Shear bond strength of orthodontic brackets bonded with light-emitting diode curing units at various polymerization times

Effect of time and photoactivated face on bond strength of brackets and on degree of monomer conversion

OBJECTIVE

To evaluate the effect of four different photoactivation protocols (according to "photoactivated faces" - mesial/distal, cervical/incisal or center - and "photoactivation time" - 6-3 s) of a high-power photo activator (Valo Cordless®-Ultradent) on the shear bond strength (SBS) between metal brackets and dental enamel and on the degree of conversion (DC) of an orthodontic resin.

MATERIALS AND METHODS

40 bovine incisor crowns were randomly assigned to 4 groups (n = 10). The brackets were bonded with Transbond XT® resin using 4 protocols according to the "photoactivation protocol" factor (which was subdivided into photoactivated faces and photoactivation time): V3C = 3 s + center; V6C = 6 s + center; V3M3D = 3 s on mesial + 3 s on distal; V3C3I = 3 s on cervical + 3 s on incisal. All the samples were stored for 4 months (water,37ºC) and then subjected to a SBS test (100KgF,1 mm/min). 40 resin discs were made to evaluate the monomer degree of conversion. Data from the SBS and DC were assessed by One-way ANOVA and Tukey's test (5%). Bond failures were analyzed according to the Adhesive Remnant Index (ARI) and evaluated by the Kruskal-Wallis test (5%).

RESULTS

There was a statistically significant difference (p = 0.008) in the One-way ANOVA result for SBS values between all groups, but the protocols showed statistically similar results (p ≥ 0.05-Tukey's tests) concerning the photoactivated faces (V6C, V3M3D and V3C3I) and photoactivation time (V3C and V6C) factors individually. There was no statistically significant difference (p ≥ 0.05) in the One-way ANOVA result for DC values.

CONCLUSION

The SBS and DC values will vary depending on the protocol applied.

CLINICAL RELEVANCE

It is possible to maintain the bracket fixation quality with the use of a high-power LED photo activator associated with a shorter photoactivation time. However, it is assumed that not all types of protocols that might be applied will provide quality bonding, such as V3C, V3M3D and V3C3I, which may - depending on the SBS and DC values - affect the final treatment time, due to brackets debonding, or increase of possibility of damage to dental enamel during bracket removal. Clinical studies are suggested to confirm the hypotheses of this research.

Shear strength of metal brackets using LED lamps with different wavelengths: An in vitro comparative study

AIM

To evaluate the shear strength of Orthocem and BracePaste polymerizable cement light-cured with light-emitting diode (LED) units with different wavelengths (Bluephase N) with their high power, low power, and soft start programs in the bonding of metal brackets.

MATERIALS AND METHODS

In vitro experimental research was performed. Mini Roth 0.022 metal brackets (Roth Orthometric brackets) were used. The adhesives were placed on the metal brackets with Orthocem and BracePaste resin cement. To compare the average strengths, the analysis of variance (ANOVA) test was used (P < 0.05).

RESULTS

The average shear strength was better with Bracepaste polymerizable cement compared to Orthocem cement in all its high power, low power, and soft star programs; the highest was Bracepaste with soft start of 26.52 MPa, and the lowest was Orthocem with soft start of 13.92 MPa. When evaluating the differences, it was found that these were statistically significant in all groups (P < 0.05).

CONCLUSIONS

Differences were found in the shear strength of light-curing Orthocem and Bracepaste light-curing cement cured with LED units with different wavelengths in bonding metal brackets to the tooth in vitro.

Evaluation of enamel roughness after orthodontic debonding and clean-up procedures using zirconia, tungsten carbide, and white stone burs: an in vitro study

BACKGROUND

The main goal of orthodontic debonding is to restore the enamel surface as closely as possible to its pretreatment condition without iatrogenic damage. This study aimed to compare the effects of different adhesive removal burs; zirconia burs, tungsten carbide burs, and white stone burs on enamel surface roughness.

MATERIALS AND METHODS

Total sample of 72 extracted premolars was randomly divided into three equal groups (n = 24) depending on the method of adhesive removal: zirconia burs (ZB); tungsten carbide burs (TC); and white stones (WS). The metal brackets were bonded using Transbond XT orthodontic adhesive (3 M Unitek, Monrovia, CA, USA) and debonded after 24 h using a debonding plier, then the ARI was assessed. The adhesive remnants were removed using the different burs and Final polishing was performed using Sof-lex discs and spirals. Thirteen samples from each group were evaluated using a Mitutoyo SJ-210 profilometer to determine average surface roughness (Ra) and three samples from each group were examined under Scanning Electron Microscopy (SEM) to determine EDI score. The evaluations were performed at three time points; before bonding (T0), after adhesive removal (T1) and after polishing (T2) and the time consumed for adhesive removal by burs was recorded in seconds. The data were analyzed statistically by ANOVA, Tukey's test and Kruskal-Wallis H-test.

RESULTS

Kruskal-Wallis H-test showed no statistically significant difference of ARI in all studied groups (p = 0.845) and two-way mixed ANOVA revealed that all burs significantly increased surface roughness at T1 compared to T0 (p < 0.001) in all groups with the lowest Ra values were observed in the ZB group, followed by the TC group, and WS group. The fastest procedure was performed with WS, followed by ZB, then TC bur (p < 0.001). After polishing (T2), Ra values showed no significant difference in ZB group (P = 0.428) and TC group (P = 1.000) as compared to T0, while it was significant in WS group (p < 0.001).

CONCLUSION

zirconia bur was comparable to tungsten carbide bur and can be considered as alternative to white stone which caused severe enamel damage. The polishing step created smoother surface regardless of the bur used for resin removal.

Impact of a High-Power Light-Emitting Diode Unit With Reduced Curing Times on the Shear Bond Strength of Orthodontic Brackets and Their Adhesive Remnant Index Scores

AIM AND OBJECTIVES

This study aims to evaluate the curing time minimally required for bonding stainless-steel (SS) brackets using a high-power light-emitting diode (LED) light curing unit (LCU) and examine the debonded enamel surface for adhesive remnant.

