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

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.

Computerized Casts for Orthodontic Purpose Using Powder-Free Intraoral Scanners: Accuracy, Execution Time, and Patient Feedback

INTRODUCTION

Intraoral scanners allow direct images of oral situation, with fewer steps than conventional impressions. The purpose of this study was to compare the accuracy of digital impressions, traditional impressions, and digitalization of full-arch gypsum models, to evaluate timing of different methods and finally to study perception of patients about conventional and digital impression techniques.

METHODS

Dental arches of fourteen patients were evaluated by alginate impression, titanium dioxide powder-free intraoral scanning (Trios, 3Shape), and digitalization obtained from gypsum models using the same scanner. Conventional and digital techniques were evaluated through measurements (lower and upper arch anteroposterior length, lower and upper intercanine distance, and lower and upper intermolar distance) with a caliber for analogic models and using a computer software for digital models (Ortho Analyzer, Great Lakes Orthodontics). In addition, chairside and processing times were recorded. Finally, each patient completed a VAS questionnaire to evaluate comfort. Statistical analyses were performed with ANOVA and Tukey tests for accuracy measurements and paired t-test for times and VAS scores. Significance was predetermined at P < 0.05.

RESULTS

The measurements obtained with intraoral scanning, gypsum models after conventional impression, and digitalized gypsum models were not significantly different. Both chairside and processing times of digital scanning were shorter than the traditional method. VAS reporting patients comfort were significantly higher when evaluating digital impression.

CONCLUSIONS

Intraoral scanners used for orthodontic applications provide useful data in clinical practice, comparable to conventional impression. This technology is more time efficient than traditional impression and comfortable for patients. Further evolution with more accurate and faster scanners could in future replace traditional impression methods.

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.

A comparative evaluation of the retention of metallic brackets bonded with resin-modified glass ionomer cement under different enamel preparations: A pilot study

Introduction:

For orthodontists, the ideal bonding material should be less moisture-sensitive and should release fluoride, thereby reducing unfavorable iatrogenic decalcification. Resin-Modified Glass Ionomer Cements (RMGICs), due to their ability to bond in the presence of saliva and blood can be a very good bonding agent for orthodontic attachments especially in the areas of mouth, which are difficult to access. Moreover, their fluoride releasing property makes them an ideal bonding agent for patients with poor oral hygiene. However, their immediate bond strength is said to be too low to immediately ligate the initial wire, which could increase the total number of appointments. The effect of sandblasting and the use of sodium hypochlorite (NaOCL) on the immediate bond failure of RMGIC clinically have not been reported in the literature until the date. This investigation intended to assess the effect of sandblasting (of the bracket base and enamel) and NaOCL on the rate of bond failure (with immediate ligation at 30 min) of Fuji Ortho LC and its comparison with that of conventional light cured composite resin over a period of 1 year.

Materials and Methods:

400 sample teeth were further divided into 4 groups of 100 each and bonded as follows: (1) Group 1: Normal metallic brackets bonded with Fuji Ortho LC. (2) Group 2: Sandblasted bracket base and enamel surface, brackets bonded with Fuji Ortho LC. (3) Group 3: Deproteinized enamel surface using sodium hypochlorite and brackets bonded with Fuji Ortho LC. (4) Group 4: Normal metallic bracket bonded with Transbond XT after etching enamel with 37% phosphoric acid. This group served as control group.

Results and Conclusion:

Results showed that sandblasting the bracket base and enamel, can significantly reduce the bond failure rate of RMGIC.

Bisphenol A release from an orthodontic adhesive and its correlation with the degree of conversion on varying light-curing tip distances

INTRODUCTION

The aims of this research were to use high-performance liquid chromatography to assess the bisphenol A (BPA) released from an orthodontic adhesive (Transbond XT; 3M Unitek, Monrovia, Calif) with various light-curing tip distances and to correlate the release to the degree of conversion.

