Clinical comparison between a resin-reinforced self-cured glass ionomer cement and a composite resin for direct bonding of orthodontic brackets. Part 2: Bonding on dry enamel and on enamel soaked with saliva

The purposes of this investigation were to compare the clinical performance of a resin-reinforced self-cured glass ionomer cement to a standard composite resin in the direct bonding of orthodontic brackets when bonded onto: a) dry teeth and b) teeth soaked with saliva. The two bonding agents were compared using a split-mouth design. In that, both systems were used for direct bonding of stainless steel brackets in every patient. Thirty-eight consecutive patients with fixed appliances were followed for a period of 12 months. The patients were randomly divided into two groups: group A (11 patients) and group B (27 patients). In group A, the performance of 220 stainless steel brackets was evaluated: 110 brackets were bonded with GC Fuji Ortho glass ionomer cement (GC Industrial Co., Tokyo, Japan) onto dry teeth, and 110 bonded with System 1+ composite resin (Ormco Corp., Glendora, CA). In group B, the performance of 540 stainless steel brackets was evaluated: 270 brackets were bonded with GC Fuji Ortho onto teeth soaked with saliva, and 270 bonded with System 1+. In group A, GC Fuji Ortho recorded an overall failure rate (34.5%) significantly higher (p < 0.05) than System 1+ (9%) when applied onto completely dry teeth. Conversely, in group B, no statistically significant differences (p > 0.05) between the failure rates of the two bonding agents were found when GC Fuji Ortho was used on teeth soaked with saliva. It was concluded, therefore, that GC Fuji Ortho shows clinically acceptable bond strengths when bonded onto moist teeth, but not when used on dry enamel. Both bonding agents failed mostly at the enamel/adhesive interface, without causing any enamel damage.     

Use of a self-etching primer in combination with a resin-modified glass ionomer: effect of water and saliva contamination on shear bond strength.

The purpose of this study was to evaluate the effects of 3 different enamel conditioners (10% polyacrylic acid, 37% phosphoric acid, and self-etching primer) on the shear bond strength and site of bond failure of a resin-modified glass ionomer (Fuji Ortho LC, GC Europe, Leuven, Belgium) bonded onto dry, water-moistened, and saliva-moistened enamel. One hundred eighty bovine permanent mandibular incisors were randomly divided into 12 groups; each group consisted of 15 specimens. Three different enamel surface conditions were studied: dry, soaked with water, soaked with saliva. One hundred eighty stainless steel brackets were bonded with the resin-modified glass ionomer. After bonding, all samples were stored in distilled water for 24 hours and then tested in a shear mode on a testing machine. After self-etching primer application, Fuji Ortho LC produced the highest shear bond strengths under all the different enamel surface conditions; these values were significantly higher than those achieved in the remaining groups, except when Fuji Ortho LC was used in combination with 37% phosphoric acid on dry enamel. Fuji Ortho LC bonded without enamel conditioning produced the lowest shear bond strengths. The bond strength of the groups conditioned with 10% polyacrylic acid was significantly lower than that of the groups etched with 37% phosphoric acid, except when both conditioners were used on enamel soaked with water.     

Bond strength of orthodontic brackets using different light and self-curing cements

The purpose of the study was to evaluate the shear bond strength of stainless steel orthodontic brackets directly bonded to extracted human premolar teeth. Fifty teeth were randomly divided into five groups: (1) System One (chemically cured composite resin), (2) Light Bond (light-cured composite resin), (3) Vivaglass Cem (self-curing glass ionomer cement), (4) Fuji Ortho LC (light-cured glass ionomer cement) used after 37% orthophosphoric acid-etching of enamel (5) Fuji Ortho LC without orthophosphoric acid-etching. The brackets were placed on the buccal and lingual surfaces of each tooth, and the specimens were stored in distilled water (24 hours) at 37 degrees C and thermocycled. Teeth were mounted on acrylic block frames, and brackets were debonded using an Instron machine. Shear bond strength values at fracture (Nw) were recorded. ANOVA and Student-Newman-Keuls multiple comparison tests were performed (P < .05). Bonding failure site was recorded by stereomicroscope and analyzed by Chi-square test, selected specimens of each group were observed by scanning electron microscope. System One attained the highest bond strength. Light Bond and Fuji Ortho LC, when using an acid-etching technique, obtained bond strengths that were within the range of estimated bond strength values for successful clinical bonding. Fuji Ortho LC and Vivaglass Cem left an almost clean enamel surface after debracketing.     

