Bond strength and debonding characteristics of a new ceramic bracket

Assessing the physico-mechanical, anti-bacterial, and anti-demineralization properties of orthodontic resin composite containing different concentrations of photoactivated zinc oxide nanoparticles on Streptococcus mutans biofilm around ceramic and metal orthodontic brackets: An ex vivo study

BACKGROUND AND PURPOSE

The aim of this study was to evaluate the physico-mechanical, anti-bacterial, and anti-demineralization properties of orthodontic resin composite containing photoactivated zinc oxide nanoparticles (ZnONPs) on Streptococcus mutans biofilm around ceramic and metal brackets.

MATERIAL AND METHODS

Following the minimum inhibitory concentration (MIC) determination for ZnONPs, shear bond strength (SBS) was tested for composites containing different concentrations of ZnONPs. The chosen concentration was used to evaluate the microleakage, anti-bacterial, and anti-demineralization properties.

RESULTS

Adding 50μg/mL of ZnONPs to the orthodontic composite did not negatively affect its physico-mechanical properties. ZnONPs (50μg/mL)-mediated aPDT and 0.2% chlorhexidine significantly (P=0.000) reduced S. mutans biofilms compared to the phosphate-buffered saline (PBS) groups (metal/PBS=7.47±0.7×106, and ceramic/PBS=7.47±0.7×106), with the lowest colony count observed in these groups (metal/chlorhexidine=1.06±0.4×105, ceramic/chlorhexidine=1±0.2×105, metal/ZnONPs-mediated aPDT=1.33±0.3×105, and ceramic/ZnONPs-mediated aPDT=1.2±0.3×105). Sodium fluoride varnish and ZnONPs-mediated aPDT showed the highest efficacy in anti-demineralization and significantly improving the enamel surface microhardness compared to the artificial saliva, especially in ceramic bracket groups (524.17±42.78N and 441.00±29.48N, 394.17±46.83N, P=0.000, and P=0.003, respectively).

CONCLUSION

ZnONPs (50μg/mL)-mediated aPDT effectively inhibited S. mutans biofilm and promoted anti-demineralization without adverse effects on the physico-mechanical properties of the composite resin. These results suggest the potential of this method in preventing white spot lesions during orthodontic treatment.

Effect of bacterial resistant zwitterionic derivative incorporation on the physical properties of resin-modified glass ionomer luting cement

Biofilms induce microbial-mediated surface roughening and deterioration of cement. In this study, zwitterionic derivatives (ZD) of sulfobetaine methacrylate (SBMA) and 2-methacryloyloxyethyl phosphorylcholine, were added in concentrations of 0, 1, and 3% to three different types of commercially available resin-modified glass ionomer cement (RMGIC) (RMC-I: RelyX Luting 2, RMC-II: Nexus RMGI, and RMC-III: GC FujiCEM 2). The unmodified RMGICs served as the control group for comparison. The resistance of Streptococcus mutans to ZD-modified RMGIC was evaluated with a monoculture biofilm assay. The following physical properties of the ZD-modified RMGIC were assessed: wettability, film thickness, flexural strength, elastic modulus, shear bond strength, and failure mode. The ZD-modified RMGIC significantly inhibited biofilm formation, with at least a 30% reduction compared to the control group. The addition of ZD improved the wettability of RMGIC; however, only 3% of the SBMA group was statistically different (P < 0.05). The film thickness increased in proportion to the increasing ZD concentrations; there was no statistical difference within the RMC-I (P > 0.05). The experimental groups' flexural strength, elastic modulus, and shear bond strength showed an insignificant decrease from the control group; there was no statistical difference within the RMC-I (P > 0.05). The mode of failure differed slightly in each group, but all groups showed dominance in the adhesive and mixed failure. Thus, the addition of 1 wt.% ZD in RMGIC favorably enhanced the resistance to Streptococcus mutans without any tangible loss in flexural and shear bond strength.

Assessment of chemical, ultrasonic, diode laser, and Er:YAG laser application on debonding of ceramic brackets

Background

Risk of enamel damage that often accompanies ceramic brackets debonding raises the demand of finding an optimal method for debonding of them without adverse effects. Different techniques were proposed in an attempt to facilitate their debonding. Comparison of these techniques is crucial. The aim of this study was to evaluate and compare different techniques for debonding of ceramic brackets in terms of shear bond strength and adhesive remnant index.

Materials and methods

A total of 100 extracted premolars were randomly allocated into 5 groups. Ceramic brackets were then bonded to teeth using light cure composite resin. Among test groups; group I: served as control, group II: chemical aided debonding via peppermint oil, group III: ultrasonic aided debonding, group IV: diode laser aided debonding, and group V: Er:YAG laser aided debonding. Brackets were shear tested using universal testing machine followed by ARI assessment and evaluation of enamel microstructure was performed using scanning electron microscopy.

