Bond strength comparison of moisture-insensitive primers

The Call for Standardization of Shear Bond Strength Testing Protocols in Orthodontics

Purpose

The shear bond strength of orthodontic brackets is an important factor in imparting desired treatment as repeated breakages during treatment not only delay its completion but also affect the quality of treatment. Thus, the aim of this review is to analyze the in vitro studies related to bond strength testing and to identify experimental conditions that are not standardized while performing in vitro studies.

Materials and Method

The total of 580 studies were searched, and 84 studies were accepted for review as per inclusion criteria. The 12 experimental conditions were analyzed, and it was found that none of the studies described all the conditions listed.

Results

There is no uniformity in parameters guidelines such as storing media, temperature, crosshead speed, type of testing method, and testing machine used in studies. None of the studies considered all reviewed conditions in their study design.

Conclusion

There is a need to frame proper recommendations for the testing protocols to be followed for in vitro bond strength studies so that baseline data as a reference will allow the intercomparison of results among studies and to reach any conclusion.

An In vitro shear bond strength study to evaluate the efficacy of moisture-insensitive primer

Aims:

We aimed to evaluate and compare the efficacy of moisture-insensitive primer (MIP) Transbond MIP while bonding to wet enamel surface.

Materials and Methods:

This study was done on 100 freshly extracted human premolar teeth, collected from the Department of Oral Surgery, Government Dental College, Calicut. They were stored in distilled water at room temperature. All teeth were healthy and without caries lesion, no evidence of surface defects, or any developmental morphological aberrations. Teeth were divided into 5 groups of twenty each for the testing and Brackets were bonded onto the tooth surface in 5 different bonding sequences using Transbond XT and Transbond MIP..

Results:

All the three groups of MIP have gained statistically significant higher SBS compared to Group I (Transbond XT primer in wet). Marked decrease in SBS of Transbond XT resin in wet environment was deduced. MIP in repriming sequence (Group IV) is found to have higher bond strength than other MIP groups.

Conclusions:

Clinical acceptability of Transbond MIP in wet environment could be recommended. MIP repriming should be done in cases where there is a doubt of contamination with saliva after initial primer application.

Effect of Adhesion Boosters on the Indirect Bonding with the Lingual Brackets: An In Vitro Study

Aims and Objectives:

To evaluate the influence of the two adhesion boosters (assure universal bonding resin and enhance adhesion booster) on the shear bond strengths of indirectly bonded lingual brackets.

Materials and Methods:

A total of 120 extracted human teeth were randomly divided into 3 groups (n = 40), each group contained equal number of anterior and posterior teeth (anterior = 20, posterior = 20), and their lingual surfaces were etched by using 37% phosphoric acid. The bracket was bonded indirectly without using adhesion booster in group 1 (control group). In group 2, the adhesion booster A (enhance adhesion booster) and adhesion booster B (assure universal bonding resin) in group 3 were applied, respectively, before the bonding. The universal testing machine was used to measure the maximum bond strength. Student’s t-test followed by the one-way analysis of variance was used to compare shear bond strength among the groups.

Results:

The shear bond strength was found to be highest in group 3, followed by group 2, and it was least in controls. There were highly significant differences statistically in shear bond strength among the groups 1, 2, and 3 ( P = .001).

Conclusion:

Shear bond strength was admissible in all the groups. The application of the assure universal bonding resin significantly increased the bond strength of lingual brackets in indirect bonding.

Evaluation of shear bond strength of orthodontic molar tubes bonded using hydrophilic primers: An in vitro study

OBJECTIVE

To evaluate and compare the shear bond strength (SBS) of orthodontic molar tubes bonded using two hydrophilic primers along with a moisture tolerant adhesive system to dry and saliva-contaminated enamel surfaces; and to assess the mode of their bond failure.

MATERIALS AND METHODS

A total of 60 extracted human mandibular molars were randomly divided into three major groups according to the primer used, each consisting of 20 molars: XT group acts as a control and bonded with the conventional hydrophobic Transbond XT primer, OS group bonded with the hydrophilic Ortho Solo primer, AP group bonded with the hydrophilic Assure Plus all surface bonding resin. Each major group was further divided into two subgroups, of 10 molars each, according to presence or absence of saliva. All the specimens were thermocycled 500 cycles between 5̊ and 55°C. Shear forces were applied to the specimens with a universal testing machine at a crosshead speed of 1mm/min and SBS was measured in megapascals (MPa). The mode of failure was determined using the adhesive remnant index (ARI). Data were analysed using two-way analysis of variance (ANOVA) followed by univariate analysis and Bonferroni post hoc tests.

RESULTS

The three tested primers did not show a significant difference in the mean SBS in dry conditions (P=0.137); the mean SBS of OS and AP primers were 15.60±5.879MPa and 12.51±2.583MPa respectively which were comparable to that of the hydrophobic XT primer (12.76±2.952MPa). In saliva-contaminated conditions, the mean SBS values were 10.41±4.457MPa and 9.22±3.422MPa for OS and AP primers respectively, which were significantly higher than that of XT primer (4.82±2.050MPa) (P=0.004). When comparing the mean SBS for each group according to the bonding condition, it was significantly higher in dry bonding compared to saliva-contaminated bonding for the three primers; XT (P<0.001), OS (P=0.003) and AP (P=0.011). In the dry field, most of the bond failures of the three primers were adhesive (score 3), whereas in the saliva-contaminated field, most of the failures were cohesive (score 1).