Effect of blood contamination on shear bond strength of brackets bonded with a self-etching primer combined with a resin-modified glass ionomer

This study assessed the effect of blood contamination on the shear bond strength and bond failure site of a resin-modified glass ionomer (Fuji Ortho LC, GC Europe, Leuven, Belgium) used with 3 enamel conditioners (10% polyacrylic acid, 37% phosphoric acid, and self-etching primer). One hundred twenty bovine permanent mandibular incisors were randomly divided into 8 groups; each group consisted of 15 specimens. Two enamel surface conditions were studied: dry and contaminated with blood. One hundred twenty stainless steel brackets were bonded with the resin-modified glass ionomer. After bonding, all samples were stored in distilled water for 24 hours and then tested in shear mode on a testing machine. The groups conditioned with self-etching primer and 37% phosphoric acid had the highest bond strengths for both dry and blood-contaminated enamel. The groups conditioned with 10% polyacrylic acid showed significantly lower shear bond strength value, and the unconditioned groups had the lowest bond strengths. For each enamel conditioner, no significant difference was reported between dry and blood-contaminated groups. Significant differences in debond locations were found among the groups bonded with the different conditioners. Blood contamination of enamel during the bonding procedure of Fuji Ortho LC did not affect its bond strength values, no matter which enamel conditioner was used.     

Changes in the enamel after in vitro debonding of brackets bonded with a modified glass ionomer cement

The aim of this study was to assess the incidence on the enamel behavior of debonding two types of orthodontic brackets, bonded with two different adhesives. Ninety recently extracted human premolars were bonded with two types of brackets (30 Minitrim and 60 Discovery). Two bonding protocols were used. The first one consisted in bonding 30 Minitrim and 30 Discovery brackets on etched and dried enamel surfaces with No Mix orthodontic resin. The second one consisted in bonding 30 Discovery brackets on unetched and wet enamel surfaces with a modified glass ionomer cement, Fuji Ortho LC. Teeth were stored in hydrated ambiance at 37 degrees C for 7 days before debonding. A LLOYD (LR 30K) testing machine was used to evaluate the orthogonal tensile bond strength. The debonded base brackets were examined with a scanning electron microscope (JEOL JSM 6400) and qualitatively analyzed with an OXFORD-LINK-ISIS to assess the site of bond failure and the enamel detachments. An Enamel Detachment Index (EDI) was defined. The results showed that the types of orthodontics brackets and adhesives influenced the bond strength and the enamel detachment. The Discovery/No Mix couple presented higher bond strength (214.9 N) than observed with the Discovery/Fuji Ortho LC (98.5 N) or the Minitrim/No Mix (82.3 N) couples. The surfaces of enamel detachment were insignificant and not extended for all brackets. Nevertheless, the Discovery/No Mix couple presented 42% of an EDI score of 1, compared to the Discovery/Fuji Ortho LC and Minitrim/No Mix couples which presented, respectively, 8% an 20% of an EDI score of 1. The laser sculpted base (Discovery) bonded on unetched and wet enamel surfaces with the modified glass ionomer cement (Fuji Ortho LC) offers a good resistance to debonding forces and preserve enamel integrity.     

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。     

In vitro study of 24-hour and 30-day shear bond strengths of three resin–glass ionomer cements used to bond orthodontic brackets

Interest in using composite resin–glass ionomer hybrid cements as orthodontic bracket adhesives has grown because of their potential for fluoride release. The purpose of this pilot study was to compare shear bond strengths of three resin–glass ionomer cements (Advance, Fuji Duet, Fuji Ortho LC) used as bracket adhesives with a composite resin 24 hours and 30 days after bonding. The amount of adhesive remaining on the debonded enamel surface was scored for each adhesive. Mesh-backed stainless-steel brackets were bonded to 100 extracted human premolars, which were stored in artificial saliva at 37° C until being tested to failure in a testing machine. The hybrid cements, with one exception, had bond strengths similar to those of the composite resin at 24 hours and 30 days. Fuji Ortho LC had significantly lower bond strengths (ANOVA p ≤ 0.05) than the other adhesives at 24 hours and 30 days when it was bonded to unetched, water-moistened enamel. Adhesive-remnant scores were similar for all cements, except for cement Fuji Ortho LC when it was bonded to unetched enamel. The resin–glass ionomer cements we tested appear to have bond strengths suitable for routine use as orthodontic bracket–bonding adhesives. (Am J Orthod Dentofacial Orthop 1998;113:620-24.)     