MATERIALS AND METHODS

Based on the LED LCU and curing time employed, 80 human maxillary first premolar teeth were equally segregated into four groups. Three groups were cured using a high-power LED unit (Guilin Woodpecker Medical Instrument Co., Ltd., Guilin, Guangxi, China) for one, two, and three seconds. The fourth group served as a control and was bonded with another intensive LED unit (Elipar™ S10 LED Curing Light; 3M, Saint Paul, Minnesota, United States) for 20 seconds. Transbond™ XT Light Cure Adhesive (3M, United States) adhesive was used for bonding the SS brackets. All the samples were exposed to shear bond strength (SBS) testing after a 24-hour immersion period in distilled water at 37°C. A stereomicroscope was used to examine and score the adhesive remnant on the debonded surface using a modified adhesive remnant index (ARI). Kruskal-Wallis-ANOVA and post-hoc Mann-Whitney U tests for multiple pairwise comparisons were performed to analyze the data.

RESULTS

Time and intensity significantly affected the SBS (P<0.001). A higher SBS value (16.04 megapascals (MPa)) was obtained in the six-second group when compared to the three-second (11.58 MPa), one-second (10.69 MPa), and 20-second control (13 MPa) groups. The ARI was significantly affected by the curing method.

CONCLUSIONS

Higher SBSs were recorded for the six-second group using the high-power LED. A greater ARI score is associated with a reduced curing duration and vice versa.

The effect of light curing time and intensity on the bond strength and fracture resistance of orthodontic adhesive

Background

This study aimed to measure the shear bond strength and compressive strength of orthodontic adhesives at different curing times and intensities.

Methods

Ninety extracted human premolars were used. Orthodontic brackets were bonded on the buccal surface of the teeth with orthodontic adhesive light-cured using VRN-VAFU LED curing light at different curing times (1, 3 and 5 seconds) and intensities (1000, 1600 and 2300 mW/cm2 ). A universal testing machine was used to measure the shear bond strength. The ratio of the adhesive remnant and compressive strength of the orthodontic adhesive, at each curing time at the different intensities, were also evaluated. The results were statistically analyzed using one-way analysis of variance followed by Tukey's test.

Results

The lowest bond strength values (6.4, 9.9 and 12.6 MPa) were recorded with 1000 mW/ cm2 intensity (at all curing times) in comparison with the other intensities (P<0.05). Increasing the curing time significantly increased the bond strength of the orthodontic brackets (P<0.05), except when the curing time was increased from 3 sec to 5 sec at 1600 mW/cm2 intensity. The highest compressive strength values (130.3, 147.1 and 174 MPa) were recorded at 2300 mW/ cm2 intensity (at all curing times) compared to the other intensities (P<0.05). The highest values of the ratio of the adhesive remnants were recorded at 1000 mW/cm2 intensity (at all curing times) compared to the other intensities (P<0.05).

Conclusion

Although, increasing the curing time and\or the curing intensity has a positive effect on the bond strength and compressive strength of the orthodontic adhesive, it might be possible to suggest reducing the curing time of orthodontic adhesive to 1 sec at curing intensity of 2300 mW/cm2.

Comparison of Enamel Surface Roughness after Bracket Debonding and Adhesive Resin Removal Using Different Burs with and without the Aid of a Magnifying Loupe

AIM

This study aimed to evaluate the impact of using a magnifying dental loupe on enamel surface roughness during adhesive resin removal by different burs.

MATERIALS AND METHODS

Ninety-six extracted premolar teeth were randomly divided according to the bur used with or without the aid of a magnifying loupe into four equal groups (N = 24): group I: naked eye tungsten carbide burs (NTC); group II: magnifying loupe tungsten carbide burs (MTC); group III: naked eye white stones (NWS); and group IV: magnifying loupe white stones (MWS). The initial surface roughness (Ra) T0 was evaluated using a profilometer, and the scanning electronic microscopy (SEM) technique. The metal brackets were bonded and debonded after 24 hours with debonding plier. After adhesive removal, Ra was evaluated again (T1) also the time spent on adhesive removal was recorded in seconds. The samples were finally polished by Sof-Lex discs and Sof-Lex spirals, and the third Ra evaluation was performed (T2).

RESULTS

The results of two-way mixed analysis of variance (ANOVA) showed that all burs increased surface roughness at T1 as compared to T0 (p < 0.001) with the highest Ra values shown in group III followed by group IV, group I, and group II. After polishing, no significant difference was noted in Ra values in group I and group II at T0 vs T2 (p = 1.000), while it was significant in group III and group IV (p < 0.001). Regarding the time required for adhesive removal, the shortest time was in group IV followed by groups III, II, and I, respectively.

CONCLUSION

The use of a magnifying loupe affects the quality of the clean-up procedure by reducing the enamel surface roughness and the time spent on adhesive removal.

CLINICAL SIGNIFICANCE

Using a magnifying loupe was helpful during orthodontic debonding and adhesive removal.

High-Intensity Light-Emitting Diode and Reduced Curing Times—An In Vitro Study

Objective:

To evaluate and compare the effect of high-intensity light-emitting diode (LED) light-curing unit at different curing times on the shear bond strength (SBS), surface enamel loss, and degree of polymerization of a light-cure and dual-cure adhesive system.

Materials and Methods:

One hundred and twenty extracted human premolar teeth were divided into 2 groups— group 1 (light cure) and group 2 (dual cure), depending on the adhesive system used. These groups were further subdivided into 3 subgroups with 20 teeth each, depending on the duration of curing. A high-intensity LED curing unit was used to bond metal brackets onto the teeth. The samples were tested on a universal testing machine to measure the SBS. The samples were then observed under a simple microscope and modified adhesive remnant index scores were assigned. The bracket bases were mapped with energy-dispersive X-ray spectrometry to evaluate the amount of enamel present. Cured adhesive was scraped and was subjected to Fourier-Transform Infrared Spectroscopy to assess the degree of cure (%DC).