Results

A significantly lower shear bond strength was found in ultrasonic, diode, and Er:YAG laser groups. However, no significant difference was found in the chemical group. A significantly higher adhesive remnant index was found solely in Er:YAG laser group with minimal enamel microstructure alterations.

Conclusions

Er:YAG laser is a promising tool in debonding ceramic brackets. Ultrasonic and diode laser significantly reduced shear bond strength. Yet, adhesive remnant index in both groups revealed no difference. Chemical aided debonding had little effect and hence, it cannot be recommended without further development.

The Effect of Brilliant Blue-Based Plaque-Staining Agents on Aesthetic Orthodontic Appliances

Orthodontic appliances discolour over treatment time, and a yellowish plaque builds up on the contact area of the brackets, adhesive and teeth. Brilliant Blue-based plaque-staining agents (BBPSAs), which increase tooth brushing efficiency, have the potential to support the maintenance of proper oral hygiene during orthodontic treatment. However, they exhibit strong colouring properties, and their impact on the aesthetics of braces remains unclear. Therefore, the aim of this study was to investigate the influence of commercially available BBPSAs on the colour of aesthetic orthodontic materials. A light-cured, colour-changing orthodontic adhesive and new-generation, monocrystalline, sapphire brackets were chosen for the experiments. The effect of the staining agent on the tested materials was investigated in terms of the reaction temperature and time, as well as the presence of black tea-induced impurities on the materials. The CIELAB (Commission Internationale de L'éclairage L* a* b*) colour system parameters were measured, and the colour differences (ΔE*ab and ΔE00-the Commission Internationale de L'éclairage 2000 colour-difference) were determined for the materials under several experimental conditions. The braces' green-red colour expression was positively affected by the BBPSA. Under in vitro conditions, the regular use of the BBPSA for 90 days visibly improved the unfavourable colour change caused by the black tea.

CO2 laser irradiation for debonding ceramic orthodontic brackets

This study evaluated shear bond strength (SBS), adhesive remnant index (ARI) and fracture mode of chemically and mechanically retained ceramic brackets bonded with different composite resins and irradiated with CO2 laser. The null hypothesis was that ceramic brackets bonded with different composite resins and irradiated with CO2 laser would have similar SBS values. Ninety human premolars were divided into four experimental groups according to the combination of type of composite resin (Transbond XT and Z 250) and type of ceramic bracket (Fascination and Mystique), and two control groups (n=15). In the four experimental groups, the brackets were irradiated with CO2 laser at 10 W for 3 seconds before SBS testing. Enamel surface ARI was calculated after debonding under electron microscopy scanning. ANOVA and the Mann-Whitney test were used for statistical analysis. The laser groups had lower SBS values than the non-irradiated groups (control) (p<0.05). The mechanically retained brackets (Mystique) had the higher (p<0.05) and Z250 had the lower SBS values after CO2 laser irradiation. The groups bonded with Z250 had the highest ARI. Adhesive fractures were the most prevalent. The null hypothesis was rejected. CO2 laser decreased SBS efficiently and facilitated debonding of mechanically and chemically retained ceramic brackets.

Do dental bleaching sessions prior to orthodontic treatment change the bond strength of esthetic brackets?

OBJECTIVE

The aim of this experimental in vitro study was to evaluate whether dental bleaching performed before orthodontic treatment change the shear bond strength (SBS) of monocrystalline and polycrystalline esthetic brackets.

METHODS

Sixty (60) bovine incisors teeth were used and randomly divided into the following six groups (n=10): SCP (without bleaching/polycrystalline brackets); SCM (without bleaching/monocrystalline brackets); 1CP (one bleaching session/polycrystalline brackets); 1CM (one bleaching session/monocrystalline brackets); 3CP (three bleaching sessions/polycrystalline brackets); and 3CM (three bleaching sessions/monocrystalline brackets). The brackets were bonded seven days after the bleaching sessions. The samples were submitted to the SBS test in a universal testing machine (Instron model 4411) at 1 mm/min crosshead speed. The two-way analysis of variance (ANOVA) and the Tukey tests were performed at a 5% level of significance. After the mechanical test, samples were evaluated to determine the adhesive remnant index (ARI).

RESULTS

The SBS values were significantly higher for the monocrystalline brackets, when compared with the polycrystalline type (p< 0.0001), and significantly higher with three bleaching sessions than without bleaching (p< 0.0436). The ARI showed predominance of failures between the bracket and resin for all the groups (score 3).

CONCLUSION

Three dental bleaching sessions increased the SBS values. Monocrystalline brackets showed higher SBS values than the polycrystalline type.

Effect of the different debonding strength of metal and ceramic brackets on the degree of enamel microcrack healing

Objective:

This study aims to determine shear debonding strength of metal and ceramic brackets, and the degree of enamel crack healing.