Demineralization around orthodontic brackets bonded with resin-modified glass ionomer cement and fluoride-releasing resin composite.

PURPOSE: Enamel demineralization adjacent to orthodontic brackets is one of the risks associated with orthodontic treatment. Glass ionomer cements have been shown to decrease enamel demineralization adjacent to brackets and bands but do not exhibit bond strengths comparable to resin composites. The purpose of this in vitro study was to compare a fluoride-releasing resin composite versus a resin-modified glass ionomer cement for inhibition of enamel demineralization surrounding orthodontic brackets. METHODS: Forty-five teeth were randomly assigned to 3 groups of 15 teeth. Fifteen were bonded with Concise (3M), a non-fluoride-releasing resin composite (control); 15 teeth were bonded with Light Bond (Reliance), a fluoride-releasing resin composite; and 15 teeth were bonded with Fuji Ortho LC (GC Corporation), a resin-modified glass ionomer cement. The teeth were placed in an artificial caries solution to create lesions. Following sectioning of the teeth in a buccolingual direction, polarized light microscopy was utilized to evaluate enamel demineralization adjacent to the orthodontic bracket. The area of the lesion was measured 100 microns from the orthodontic bracket and bonding agent. RESULTS: MANOVA (P < .0001) and Duncan's test (P < .05) indicated the resin-modified glass ionomer cement (Fuji Ortho LC) and the fluoride-releasing resin composite (Light Bond) had significantly less adjacent enamel demineralization than the non-fluoride-releasing resin composite control. However, there was no significant difference between the resin-modified glass ionomer cement and the fluoride-releasing resin composite. CONCLUSIONS: Based on the results of this in vitro study, it can be concluded that Fuji Ortho LC and Light Bond exhibit significant inhibition of adjacent demineralization compared to the non-fluoride-releasing control.     

Effect of fluoride application on shear bond strength of brackets bonded with a resin-modified glass-ionomer.

PURPOSE: The purpose of this study was to assess the effect of fluoride application at 3 different steps of the bonding process on the shear bond strength and bond failure site of a resin-modified glass ionomer cement. MATERIAL: Sixty stainless steel brackets were bonded to bovine incisors with Fuji Ortho LC (GC Europe, Leuven, Belgium) under 4 different enamel conditions: (1) uncontaminated enamel, (2) enamel precleaned with fluoride-containing prophylaxis paste, (3) 1.1% acidulated phosphate fluoride (APF) gel applied immediately before conditioning, and (4) 1.1% APF gel applied immediately before bonding. After bonding, all samples were stored in distilled water for 24 hours and subsequently tested in shear mode on a universal testing machine. RESULTS: No significant differences were found between groups 1 (uncontaminated enamel) and 2 (fluoride application during prophylaxis). Both groups showed significantly greater shear bond strength values than groups 3 (fluoride application before conditioning) and 4 (fluoride application before bonding). Groups 3 and 4 did not differ significantly. Moreover, no significant differences in debond locations were found among the 4 groups. CONCLUSIONS: Fluoride application during initial prophylaxis does not affect the bond strength values of Fuji Ortho LC, whereas it significantly lowers bond strength values when applied before both conditioning and bonding.     

Comparison of bracket debonding force between two conventional resin adhesives and a resin-reinforced glass ionomer cement: an in vitro and in vivo study.