METHODS

One hundred thirty-eight premolar brackets were divided into 3 groups of 40 each for the high-performance liquid chromatography analysis and 3 groups of 6 each for assessing the degree of conversion. Fourier transform infrared spectroscopy was used for this purpose. Each group was studied at light-curing tip distances of 0, 5, and 10 mm. Statistical analyses were performed by using 2-way analysis of variance (ANOVA), post-hoc multiple comparisons Tukey HSD tests, and paired t tests. Pearson correlation was used to assess the correlation between the degree of conversion and BPA release.

RESULTS

BPA release was greater in specimens cured with a greater light-curing tip distance. The degree of conversion decreased with increased light-curing tip distances. A negative correlation was found between BPA release and degree of conversion.

CONCLUSIONS

Clinicians should ensure that the adhesive is completely cured by keeping the light-curing tip as close to the adhesive as clinically possible.

Fabrication and evaluation of Bis-GMA/TEGDMA resin with various amounts of silane-coated silica for orthodontic use

The objective of this research was to fabricate a composite with an optimum filler level in a bisphenol-A-glycidyldimethacrylate (Bis-GMA) triethylene glycidal dimethacrylate (TEGDMA) resin for bonding of metallic orthodontic brackets to achieve the best handling characteristics with optimum bond strength and without compromising the mechanical properties of the adhesive. One-hundred and sixty extracted human premolars free of any detectable pathology or buccal surface alterations were collected and divided into four groups. In group 1 (control), the teeth were bonded with stainless steel brackets using Transbond XT. In groups 2, 3, and 4, the teeth were bonded with metal brackets using a Bis-GMA/TEGDMA resin with 80, 60, and 20 per cent by weight silane-coated silica of a spherical shape with a mean size of 0.01 μm. Shear bond strength (SBS) of the composites was determined and the adhesive remnant index (ARI) and enamel fracture post-debonding were assessed. According to one-way analysis of variance and Tukey's honestly significant difference (HSD) multiple comparison tests, the SBS of group 4 (10.54 MPa) was considerably less than that of groups 1 (26.1 MPa), 2 (25.5 MPa), and 3 (24.6 MPa). Chi-square analysis revealed that there was an insignificant difference in the incidence of enamel fracture between groups 1 and 2, while a significant difference was present between groups 1 and 2 and 3 and 4. An insignificant difference was also observed in the location of the adhesive failure between the four groups. While all the bonding adhesives tested can be safely used for bonding of brackets, 60 per cent filled Bis-GMA/TEGDMA was superior clinically due to its ease of handling and superior bond strength.

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).

Effect of blue light on the proliferation of human gingival fibroblasts

OBJECTIVES

Previous studies have reported that blue light, under conditions similar to those used for orthodontic bonding, influences several aspects of cellular physiology. The purpose of this study was to investigate the effect of the exposure to blue light curing sources, i.e. halogen, light emitting diode (LED) and plasma arc irradiation, on the proliferation of human gingival fibroblasts.

METHODS

Primary cultures of human gingival fibroblasts were exposed to halogen, LED and plasma arc irradiation for 240, 180 and 120 s, respectively. The effect of blue light on DNA synthesis and cell proliferation was estimated by tritiated thymidine incorporation and direct cell counting, respectively. The possible involvement of an oxidative stress on the effect of blue light irradiation was studied by using N-acetyl-cysteine. Finally the formation of DNA double-strand breaks after irradiation was studied by immunofluorescence with an antibody against histone H2A.x phosphorylated in Ser139.

RESULTS

Blue light showed no immediate effect on the regulation of DNA synthesis. However, exposure of cells to these light sources inhibits cell proliferation measured one week after irradiation. This phenomenon is not attributed to the formation of DNA double strand breaks and cannot be annulled by N-acetyl-cysteine.

SIGNIFICANCE

The results presented here indicate a mild inhibition of gingival fibroblasts' proliferation after exposure to blue light and necessitate further study to clarify the exact mechanism underlying this effect.

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.

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.