Material and Methods:

Extracted human maxillary premolars were flattened on the buccal surface, and randomly separated into five groups (n = 15). In control groups (groups 1 and 2), metal and ceramic brackets were bonded on flat polished enamel, while in experimental groups (groups 3 and 4), metal and ceramic brackets were bonded on the surface with boundary where corner cracks were created. Additionally, fifteen specimens (group 5) were also prepared for an indentation procedure with no bracket installation. The degree of crack healing was measured. All brackets were detached with a universal testing machine, and the adhesive remnant index (ARI) was also identified. Healing degree and apparent fracture toughness were then calculated.

Results:

Between groups with similar bracket types, there was no statistically significant difference in debonding strength. Regarding bracket types, ceramic brackets provided significantly higher debonding strength than metal brackets. There was a significant difference in ARI scores between metal and ceramic brackets. The corner cracks showed signs of healing in both horizontal and vertical directions. No statistically significant difference in the healing rates among the groups was found and the apparent fracture toughness increased from the initial to the final measurement.

Conclusions:

Within the limitations of this study, even though ceramic brackets required significantly higher debonding force compared to metal brackets, debonding stress was limited to the bonding site and did not affect the surrounding cracks on enamel.

Mean Shearing Stroke Frequency of Orthodontic Brackets under Cycling Loading: An In Vitro Study

Based on the development of many adhesive systems and bonding techniques, bonding strength of orthodontic brackets has become even more important in modern clinical orthodontics. The aim of this study was to determine mean shearing stroke frequency of different orthodontic bracket types and bonding agents under cycling loading. Therefore, 10 different types of orthodontic bracket from 4 different brands were divided into 2 groups. Two different adhesives, namely Transbond™ XT etch-and-rinse for Group 1 and Transbond™ Plus self-etching-primer adhesive for Group 2 were considered. The brackets were tested under cycling loading force of 10-N and a crosshead speed of 300 mm/min and 40 cycle/min. The frequency of strokes that the brackets failed were determined and these data were analyzed by statistical analysis using an independent sample t-test and one-way analysis of variance (ANOVA). The level of significance was set at p < 0.05. Generally, differences between the frequency of shearing strokes of the bracket failures were found to be statistically significant depending on the type of adhesives and brackets (p < 0.05). The bonding technique for Group 1 was found to have a significantly higher shear bonding strength than Group 2. It is also seen that different types of bracket belonging to the same or different brands had different shear bonding strength. It may be concluded that: (i) all bracket types used in this study can be applied with both bonding techniques, (ii) in order to minimize the risk of hard tissue damage, ceramic brackets should be carefully bonded using the self-etching primary adhesive technique.

Effects of plastic bracket primer on the shear bond strengths of orthodontic brackets

Background/purpose

To assess the usefulness of plastic bracket primer (PBP) for improving the bond strength of plastic brackets (PBs) using three types of orthodontic brackets, including PBs, metal brackets (MBs), and ceramic brackets (CBs).

Materials and methods

A total of 162 premolars were gathered and divided equally into six groups of 27. Three groups were tested with the application of PBP (PB+, MB+, and CB+), and three groups were tested without primer (groups PB-, MB-, and CB-). All the groups were bonded using BeautiOrtho Bond II self-etching adhesive. The shear bond strength (SBS) was measured and the bond failure mode was evaluated using the adhesive remnant index after debonding.

Results

There were significant differences in the mean SBS between groups PB-, MB and CB-, between PB+ and CB+, and between MB+ and CB+. Group PB + had a significantly higher mean SBS than group PB-. The occurrence of bond failure at the enamel and adhesive interface was more frequent in groups PB+ and CB- than in group PB-; and in groups PB+ and CB + than in group MB+.

Conclusion

Plastic bracket primer can increase the bond strength of PBs to the level of metal brackets, but not to the level of ceramic brackets.

A Clinical Comparison of Failure Rates of Metallic and Ceramic Brackets: A Twelve-Month Study

Objective

Clinical comparison of the survival rates between stainless steel and ceramic brackets over a 12-month period.

Materials and Methods

The study involved 20 consecutive patients with diagnosed malocclusion that required two-arch fixed appliance treatment. The participants were randomly divided into two 10-member groups. Group 1 was treated with Abzil Agile (3M Unitek) stainless steel brackets; group 2 was treated with Radiance (American Orthodontics) monocrystalline ceramic brackets. All the brackets were bonded by the same operator. Over the next 12 months, all bracket failures were recorded with each appointment. The received data were processed statistically using the Mantel–Cox test, Kaplan–Meier method, and Cox hazard model.

