A novel biomimetic orthodontic bonding agent helps prevent white spot lesions adjacent to brackets

Objective:To compare changes in enamel microhardness adjacent to orthodontic brackets after using bonding agents containing various compositions of bioactive glass compared to a traditional resin adhesive following a simulated caries challenge.Materials and Methods:Extracted human third molars (n  =  10 per group) had orthodontic brackets bonded using one of four novel bioactive glass (BAG)-containing orthodontic bonding agents (BAG-Bonds) or commercially available Transbond-XT. The four new adhesives contained BAG in varying percentages incorporated into a traditional resin monomer mixture. Teeth were cycled through low-pH demineralizing and physiologic-pH remineralizing solutions once each day over 14 days. Microhardness was measured on longitudinal sections of the teeth 100, 200, and 300 µm from the bracket edge and beneath the brackets, at depths of 25 to 200 µm from the enamel surface. Normalized hardness values were compared using three-way analysis of variance.Results:Significantly less reduction in enamel microhardness was found with the experimental adhesives at depths of 25 and 50 µm at all distances from the bracket edge. In all groups, there were no significant changes in enamel microhardness past 125-µm depth. Results varied with the different BAG-Bonds, with 81BAG-Bond showing the smallest decrease in enamel microhardness.Conclusions:The BAG-Bonds tested in this study showed a reduction in the amount of superficial enamel softening surrounding orthodontic brackets compared to a traditional bonding agent. The results indicate that clinically, BAG-Bonds may aid in maintaining enamel surface hardness, therefore helping prevent white spot lesions adjacent to orthodontic brackets.     

Bracket base remnants after orthodontic debonding

Objective:To evaluate whether the debonding procedure leads to restitutio ad integrum of the enamel surface by investigating the presence of enamel within the bracket base remnants after debonding.Materials and Methods:Sixty patients who completed orthodontic treatment with fixed appliances were included. A total of 1068 brackets were microphotographed; the brackets presenting some remnants on the base (n  =  818) were selected and analyzed with ImageJ software to measure the remnant area. From this population a statistically significant sample (n  =  100) was observed under a scanning electron microscope to check for the presence of enamel within the remnants. Energy dispersive x-ray spectrometry was also performed to obtain quantitative data.Results:Statistically significant differences in the remnant percentage between arches were observed for incisor and canine brackets (P < .0001 and P  =  .022, respectively). From a morphologic analysis of the scanning electron micrographs the bracket bases were categorized in 3 groups: group A, bases presenting a thin enamel coat (83%); group B, bases showing sizable enamel fragments (7%); group C, bases with no morphologic evidence of enamel presence (10%). Calcium presence was noted on all evaluated brackets under energy dispersive x-ray spectrometry. No significant difference was observed in the Ca/Si ratio between group A (16.21%) and group B (18.77%), whereas the Ca/Si ratio in group C (5.40%) was significantly lower than that of the other groups (P < .323 and P  =  .0001, respectively).Conclusion:The objective of an atraumatic debonding is not achieved yet; in some cases the damage could be clinically relevant.     

Suitability of orthodontic brackets for rebonding and reworking following removal by air pressure pulses and conventional debracketing techniques

Aim:To test the null hypothesis that there are no significant differences in the reusability of debonded brackets with regard to debonding technique and adhesive used.Method:Ninety-six osteotomed third molars were randomly assigned to two study groups (n  =  48) for bonding of a 0.018-inch bracket (Ormesh, Ormco) with either a composite adhesive (Mono-Lok2; RMO) or a glass ionomer cement (GIC; Fuji Ortho LC;GC). Each of these two groups were then randomly divided into four subgroups (n  =  12) according to the method of debonding using (1) bracket removal pliers (BRP; Dentaurum), (2) a side cutter (SC; Dentaurum), (3) a lift-off debracketing instrument (LODI; 3M-Unitek), or (4) an air pressure pulse device (CoronaFlex; KaVo). The brackets were subsequently assessed visually for reusability and reworkability with 2× magnification and by pull testing with a 0.017- × 0.025-inch steel archwire. The proportions of reusable brackets were individually compared in terms of mode of removal and with regard to adhesives using the Fisher exact test (α  =  5%).Results:The null hypothesis was rejected. Not taking into account the debonding method, brackets bonded with GIC were judged to a significant extent (81%; n  =  39; P < .01) to be reworkable compared with those bonded with composite (56%; n  =  27). All brackets in both adhesive groups removed with either the LODI or the CoronaFlex were found to be reusable, whereas 79% (46%) of the brackets removed with the BRP (SC) were not. The proportion of reusable brackets differed significantly between modes of removal (P < .01).Conclusion:With regard to bracket reusability, the SC and the BRP cannot be recommended for debonding brackets, especially in combination with a composite adhesive.     