Results:

An increase in curing durations increased mean SBS values, %DC, and calcium-phosphorous ratios (Ca:P). Similarly, these parameters were higher for dual-cure subgroups when compared to light-cure subgroups.

Conclusion:

High-intensity LEDs can be used successfully for bonding orthodontic brackets with reduced curing duration. These LEDs help to reduce chairside time and can minimize damage to enamel without compromising bond strength.

Comparison of Light-Emitting Diode-Curing Unit and Halogen-Based Light-Curing Unit for the Polymerization of Orthodontic Resins: An In vitro Study

Aims and Objectives

Conventionally, composites are cured using halogen-based light-curing units (LCUs). However, recently, light-emitting diode (LED) LCUs have been introduced commercially, claiming many advantages, yet producing comparable bond strength even when cured with single LED LCUs. This present study was undertaken to compare the shear bond strength of orthodontic brackets bonded to teeth with conventional halogen LCU (3M ESPE Elipar 2500) and LED LCU (3M ESPE Elipar FreeLight 2) and to determine the site of bond failure.

Materials and Methods

Fifty extracted human bicuspid teeth were randomly divided into two groups of 25 each. All the teeth were etched and primed. Then, orthodontic brackets were bonded onto the teeth with the light-cured adhesive (Transbond XT, 3M Unitek), and the adhesive was cured with halogen LCU and LED LCU for Group I and Group II, respectively. The brackets were then subjected to shear stress using a Hounsfield universal testing machine at a crosshead speed of 1 mm/min. The force was recorded in Kgf and converted to MPa. The residual adhesive was scored based on the modified adhesive remnant index (ARI) using an optical stereomicroscope. The data were analyzed using the Student's t-test and the Mann-Whitney test at a significance level of 0.05.

Results

The results have shown that there is no significant difference between the shear bond strengths and the ARI scores of both the groups.

Conclusion

From this study, it can be concluded that (1) LED LCUs containing even only a single LED can cure the composite as well as a halogen-based LCU; (2) there is no statistically significant difference in the shear bond strengths of the two groups; and (3) the ARI scores show no significant difference.

Effects of reducing light-curing time of a high-power LED device on shear bond strength of brackets

PURPOSE

To assess the effects of reducing the curing time of a high-power light-emitting diode (LED) unit (Valo, Ultradent, South Jordan, UT, USA) on shear bond strength (SBS) of metal brackets and on the amount of adhesive remnant of two orthodontic composites.

METHODS

Eighty human premolars were divided into four groups (G1-4) according to curing time and composite: G1 (Transbond XT, 6 s), G2 (Opal Bond MV, 6 s), G3 (Transbond XT, 3 s), and G4 (Opal Bond MV, 3 s). Twenty-four hours after bonding, brackets were subject to a SBS test performed with a universal testing machine. Enamel surface was analyzed by SEM and the amount of adhesive remnant was assessed by the Image J software area calculation tool. Two-way analysis of variance was used for statistical analysis of SBS data, while Friedman and Mann-Whitney post hoc tests were used to analyze data on the amount of adhesive remnant.

RESULTS

Time and composite significantly affected SBS (p < 0.001). The 6 s curing showed a higher SBS value (21.56 MPa) in comparison to 3 s curing (15.79 MPa). Transbond XT composite showed a significantly higher SBS value (21.06 MPa) compared to Opal Bond MV (16.29 MPa). After the SBS test, Opal Bond MV showed a significantly greater amount of composite adhered to enamel (p < 0.001).

CONCLUSION

Reducing exposure time from 6 to 3 s significantly decreased mean values of SBS, even with the use of a high-power LED unit. Reduction in time did not affect the amount of adhesive remnant.

Shear bond strength of a bracket-bonding system cured with a light-emitting diode or halogen-based light-curing unit at various polymerization times

Purpose

To determine and compare the shear bond strength (SBS) of bracket-bonding system cured with light-emitting diode (LED) and halogen-based light-curing unit at various polymerization times.

Materials and methods

Ninety six human maxillary premolar teeth extracted for orthodontic purpose were divided into four groups, according to the light-curing unit and exposure times used. In the halogen group, the specimens were light cured for 20 and 40 seconds. In the LED group, the specimens were light cured for 5 and 10 seconds. Stainless steel brackets were bonded with Enlight bonding system, stored in distilled water at 37°C for 24 hours and then submitted to SBS testing in a universal testing machine at a crosshead speed of 0.5 mm/minute. Adhesive remnant index (ARI) was used to evaluate the amount of adhesive remaining on the teeth determined by stereomicroscope at 10× magnification.

Results

The highest mean SBS was obtained with the halogen 40 seconds (18.27 MPa) followed by halogen 20 seconds (15.36 MPa), LED 10 seconds (14.60 MPa) and least with LED 5 seconds (12.49 MPa) group. According to analysis of variance (ANOVA) and Tukey’s multiple-comparison test, SBS of halogen 20 seconds group was not significantly different from halogen 40 seconds group, LED 5 seconds group and LED 10 seconds group, whereas halogen 40 seconds group was significantly different from LED 5 seconds and LED 10 seconds group. The method of light curing did not influence the ARI, with score 2 being predominant.

Conclusion

Polymerization with both halogen and LED resulted in SBS values that were clinically acceptable for orthodontic treatment in all groups. Hence, for bonding orthodontic brackets, photoactivation with halogen for 20 seconds and LED for 5 seconds is suggested.

Comparison of the bonding strengths of second- and third-generation light-emitting diode light-curing units

Objective

With the introduction of third-generation light-emitting diodes (LEDs) in dental practice, it is necessary to compare their bracket-bonding effects, safety, and efficacy with those of the second-generation units.

Methods

In this study, 80 extracted human premolars were randomly divided into eight groups of 10 samples each. Metal or polycrystalline ceramic brackets were bonded on the teeth using second- or third-generation LED light-curing units (LCUs), according to the manufacturers’ instructions. The shear bond strengths were measured using the universal testing machine, and the adhesive remnant index (ARI) was scored by assessing the residual resin on the surfaces of debonded teeth using a scanning electron microscope. In addition, curing times were also measured.