CONCLUSION

Dry bonding yielded the highest SBS for the three primers. Saliva contamination significantly decreased the bond strength of both hydrophilic primers; however, the values were above the clinically acceptable limit. The hydrophilic primers tested in the present study can be successfully used for bonding orthodontic molar tubes under dry and saliva-contaminated enamel surface conditions.

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.

In vitro Evaluation of Shear Bond Strength of Orthodontic Brackets Bonded with Different Adhesives

Background:

There is necessary of dry operating field for bonding of orthodontic brackets. The presence of moisture can alter the bond strength. Hence, the aim of the present study was to evaluate the shear bond strength of orthodontic brackets with different adhesives.

Materials and Methods:

In this in vitro study, a total of 100 orthodontically extracted premolars with sound crown structure were divided into 4 equal groups of different primers. Bonding on the buccal surface of all teeth was done after acid etching with upper premolar brackets using different primers followed by light curing. Shear bond strength was evaluated with or without salivary contamination with both adhesives. A shear force for deboning the bracket was done with universal testing machine. The debonded specimens were examined at ×10 magnification to check site of bond failure and remaining adhesive on tooth using adhesive remnant index (ARI). The obtained data were statistically evaluated using SPSS 20 for Windows (SPSS Inc., Chicago, IL, USA) using ANOVA, Kolmogorov–Smirnov, and Levene's test at the statistical significance of P < 0.05.

Results:

Transbond Plus showed higher shear bond strength of 8.92 MPa under dry and 5.65 MPa with saliva contamination over Transbond XT of 7.24 MPa under dry and 2.43 MPa with saliva contamination, respectively. Higher ARI score was found without contamination in both adhesives.

Conclusion:

Transbond Plus hydrophilic resin had good shear bond strength under both dry and contamination condition compared to hydrophobic Transbond XT resin material.

Er:YAG pre-treatment for bonding of orthodontic bracket: 1 year of in vitro treatment

Objective

The aim of this study was to evaluate in vitro bond strength of metal brackets bonded with: total etch, total etch with erbium: yttrium aluminum garnet laser (Er:YAG) and self-etching adhesive systems, submitted to thermal-mechanical cycling, simulating 1 year of orthodontic treatment.

Materials and methods

For the study, 80 bovine incisors were randomly divided into 3 experimental groups (n=16 each): XT- acid etching + Transbond XT, XT/Er:YAG- Transbond XT associated with Er:YAG laser irradiation (λ=2.94 μm, 60 mJ, 10 Hz) and SEP- Transbond Plus Self Etching Primer. Samples were submitted to thermal-mechanical cycling, simulating 1 year of orthodontic treatment. Afterward, the shear bond strength test was performed in a universal test machine at a speed of 0.5mm/min. Samples were evaluated under a stereomicroscope and by scanning electron microscopy for analysis of enamel surface and adhesive remnant index. Data were analyzed using Kruskal–Wallis and Mann–Whitney (with Bonferroni correction) statistical tests.

Results

Statistically significant difference was observed between the groups studied (p<0.05). Groups XT and SEP showed the highest bond strength values, without statistical difference between them, while group XT/Er:YAG showed reduction in bond strength values. Higher frequency of adhesive failures between enamel and adhesive system was verified for groups XT and XT/Er:YAG.

Conclusion

The conventional (XT) and self-etching (SEP) adhesive systems showed mean bond strength values, similar between them, whereas the previous application of Er:YAG laser promoted the lowest bond strength values.

Evaluation of enamel damages following orthodontic bracket debonding in fluorosed teeth bonded with adhesion promoter

Objective:

To evaluate shear bond strength (SBS) of the orthodontic brackets bonded to fluorosed and nonfluorosed teeth using Light Bond with and without adhesion promoters and compare their enamel damages following debonding.

Materials and Methods:

In this study, 30 fluorosed (Thylstrup and Fejerskov Index = 4–5) and 30 nonfluorosed teeth were randomly distributed between two subgroups according to the bonding materials: Group 1, fluorosed teeth bonded with Light Bond; Group 2, fluorosed teeth bonded with adhesion promoters and Light Bond; Group 3, nonfluorosed teeth bonded with Light Bond; Group 4, nonfluorosed bonded with adhesion promoters and Light Bond. After bonding, the SBS of the brackets was tested with a universal testing machine. Stereomicroscopic evaluation was performed by unbiased stereology in all teeth to determine the amount of adhesive remnants and the number and length of enamel cracks before bonding and after debonding. The data were analyzed using two-way analysis of variance, Kruskal–Wallis, Wilcoxon Signed Rank, and Mann–Whitney test.

Results:

While fluorosis reduced the SBS of orthodontic bracket (P = 0.017), Enhance Locus Ceruleus LC significantly increased the SBS of the orthodontic bracket in fluorosed and nonfluorosed teeth (P = 0.039). Significant increasing in the number and length of enamel crack after debonding was found in all four groups. There were no significant differences in the length of enamel crack increased after debonding among four groups (P = 0.768) while increasing in the number of enamel cracks after debonding was significantly different among the four groups (P = 0.023). Teeth in Group 2 showed the highest enamel damages among four groups following debonding.

Conclusion:

Adhesion promoters could improve the bond strength of orthodontic brackets, but conservative debonding methods for decreasing enamel damages would be necessary.