Results

A total of 381 brackets were bonded, 195 of which were metallic brackets and 186 were ceramic ones. In the 12-month observation period, there were 14 metal (7.2%) and 2 ceramic bracket (1.1%) failures. The overall failure rate was 4.2% (n = 16). The majority of failures (14 brackets; 87.5%) occurred during the first 6 months of the experiment, 12 (83%) of which were metal brackets and 2 (100%) were ceramic brackets. The statistical analysis revealed significant differences between the groups (p < 0.05).

Conclusions

Metal brackets demonstrated significantly higher failure rates than ceramic brackets for both 6- and 12-month observation periods (p < 0.05). The 6% difference between the brackets is clinically significant as it corresponds to one additional failure within 12 months.

Priming and bonding metal, ceramic and polycarbonate brackets

Objective: To investigate if primers can be used to modify bonding characteristics of orthodontic brackets.

Materials and methods: Stainless steel, zirconia-alumina ceramic and polycarbonate brackets were bonded to enamel with and without universal and bracket material specific primers on the bracket base. Orthodontic adhesive cement (Transbond™XT) was used for bonding. The primers in each group (n = 10) were silane based (RelyX™ Ceramic Primer) and universal primer (Monobond Plus) for ceramic and metal brackets, and adhesive resin (Adper™ Scotchbond™ Multi-Purpose Adhesive) and composite primer (GC Composite Primer) for polycarbonate brackets. Controls with no primer were used for all bracket types. Teeth with bonded brackets were stored in distilled water in 37 °C for 7 days and debonded with static shear loading. Debonding forces were recorded and analyzed with ANOVA. Adhesive remnant index (ARI) was determined and enamel damage examined.

Results: The bond strength without primers was 8.14 MPa (±1.49) for metal, 21.9 MPa (±3.55) for ceramic and 10.47 MPa (±2.11) for polycarbonate brackets (p < .05). Using silane as primer increased the bond strength of ceramic brackets significantly to 26.45 MPa (±5.00) (p < .05). ARI-scores were mostly 2–3 (>50% of the adhesive left on the enamel after debonding), except with silane and ceramic brackets, ARI-score was mostly 0–1 (>50% of the adhesive left on the bracket). Debonding caused fractured enamel in four specimens with ceramic brackets.

Conclusions: Bond strength was highest for ceramic brackets. Silane primer increased bond strength when used with ceramic brackets leading to enamel fractures, but otherwise primers had only minor effect on the bond strength values.

Efeito da contaminação por saliva na resistência adesiva de braquetes cerâmicos utilizando uma resina ortodôntica hidrofílica

Resumo Introdução Alguns fatores, como a presença de saliva, são capazes de influenciar a adesão do braquete ao dente durante o procedimento de colagem e podem causar falha da resistência adesiva. Objetivo O objetivo deste estudo foi avaliar a resistência ao cisalhamento de braquetes cerâmicos ortodônticos colados com Transbond XT e Transbond Plus Color Change em esmalte de dentes bovinos, contaminado e não contaminado por saliva, além de analisar o local da falha adesiva. Material e método Sessenta incisivos bovinos foram divididos aleatoriamente em quatro grupos (n=15), de acordo com o material de colagem e a presença de contaminação: Grupo 1 (G1): colagem com Transbond XT na ausência de contaminação; Grupo 2 (G2): colagem com Self Etching Pimer e Transbond Color Change na ausência de contaminação; Grupo 3 (G3): colagem com Transbond XT na presença de contaminação, e Grupo 4 (G4): colagem com Self Etching Primer e Transbond Color Change na presença de contaminação. Resultado O teste não paramétrico de Kruskal-Wallis mostrou que G1 diferiu estatisticamente (p<0,05) de G2 e G3. Não houve diferença estatística significativa entre os demais grupos. O índice de adesivo remanescente (IAR) variou entre 2 e 3 no G1 e entre 0 e 1 nos outros grupos. Conclusão A contaminação por saliva diminui a resistência adesiva ao cisalhamento de braquetes cerâmicos colados com a resina hidrofóbica Transbond XT convencional. Por outro lado, a utilização da resina hidrofílica Transbond Plus Color Change associada ao Self Etching Primer, em ambiente contaminado por saliva, confere resistência adesiva adequada para o seu uso clínico.

Shear bond strength of two 2-step etch-and-rinse adhesives when bonding ceramic brackets to bovine enamel

AIM

The present study assessed a fracture analysis and compared the shear bond strength (SBS) of two 2-step etch-and-rinse (E&R) adhesives when bonding ceramic orthodontic brackets to bovine enamel.