Results

The shear bond strengths in all experimental groups were higher than the acceptable clinical shear bond strengths, regardless of the curing unit used. In both LED LCU groups, all ceramic bracket groups showed significantly higher shear bond strengths than did the metal bracket groups except the plasma emulation group which showed no significant difference. When comparing units within the same bracket type, no differences in shear bond strength were observed between the second- and third-generation unit groups. Additionally, no significant differences were observed among the groups for the ARI.

Conclusions

The bracket-bonding effects and ARIs of second- and third-generation LED LCUs showed few differences, and most were without statistical significance; however, the curing time was shorter for the second-generation unit.

Temperature increase during orthodontic bonding with different curing units using an infrared camera

AIM

To evaluate the effects of different curing units and light-tip tooth surface distances on the temperature increase generated during orthodontic bonding, using an infrared camera (IR) and artificial neural networks (ANN).

MATERIALS AND METHODS

Fifty-two freshly extracted human premolar teeth were used. Metallic orthodontic brackets were bonded to the buccal surfaces of the teeth and thermal records were taken using an IR camera and ANN. Brackets were cured with a light-emitting diode (LED) and high intensity halogen (HQTH). Teeth were divided into four groups according to the curing units (LED and HQTH) and curing distances (from tooth surface and 10 mm away from tooth surface). The results were analyzed with analysis of variance (ANOVA) and the Tukey HSD test.

RESULTS

The ANOVA and Tukey HSD tests revealed that temperature changes were influenced by the type of light source and exposure times. All groups revealed significant differences between each other (p < 0.001). The highest surface temperature increase was gained from curing with a LED unit from the tooth surface (11.35°C ± 0.91°C). The lowest surface temperature increase was gained from curing with a HQTH unit 10 mm away from the tooth surface (2.57°C ± 0.6°C).

CONCLUSION

The LED unit induced significantly higher temperature changes than did the HQTH. The temperature increase during orthodontic bonding was increased with long exposure time. A shorter light-tip tooth surface distance leads to greater increases in temperature.

Debonding forces of three different customized bases of a lingual bracket system

Objective

The purpose of this study was to investigate whether extension of the custom base is necessary for enhancement of bond strength, by comparing the debonding forces and residual adhesives of 3 different lingual bracket systems.

Methods

A total of 42 extracted upper premolars were randomly divided into 3 groups of 14 each for bonding with brackets having (1) a conventional limited resin custom base; (2) an extended gold alloy custom base: Incognito™; and (3) an extended resin custom base: KommonBase™. The bonding area was measured by scanning the bracket bases with a 3-dimensional digital scanner. The debonding force was measured with an Instron universal testing machine, which applied an occlusogingival shear force.

Results

The mean debonding forces were 60.83 N (standard deviation [SD] 10.12), 69.29 N (SD 9.59), and 104.35 N (SD17.84) for the limited resin custom base, extended gold alloy custom base, and extended resin custom base, respectively. The debonding force observed with the extended resin custom base was significantly different from that observed with the other bases. In addition, the adhesive remnant index was significantly higher with the extended gold alloy custom base.

Conclusions

All 3 custom-base lingual brackets can withstand occlusal and orthodontic forces. We conclude that effective bonding of lingual brackets can be obtained without extension of the custom base.

Does a reduction of polymerization time and bonding steps affect the bond strength of brackets?

High bond strengths are required in order to avoid bracket failure during treatment while brackets should be removable. In addition, chair time should be kept at a minimum. Therefore, the aim of this study was to investigate any differences in bracket's bond strength to enamel by reducing the polymerization time and the steps of bonding procedure. Five hundred teeth were randomly allocated into 20 groups. The groups were established considering the investigated curing units (quartz-tungsten-halogen (QTH) and light-emitting diode (LED), each with two different polymerization times) and the used bonding agents (Clearfil SE Bond, Transbond Plus, Ideal1, iBond, and Transbond XT Primer following acid etching). The brackets were debonded using a shear-peel load and used to calculate the bond strength. The location of adhesive failure was registered by using the modified adhesive remnant index (ARI). The influence of the parameters curing unit, curing time, and bonding agent as well as their interaction products on bond strength showed that the bonding agent influenced the bond strength most followed by curing time. The parameter curing unit as well as all the generated interaction products of it showed a lower impact. Regarding the ARI, the bonding agent exhibited also the highest influence. Using a LED resulted in comparable bond strengths as the QTH curing device also at shorter exposure times. Additionally, the two-component self-etching primers showed similar bond strengths compared to the acid-etching method. Chair time can be reduced by using two-component self-etching primers and LED without decrease of bond strength.

In vitro orthodontic bracket bonding to porcelain

This in vitro study investigated the influence of using different combinations of bracket, adhesive, and light-curing source on the tensile bond strength to porcelain and on failure patterns at debonding. Tensile tests were performed using: one ceramic bracket versus one metal bracket, two orthodontic composites; type bisphenol A-glycidyldimethacrylate and urethane dimethacrylate (UDMA), and four light-curing units with the same range of emission spectrum but various light intensities: three light-emitting diode (LED) units and one halogen-based unit. One hundred and sixty porcelain samples were randomly divided into 16 equal groups. The porcelain surface was conditioned with 9 per cent hydrofluoric acid before silane application. The composite was photo-polymerized for 40 seconds. After storage in water at 37°C for 24 hours, the samples were subjected to tensile force until bond failure. Bond strength and bond failure mode were recorded; results were analysed (α = 0.05) using R language; linear model with constant variance for the bond strength and multinomial distribution for the failure mode. The bond strength in all groups was sufficient to withstand orthodontic treatment (>6 MPa). There was no statistical difference between the adhesives, but comparing bracket × light interaction, it was significantly higher with the ceramic bracket. No significant differences were seen between the metal bracket groups, but for the ceramic bracket, the results were significantly higher with the LED light. No fracture was observed in porcelain with the metal bracket but it occurred in 35 per cent of the ceramic bracket samples and the risk was higher when using UDMA composite and lower with LED high intensity light.