The purpose of this study was to compare the debonding force of orthodontic brackets bonded with two conventional resin adhesives (Resilience L3 and Light Bond) and a resin-reinforced glass ionomer cement (Fuji Ortho LC). For the in vitro part of the study, 80 extracted premolars were randomly divided into four groups. In groups A and B, brackets were bonded to unetched enamel using Fuji Ortho LC cement in wet and dry conditions, respectively. In groups C and D, brackets were bonded to etched enamel using Resilience L3 and Light Bond, respectively. Debonding force was determined using a servohydraulic testing machine at a crosshead speed of 1 mm/min. Data was analyzed using the ANOVA and Tukey-Kramer multiple comparison test at p<0.05. A significant difference was found in debonding force between unetched Fuji Ortho LC and the two conventional resins. There was no significant difference between the two conventional resins or between unetched resin-reinforced glass ionomer in the wet and dry conditions. For the in vivo part of the study, 30 patients were randomly assigned to one of the three bonding material groups. Bracket survival rates and distributions were obtained by following these patients for 1.2 years. Data was analyzed using the Kaplan-Meier product-limit estimates of survivorship function. Bond failure interface was determined using a modified adhesive remnant index (ARI). These results showed no significant difference between survival rates and distributions among the three bonding materials with respect to the type of malocclusion, type of orthodontic treatment, or location of bracket. There were significant differences between survival distributions of males and females in the unetched Fuji Ortho LC group and among type of teeth in the conventional resin groups. The predominant mode of bracket failure for the unetched Fuji Ortho LC cement was at the enamel-adhesive interface, and for conventional resins, the enamel-adhesive interface and the bracket-adhesive interface. These results suggest that resin-reinforced glass ionomer cement can withstand occlusal and orthodontic forces despite having a bond strength lower than that of conventional resin adhesives.     

Comparison of bond strength between a conventional resin adhesive and a resin-modified glass ionomer adhesive: an in vitro and in vivo study.

The objectives of this study were (1) to compare the in vivo survival rates of orthodontic brackets bonded with a resin-modified glass ionomer adhesive (Fuji Ortho LC; GC America, Alsip, Ill) after conditioning with 10% polyacrylic acid and a conventional resin adhesive (Light Bond; Reliance Orthodontic Products, Itasca, Ill) bonded with 37% phosphoric acid, (2) to compare the in vitro bond shear/peel bond strength between the 2 adhesives, (3) to determine the mode of bracket failure in the in vivo and in vitro tests according to the adhesive remnant index (ARI), and (4) to compare the changes in surface morphology of enamel surface after etching or conditioning with 10% polyacrylic acid, with scanning electron microscopy. In the in vitro study, 50 extracted premolars were randomly divided into 4 groups: brackets bonded with Fuji Ortho LC or Light Bond adhesive that were debonded after either 30 minutes or 24 hours. Bond strengths were determined with a testing machine at a crosshead speed of 1 mm/min. Data were analyzed with analysis of variance and a paired Student t test. The in vivo study consisted of 398 teeth that were randomly bonded with Fuji Ortho LC or Light Bond adhesive in 22 subjects with the split-mouth technique. Bracket survival rates and distribution were followed for 1.3 years. Data were analyzed with Kaplan-Meier product-limit estimates of survivorship function. The in vitro study results showed significant differences (P <.05) among the adhesives and the debond times. Light Bond had significantly greater bond strengths than Fuji Ortho LC at 24 hours (18.46 +/- 2.95 MPa vs 9.56 +/- 1.85 MPa) and 30 minutes (16.19 +/- 2.04 MPa vs 6.93 +/- 1.93 MPa). Mean ARI scores showed that Fuji Ortho LC had significantly greater incidences of enamel/adhesive failure than Light Bond adhesive (4.9 vs 4.1). For the in vivo study, no significant differences in failure rate, sex, or location in dental arch or ARI ratings were found between the 2 adhesives. These results suggest that, compared with conventional resin, brackets bonded with resin-modified glass ionomer adhesive had significantly less shear bond strength in vitro. However, similar survival rates of the 2 materials studied after 1.3 years indicate that resin-reinforced glass ionomers can provide adequate bond strengths clinically. The weaker chemical bonding between the adhesive and the enamel might make it easier for clinicians to clean up adhesives on the enamel surface after debonding.     

Enamel demineralization adjacent to orthodontic brackets bonded with hybrid glass ionomer cements: An in vitro study