Effects of third-order torque on frictional force of self-ligating brackets

Objective:To investigate the effects of third-order torque on frictional properties of self-ligating brackets (SLBs).Materials and Methods:Three SLBs (two passive and one active) and three archwires (0.016 × 0.022-inch nickel-titanium, and 0.017 × 0.025-inch and 0.019 × 0.025-inch stainless steel) were used. Static friction was measured by drawing archwires though bracket slots with four torque levels (0°, 10°, 20°, 30°), using a mechanical testing machine (n  =  10). A conventional stainless-steel bracket was used for comparison. Results were subjected to Kruskal-Wallis and Mann-Whitney U-tests. Contact between the bracket and wire was studied using a scanning electron microscope.Results:In most bracket-wire combinations, increasing the torque produced a significant increase in static friction. Most SLB-wire combinations at all torques produced less friction than that from the conventional bracket. Active-type SLB-wire combinations showed higher friction than that from passive-type SLB-wire combinations in most conditions. When increasing the torque, more contact between the wall of a bracket slot and the edge of a wire was observed for all bracket types.Conclusions:Increasing torque when using SLBs causes an increase in friction, since contact between the bracket slot wall and the wire edge becomes greater; the design of brackets influences static friction.     

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.     

Laser-aided debonding of orthodontic ceramic brackets.

The removal of ceramic brackets from the enamel surface by means of laser heating was investigated with the use of CO2 and YAG lasers. The two bracket types investigated were polycrystalline alumina and monocrystalline alumina. The average torque force necessary to break the adhesive between the polycrystalline ceramic brackets and the tooth was lowered by a factor of 25 when the brackets were illuminated with a CO2 laser beam of 14 watts for 2 seconds. All polycrystalline brackets debonded with the CO2 laser resulted in a complete bracket detachment without bracket failure. The average torque force needed to debond monocrystalline brackets was lowered by a factor of 5.2 when illuminated with a laser setting of 7 watts. Monocrystalline brackets cracked along the bracket slot in 2 of 10 cases. Debracketing without laser heating resulted in a slightly higher incidence of bracket failure (12 of 50). Nevertheless, no visible damage to the enamel surface was observed. Advantages of the laser-aided bracket-removal techniques include the following: The heat produced is localized and controlled; the debracketing tool is essentially "cold"; and the method can be used for removal of various types of ceramic brackets, regardless of their design.     

Heat treatment following surface silanization in rebonded tribochemical silica-coated ceramic brackets: shear bond strength analysis

Objective

This study aimed to evaluate the effects of heat treatment on the tribochemical silica coating and silane surface conditioning and the bond strength of rebonded alumina monocrystalline brackets.

Material and Methods

Sixty alumina monocrystalline brackets were randomly divided according to adhesive base surface treatments (n=20): Gc, no treatment (control); Gt, tribochemical silica coating + silane application; Gh, as per Gt + post-heat treatment (air flux at 100ºC for 60 s). Brackets were bonded to the enamel premolars surface with a light-polymerized resin and stored in distilled water at 37ºC for 100 days. Additionally, half the specimens of each group were thermocycled (6,000 cycles between 5-55ºC) (TC). The specimens were submitted to the shear bond strength (SBS) test using a universal testing machine (1 mm/min). Failure mode was assessed using optical and scanning electron microscopy (SEM), together with the surface roughness (Ra) of the resin cement in the bracket using interference microscopy (IM). 2-way ANOVA and the Tukey test were used to compare the data (p>0.05).