Effect of short curing times with a high-intensity light-emitting diode or high-power halogen on shear bond strength of metal brackets before and after thermocycling

OBJECTIVE

To test the hypothesis that short curing times using a high-intensity light-emitting diode (LED) or high-power halogen are not associated with compromised shear bond strength (SBS) of metal brackets before and after thermocycling.

MATERIALS AND METHODS

Two hundred forty extracted human premolar teeth were divided into six groups of 40 each. Metal brackets were bonded using a light-cured composite (Transbond XT). In group 1 a conventional halogen light (Hilux) was used for 40 seconds. In groups 2, 3, and 4 a high-power halogen light (Swiss Master) was used for 2, 3, and 6 seconds, respectively. In groups 5 and 6 a high-intensity LED (Bluephase) was used for 10 and 20 seconds, respectively. After bonding, half of the specimens in each group were thermocycled, and all specimens were tested for SBS. After debonding, the bracket bases and the enamel surfaces were scored according to the Adhesive Remnant Index.

RESULTS

Two-way analysis of variance detected significant differences in SBS values with respect to curing method (type of light-curing unit and curing time) (P  =  .0001) and thermocycling (P  =  .01). Tukey post hoc analysis showed that with or without thermocycling the mean SBS values of groups 1, 4, 5, and 6 were not significantly different, whereas group 2 showed the lowest SBS values. The predominant failure site for groups 2 and 3 was between the bracket and the adhesive and for groups 4, 5, 6 it was at the tooth/adhesive interface.

CONCLUSION

Curing time can be reduced to 6 seconds with high-power halogen light and to 10 seconds with high-intensity LED without compromising in vitro SBS of metal brackets.

Effects of thermocycling and light source on the bond strength of metallic brackets to bovine teeth

This study evaluated the effects of thermocycling and different light sources on the bond strength of metallic brackets to bovine tooth enamel using an adhesive resin. Bovine teeth were etched with 35% phosphoric acid gel for 20 s. After application of primer, metallic brackets were bonded to the buccal surface using Transbond XT, forming 8 groups (n=20), depending on the light source used for photoactivation (AccuCure 3000 argon laser - 20 s, Apollo 95E plasma arc - 12 s, UltraLume 5 LED - 40 s and XL2500 halogen light - 40 s) and experimental conditions without (Groups 1 to 4) or with thermocycling (Groups 5 to 8). Shear bond testing was carried out after 24 h of distilled water storage (Groups 1 to 4) or storage and thermocycling in distilled water (groups 5 to 8; 1,500 cycles - 5o/55oC). Data were subjected to two-way ANOVA and Tukey’s test (α=0.05). The Adhesive Remnant Index (ARI) was evaluated at ×8 magnification. No significant differences (p>0.05) in bond strength were found when the conditions without and with thermocycling were compared for any of the light sources. No significant differences (p>0.05) in bond strength were found among the light sources, irrespective of performing or not thermocycling. There was a predominance of ARI scores 1 in all groups. In conclusion, light sources and thermocycling had no influence on the bond strength of brackets to bovine enamel.

Influence of prolonged light-curing time on the shear bonding strength of resin to bleached enamel

This study evaluated the effect of prolonged light-curing time using a light-emitting diode unit (LED) on the shear bond strength of a resin composite to enamel immediately after bleaching. The enamel surfaces of human molars were divided into four groups: one control and three bleaching groups. One bleaching group (CP) was exposed to a 10% carbamide peroxide bleaching agent and bonded after 24 hours. The other two bleaching groups (HP) were bleached with a 38% hydrogen peroxide bleaching agent, then bonded either within one hour (HPA) or after 24 hours (HPB). All groups were subdivided into two subgroups and cured for two different times (20 or 40 seconds) with an LED unit. Shear bond strength (SBS) was tested with a universal-testing machine and the data were analyzed by ANOVA and post-hoc tests. Scanning electron micrographs of representative specimens were taken. A significant difference was seen between the control and HPA groups for both curing times (p = 0.000). However, neither the CP nor HPB groups showed any significant differences compared with the control groups (p > 0.05). Two-way ANOVA showed that a significant effect of the curing time factor was recorded for all groups (p = 0.000). Prolonged curing time, using an LED unit with a light intensity of 500 mW/cm2, increased resin-enamel bonding strengths for the control and bleached groups when bonding was performed after 24 hours of immersion in deionized water. However, the SBS was still compromised when bonding was performed immediately to enamel bleached with 38% HP.

The effects of primer precuring on the shear bond strength between gold alloy surfaces and metal brackets

The objective of this study was to investigate the effects of precuring of primer coated on bracket bases on the strength of bonds between metal brackets and gold alloy. Square type III gold alloy plates were sandblasted with 30 μm silicon dioxide. After silica coating, excessive particles were removed gently with air. Silane was then applied, and maxillary central incisor metal brackets were bonded to each conditioned alloy surface with Transbond XT. Half of the specimens were precured at the bracket base after primer coating and the other half was not precured before bonding to the alloy surface. After bracket positioning, samples were cured using a light emitting diode (LED) for 40 seconds. Shear bond strengths were tested and adhesive remnant index (ARI) was evaluated after 1 hour and 24 hours. The primer precuring and 24 hours group exhibited highest bond strength (12.53 MPa) and the no precuring and 1 hour group showed lowest bond strength (5.58 MPa). Precured groups showed lower ARI scores. Due to the shallow curing depth of LED light and inhibition of transillumination at the metal surface, primer precuring at the bracket base is required for secure bracket bonding on gold alloy surfaces using LED curing units.

Efficiency of light-emitting diode and halogen units in reducing residual monomers

INTRODUCTION

In this in-vitro study, we aimed to compare the residual monomers in composites beneath brackets bonded to enamel, using a light-emitting diode (LED) or a halogen unit, and to compare the residual monomers in the central to the peripheral areas of the composite.