Shear Bond Strength of Orthodontic Brackets Fixed with Remineralizing Adhesive Systems after Simulating One Year of Orthodontic Treatment

The objective of this study is to assess, in vitro, the shear bond strength of orthodontic brackets fixed with remineralizing adhesive systems submitted to thermomechanical cycling, simulating one year of orthodontic treatment. Sixty-four bovine incisor teeth were randomly divided into 4 experimental groups (n = 16): XT: Transbond XT, QC: Quick Cure, OL: Ortholite Color, and SEP: Transbond Plus Self-Etching Primer. The samples were submitted to thermomechanical cycling simulating one year of orthodontic treatment. Shear bond strength tests were carried out using a universal testing machine with a load cell of 50 KgF at 0.5 mm/minute. The samples were examined with a stereomicroscope and a scanning electron microscope (SEM) in order to analyze enamel surface and Adhesive Remnant Index (ARI). Kruskal-Wallis and Mann-Whitney (with Bonferroni correction) tests showed a significant difference between the studied groups (p < 0.05). Groups XT, QC, and SEP presented the highest values of adhesive resistance and no statistical differences were found between them. The highest frequency of failures between enamel and adhesive was observed in groups XT, QC, and OL. Quick Cure (QC) remineralizing adhesive system presented average adhesive resistance values similar to conventional (XT) and self-etching (SEP) adhesives, while remineralizing system (OL) provided the lowest values of adhesive resistance.

Moisture insensitive primer: A myth or truth

OBJECTIVES

To compare the mean shear bond strength (SBS) of moisture insensitive primer (MIP) used for orthodontic bonding in the presence and absence of saliva.

MATERIALS AND METHODS

A total of 60 human noncarious maxillary premolars with sound buccal surfaces, recently extracted were collected in two groups of each 30. Maxillary premolar brackets were bonded to the teeth using light cure (Transbond XT, 3M Unitek, Monrovia, CA, USA) and MIP (Transbond MIP 3M Unitek, Monrovia, CA, USA,) in the presence and absence of saliva. Operators' saliva was used during the bonding under moist condition. After debonding, all the specimens were examined under a stereomicroscope (×40 magnification) for adhesive remnant using adhesive remnant index (ARI). The SBS tests were done using Instron universal testing machine at cross-head speed of 1 mm/min, force passing parallel to the buccal surface using custom rod and registered in Newtons later converted into Megapascals.

RESULTS

Light cure and MIP (Transbond MIP and Transbond XT, 3M Unitek, Monrovia, CA, USA) in the absence of saliva showed higher mean SBS than the presence of saliva. Group I (light cure and MIP) in the absence of saliva showed mean SBS of 9.65 ± 0.90 Mpa. Group II (light cure and MIP) with the presence of saliva showed mean SBS of 9.03 ± 1.14 Mpa. The difference between both the groups was statistically significant, as confirmed by paired t-test (P < 0.05). In-Group I, ARI scores showed that more than half of the adhesive was left over the tooth surface, and Group II showed that there was no or insignificant amount of adhesive left over the tooth surface. Chi-square test revealed significant difference in debonding characteristics among the test groups of ARI (P < 0.05). Failure occurred mainly in resin- bracket base and resin - adhesive interfaces (χ² = 10.04, df = 3, P = 0.031).

CONCLUSION

Moisture insensitive primer is effective in the presence/absence of moisture and has shown SBS value of more than 7.8 Mpa as stated by Reynolds, hence material is suitable for clinical use.

Effect of adhesion boosters on indirect bracket bonding

OBJECTIVE

To determine the influence of two adhesion boosters on shear bond strength and on the bond failure location of indirectly bonded brackets.

MATERIALS AND METHODS

Sixty bovine incisors were randomly divided into three groups (n = 20), and their buccal faces were etched using 37% phosphoric acid. In group 1 (control), brackets were indirectly bonded using only Sondhi adhesive. In groups 2 and 3, the adhesion boosters Enhance Adhesion Booster and Assure Universal Bonding Resin, respectively, were applied before bonding with Sondhi. Maximum bond strength was measured with a universal testing machine, and the location of bond failure was evaluated using the Adhesive Remnant Index (ARI). One-way analysis of variance followed by the Tukey test (P < .05) was used to compare the shear bond strength among groups, and the differences in ARI scores were evaluated using the Kruskal-Wallis test (P < .05). The Pearson correlation coefficient was calculated to determine whether there was any correlation between bond strength and ARI scores.

RESULTS

The mean shear bond strength in group 3 was significantly higher (P < .01) than in the other groups. Evaluation of the locations of bond failure revealed differences (P < .05) among the three groups. There was a moderate correlation between bond strength and ARI scores within group 3 (r  =  0.5860, P < .01).

CONCLUSION

In vitro shear bond strength was acceptable in all groups. The use of the Assure adhesion booster significantly increased both the shear bond strength of indirectly bonded brackets and the amount of adhesive that remained on the enamel after bracket debonding.

Effect of saliva contamination on bond strength with a hydrophilic composite resin

OBJECTIVE

To evaluate the influence of saliva contamination on the bond strength of metallic brackets bonded to enamel with hydrophilic resin composite.

METHODS

Eighty premolars were randomly divided into 4 groups (n = 20) according to bonding material and contamination: G1) bonded with Transbond XT with no saliva contamination, G2) bonded with Transbond XT with saliva contamination, G3) bonded with Transbond Plus Color Change with no saliva contamination and G4) bonded with Transbond Plus Color Change with saliva contamination. The results were statistically analyzed (ANOVA/Tukey).

RESULTS

The means and standard deviations (MPa) were: G1) 10.15 ± 3.75; G2) 6.8 ± 2.54; G3) 9.3 ± 3.36; G4) 8.3 ± 2.95. The adhesive remnant index (ARI) ranged between 0 and 1 in G1 and G4. In G2 there was a prevalence of score 0 and similar ARI distribution in G3.