Results

The strategies used to treat the bracket surface had an effect on the SBS results (p=0.0), but thermocycling did not (p=0.6974). Considering the SBS results (MPa), Gh-TC and Gc showed the highest values (27.59±6.4 and 27.18±2.9) and Gt-TC showed the lowest (8.45±6.7). For the Ra parameter, ANOVA revealed that the aging method had an effect (p=0.0157) but the surface treatments did not (p=0.458). For the thermocycled and non-thermocycled groups, Ra (µm) was 0.69±0.16 and 1.12±0.52, respectively. The most frequent failure mode exhibited was mixed failure involving the enamel-resin-bracket interfaces.

Conclusion

Regardless of the aging method, Gh promoted similar SBS results to Gc, suggesting that rebonded ceramic brackets are a more effective strategy.     

Measurement and comparison of bracket transfer accuracy of five indirect bonding techniques

Objective:To measure and compare bracket transfer accuracy of five indirect bonding (IDB) techniques.Materials and Methods:Five IDB techniques were studied: double polyvinyl siloxane (double-PVS), double vacuum-form (double-VF), polyvinyl siloxane vacuum-form (PVS-VF), polyvinyl siloxane putty (PVS-putty), and single vacuum-form (single-VF). Brackets were bonded on 25 identical stone working models. IDB trays were fabricated over working models (n  =  5 per technique) to transfer brackets to another 25 identical stone patient models. The mesiodistal (M-D), occlusogingival (O-G), and faciolingual (F-L) positions of each bracket were measured on the working and patient models using digital photography (M-D, O-G) and calipers (F-L). Paired t-tests were used to compare bracket positions between working and patient models, and analysis of variance was used to compare bracket transfer accuracy among the five techniques.Results:Between the working and patient models, double-VF had the most teeth with significant differences (n  =  6) and PVS-VF the fewest (n  =  1; P < .05). With one exception, all significant differences were ≤0.26 mm and most (65%) were ≤0.13 mm. When the techniques were compared, bracket transfer accuracy was similar for double-PVS, PVS-putty, and PVS-VF, whereas double-VF and single-VF showed significantly less accuracy in the O-G direction.Conclusions:Although overall differences in bracket position were relatively small, silicone-based trays had consistently high accuracy in transferring brackets, whereas methods that exclusively used vacuum-formed trays were less consistent.     

Dimensional accuracy of ceramic self-ligating brackets and estimates of theoretical torsional play

Objective:To ascertain the dimensional accuracies of some commonly used ceramic self-ligation brackets and the amount of torsional play in various bracket–archwire combinations.Materials and Methods:Four types of 0.022-inch slot ceramic self-ligating brackets (upper right central incisor), three types of 0.018-inch ceramic self-ligating brackets (upper right central incisor), and three types of rectangular archwires (0.016 × 0.022-inch beta-titanium [TMA] (Ormco, Orange, Calif), 0.016 × 0.022-inch stainless steel [SS] (Ortho Technology, Tampa, Fla), and 0.019 × 0.025-inch SS (Ortho Technology)) were measured using a stereomicroscope to determine slot widths and wire cross-sectional dimensions. The mean acquired dimensions of the brackets and wires were applied to an equation devised by Meling to estimate torsional play angle (γ).Results:In all bracket systems, the slot tops were significantly wider than the slot bases (P < .001), yielding a divergent slot profile. Clarity-SLs (3M Unitek, Monrovia, Calif) showed the greatest divergence among the 0.022-inch brackets, and Clippy-Cs (Tomy, Futaba, Fukushima, Japan) among the 0.018-inch brackets. The Damon Clear (Ormco) bracket had the smallest dimensional error (0.542%), whereas the 0.022-inch Empower Clear (American Orthodontics, Sheboygan, Wis) bracket had the largest (3.585%).Conclusions:The largest amount of theoretical play is observed using the Empower Clear (American Orthodontics) 0.022-inch bracket combined with the 0.016 × 0.022-inch TMA wire (Ormco), whereas the least amount occurs using the 0.018 Clippy-C (Tomy) combined with 0.016 × 0.022-inch SS wire (Ortho Technology).     

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.     