METHODS

Twenty bovine teeth preserved in 0.1% thymol were used in this study. Ten teeth were used to standardize the thickness of the composite film, since different thicknesses would cause different absorbance of light. Brackets were bonded to 10 bovine incisors, with the halogen light (n = 5) and the LED (n = 5). The brackets were debonded, and the remaining composite on the enamel surface was sectioned in 2 regions: peripheral (0.8 mm) and central, resulting in 2 subgroups per group: central halogen (n = 5), peripheral halogen (n = 5), central LED (n = 5), and peripheral LED (n = 5). The spectrometric analysis in the infrared region was used to measure the free monomers with the attenuated total reflectance method.

RESULTS

Normal distribution was tested by using the Kolmogorov-Smirnov test. Data were compared by 2-way analysis of variance (ANOVA) at P <0.05. The LED group showed fewer residual monomers than did the halogen group (P = 0.014). No differences were found among the regions (P = 0.354), and there were no interactions between light type and region (P = 0.368).

CONCLUSIONS

LED leaves less residual monomer than does the halogen light, even with half of the irradiation time; there were no differences between the central and peripheral regions, and no interaction between light type and region.

Effect of light-curing units in shear bond strength of metallic brackets: an in vitro study

Objective

To determine the influence of the light curing units on the shear bond strength of orthodontic brackets.

Material and Methods

Seventy-two premolars were divided into six groups (n=12): Group I: brackets bonded with Transbond and polymerization with halogen light; Group II: Transbond and LED; Group III: Fuji Ortho and halogen light; Group IV: Fuji Ortho and LED; Group V: Fuji Ortho, without acid and halogen light; Group VI: Fuji Ortho, without acid and LED. The groups were tested to shear strength in a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed statistically by ANOVA and Tukey’s test.

Results

The composite resin presented higher shear bond strength than the resin-modified glass ionomer cement (p<0.05). The halogen light and LED sources produced similar shear bond strength (p>0.05).

Conclusion

The shear bond strength was influenced by the material but not by the light-curing unit. The use of LED reduced the experimental time by approximately 60%, with the same curing efficiency.

Enhanced Degree of Monomer Conversion of Orthodontic Adhesives Using a Glass-Fiber Layer under the Bracket

Objective: To test the hypothesis that there is no difference in the degree of conversion (DC%) of orthodontic composites during the light-curing process with or without the use of a glass-fiber reinforcement.

Materials and Methods: Two light-curing orthodontic adhesives, Transbond XT (TB) and Beauty Ortho Bond (BO), were used with woven preimpregnated glass fibers. The degree of monomer conversion was determined for both adhesives in three settings (n = 5 per group): in the first group, the adhesive was cured without a bracket (control); in the second group, the bracket was bonded using adhesive without fiber reinforcement; and in the third group, a layer of glass-fiber net was added between the bracket and resin. The adhesive resin was light cured, and the DC% was determined by Fourier transform infrared spectroscopy.

Results: A two-way analysis of variance revealed significant differences in the DC% (P &lt; .001) between adhesives and between the fiber-reinforced and nonreinforced groups. When the nonreinforced adhesives were light cured under the brackets, the DC% was significantly lower (TB: 37.0%, SD 3.4; BO: 36.9%, SD 1.9) compared with the control (TB: 54.7%, SD 0.6; BO: 65.9%, SD 0.5). A higher DC% was found when the resin was light cured in the presence of a glass-fiber net (TB: 44.1%, SD 0.3; BO: 55.3%, SD 1.7).

Conclusion: The hypothesis is rejected. The degree of monomer conversion of the light-curing adhesive resin under stainless steel bracket can be improved by adding a thin layer of glass-fiber–reinforced composite between the bracket and adhesive resin.

LED vs Halogen Light-Curing of Adhesive-Precoated Brackets

Objective: To test the hypothesis that bonding with a blue light-emitting diode (LED) curing unit produces no more failures in adhesive-precoated (APC) orthodontic brackets than bonding carried out by a conventional halogen lamp.

Materials and Methods: Sixty-five patients were selected for this randomized clinical trial, in which a total of 1152 stainless steel APC brackets were employed. In order to carry out a valid comparison of the bracket failure rate following use of each type of curing unit, each patient's mouth was divided into four quadrants. In 34 of the randomly selected patients, designated group A, the APC brackets of the right maxillary and left mandibular quadrants were bonded using a halogen light, while the remaining quadrants were treated with an LED curing unit. In the other 31 patients, designated group B, halogen light was used to cure the left maxillary and right mandibular quadrants, whereas the APC brackets in the remaining quadrants were bonded using an LED dental curing light. The bonding date, the type of light used for curing, and the date of any bracket failures over a mean period of 8.9 months were recorded for each bracket and, subsequently, the chi-square test, the Yates-corrected chi-square test, the Fisher exact test, Kaplan-Meier survival estimates, and the log-rank test were employed in statistical analyses of the results.

Results: No statistically significant difference in bond failure rate was found between APC brackets bonded with the halogen light-curing unit and those cured with LED light. However, significantly fewer bonding failures were noted in the maxillary arch (1.67%) than in the mandibular arch (4.35%) after each light-curing technique.

Conclusions: The hypothesis cannot be rejected since use of an LED curing unit produces similar APC bracket failure rates to use of conventional halogen light, with the advantage of a far shorter curing time (10 seconds).

Clinical Evaluation of Bracket Bonding Using Two Different Polymerization Sources

Objective: To comparatively assess clinical failure rate of brackets cured with two different photopolymerization sources after nine months of orthodontic treatment.

Materials and Methods: The sample of this study comprised 30 patients who received comprehensive orthodontic treatment by means of fixed appliances. Using the same adhesive, 600 stainless steel brackets were directly bonded and light cured for 10 seconds with the light-emitting diode (LED) lamp or for 20 seconds with the conventional halogen lamp. A split-mouth design randomly alternated from patient to patient was applied. Failure rates were recorded for nine months and analyzed with Pearson χ2 test, and log-rank test at α = .05 level of significance.

