systems (two-paste, no-mix, and powder/liquid) were used to bond stainless steel brackets to bovine teeth. Heat was applied to the bracket, and the temperature at debonding was noted for each type of resin. The two-paste systems required a higher temperature to debond than did the no-mix systems. The powder/liquid system required the lowest temperature. There is a direct relationship between filler content and debonding temperature. There is an inverse exponential relationship between debonding temperature and load needed to cause debracketing. Room-temperature debonding showed failure at the bracket/resin interface with evidence of cohesive enamel fracture. Thermal debonding showed no evidence of overt enamel fracture, and failure site shifted toward the tooth/resin interface. Ceramic brackets required almost twice the time to debracket than did stainless steel brackets.     

Nd: YAG laser for debonding ceramic orthodontic brackets.

INTRODUCTION: The purpose of this study was to develop an effective method for debonding ceramic orthodontic brackets with a high-peak power Nd:YAG laser. METHODS: Two types of ceramic brackets (single crystal and polycrystalline) were bonded to mandibular bovine teeth with 2 types of bonding resins (4-META/MMA and Bis-GMA). The laser was applied to 2 points on each bracket, each with a 1-pulse-per-second shot. Bond strength and thermal effects of the laser on the dentin surface were assessed at 3 laser energy levels: 1.0, 2.0, and 3.0 joules (J). Shear tests were performed on the irradiated test group and on a nonirradiated control group. ANOVA was used to determine significant differences. RESULTS: The shear test (P < .05) showed that every specimen in the 2.0-J and 3.0-J groups underwent a significant decrease in bonding strength compared with the nonirradiated group. However, the 1.0-J group did not exhibit any such difference. In the 2 former groups, laser irradiation alone was sufficient to debond some specimens. No significant difference was found between bonding resins. The maximum temperature rise measured on the pulpal walls at the lasing points was 5.1 degrees C. CONCLUSIONS: The application of a high-peak power Nd:YAG laser at 2.0 J or more is effective for debonding ceramic brackets.     

表面封闭法对托槽粘接抗剪强度影响的实验研究

目的:研究表面封闭法对托槽粘接抗剪强度(shear bond strength,SBS)的影响.方法:将正畸拔除的20 颗离体前磨牙切割成颊面牙片,用自凝塑料包埋,其颊面经Transbond~(TM) Plus自酸蚀处理液酸蚀30 s后随机等量分为2 组,①实验组:涂Filtek Flow 1400A3流动复合树脂形成封闭层,Transbond~(TM) XT复合树脂粘接托槽;②对照组:Transbond~(TM) XT复合树脂粘接托槽.37 ℃恒温水浴48 h及冷热循环(5 ℃ 30 s,55 ℃ 30 s)1 000 次后,以0.5 mm/min的速度对托槽SBS进行测试;10 倍体视显微镜下观察托槽脱落后牙面树脂残留情况并进行评估.结果:实验组、对照组托槽SBS(Mpa)平均是8.08±1.38、8.34±1.37,牙面树脂残留指数(resin remnant index,RRI)分别是: 2.80±1.03、 3.20±1.03,经检验, 2 组SBS、RRI差异无统计学意义.结论:表面封闭法不影响托槽粘接抗剪强度,能满足固定矫治需要.     

Evaluation of the debonding characteristics of 2 ceramic brackets: an in vitro study.

The objectives of this study were to evaluate and compare the shear bond strengths and bond failure locations of 2 currently available orthodontic ceramic brackets. Forty polycrystalline ceramic brackets (Clarity, 3M Unitek, Monrovia, Calif) and 40 monocrystalline ceramic brackets (Inspire, Ormco, Orange, Calif) were bonded to 80 extracted premolars with the same bonding system. All bonded specimens were placed in distilled water for 42 hours at 37 degrees C followed by thermal cycling for 700 complete cycles. Forty ceramic brackets, 20 of each type, were tested on a universal testing machine to determine the shear force levels required to debond them. Forty ceramic brackets were removed with the debonding pliers recommended by the manufacturers. All teeth were examined under an optical microscope, and the adhesive remnant index was used to assess the bond failure locations. The mean shear bond strength of the Clarity brackets was 21.67 +/- 5.19 MPa, and the mean shear bond strength of the Inspire brackets was 20.32 +/- 8 MPa. The mean shear bond strengths of both brackets were higher than those considered clinically optimal. Most of the brackets (85% of Clarity and 75% of Inspire) tested on the machine failed at the bracket-adhesive interface. One premolar bonded with an Inspire bracket had enamel fracture upon debonding. Most of the brackets (90% of Clarity and 95% of Inspire) debonded with pliers failed at the bracket-adhesive interface. No enamel damage was evident in any specimen when the brackets were removed with the appropriate pliers. The results indicate that the safest way to remove ceramic brackets with respect to reducing the chance of enamel damage is to use the debonding technique specifically designed for each.     

树脂修饰化玻璃离子托槽粘结剂粘结强度的体外研究

目的：评估一种树脂修饰化的玻璃离子托槽粘结剂在牙面不同处理方式和环境下的两次粘结后的剪切强度情况。方法：将新近拔除的105颗上颌第一前磨牙随机均分成7组,按照说明书的要求完成托槽的粘结。对照组牙面用37%的磷酸处理后,用光固化复合树脂粘结剂（3M,Transbond XT）粘结。其它6组牙面分别在37%的磷酸、GC处理剂（GC Self-Conditioner）、和不做任何处理的条件下,分别在干燥和湿润的环境下用树脂修饰化的玻璃离子（RMGIC;Fuji ORTHO LC,GC Corporation,Tokyo,Japan）粘结,所有牙齿均选用同种托槽。托槽粘结24 h后,在万能测力机下以1 mm/min的速度卸载,并记录下数值。除去牙面和托槽底面多余粘结剂后,重复上述过程。每次卸载后检查牙釉质损坏情况。结果：对照组两次剪切强度有较小的差异,其它GC玻璃离子粘结剂组两次剪切强度没有统计学意义。GC粘结剂不做任何处理组在干燥和湿润的环境下其剪切强度存在明显的差异。干燥环境下,37%的磷酸和GC处理剂处理后,GC粘结剂组两次卸载后的牙釉质均出现不同程度的釉裂或釉质脱落。结论：这种树脂修饰化的玻璃离子粘结剂可以在多种条件下用于托槽的粘结。