CONCLUSIONS

Saliva contamination reduced bond strength when Transbond XT hydrophobic resin composite was used. However, the hydrophilic resin Transbond Plus Color Change was not affected by the contamination.

Resistência ao cisalhamento da colagem com compósitos utilizando potencializador de adesão

OBJETIVO: avaliar a resistência ao cisalhamento dos compósitos Transbond XT e Concise Ortodôntico utilizando o potencializador de adesão Ortho Primer. MÉTODOS: a amostra consistiu de 90 incisivos bovinos divididos em seis grupos (n=15). Todos os dentes receberam profilaxia com pedra-pomes e condicionamento do esmalte com ácido fosfórico. No Grupo I, utilizou-se Transbond XT de maneira convencional. O Grupo II foi semelhante ao I, porém, aplicou-se o Ortho Primer ao invés do XT Primer. No Grupo III, após condicionamento, o esmalte foi contaminado com saliva, aplicou-se o Ortho Primer e colagem com Transbond XT. No Grupo IV, utilizou-se o Concise Ortodôntico de maneira convencional. O Grupo V foi semelhante ao IV, porém, utilizou-se o Ortho Primer ao invés da resina fluida. No Grupo VI, após condicionamento, o esmalte foi contaminado com saliva, aplicou-se o Ortho Primer e colagem com Concise. Os corpos de prova foram armazenados em água destilada em estufa a 37ºC por 24h e submetidos ao ensaio de resistência ao cisalhamento. Os dados foram submetidos à ANOVA e ao teste de Tukey (5%). RESULTADOS: a resistência da colagem no Grupo IV foi estatisticamente superior à dos Grupos II, III e VI (p<0,05). Entre os Grupos I, IV e V; e entre os Grupos I, II, III e VI não foram encontradas diferenças estatísticas significativas (p>0,05). O Transbond XT e o Concise utilizados convencionalmente obtiveram os maiores valores adesivos. O Ortho Primer em esmalte seco atuou efetivamente como agente de união dos compósitos avaliados. Em esmalte contaminado, a colagem com Concise obteve baixa resistência adesiva.

Effect of mucoprotein on the bond strength of resin composite to human dentin

The purpose of this study was to test the bond strength and analyze the morphology of the dentin-adhesive interface of two etch and rinse and two self-etch adhesive systems with two kinds of artificial saliva (with and without 450 mg/L mucin) contamination under different conditions of decontaminating the interface. Bonded specimens were sectioned perpendicularly to the bonded surface in 1-mm thick slabs. These 1-mm thick slabs were remounted in acrylic blocks and sectioned in sticks perpendicular to the bonding interfaces with a 1-mm(2) area. Nine specimens from each condition were tested after 24 h on a testing machine (Instron) at a speed of 0.5 mm/min for a total of 360 specimens. Mean and standard deviations of bond strength (MPa) were calculated. ANOVA showed significant differences as well as Fisher's PLSD intervals (p < 0.05). The following values are the results for different groups: Control group 34-60 MPa, saliva without mucin 0-52 MPa, and saliva with mucin 0-57 MPa. Failure sites were mixed and adhesive failure was common for the low bond strength results. P&BNT with ideal conditions and following the manufacturer's instructions (control) had the highest bond strengths and the dentin-adhesive interface exhibited an ideal morphology of etch-and-rinse system. SEM gave complementary visual evidence of the effect in the dentin/adhesive interface structure with some contaminated conditions compared with their respective control groups. This in vitro artificial saliva model with and without mucin showed that an organic component of saliva could increase or decrease the bond strength depending on the specific bonding agent and decontamination procedure.

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.

Influence of four systems for dental bleaching on the bond strength of orthodontic brackets

OBJECTIVE

To compare the influence of four systems for dental bleaching on the shear bond strength (SBS) of orthodontic brackets.

MATERIALS AND METHODS

One-hundred and fifty freshly extracted bovine teeth were randomly divided into five groups. In group I the teeth were untreated (control). In the remaining groups the teeth were bleached, as follows: group II: 38% hydrogen peroxide; group III: 10% carbamide peroxide; group IV: resin-based coating material (RBCM), Beauty Coat; and group V: RBCM, White Coat. In all groups the enamel was conditioned with a self-etching primer and brackets were bonded with composite resin. Samples were stored (37°C, 24 hours), tested, and statistically analyzed, with significance predetermined at P ≤ .05. The adhesive remnant index (ARI) was also evaluated and analyzed.

RESULTS

The SBS of group V (22.49 ± 5.34 MPa) was significantly higher than that of all other groups (I: 17.1 ± 5.11 MPa; II: 14.72 ± 5.42 MPa; III: 12.04 ± 5.29 MPa; and IV: 18.23 ± 5.58 MPa). In contrast, the SBS of group III was significantly lower than that of all groups (except group II). Significant differences in the ARI scores were present between groups.

CONCLUSIONS

The use of RBCM for dental bleaching before bonding orthodontic brackets did not reduce the SBS. In contrast, hydrogen and carbamide peroxides negatively affected the SBS. The SBS yielded after bleaching with carbamide peroxide was significantly lower.

Influence of decontamination procedures on shear forces after contamination with blood or saliva

INTRODUCTION

Despite rapid development in adhesive technology, contamination of bonding surfaces remains a major problem. The aims of this study were to evaluate the influence of contamination on bond strength and to investigate possible decontamination procedures.

METHODS

Four bonding systems were evaluated for their shear bond strengths under 5 bonding situations: control (without contamination and decontamination); contamination with blood; contamination with saliva; decontamination with water and air, and repriming after blood contamination; and decontamination with water and air, and repriming after saliva contamination. The 25 specimens of each group consisted of composite blocks bonded to bovine teeth. Shear forces were measured with a testing machine after thermocycling.