Effects of different bleaching methods on shear bond strengths of orthodontic brackets

Objective:To evaluate the effects of different bleaching methods on the shear bond strength (SBS) of orthodontic brackets.Materials and Methods:Forty-five freshly extracted premolars were randomly divided into three groups (n  =  15 per group). In group I, bleaching was performed with the office bleaching method. In group II, bleaching was performed with the home bleaching method. Group III served as the control. Orthodontic brackets were bonded with a light cure composite resin and cured with an LED light. After bonding, the SBS of the brackets were tested with a Universal testing machine.Results:Analysis of variance indicated a significant difference between groups (P < .001). The highest values for SBS were measured in group III (20.99 ± 2.32 MPa). The SBS was significantly lower in groups I and II than in group III (P < .001). The lowest values for SBS were measured in group II (6.42 ± 0.81 MPa). SBS was significantly higher in group I than in group II (P < .001).Conclusions:Both of the bleaching methods significantly affected the SBS of orthodontic brackets on human enamel. Bleaching with the home bleaching method affected SBS more adversely than did bleaching with the office bleaching method.     

The prognostic value of visually assessing enamel microcracks: Do debonding and adhesive removal contribute to their increase?

Objective:To find a correlation between the severity of enamel microcracks (EMCs) and their increase during debonding and residual adhesive removal (RAR).Materials and Methods:Following their examination with scanning electron microscopy (SEM), 90 extracted human premolars were divided into three groups of 30: group 1, teeth having pronounced EMCs (visible with the naked eye under normal room illumination); group 2, teeth showing weak EMCs (not apparent under normal room illumination but visible by SEM); and group 3, a control group. EMCs have been classified into weak and pronounced, based on their visibility. Metal brackets (MB) and ceramic brackets (CB), 15 of each type, were bonded to all the teeth from groups 1 and 2. Debonding was performed with pliers, followed by RAR. The location, length, and width of the longest EMCs were measured using SEM before and after debonding.Results:The mean overall width (W_overall) was higher for pronounced EMCs before and after debonding CB (P < .05), and after the removal of MB. Pronounced EMCs showed greater length values using both types of brackets. After debonding, the increase in W_overall of pronounced EMCs was 0.57 µm with MB (P < .05) and 0.30 µm with CB; for weak EMCs, − 0.32 µm with MB and 0.30 µm with CB.Conclusions:Although the teeth having pronounced EMCs showed higher width and length values, this did not predispose to greater EMCs increase after debonding MB and CB followed by RAR.     

Plasma arc curing of ceramic brackets: an evaluation of shear bond strength and debonding characteristics.

The aim of this in vitro investigation was to evaluate bond strength and debonding characteristics when a xenon plasma arc curing light is used to bond polycrystalline and monocrystalline ceramic brackets. Brackets were bonded to 240 extracted bovine mandibular incisors with a composite adhesive. Curing intervals of 1, 3, and 6 seconds were chosen for curing with the plasma arc light, and the control group was cured at 10 seconds per bracket with a conventional halogen light. Debonding was performed on a universal testing machine and according to the bracket manufacturers' recommendations. Both the polycrystalline and the monocrystalline brackets consistently debonded at the bracket-adhesive interface, regardless of debonding method, curing interval, or curing light. No enamel fractures were observed after debonding. Bracket fractures were rare and did not affect debonding. Bond strength was significantly higher for the monocrystalline brackets (P <.0001): mean shear bond strength ranged between 9.68 +/- 2.17 MPa (plasma arc curing light, 1 sec curing interval) and 10.73 +/- 3.22 MPa (halogen light, 10 sec curing interval) for the polycrystalline brackets and between 19.85 +/- 2.97 MPa (plasma arc curing light, 1 sec curing interval) and 22.94 +/- 3.20 MPa (plasma arc curing light, 3 sec curing interval) for the monocrystalline brackets. Significant differences were also found for the curing methods used (P =.047). A curing interval of 3 seconds with the plasma arc curing light is recommended for both polycrystalline and monocrystalline ceramic brackets.     