Enamel demineralization is recognized as a possible side effect of bonding orthodontic brackets with composite resins. Fluoride-releasing restorative materials have been shown to inhibit tooth demineralization. The purpose of this study was to evaluate two fluoride-releasing hybrid glass ionomer bonding agents for inhibition of enamel demineralization surrounding orthodontic brackets under two experimental conditions. This in vitro study used 72 extracted human premolars. Twenty-four teeth were bonded with Advance resionomer, 24 were bonded with Fuji Ortho LC hybrid glass ionomer and 24 were bonded with Transbond XT composite resin as the control. The teeth were cycled in an artificial caries challenge three times daily for 30 days. Half of the teeth in each group were brushed twice daily with a fluoridated dentifrice, and the other half were not brushed. Demineralization of enamel surrounding orthodontic brackets was evaluated with polarized light microscopy. Enamel lesions were photographed under maximum illumination. Images were projected, and demineralized areas were traced. Both average depth and area were measured with a sonic digitizer. Analysis of variance (P < .0001) and Duncan’s test (P < .05) indicated significant differences in depth and area of demineralized enamel such that lesion size was: Transbond XT no brush > Transbond XT brush > Advance no brush = Advance brush = Fuji Ortho LC no brush = Fuji Ortho brush. The promising results of this in vitro study warrant further clinical investigation of hybrid glass ionomer adhesives as orthodontic bonding agents to minimize enamel demineralization. (Am J Orthod Dentofacial Orthop 1998;114:668-74)     

Glass ionomer cements as luting agents for orthodontic brackets

The objectives of the present study were to (1) assess the shear bond strengths of resin-reinforced glass ionomer Fuji Ortho LC and GC Fuji Ortho cements under differing conditions and (2) compare their bonding performance with that of conventional resin composite bonding systems. A sample of 264 bovine incisors was divided into 22 groups of 12 teeth each and bonded with SPEED central incisor brackets. Enamel surfaces of the teeth in the two experimental groups were conditioned according to the manufacturer's instructions; moreover, groups unconditioned before bonding were also included under both wet and dry conditions. A self-cure composite resin (Phase II) and a light-cure composite resin (Transbond XT) served as controls and were etched with 37% phosphoric acid and bonded in a dry field. After incubation at 37 degrees C for 24 hours and for seven days, the specimens were tested to failure with a shear force in an Instron machine. The Adhesive Remnant Index (ARI) was used to assess the amount of resin left on the enamel surfaces after debonding. Selected specimens were examined using scanning electron microscopy. Statistical analyses included analysis of variance tests, t-tests, and correlation coefficient calculations and showed that no significant difference existed between the glass ionomer cements under wet or dry conditions, provided the enamel was conditioned with 10% polyacrylic acid before bonding. Both glass ionomer cements were thus acceptable for bonding. Transbond XT had the highest mean shear bond strength irrespective of the incubation period. A positive correlation was obtained between the ARI scores and bond strength.     

Bond Strength of Various Fluoride-Releasing Orthodontic Bonding Systems Experimental Study

The aim of the study was to compare the shear bond strength of a fluoride-releasing composite resin adhesive (Light Bond, Reliance) and a light-cured resin-reinforced glass ionomer cement (Fuji Ortho LC, GC America) bonded to extracted teeth under different enamel surface conditions. Forty human premolars were divided at random into 4 groups of 10 specimens. Stainless steel brackets were attached to the enamel surface by 1 of the 4 protocols: 1. Fuji Ortho LC, moist non-etched enamel; 2. Fuji Ortho LC, moist etched (37% H3PO4); 3. Light Bond, dry etched (37% H3PO4); 4. Light Bond, dry etched (Etch & Prime 3.0, Degussa). The teeth were stored in deionized water at 37 degrees C for 48 hours. Shear bond strengths was determined at a crosshead speed of 1 mm/min. The residual adhesive on the enamel surface was evaluated with the modified Adhesive Remnant Index (ARI). Analysis of variance (ANOVA) and Duncan's test were used to compare the 4 groups. Significance was predetermined at p = 0.05. Significant inter-group differences were found (p < 0.0001). The mean SBS (and SD), in MPa were: Group 1: 15.9 (4.7); Group 2: 20.3 (2.5); Group 3: 16.7 (2.6); Group 4: 11.7 (2.5). Glass ionomer cement without etching and composite with Etch & Prime showed adhesive failures at the enamel and good enamel integrity after debonding. The other specimens showed mixed or adhesive fractures at the bracket failure sites. Glass ionomer used on wet tooth surfaces without etching shows a clinically acceptable bond strength with clean separation from the enamel after debonding.     