RESULTS

The 3 composite primers showed similar behavior. With the exception of Transbond SEP (3M Unitek, Monrovia, Calif) with saliva contamination, all contaminated samples showed greatly reduced shear forces. The control and decontaminated groups showed shear forces about 20 MPa. The resin-modified glass ionomer, however, did not reach clinically sufficient bond strengths in either setup.

CONCLUSIONS

Decontamination with water and air and repriming is sufficient after contamination with blood or saliva. Etching again is not necessary. The bond strength of Transbond SEP was not significantly altered by saliva contamination and can be recommended for conventional bonding procedures.

In-vitro orthodontic bond strength testing: a systematic review and meta-analysis

INTRODUCTION

The aims of this study were to systematically review the available literature regarding in-vitro orthodontic shear bond strength testing and to analyze the influence of test conditions on bond strength.

METHODS

Our data sources were Embase and Medline. Relevant studies were selected based on predefined criteria. Study test conditions that might influence in-vitro bond strength were independently assessed by 2 observers. Studies reporting a minimum number of test conditions were included for meta-analysis by using a multilevel model with 3 levels, with author as the highest level, study as the second level, and specimens in the study as the lowest level. The primary outcome measure was bond strength.

RESULTS

We identified 121 relevant studies, of which 24 were included in the meta-analysis. Methodologic drawbacks of the excluded studies were generally related to inadequate reporting of test conditions and specimen storage. The meta-analysis demonstrated that 3 experimental conditions significantly affect in-vitro bond strength testing. Although water storage decreased bond strength on average by 10.7 MPa, each second of photopolymerization time and each millimeter per minute of greater crosshead speed increased bond strength by 0.077 and 1.3 MPa, respectively.

CONCLUSIONS

Many studies on in-vitro orthodontic bond strength fail to report test conditions that could significantly affect their outcomes.

Effect of Saliva Contamination and Decontamination on Bovine Enamel Bond Strength of Four Self-etching Adhesives

Salivary contamination before and after priming could significantly reduce the enamel bond strength of self-etching adhesives. Proper isolation should be performed before and during application of the adhesives and placement of the resin composite. Thorough water-spraying could significantly improve the μTBS of saliva-contaminated enamel.

One-component self-etching primer: a seventh generation of orthodontic bonding system?

The purpose of this study was to compare the bond strengths and to evaluate the debonding site using the adhesive remnant index (ARI) provided by a conventional acid-etch conditioner and a new self-etching adhesive system, Xeno IV (Dentsply Caulk). One hundred and eighty bovine lower incisors were randomly divided into six groups (n = 30). In groups 1, 2, and 3, Transbond XT (3M Unitek) composite was used to bond the brackets to enamel samples conditioned with 37 per cent phosphoric acid + XT primer (3M Unitek), Xeno IV + XT primer, or Xeno IV only, respectively. In groups 4, 5, and 6, the bonding procedures were performed using Fuji Ortho LC (GC Corp.) resin-modified glass ionomer cement unconditioned, enamel conditioned with 37 per cent phosphoric acid, or Xeno IV, respectively. All samples underwent thermocycling and then shear bond strength (SBS) testing was performed using a universal testing machine (Emic DL 10.000). Analysis of variance was applied. For the post hoc test, the Tukey's test was used. Kruskal-Wallis and Mann-Whitney U-tests were used to assess ARI scores. The results demonstrated no statistical differences between groups 1, 2, and 3. However, statistically significant differences were found between these samples and groups 4, 5, and 6. With regard to ARI score, the highest mean value was found in group 5 (Fuji Ortho LC + 37 per cent acid conditioning), whereas group 4 (Fuji Ortho LC + no conditioning) had the lowest SBS. Xeno IV self-etching bonding agent was able to bond orthodontic brackets in association with Transbond XT composite as well as with Fuji Ortho LC, thus maximizing bracket bonding.

Bond strength of adhesives to dentin contaminated with smoker's saliva

The purpose of this study was to determine the effects of contamination with smoker's and non-smoker's saliva on the bond strength of resin composite to superficial dentin using different adhesive systems. The interfacial structure between the resin and dentin was evaluated for each treatment using environmental scanning electron microscopy (ESEM). Freshly extracted human molars were ground with 600-grit SiC paper to expose the superficial dentin. Adhesives [One-Up-Bond-F-Plus (OUFP) and Adper-Prompt-L-Pop (APLP)] and resin composite (TPHSpectrum) were bonded to the dentin (n = 8/group, 180 total specimens) under five surface conditions: control (adhesive applied following manufacturers' instructions); saliva, then 5-s air dry, then adhesive; adhesive, saliva, 5-s air dry; adhesive, saliva, 5-s water rinse, 5-s air dry (ASW group); and adhesive, saliva, 5-s water rinse, 5-s air dry, reapply adhesive (ASWA group). After storage in water at 37 degrees C for 24 h, the specimens were debonded under tension at a speed of 0.5 mm/min. ESEM photomicrographs of the dentin/adhesive interfaces were taken. Mean bond strength ranged from 8.1 to 24.1 MPa. Fisher's protected least significant difference (P = 0.05) intervals for critical adhesive, saliva, and surface condition differences were 1.3, 1.3, and 2.1 MPa, respectively. There were no significant differences in bond strength to dentin between contamination by smoker's and nonsmoker's saliva, but bond strengths were significantly different between adhesive systems, with OUFP twice as strong as APLP under almost all conditions. After adhesive application and contamination with either smoker's or nonsmoker's saliva followed by washing and reapplication of the adhesive (ASWA group), the bond strength of both adhesive systems was the same as that of the control group.