MATERIALS AND METHODS

Thirty healthy bovine mandibular incisors were selected and were equally and randomly assigned to 2 experimental groups. Ceramic brackets (FLI Signature Clear^®, RMO) were bonded onto bovine enamel using an adhesive system. In group 1 (n=15), the conventional E&R adhesive (OrthoSolo^®+Enlight^®, Ormco) was used, and in group 2 (n=15), the new E&R adhesive limited to ceramic bracket bonding (FLI ceramic adhesive^®: FLI sealant resin^®+FLI adhesive paste^®, RMO) was used. In order to obtain appropriate enamel surfaces, the vestibular surfaces of mandibular bovine incisors were flat ground. After bonding, all the samples were stored in distilled water at room temperature for 21 days and subsequently tested for SBS, using the Instron^® universal testing machine. The Adhesive Remnant Index (ARI) scores were evaluated. Failure modes were assessed using optical microscopy at magnification ×40. A statistic data analysis was performed using the Mann-Whitney U-test (P<0.05).

RESULTS

The test showed a significant difference (P=0.00155) between the two groups for the SBS values. Group 1 had significantly higher SBS values (9.79 to 20.83MPa) than group 2 (8.45 to 13.94MPa). Analysis of the ARI scores revealed that most of the failures occurred at the enamel/adhesive interface. A statistically significant difference was found for the ARI scores between the two groups (P=0.00996). Only two fractured brackets, which remained bonded onto the bovine enamel, were reported. Both occurred in group 1.

CONCLUSION

When bonded to ceramic brackets, FLI ceramic adhesive^® (RMO) was demonstrated to be very predictable and safe for clinical application in enamel bonding, whereas the results obtained with the conventional adhesive system (OrthoSolo^®+Enlight^®, Ormco) were less reproducible and revealed slightly excessive shear bond strength values.

Shear bond strength of ceramic and metallic orthodontic brackets bonded with self-etching primer and conventional bonding adhesives

Introduction

Adult patients typically require high-quality orthodontic treatment for ceramic brackets, but some clinicians remain concerned about the bond strength of these brackets. Therefore, the aim of this study was to determine the shear bond strength and de-bonding characteristics of metallic and ceramic brackets bonded with two types of bonding agents.

Methods

In an experimental study done in 2013 in Babol, Iran, 120 extracted human maxillary premolar teeth were randomly divided into four groups as follows: HM group: metallic bracket/conventional bonding agent; SM group: metallic bracket/Transbond self-etching primer; HC group: ceramic bracket/conventional bonding agent; SC group: ceramic bracket/Transbond self-etching primer. Twenty-four hours after thermocycling (1000 cycle, 5 °C–55 °C), the shear bond strength values were measured. The amount of resin remaining on the tooth surface (adhesive remnant index: ARI) was determined under a stereomicroscope. Enamel detachment index was evaluated under a scanning electron microscope. To perform statistical analysis, ANOVA, Kruskal–Wallis, and Tukey post-hoc tests were applied. The level of significance was set at p <0.05.

Results

The mean shear bond strength values (MPa ± SD) were group HM=12.59, group SM=11.15, group HC=7.7, and group SC=7.41. Bond strength differences between groups HM and SM (p=0.063) and between HC and SC (p=0.091) were not statistically significant. There were significant differences between HM and HC and between SM and SC groups (p < 0.05). Insignificant differences were found in ARI among all groups.

Conclusion

Our findings indicated that the metallic brackets had higher bond strengths in comparison with ceramic brackets. In addition, self-etching primer was able to produce fewer bonds compared with the conventional technique. Many samples showed the bracket-adhesive interface failure or failure inside the adhesive.

Shear bond strength and debonding characteristics of metal and ceramic brackets bonded with conventional acid-etch and self-etch primer systems: An in-vivo study

Background

Different in-vitro studies have reported various results regarding shear bond strength (SBS) of orthodontic brackets when SEP technique is compared to conventional system. This in-vivo study was designed to compare the effect of conventional acid-etching and self-etching primer adhesive (SEP) systems on SBS and debonding characteristics of metal and ceramic orthodontic brackets.

Material and Methods

120 intact first maxillary and mandibular premolars of 30 orthodontic patients were selected and bonded with metal and ceramic brackets using conventional acid-etch or self-etch primer system. The bonded brackets were incorporated into the wire during the study period to simulate the real orthodontic treatment condition. The teeth were extracted and debonded after 30 days. The SBS, debonding characteristics and adhesive remnant indices (ARI) were determined in all groups.

Results

The mean SBS of metal brackets was 10.63±1.42 MPa in conventional and 9.38±1.53 MPa in SEP system, (P=0.004). No statistically significant difference was noted between conventional and SEP systems in ceramic brackets. The frequency of 1, 2 and 3 ARI scores and debonding within the adhesive were the most common among all groups. No statistically significant difference was observed regarding ARI or failure mode of debonded specimens in different brackets or bonding systems.