A new flash-free orthodontic adhesive system: A first clinical and stereomicroscopic study

Objective:To analyze the clinical and laboratory properties of the recently introduced APC flash-free orthodontic adhesive.Material and Methods: After bonding of 80 brackets on human teeth (group A: APC flash-free adhesive n  =  40, group B: APC Plus adhesive n  =  40), the following measurements were recorded: time for bonding, stereomicroscopic evaluation of excess adhesive, color penetration (methylene blue, 0.5%/24 h), and Adhesive Remnant Index (ARI) score after debonding.Results:The time needed for bonding differed significantly between the two groups (A: 19.5 s/tooth vs B: 33.8 s/tooth). The adhesive excess, which was metrically measured from the bracket edge, ranged from 166.27 µm to 81.66 µm (group A) and 988.53 µm to 690.81 µm (group B). After methylene coloration in group A, 52 of 80 measurements showed discoloration on the bracket-adhesive and/or adhesive-enamel interface, while for group B, 78 of 80 were coloration positive. The ARI scores did not differ, with an average ARI score of 2.0 for group A and 2.8 for group B.Conclusion:The flash-free adhesive significantly reduced the time needed for the bonding process. The excess resin expanded 0.16 to 0.08 mm over the bracket margin. The new technology seems to facilitate a smooth and sufficient marginal surface of the adhesive, which clinically might improve reduction of plaque accumulation.     

A prospective randomized split-mouth study on pain experience during chairside archwire manipulation in self-ligating and conventional brackets

Objective:To investigate patient discomfort during archwire engagement and disengagement in patients treated with self-ligating and conventional brackets using a split-mouth design.Materials and Methods:Eighteen consecutive patients (15 female, 3 male; age: 22.2 ± 6.4 years) who requested treatment with fixed orthodontic appliances were randomly assigned for bonding with SmartClip self-ligating brackets on one side of the dentition and conventional standard edgewise brackets on the other. During the course of treatment, patients rated the discomfort experienced during every archwire engagement and disengagement using a numeric rating scale. Results were evaluated for round and rectangular nickel titanium and rectangular stainless steel, titanium molybdenum, and Elgiloy archwires. Patients also rated their overall experience retrospectively for both bracket systems.Results:Regardless of archwire type, disengagement was rated as being significantly more painful on the SmartClip side (P  =  .027). For rigid, rectangular archwires, engagement and disengagement were rated as being significantly more painful on the SmartClip side (P  =  .031; P  =  .004). Retrospective ratings favored conventional brackets beyond ratings recorded during treatment.Conclusion:Engagement and disengagement of rigid rectangular archwires caused more pain with SmartClip self-ligating brackets than with conventional ones. Careful archwire manipulation and patience during full alignment are essential for limiting chairside pain. Low pain levels will help ensure treatment satisfaction and compliance.     

Comparison of root resorption between self-ligating and conventional preadjusted brackets using cone beam computed tomography

Objective:To compare the magnitude of external apical root resorption (EARR) of incisors in patients undergoing the initial phase of orthodontic treatment with two sets of brackets.Materials and Methods:According to the results of the power analysis for sample size calculation, 19 Angle Class I patients (anterior crowding: 3 to 5 mm; mean age: 20.6 years) were included in the study and randomly divided into two groups: group I (n  =  11, self-ligating brackets) and group II (n  =  8, conventional preadjusted brackets). The degree of EARR was detected in 152 upper and lower incisors by using cone-beam computed tomography (CBCT) scans and a three-dimensional program (Dolphin 11.5, Dolphin Imaging & Management Solutions, Chatsworth, Calif) with 25% level of sensitivity. The CBCT scans were obtained before (T1) and 6 months after initiation of treatment (T2). Differences between and within groups were analyzed by nonpaired and paired t-test, respectively, with 5% significance level.Results:Significant differences were found for both groups between T1 and T2. However, no differences in the degree of EARR were detected between the groups studied.Conclusions:Although EARR has occurred in all teeth evaluated, the bracket design (self-ligating or conventional) did not demonstrate any influence on the results observed.     

Active and passive self-ligation—a myth?