Results: The overall failure rate recorded with the halogen unit (3.33%) was not significantly different from the failure rate for the LED lamp (5.00%). Significantly more failures were found in boys compared with girls, in the mandibular dental arch compared with the maxillary arch, and in posterior segments compared with anterior segments. However, no significant difference was found between the right and left segments.

Conclusion: Both light-curing units showed sufficiently low bond failure rates. LED curing units are an advantageous alternative to conventional halogen sources in orthodontics because they enable a reduced chair-time bonding procedure without significantly affecting bond failure rate.

Shear bond strength of metallic brackets photo-activated with light-emitting diode (LED) at different exposure times

The purpose of this study was to compare the shear bond strength of orthodontic metallic brackets photo-activated with two different light-curing sources at different exposure times: halogen light (XL 1500, 3M ESPE) and LED light (Ortholux, 3M Unitek). Sixty bovine permanent lower incisors were inserted into PVC tubes containing plaster. The buccal surfaces were cleaned with pumice and water, and then etched with 37% phosphoric acid gel. The XT Primer bonding agent (3M Unitek) was applied to the enamel surfaces and the metallic pre-coated brackets (Transbond APC II system, 3M Unitek) were attached to upper central incisors. The teeth were randomly divided into four groups (n=15). In Group I (Control), halogen light was used for 40 seconds, while in Groups II, III, and IV were light-cured with LED light unit for 40, 10, and 5 seconds, respectively. The teeth were stored in distilled water at 37°C for 24 hours. The brackets were submitted to shear bond strength test in universal testing machine (Instron) at a crosshead speed of 0.5 mm/minute. Shear bond strength means (MPa) were 4.87 for Group I; 5.89 for Group II; 4.83 for Group III, and 4.39 for Group IV. Tukey's test detected no statistically significant differences among the groups regarding the shear bond strength (p>0.05). Neither of the types of light-curing sources or exposure times influenced the shear bond strength of metallic brackets.

Long-term Failure Rate of Brackets Bonded with Plasma and High-intensity Light-emitting Diode Curing Lights

Objective: To comparatively assess the long-term failure rate of brackets bonded with a plasma or a high-intensity light-emitting diode (LED) curing light.

Materials and Methods: Twenty-five patients with complete permanent dentitions with similar treatment planning and mechanotherapy were selected for the study. Brackets were bonded according to a split-mouth design with the 3M Ortholite Plasma or the high-power Satelec mini LED Ortho curing light. Irradiation with the two curing lights was performed for 9 seconds at an alternate quadrant sequence so that the bonded brackets cured with either light were equally distributed on the maxillary and mandibular right and left quadrants. First-time bracket failures were recorded for a mean period of 15 months (range 13–18 months) and the results were analyzed with the chi-square test and binary logistic regression.

Results: The failure rate for brackets was 2.8% for the plasma light and 6.7% for the LED light source. Although significantly more failures were found for the mandibular arch, no difference was identified in failure rate between anterior and posterior teeth.

Conclusions: High-intensity LED curing lights present a 2.5 times higher failure rate relative to plasma lamps for nominally identical irradiation time. Mandibular teeth show almost 150% higher failure incidence compared with maxillary teeth. No effect from the arch side (right vs left) and location (anterior vs posterior) was identified in this study.

The effect of a light-emitting diode on shear bond strength of ceramic brackets bonded to feldspathic porcelain with different curing times

The aim of this study was to evaluate different curing times of a light-emitting diode (LED) unit on shear bond strength (SBS) of ceramic brackets bonded to feldspathic porcelain. Ceramic brackets were bonded with a light-cured adhesive to 96 feldspathic porcelain facets. Air-borne particle abrasion was performed using 25 mum aluminium trioxide (Al(2)O(3)) with an air abrasion device from a distance of approximately 10 mm at a pressure of 2.5 bars for 4 seconds, then the porcelain surfaces were etched with 9.6 per cent hydrofluoric acid for 2 minutes. After surface preparation of the porcelain specimens, silane was applied. In groups 1 and 2, the adhesive was cured with a quartz-tungsten-halogen (QTH) unit for 10 and 20 seconds, respectively. The LED was used in the standard mode for 3, 5, and 10 seconds for groups 3, 4, and 5, respectively. For the other three groups, the LED was used in the fast mode for 3, 5, and 10 seconds, respectively. The SBS of the brackets was measured on a universal testing machine. The adhesive remnant index (ARI) scores, damage to the porcelain, and fracture of the ceramic bracket bases were determined. No significant differences were observed for SBS between the eight groups (P=0.087). There was no significant difference between the groups' ARI scores, porcelain damage, and bracket base fracture (P=0.340, P=0.985, and P=0.340, respectively). There was a greater frequency of ARI scores of 0 for all groups. Fifty per cent of the porcelain facets displayed damage. Nineteen ceramic bracket base fractures were observed. No significant difference was found for the SBS of the groups with QTH and LED units and curing times. It is reliable to use LED with a 3-second curing time since it provided adequate bond strength for ceramic brackets bonded to porcelain surfaces.

Orthodontic materials research and applications: Part 1. Current status and projected future developments in bonding and adhesives

The purpose of this opinion article, to be presented in 2 parts, is to project immediate future developments expected in orthodontic materials research and applications. Analysis of the material is structured around 2axes: presentation of evidence summarizing the current status in various fields, and formulation of a hypothesis for short-term future developments. This first part of the article deals with advances and developments in bonding to enamel. Projected adhesive developments include greater use of high-energy lamps for polymerization in light-cured systems, universal application of molar tube bonding, widespread use of self-etching primers, broader acceptance of glass ionomers in their conventional and modified modes, and elimination of 2-phase adhesives in favor of no-mix and light-cured adhesives. Long-term future adhesive applications might also include biomimetic approaches, adopting mechanisms used by living organisms to adhere to surfaces.

Effective single-charge end point of cordless light-emitting diode light-curing units

INTRODUCTION

The purpose of this study was to evaluate the battery lives of cordless light-emitting diodes (LEDs) and their effect on orthodontic bracket bond strength.