Conclusions

The SBS of metal brackets bonded using conventional system was significantly higher than SEP system, although the SBS of SEP system was clinically acceptable. No significant difference was found between conventional and SEP systems used with ceramic brackets. Total SBS of metal brackets was significantly higher than ceramic brackets. Due to adequate SBS of SEP system in bonding the metal brackets, it can be used as an alternative for conventional system.

Key words:Shear bond strength, Orthodontic brackets, Adhesive remnant index, self-etch.

Factors Affecting the Shear Bond Strength of Orthodontic Brackets - a Review of In Vitro Studies

The adhesive material used to bond orthodontic brackets to teeth should neither fail during the treatment period, resulting in treatment delays, untoward expenses or patient inconvenience nor should it damage the enamel on debonding at the end of the treatment. Although the effectiveness of a bonding system and any unfavorable effects on the enamel may be studied by conducting in-vivo studies, it is nearly impossible to independently analyze different variables that influence a specific bonding system in the oral environment. In-vitro studies, on the other hand, may utilize more standardized protocols for testing different bonding systems and materials available. Thus, the present review focused attention on in-vitro studies and made an attempt to discuss material-related, teeth-related (fluorotic vs non-fluorotic teeth) and other miscellaneous factors that influences the shear bond strength of orthodontic brackets. Within the limitations of this review, using conventional acid-etch technique, ceramic brackets and bonding to non-fluorotic teeth was reported to have a positive influence on the shear bond strength of orthodontic brackets, but higher shear bond strength found on using ceramic brackets can be dangerous for the enamel.

In vitro study of color stability of polycrystalline and monocrystalline ceramic brackets

Objective

The aim of this in vitro study was to analyze color stability of monocrystalline and polycrystalline ceramic brackets after immersion in dye solutions.

Methods

Seven ceramic brackets of four commercial brands were tested: Two monocrystalline and two polycrystalline. The brackets were immersed in four dye solutions (coffee, red wine, Coke and black tea) and in artificial saliva for the following times: 24 hours, 7, 14 and 21 days, respectively. Color changes were measured by a spectrophotometer. Data were assessed by Multivariate Profile Analysis, Analysis of Variance (ANOVA) and Multiple Comparison Tests of means.

Results

There was a perceptible change of color in all ceramic brackets immersed in coffee (ΔE* Allure = 7.61, Inspire Ice = 6.09, Radiance = 6.69, Transcend = 7.44), black tea (ΔE* Allure = 6.24, Inspire Ice = 5.21, Radiance = 6.51, Transcend = 6.14) and red wine (ΔE* Allure = 6.49, Inspire Ice = 4.76, Radiance = 5.19, Transcend = 5.64), but no change was noticed in Coke and artificial saliva (ΔE < 3.7).

Conclusion

Ceramic brackets undergo color change when exposed to solutions of coffee, black tea and red wine. However, the same crystalline structure, either monocrystalline or polycrystalline, do not follow the same or a similar pattern in color change, varying according to the bracket fabrication, which shows a lack of standardization in the manufacturing process. Coffee dye produced the most marked color changes after 21 days of immersion for most ceramic brackets evaluated.

Imaging cleared intact biological systems at a cellular level by 3DISCO

Tissue clearing and subsequent imaging of transparent organs is a powerful method to analyze fluorescently labeled cells and molecules in 3D, in intact organs. Unlike traditional histological methods, where the tissue of interest is sectioned for fluorescent imaging, 3D imaging of cleared tissue allows examination of labeled cells and molecules in the entire specimen. To this end, optically opaque tissues should be rendered transparent by matching the refractory indices throughout the tissue. Subsequently, the tissue can be imaged at once using laser-scanning microscopes to obtain a complete high-resolution 3D image of the specimen. A growing list of tissue clearing protocols including 3DISCO, CLARITY, Sca/e, ClearT2, and SeeDB provide new ways for researchers to image their tissue of interest as a whole. Among them, 3DISCO is a highly reproducible and straightforward method, which can clear different types of tissues and can be utilized with various microscopy techniques. This protocol describes this straightforward procedure and presents its various applications. It also discusses the limitations and possible difficulties and how to overcome them.

Effect of a DPSS laser on the shear bond strength of ceramic brackets with different base designs

This study evaluated the shear bond strength (SBS) and adhesive remnant index (ARI) of ceramic brackets with different base designs using a 473-nm diode-pumped solid-state (DPSS) laser to test its usefulness as a light source. A total of 180 caries-free human premolars were divided into four groups according to the base designs: microcrystalline, crystalline particle (CP), dovetail, and mesh. For each base design, teeth were divided into three different subgroups for light curing using three different light-curing units (LCUs) (quartz-tungsten-halogen unit, light-emitting diode unit, and a DPSS laser of 473 nm). Applied light intensities for the DPSS laser and the other LCUs were approximately 630 and 900 mW/cm(2), respectively. Stainless steel brackets with a mesh design served as controls. The failure modes of debonded brackets were scored using ARI. As a result, brackets bonded using the DPSS laser had the highest SBS values (16.5-27.3 MPa) among the LCUs regardless of base design. Regarding base designs, the CP groups showed the highest SBS values (22.9-27.3 MPa) regardless of LCU. Furthermore, stainless steel brackets with a mesh design had the lowest SBS values regardless of LCU. In many cases, brackets bonded using the DPSS laser had higher ARI scores and had more adhesive on their bases than on tooth surfaces. The study shows that the 473-nm DPSS laser has considerable potential for bonding ceramic brackets at lower light intensities than the other light-curing units examined.