Tensile bond strength of a light-cured glass ionomer cement when used for bracket bonding under different conditions: an in vitro study

The purpose of this study was to investigate the tensile bond strength of a new light-cured resin reinforced glass ionomer cement (Fuji Ortho LC), following the bonding of stainless steel brackets to 40 extracted human premolar teeth under four different enamel surface conditions: (1) non-etched, moistened with water; (2) etched, moistened with water; (3) etched, moistened with human saliva; and (4) etched, moistened with human plasma. The etched surface produced a higher bond strength than the non-etched surface when contaminated with distilled water. Contamination with human saliva resulted in a further increase in bond strength whilst plasma contamination produced an even higher strength. However, one-way analysis of variance showed no statistically significant difference between the various groups. After debonding, enamel and bracket base surfaces were examined for residual adhesive. The location of the adhesive also indicated improved bonding to etched enamel. This investigation shows that regardless of enamel surface pretreatment or environment, Fuji Ortho LC provides an adequate strength for bonding of orthodontic brackets.     

A comparison of the shear bond strengths of two glass ionomer cements

The objective of this study was to determine the in vitro shear bond strength (in megapascals) and location of bond failure with two light-cured glass ionomer resin systems. One system was a hybrid glass ionomer cement with resin (GC Orthodontics, Aslip, Ill), and the other system a glass-filled resin system (Reliance Orthodontic Products, Inc, Itasca, Ill). These systems, Fuji Ortho LC (GC Orthodontics) and Ultra Band Lok^{^} (Reliance), respectively, were compared to a light-cured composite resin. Maxillary premolar brackets (n = 200) were bonded to the facial surface of human premolar teeth. The two glass ionomer resin systems were each evaluated by two protocols, one according to the manufacturers’ direction plus a variation of their respective technique. The five distinct groups (n = 40) were stored in 37°C distilled water for 30 days and subjected to thermocycling before shear bond strength testing. The findings indicated that large variations existed between the bond strengths of the materials tested. The laboratory shear bond strength of the glass-filled resin glass ionomer cement (Reliance), whether tested in a dry or moist field, was similar to the composite control with all of the previous materials being significantly (P < .01) higher than both the hybrid glass ionomer cement groups (Fuji Ortho LC). However, the hybrid glass ionomer cement with enamel conditioner demonstrated a clinically acceptable mean megapascal value. The Adhesive Remnant Index values ranged from 0.53 to 1.62. The hybrid glass ionomer cement without enamel conditioning recorded the lowest mean adhesive remnant index score and the lowest mean megapascal score. Although both products are glass ionomer resin systems, their individual chemistries vary; this affects their clinical performance. Clinically, it may be suggested that glass ionomers used in a dry field may be beneficial for orthodontic bonding, and that glass ionomer resin systems used in a moist environment need an enamel conditioner. (Am J Orthod Dentofacial Orthop 1999;115:125-32.)     

Metallic brackets bonded with resin-reinforced glass ionomer cements under different enamel conditions

OBJECTIVE: To assess the shear bond strength of metallic orthodontic brackets bonded with either Fuji Ortho or Ortho Glass LC resin-reinforced glass ionomer cements to enamel surfaces under different conditions, namely, enamel without etching, enamel conditioned with 37% phosphoric acid and enamel conditioned with Transbond Plus Self Etching Primer (TPSEP). MATERIALS AND METHODS: One hundred and five bovine inferior incisors were divided into seven groups (n = 15). In group 1 (control) Transbond XT was used according to the manufacturer's recommendations. In groups 2, 3, and 4 all using Fuji Ortho LC, the brackets were bonded, respectively, to enamel nonetched, enamel etched with 37% phosphoric acid, and enamel etched with TPSEP. In groups 5, 6, and 7, the bonding was performed using Ortho Glass LC under the same enamel conditions observed in the other experimental groups. After 24 hours, shear bond strength tests were performed for all samples at a crosshead speed of 0.5 mm/min. RESULTS: The results (MPa) showed no statistically significant difference between groups 1, 3, and 4 (P > .05). However, such groups were statistically superior to the others (P < .05). No statistically significant difference was observed between groups 2, 6, and 7 (P > .05). Group 5 showed the lowest shear strength value, which was also statistically inferior to the other groups (P < .05). CONCLUSIONS: Regardless of the enamel treatment, Fuji Ortho LC yielded shear strength values superior to those from Ortho Glass LC.     