METHODS

One hundred eighty-six metal orthodontic brackets were bonded to extracted molars. Two LED light-curing units (L. E. Demetron [SDS/Kerr, Orange, Calif] and Ortholux [3M Unitek, Monrovia, Calif]) were evaluated. Each light was used to bond 93 specimens. One bracket was bonded every 5 minutes until the battery ran out. The lights were activated for 20 seconds, then automatically turned off for 40 seconds every minute (33% duty cycle) without recharging. Bonded specimens were stored in water at 37 degrees C for 24 hours and then subjected to shear force with a universal testing machine until bracket failure.

RESULTS

Repeated measures ANOVA detected significantly weaker mean shear bond strength and fewer consecutive cures with the Ortholux compared with the L. E. Demetron light-curing unit. However, when the first 5 time points were excluded, there were no differences between the 2 lights, demonstrating that the lights performed similarly after the first 20 minutes of operation Just before battery failure, both lights still provided the same power density as at the beginning.

CONCLUSIONS

Both light-curing units provided adequate power density for up to 2 hours without recharging at a 33% duty cycle. There was no significant decrease in power in cordless LED light-curing units as the battery life approached its end point.

Effect of light-tip distance on the shear bond strengths of resin-modified glass ionomer cured with high-intensity halogen, light-emitting diode, and plasma arc lights

INTRODUCTION

The purpose of this study was to assess the effect of light-tip distance on the shear bond strength and the failure site of brackets cured with 3 light-curing units (high-intensity halogen, light-emitting diode, and plasma arc).

METHODS

One hundred thirty-five bovine mandibular permanent incisors were randomly allocated to 9 groups of 15 specimens each. Stainless steel brackets (Victory Series, Unitek/3M, Monrovia, Calif) were bonded with a resin-modified glass-ionomer (Fuji Ortho LC, GC Europe, Leuven, Belgium) to the teeth, and each curing light was tested at 3 distances from the bracket: 0, 3, and 6 mm. After bonding, all samples were stored in distilled water at room temperature for 24 hours and subsequently tested for shear bond strength.

RESULTS

When the 3 light-curing units were compared at a light-tip distance of 0mm, they showed no significantly different shear bond strengths. At a light-tip distance of 3 mm, no significant differences were found between the halogen and plasma arc lights, but both lights showed significantly higher shear bond strengths than the light-emitting diode light. At a light-tip distance of 6 mm, no significant differences were found between the halogen and light-emitting diode lights, but both showed significantly lower bond strengths than the plasma arc light. When the effect of the light-tip distance on each light-curing unit was evaluated, the halogen and light-emitting diode lights showed no significant differences among the 3 distances. However, the plasma arc light produced significantly higher shear bond strengths at a greater light-tip distance. No significant differences were found among the adhesive remnant index scores of the various groups, except with the LED light at a distance of 3 mm.

CONCLUSIONS

In hard-to-reach areas, the plasma arc curing light is suggested for optimal curing efficiency.

Effect of shorter polymerization times when using the latest generation of light-emitting diodes

INTRODUCTION

Recent studies have suggested that a 10-second cure time with a high-energy quartz-tungsten-halogen (QTH) or a light-emitting diode (LED) light might be adequate when bonding orthodontic brackets to tooth enamel. The purpose of this study was to evaluate the ability of the latest generation of QTH and LED light-curing units (LCUs) to bond orthodontic brackets to teeth at decreased polymerization times.

METHODS

Two LED LCUs (Ortholux LED, 3M Unitek, Monrovia, Calif; UltraLume LED 5, Ultradent Products, South Jordan, Utah) and a QTH LCU (Optilux 501, Demetron, Danbury, Conn) were evaluated. One hundred eighty metal orthodontic brackets were bonded to extracted human molars. The specimens were divided into 9 groups (3 lights and 3 curing times) of 20 teeth each. Each group was cured with 1 of the 3 lights for 20, 10, or 6 seconds. Thirty minutes after polymerization, the specimens were subjected to shear force on a universal testing machine until bracket failure.

RESULTS

Two-way ANOVA detected significant differences among the main effects of light type and cure time. Tukey post-hoc tests determined that brackets bonded by all light types had lower bond strengths with the 6-second cure than the 20-second cure (P < .001). The highest bond strengths were obtained with the Optilux 501 QTH LCU and the UltraLume LED 5 LCU at the longest cure time of 20 seconds.

CONCLUSIONS

It is recommended that orthodontic brackets be photopolymerized for at least 20 seconds with the QTH or the LED LCU before the archwires are engaged.

Light-curing time reduction with a new high-power halogen lamp

INTRODUCTION

Orthodontic brackets are routinely bonded with light-cured adhesives. Conventional halogen lights used in bonding have the disadvantage of a long curing time, and the available alternatives (laser and plasma lights) are expensive. Our aim was to investigate the minimum time necessary to bond brackets with a new, relatively low-priced, high-power halogen light.

METHODS

Five groups of 15 deciduous bovine incisors were bonded with stainless steel brackets (Mini Diamond Twin, Ormco, Orange, Calif) by using different lamps and curing times. Three of the groups were bonded by using a high-power halogen light (Swiss Master Light, Electro Medical Systems, Nyon, Switzerland) for 2, 3, and 6 seconds, respectively. The fourth group, bonded with a fast halogen light (Optilux 501, Sybron Dental Specialties, Danbury, Conn) for 40 seconds, served as the positive control group. The fifth group, the comparison group, was bonded with a plasma light (Remecure, Remedent, Deurle, Belgium) for 4 seconds. After storage for 24 hours in the dark at 37 degrees C in water, shear bond strength was measured with a universal testing machine.

RESULTS

A curing time of 2 seconds with the high-power halogen light negatively affected the bond strength and the probability of bond survival. The adhesive remnant index scores were not significantly different among the groups. Most failures (> 60%) occurred at the bracket base/adhesive interface.

CONCLUSIONS

The high-power halogen light seems to be a cost-effective solution to reducing curing time. The recommended curing times to bond stainless steel brackets are 6 seconds and, with caution, even 3 seconds.