Objective:To compare the frictional behavior of several self-ligating brackets with that of normal brackets both with and without tipping force-moments and in combination with different archwire dimensions.Materials and Methods:The resistance to sliding (RS) of seven self-ligating brackets, a conventional bracket, and a ceramic bracket with a low-friction clip were evaluated in combination with three different archwires and tipping force-moments of 0 and 10 Nmm. The center of rotation for the measurements was set within the center of the bracket or with a 10-mm offset. Resistance to sliding was measured using an Instron 3344 at a cross-head speed of 10 mm/min at a temperature of 36°C.Results:Without a tipping moment, RS increased with the active self-ligating brackets with increasing archwire size. No RS was found for any of the passive self-ligating brackets. The 10-Nmm tipping moment resulted in more RS and was similar for all bracket and archwire combinations. RS was approximately doubled when the center of rotation was located at the bracket rather than with a 10-mm offset.Conclusions:RS between brackets and archwires is highly dependent on the experimental setup. Different setups can result in contradictory results. Almost 1 N of traction force is lost in RS when a moment of 10 Nmm is placed at a rotational center 10 mm from the bracket.     

Effects of surface treatment and artificial aging on the shear bond strength of orthodontic brackets bonded to four different provisional restorations

Objective:To evaluate the combined effects of material type, surface treatment, and thermocycling on the bond strength of orthodontic brackets to materials used for the fabrication of provisional crowns.Materials and Methods:Four materials were included in this study (ProTemp, Trim Plus, Trim II, and Superpont C+B). Sixty cylindrical specimens (1 × 3 cm) were prepared from each material and equally divided into three groups. The first group was ground with silica carbide paper, the second was polished with pumice, and the last group was sandblasted with 50-µm aluminum oxide particles. Stainless-steel maxillary central incisor brackets (Victory Series, 3M) were bonded to the provisional material specimens with Transbond XT light-cured composite resin, and half of the specimens from each group were thermocycled 500 times in 5°C and 55°C water baths. Then the brackets were debonded with shear testing, and the results were statistically analyzed by three-way analysis of variance and Tukey''s multiple-comparison tests at α  =  0.05. Adhesive Remnant Index (ARI) was also identified.Results:Before and after thermocycling, ProTemp materials showed the highest shear bond strength with orthodontic brackets (10.3 and 13.1 MPa, respectively). The statistical analysis indicated an interaction among the three independent variables (P < .05) and statistically significant differences in bond strength among provisional materials (P < .001), surface treatments (P < .001), and thermocycling (P < .05). According to the ARI, most groups demonstrated adhesive failure.Conclusions:The provisional material type, surface treatment, and artificial aging have a significant effect on bond strength. Sandblasting treatment exerts a beneficial effect on shear bond strength.     

Porcelain Surface Alterations and Refinishing After Use of Two Orthodontic Bonding Methods

Objective:To compare porcelain surfaces at debonding after use of two surface preparation methods and to evaluate a method for restoring the surface.Materials and Methods:Lava Ceram feldspathic porcelain discs (n  =  40) underwent one of two surface treatments prior to bonding orthodontic brackets. Half the discs had sandblasting, hydrofluoric acid, and silane (SB + HF + S), and the other half, phosphoric acid and silane (PA + S). Brackets were debonded using bracket removing pliers, and resin was removed with a 12-fluted carbide bur. The surface was refinished using a porcelain polishing kit, followed by diamond polishing paste. Measurements for surface roughness (Ra), gloss, and color were made before bonding (baseline), after debonding, and after each step of refinishing. Surfaces were also examined by scanning electron microscopy (SEM). Data was analyzed with 2-way ANOVA followed by Tukey HSD tests (α  =  0.05).Results:The SB + HF + S bonding method increased Ra (0.160 to 1.121 µm), decreased gloss (41.3 to 3.7) and altered color (ΔE  =  4.37; P < .001). The PA + S method increased Ra (0.173 to 0.341 µm; P < .001), but the increase in Ra was significantly less than that caused by the SB + HF + S bonding method (P < . 001). The PA + S method caused insignificant changes in gloss (41.7 to 38.0) and color (ΔE  =  0.50). The measurements and SEM observations showed that changes were fully restored to baseline with refinishing.Conclusions:The PA + S method caused significantly less damage to porcelain than the SB + HF + S method. The refinishing protocol fully restored the porcelain surfaces.