Evaluation of enamel surface after bracket debonding and polishing

INTRODUCTION: Preserving the dental enamel structure during removal of orthodontic accessories is a clinician's obligation. Hence the search for an evidence based debonding protocol. OBJECTIVE: to evaluate and compare, by means of scanning electron microscopy (SEM), the effects of four different protocols of bracket debonding and subsequent polishing on enamel surface, and to propose a protocol that minimizes damage to enamel surface. METHODS: Twelve bovine permanent incisors were divided into four groups according to the instrument used for debonding and removal of the adhesive remnant. In groups 1 and 2, brackets were debonded with a straight debonding plier (Ormco Corp., Glendora, California, USA), and in groups 3 and 4, debonding was performed with the instrument Lift-Off (3M Unitek, Monrovia, California, USA). In groups 1 and 3, the adhesive remnant was removed using a long adhesive removing plier (Ormco Corp., Glendora, California, USA) and in groups 2 and 4, residual adhesive was removed with a tungsten carbide bur (Beavers Dental) at high-speed. After each stage of debonding and polishing, enamel surfaces were replicated and electron micrographs were obtained with 50 and 200X magnification. RESULTS: All four protocols of debonding and polishing caused enamel irregularities. CONCLUSION: Debonding brackets with straight debonding plier, removal of adhesive remnant with a tungsten carbide bur and polishing with pumice and rubber cup was found to be the protocol that caused less damage to enamel surface, therefore this protocol is suggested for debonding brackets.

Does ultra-pulse CO(2) laser reduce the risk of enamel damage during debonding of ceramic brackets?

This study seeks to evaluate the enamel surface characteristics of teeth after debonding of ceramic brackets with or without laser light. Eighty premolars were bonded with either of the chemically retained or the mechanically retained ceramic brackets and later debonded conventionally or through a CO(2) laser (188 W, 400 Hz). The laser was applied for 5 s with scanning movement. After debonding, the adhesive remnant index (ARI), the incidence of bracket and enamel fracture, and the lengths, frequency, and directions of enamel cracks were compared among the groups. The increase in intrapulpal temperature was measured in ten extra specimens. The data were analyzed with SPSS software. There was one case of enamel fracture in the chemical retention/conventional debonding group. When brackets were removed with pliers, incidences of bracket fracture were 45% for the chemical retention, and 15% for the mechanical retention brackets. No case of enamel or bracket fracture was seen in the laser-debonded teeth. A significant difference was observed in ARI scores among the groups. Laser debonding caused a significant decrease in the frequency of enamel cracks, compared to conventional debonding. The increase in intrapulpal temperatures was below the benchmark of 5.5 °C for all the specimens. Laser-assisted debonding of ceramic brackets could reduce the risk of enamel damage and bracket fracture, and produce the more desirable ARI scores without causing thermal damage to the pulp. However, some augmentations in the length and frequency of enamel cracks should be expected with all debonding methods.

Effect of self-etching primer/adhesive and conventional bonding on the shear bond strength in metallic and ceramic brackets

Introduction: Bracket debonding from the tooth surface is a common problem in fixed orthodontics. The aims of the present study were to assess the bond strength and failure sites in two ways of bonding technique, with metallic and ceramic brackets. Material and Methods: One hundred premolars were assigned to 4 groups of 25 each: Group A, metallic brackets/ conventional procedure; Group B, metallic brackets/Transbond XT; Group C, ceramic brackets/conventional procedure; and Group D, ceramic brackets/Transbond XT. Transbond XT composite paste was used for bracket bonding and cured by conventional light-cure device. Specimens were subjected to thermocycling. One week after bonding shearing force was applied to the bracket-tooth interface. Bonding failure site optically examined using a stereomicroscope under 10 × magnifications and scoring was done using the adhesive remnant index (ARI). Data were subjected to analysis of One-way variance, Tukey post hoc, Chi-square and Spearman’s tests. Results: Mean bond strength (in MPa) were: group A=9.2, group B=8.5, group C=6.2 and group D=5.7. Bond strength differences between groups A and B, and between C and D were not significant, (p<0.0005). Insignificant difference found in ARI in all groups. Conclusion: The bond strengths of metallic brackets were significantly higher than ceramic ones and the selfetching primer produce fewer bonds than the conventional method (clinically acceptable). A positive correlation found between changes in shearing bond strength and ARI.