A 12 month clinical study of bond failures of recycled versus new stainless steel orthodontic brackets

The purpose of this prospective longitudinal randomized study was to compare the clinical performance of recycled brackets with that of new stainless steel brackets (Orthos). Twenty patients treated with fixed appliances were included in the investigation. Using a 'split-mouth' design, the dentition of each patient was divided into four quadrants. In 11 randomly selected patients, the maxillary left and mandibular right quadrants were bonded with recycled brackets, and the remaining quadrants with new stainless steel brackets. In the other nine patients the quadrants were inverted. Three hundred and ten stainless steel brackets were examined: 156 were recycled and the remaining 154 were new. All the brackets were bonded with a self-cured resin-modified glass ionomer (GC Fuji Ortho). The number, cause, and date of bracket failures were recorded over 12 months. Statistical analysis was performed by means of a paired t-test, Kaplan-Meier survival estimates, and the log-rank test. No statistically significant differences were found between: (a) the total bond failure rate of recycled and new stainless steel brackets; (b) the upper and lower arches; (c) the anterior and posterior segments. These findings demonstrate that recycling metallic orthodontic brackets can be of benefit to the profession, both economically and ecologically, as long as the orthodontist is aware of the various aspects of the recycling methods, and that patients are informed about the type of bracket that will be used for their treatment.     

In vivo effect of a resin-modified glass ionomer cement on enamel demineralization around orthodontic brackets.

Because the risk of dental caries increases with the use of orthodontic appliances and its control cannot depend only on the patient's self-care, this study evaluated the effect of a glass ionomer cement on reducing enamel demineralization around orthodontic brackets. Fourteen orthodontic patients were randomly divided into 2 groups of 7; they received 23 brackets fitted to their premolars, bonded with either Concise (3M Dental Products, St Paul, Minn), a composite resin (control group), or Fuji Ortho LC (GC America, Chicago, Ill), a resin-modified glass ionomer cement (experimental group). The volunteers lived in a city that has fluoridated water, but they did not use fluoridated dentifrices during the study. After 30 days, the teeth were extracted and longitudinally sectioned; in the enamel around the brackets, demineralization was assessed by cross-sectional microhardness. The determinations were made at the bracket edge cementing limits, and at occlusal and cervical points 100 and 200 microm away from them. In all of these positions, indentations were made at depths from 10 to 90 microm from enamel surface. Analysis of variance showed statistically significant effects for position, material, depth, and their interactions (P<.05). The Tukey test showed that the glass ionomer cement was statistically more efficient than the control, reducing enamel demineralization in all analyses (P<.05). The use of glass ionomer cement for bonding can be encouraged because it decreases the development of caries around orthodontic brackets.     

Comparison of bond strength of three adhesives: composite resin, hybrid GIC, and glass-filled GIC.

The objective of this study was to compare 3 orthodontic adhesives in the areas of shear-peel bond strength, location of adhesive failure, and extent of enamel cracking before bonding and after debonding of orthodontic brackets. The adhesives included a composite resin control (Transbond XT; 3M/Unitek, St Paul, Minn), a resin-modified glass ionomer cement (Fuji Ortho LC; GC America Corp, Alsip, Ill), and a polyacid-modified composite resin under dry and saliva-contaminated conditions (Assure; Reliance Orthodontic Products Inc, Itasca, Ill). Metal brackets were bonded to the buccal surfaces of 160 (4 groups of 40) human premolars. The bonded teeth were stored in deionized water at 37 degrees C for 30 days and thermocycled for 24 hours before debonding with a Universal Instron (Instron Corp, Canton, Mass) testing machine. The extent of cracking in the buccal surfaces was evaluated under 16x magnification before bonding and after debonding. Although the bond strength of the composite resin control (20.19 MPa) was significantly greater (P <.05) than that of the adhesives in the other groups, clinically acceptable shear-peel bond strengths were found for all adhesives (Fuji Ortho LC = 13.57 MPa, Assure-dry = 10.74 MPa, Assure-wet = 10.99 MPa). The bond strength for the Assure adhesive was not significantly affected by saliva contamination. The sample of extracted premolars used in this study displayed a greater frequency of buccal surface enamel cracking (46.7%) than that reported in the literature for in vivo premolars (7.8%-10.2%), which was possibly due to the extraction process. The frequency of enamel cracking in a subset of this sample (n = 34) increased from 46.4% at prebonding to 62.4% at postdebonding as a result of the forces of debonding.