Water and saliva contamination effect on shear bond strength of brackets bonded with a moisture-tolerant light cure system

OBJECTIVE

To evaluate the effects of water and saliva contamination on shear bond strength of brackets bonded with a moisture-tolerant light cure system.

MATERIALS AND METHODS

Brackets were bonded to 240 bovine lower incisors divided into 12 groups. Four bonding procedures were evaluated, including (1) TSEP/Transbond XT, (2) TMIP/ Transbond XT, (3) TSEP/Transbond PLUS, and (4) TMIP/Transbond PLUS, each under three different bonding conditions: without contamination, with water contamination, and with saliva contamination. Shear bond strength was measured with a universal testing machine. The adhesive remnant on the teeth was quantified with the use of image analyzing equipment.

RESULTS

Without contamination, bond strengths for the four procedures were similar (P > .05). TSEP/Tranbond PLUS and TMIP/Transbond PLUS left significantly less adhesive on the teeth after debonding than TSEP/Transbond XT and TMIP/Transbond XT (P < .008). Bond strength and adhesive remaining for TMIP/Transbond XT contaminated with water or saliva showed significantly worse performance than the other procedures evaluated (P < .008). Contamination (with water or saliva) did not affect either bond strength or adhesive remaining on the teeth for TSEP/ Transbond XT, TSEP/Transbond PLUS, or TMIP/Transbond PLUS (P > .017), although for TMIP/ Transbond XT, both variables showed significant reductions after contamination (P < .017).

CONCLUSION

TSEP/Transbond PLUS, TMIP/Transbond PLUS, and TSEP/Transbond XT showed greater tolerance to wet conditions than was shown by TMIP/Transbond XT.

Artificial saliva contamination effects on bond strength of self-etching primers

OBJECTIVE

To test the hypothesis that there is no difference in the bond strength with or without contamination with artificial saliva when using two different self-etching primers (Transbond Plus and iBond) in comparison with a conventional acid-etching method (37% phosphoric acid and Transbond XT) for bonding of orthodontic brackets.

MATERIALS AND METHODS

One hundred fifty extracted human premolars were randomly allocated to six different groups, with 25 teeth in each group. Orthodontic metal brackets (APC II, Victory Twin 22 UNIV) were used. For contamination, a saliva replacement (Ptyalin) was applied. After contamination the surface was air-dried for 5 seconds and the bonding procedure continued. The bonded teeth were stored in deionized water at 37 degrees C for 30 days and then thermocycled for 24 hours before debonding with a universal testing machine. The load was recorded at bond failure. The location of adhesive failure was determined under magnification using the adhesive remnant index (ARI).

RESULTS

Clinically acceptable bond strengths were found for all primers used in this study. The contamination by saliva significantly decreased the bond strength when using the conventional acid-etching method (t = 0.0001). Self-etching primers were less influenced by saliva contamination. There was no significant difference in the ARI score among the groups (P > .05).

CONCLUSIONS

Saliva contamination significantly decreased the bond strength when the conventional acid-etching method was used. The self-etching primers were influenced the least. The bond strengths achieved for the self-etching primers and the conventional etching method after saliva contamination were not significantly different.

Examination of enamel-adhesive interface with focused ion beam and scanning electron microscopy

INTRODUCTION

The purpose of this study was to observe, with a scanning electron microscope, the interface between enamel and orthodontic adhesive after focused ion-beam milling. In addition, enamel etched with phosphoric acid was compared with enamel conditioned with self-etching primer.

METHODS

Four freshly extracted human premolars were collected and pumiced by using rubber cups with fluoride-free paste, washed, and dried. The enamel of 2 teeth was etched with 37% phosphoric acid for 30 seconds, washed, and dried; the enamel of the other 2 teeth was conditioned with self-etching primer for 5 seconds. Stainless steel brackets were bonded with Transbond XT adhesive (3M Unitek, Monrovia, Calif) according to the manufacturer's instructions. The specimens were milled by focused ion beam and observed under the scanning electron microscope.

RESULTS

The scanning electron micrographs showed that 37% phosphoric acid seemed to produce more enamel loss than the self-etching primer. Moreover, the enamel-adhesive interface was more irregular when the enamel was etched with 37% phosphoric acid. Finally, a gentler etch pattern of the self-etching primer on the enamel surface was observed, and this conditioner could be used clinically for minimal intervention in the orthodontic bonding procedure.

CONCLUSIONS

Focused ion-beam milling to prepare samples allowed clear observation of the enamel-adhesive interface without artificial damage.

Antibacterial Activity and Shear Bond Strength of 4-Methacryloxyethyl Trimellitate Anhydride/Methyl Methacrylate-Tri-n-butyl Borane Resin Containing an Antibacterial Agent

OBJECTIVE

To produce an antibacterial adhesive for orthodontic bonding without compromising the mechanical property.

MATERIALS AND METHODS

We added benzalkonium chloride (BAC) to the Superbond C&B (4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane [4-META/MMA-TBB]), a resin that exhibits a strong bonding strength between enamel and bracket. BAC concentrations in the BAC composites were 0.25%, 0.75%, 1.25%, 1.75%, 2.5%, and 5% (wt/wt). Antibacterial activity of the BAC composite was measured by the disk diffusion method. BAC-composite discs were placed on the surface of the agar inoculated with Streptococcus mutans and Streptococcus sobrinus, and the plates were incubated at 37 degrees C. After 48 hours of incubation, the inhibition zone around each sample was measured and recorded. The BAC-modified composite was used to bond metal brackets to the phosphoric acid-etched enamel surface of human premolars. The shear bond strengths were measured after immersion in water at 37 degrees C for 24 hours.