Key words: Acid etching, adhesive remnant index, orthodontic brackets, self-etching primer, shearing bond strength.

Enamel Cracks and Ceramic Bracket Failure during Debonding In Vitro

Objective: To test the null hypothesis that no difference in bracket failure characteristics is noted when use of a new ceramic bracket debonding instrument is compared with the use of conventional pliers.

Materials and Methods: Thirty maxillary premolars were randomly assigned to one of two groups. In group 1, Clarity collapsible ceramic brackets (3M Unitek, Monrovia, Calif) were debonded with the use of conventional Utility/Weingart (3M Unitek, Monrovia, Calif) pliers. In group 2, Clarity brackets were debonded with a new Debonding Instrument (3M Unitek). For all teeth, the same bracket bonding system was used. Following debonding, teeth and brackets were examined under 10× magnification for assessment of bracket failure (fracture) and of residual adhesive on the enamel surface. Enamel surfaces were visualized with transillumination prior to bonding and after removal of the residual adhesive, so the effect of the debonding forces could be determined.

Results: The results of Adhesive Remnant Index comparisons indicated that a statistically significant difference (χ2 = 8.73; P = .013) in bond failure patterns was apparent when the two groups were compared. Brackets debonded with the new instrument showed a greater tendency for the adhesive to be removed from the tooth during debonding.

Conclusions: The hypothesis is rejected. Although the incidence of enamel damage following debonding was similar in the two groups, the use of the new Debonding Instrument decreased the incidence of bracket fracture.

Changes in the reflected and transmitted color of esthetic brackets after thermal cycling

INTRODUCTION

The objective of this study was to determine the changes in the reflected and transmitted color and the color parameters of esthetic brackets after thermal cycling.

METHODS

Four brands of plastic and 4 brands of ceramic brackets were investigated. Reflected color of the labial side of bracket was measured according to the Commission Internationale de l'Eclairage (CIE) LAB color scale before and after thermal cycling for 5000 cycles. Transmitted color was measured with the same measurement protocol. Color change was calculated with the equation: DeltaE*(ab) = [(DeltaL*)(2)+ (Deltaa*)(2)+ (Deltab*)(2)](1/2). Changes in color parameters such as lightness (CIE L*), chroma (C*(ab)), CIE a* and b* values were calculated as the value after thermal cycling minus the value before thermal cycling. One-way analyses of variance were performed for the changes in color and color parameters by the brand of bracket (alpha = 0.05), and the Tukey multiple comparison test was performed.

RESULTS

Changes in the reflected and transmitted color and the color parameters were influenced by the brand of bracket (P <0.05). Reflected color change was 1.4 to 6.4 DeltaE*(ab) units, and transmitted color change was 1.0 to 2.8 DeltaE*(ab) units. Kind of material (plastic or ceramic) and crystal structure of ceramic brackets did not influence color stability, but color stability was mainly brand-dependent.

CONCLUSIONS

Reflected color changes of 3 of 8 brands were in the clinically perceptible range (DeltaE*(ab) > 3.7). Therefore, color stability of esthetic brackets should be enhanced for long-term esthetic performance of these brackets.

Influence of light transmittance and background reflectance on the light curing of adhesives used to bond esthetic brackets

INTRODUCTION

The objectives of this study were to determine the correlation between diffuse light transmittance (DLT) of esthetic brackets and the degree of cure (DC) of light-cured adhesives after direct irradiation, and to evaluate the influence of background reflectance. The influences of curing unit and irradiation time were also determined.

METHODS

The DLT of 4 ceramic and 4 plastic brackets was measured. Two reference light-curing protocols (cured over a glass slab; mean reflectance, 14.7%) and 4 experimental protocols (cured over bovine tooth slab; mean reflectance, 66.5%) were followed with 3 curing units: halogen, plasma arc, and light-emitting diode. The DC of 2 adhesives was calculated based on Fourier transform infrared spectroscopy. Two-way analysis of variance for the DC was performed (P = .05). The Pearson correlation between the DC and the DLT was determined.

RESULTS

Mean DLTs were 44.9% to 75.9%. DC varied by bracket and curing protocol (P <.05) and also by adhesive. In the experimental protocols, there was no significant linear correlation between the DLT and the DC in both adhesives except 1 among 8 groups. The difference in reflectance of background influenced DC (P <.05).

CONCLUSIONS

Based on this clinically simulated model, it was confirmed that the reflectance of the background tooth influenced the DC, instead of the DLT of a bracket. The interaction of the DLT and the reflectance of the background tooth on the light curing of adhesives should be studied further.

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.