RESULTS

The BAC-composite samples showed significant (P < .0001) antibacterial activity compared with the control. Measurable zones of bacterial inhibition increased as the BAC content in test samples increased. The shear bond strength declined with the increase in BAC concentration in the composite. A significant difference was found between the control composite and composites containing 1.25%, 1.75%, 2.5%, and 5% BAC (P < .05). No significant difference was found between the control composite and composites containing 0.25% and 0.75% BAC. However, shear bond strengths of the modified composites ranged from 10.12 MPa to 20.94 MPa.

CONCLUSIONS

These results confirmed that BAC-modified 4-META/MMA-TBB resin has a possibility for clinical application as an orthodontic bonding adhesive.

Xeno III self-etching adhesive in orthodontic bonding: the next generation

INTRODUCTION

The newer single-step self-etching adhesives that etch, prime, and apply the resin bonding agent simultaneously without rinsing have been increasing in popularity in orthodontic bonding. The purpose of this study was to compare the bond strengths and to evaluate the debonding site (with the adhesive remnant index), when a conventional acid-etch conditioner and a self-etching adhesive system (Xeno III, Dentsply DeTrey GmbH, Konstanz, Germany) were used with either a composite resin adhesive (Transbond XT, 3M Unitek, Monrovia, Calif) or a resin-modified glass ionomer cement (Fuji Ortho LC, GC Corp, Tokyo, Japan).

METHODS

One hundred twenty extracted human premolars were mounted in acrylic resin and randomly assigned to 6 groups of 20 teeth each. Shear-peel bond strength testing was performed after thermocycling (5 degrees C-55 degrees C for 500 times) with a Zwick 1440 compression machine (Zwick, Ulm, Germany).

RESULTS

The results showed that the bond strengths achieved with Xeno III were comparable with the traditional methods of either 37% phosphoric acid or 10% polyacrylic acid for both Transbond XT and Fuji Ortho LC. Adhesive remnant index scores showed less adhesive remaining on the tooth surface in the Xeno III/Transbond XT adhesive only (no primer) group.

CONCLUSIONS

Xeno III can be used to bond orthodontic brackets with the adhesives in this study.

Effect of blood and saliva contamination on shear bond strength of brackets bonded with 4 adhesives

INTRODUCTION

The purpose of this study was to assess the effect of blood and saliva contamination on the shear bond strength of 4 orthodontic adhesives.

METHODS

Four adhesives (Transbond XT primer [3M Unitek, Monrovia, Calif], Transbond Plus self-etch primer [3M Unitek], Assure hydrophilic primer [Reliance, Itasca, Ill], and SmartBond cyanoacrylate [Gestenco, Gothenburg, Sweden]) were used to bond stainless steel maxillary central incisor brackets to 120 bovine permanent mandibular incisors. The teeth were randomly divided into 12 groups of 10 specimens, and each primer-adhesive combination was tested under different enamel conditions: dry, and blood and saliva contamination after priming. Shear forces were applied to the samples with a testing machine. Bond strengths were measured in megapascals.

RESULTS

Statistical evaluations showed that the shear bond strength of the SmartBond cyanoacrylate adhesive group was significantly lower than all other groups; however, it was the only adhesive that was not affected by contamination. Saliva and blood contamination resulted in significant drops in shear bond strengths of the Transbond XT and Assure groups. Transbond Plus self-etch primer was also negatively affected by blood contamination, although it was suitable for bonding with saliva contamination.

Shear Bond Strength of a New Fluoride-releasing Orthodontic Adhesive

This study evaluated the shear bond strength of stainless steel brackets bonded to enamel with a new fluoride-releasing orthodontic adhesive system. A total of 140 extracted human bicuspids were randomly divided into four groups. Group I (Transbond XT) was a control group in which enamel was etched with phosphoric acid. For the remaining groups, enamel was conditioned with a self-etching primer (SEP): Group II (Transbond Plus), Group III (BeautyOrtho Bond), and Group IV (BeautyOrtho Bond + Salivatect). Stainless steel brackets were bonded to all tooth samples. After which, the samples were stored, thermocycled, tested, and statistically analyzed. Besides bond strength evaluation, the adhesive remnant index (ARI) was also evaluated. The shear bond strengths of Groups II, III, and IV were significantly lower than Group I, and Group II was significantly greater than that of Group III. Concerning ARI scores, no significant differences were found between the groups. Further, no enamel fracture was observed during shear bond test with the new SEP. In conclusion, when enamel was conditioned with the new SEP, the mean values of shear bond strength yielded were lower than when it was etched with 37% phosphoric acid. Nonetheless, these mean values were higher than the average suggested by Reynolds as optimum for clinical treatment.

Modification of 4-META/MMA-TBB resin for safe debonding of orthodontic brackets--influence of the addition of degradable additives or fluoride compound

The purpose of this study was to evaluate the performance of modified 4-META/MMA-TBB resin cements (Superbond C&B) in terms of debonding orthodontic brackets easily and safely from enamel without the loss of proper bracket bond strength. Poly (DL-lactide-co-glycolide) (PLGA), calcium fluoride (CaF2), or alpha-tricalcium phosphate (alpha-TCP) was added to the polymer powder of 4-META/MMA-TBB resin, and the shear bond strength of orthodontic brackets to human enamel using modified resins was measured before and after 10,000-cycle thermal cycling test between 5 degrees C and 55 degrees C. The modified resins tended to provide lower bond strength compared with the original 4-META/MMA-TBB resin. However, alpha-TCP- or CaF2-modified resin showed no significant differences in bond strength before and after thermal cycling. Moreover, there was a tendency of more residual resin remaining on the tooth surface after debonding, thereby suggesting a lower risk of enamel fracture. In conclusion, alpha-TCP- or CaF2-modified 4-META/MMA-TBB resin seemed to allow easy and safe debonding of orthodontic brackets without loss of proper bracket bond strength.

Bond strength comparison of 2 self-etching primers over a 3-month storage period

The purpose of this in vitro study was to evaluate the shear-peel bond strength of 2 self-etching primer systems, Transbond Plus (3M/ Unitek, Monrovia, Calif) and First Step (Reliance Orthodontic Products, Itasca, Ill), with their respective adhesives, and compare them with a control adhesive system (Transbond XT, 3M/ Unitek) over a 3-month period. Two hundred seventy extracted human premolars were obtained and randomly divided into 9 groups of 30 teeth. Metal orthodontic brackets were bonded to the enamel, and each adhesive group was stored for 24 horrs (T1), 30 days (T2), or 3 months (T3) in deionized water at 37 degrees C. All bonded specimens were thermocycled at 10 degrees C and 50 degrees C for 24 hours before debonding. Brackets were debonded by using a shear-peel load on a testing machine at a cross-head speed of 2 mm/min. Bond failure was also evaluated. The shear-peel bond strengths of the 3 bonding systems were clinically acceptable with the possible exception of First Step at 30-day storage. Repeated measures analysis of variance showed a statistically significant (P < .0001) difference in mean bond strengths between the 3 adhesive systems. The shear-peel bond strength of the adhesives over the 3 time intervals showed statistically significant (P = .005) changes. In each group, there were statistically significant differences in shear-peel bond strength between time intervals T1-T2 and T2-T3 for Transbond Plus and T2-T3 for First Step. The change in mean shear-peel bond strength of the 3 adhesives demonstrated a consistent pattern of behavior over the 3 storage intervals. The lowest mean shear-peel bond strength values were noted at the 30-day storage. Bond failure analysis (adhesive remnant index) demonstrated mainly cohesive bond failures.

Effects of blood contamination on the shear bond strengths of conventional and hydrophilic primers

The purpose of this study was to assess the effect of blood contamination on the shear bond strength and failure site of 2 orthodontic primers (Transbond XT and Transbond MIP; 3M/Unitek, Monrovia, Calif) when used with adhesive-precoated brackets (APC II brackets; 3M/Unitek). One hundred twenty bovine permanent mandibular incisors were randomly divided into 8 groups; each group contained 15 specimens. Each primer-adhesive combination was tested under a different enamel surface condition: dry, blood contamination before priming, blood contamination after priming, or blood contamination before and after priming. Stainless steel APC II brackets were bonded to the teeth. After bonding, all samples were stored in distilled water at room temperature for 24 hours and subsequently tested for shear bond strength. Noncontaminated enamel surfaces had the highest bond strengths for both conventional and hydrophilic primers; their values were almost the same. Under blood-contaminated conditions, both primers showed significantly lower shear bond strengths. For each type of primer, no significant differences were reported among the blood-contaminated groups. Significant differences in debond locations were found among the groups bonded with the 2 primers under the various enamel surface conditions. Blood contamination of enamel during the bonding procedure of conventional and hydrophilic primers significantly lowers their bond strength values and might produce a bond strength that is not clinically adequate.

Effect of saliva on shear bond strength of an orthodontic adhesive used with moisture-insensitive and self-etching primers

The purpose of this study was to investigate the effect of saliva contamination on the shear bond strength of an orthodontic adhesive used with Transbond Moisture-Insensitive Primer (MIP, 3M Unitek, Monrovia, Calif) and Transbond Plus Self-Etching Primer (SEP, 3M Unitek). Hydrophobic Transbond XT primer (XT, 3M Unitek) was used as a control. A total of 162 extracted premolars were collected and divided equally into 9 groups of 18 teeth each, and brackets were bonded with Transbond XT adhesive (3M Unitek) under different experimental conditions: (1) control: etch/dry/XT, (2) etch/dry/MIP, (3) etch/dry/MIP/wet (saliva)/MIP, (4) etch/wet/MIP, (5) etch/wet/MIP/wet/MIP, (6) dry/SEP, (7) dry/SEP/wet/SEP, (8) wet/SEP, and (9) wet/SEP/wet/SEP. Shear bond strength of each sample was examined with a testing machine. The results showed that the control group had the highest mean shear bond strength (group 1, 21.3 +/- 6.8 MPa), followed by the MIP group in a dry field (group 2, 20.7 +/- 5.0 MPa). No significant difference was found between groups 1 and 2. Groups 3 through 9 had similar mean strengths, ranging from 12.7 to 15.0 MPa (P >.05), which were significantly lower than in groups 1 and 2 (P <.05). There was no significant difference in bond-failure site among the 9 groups. It was concluded that (1) Transbond XT adhesive with Transbond XT primer and MIP in a dry field yields similar bond strengths, which are greater than all other groups, (2) saliva contamination significantly lowers the bond strength of Transbond MIP, (3) saliva has no effect on the bond strength of Transbond SEP, (4) Transbond XT adhesive with Transbond MIP and SEP might have clinically acceptable bond strengths in either dry or wet fields.

Factors affecting in vitro bond strength of bonding agents to human dentin

Four generations of total-etch (fourth, fifth) and self-etching (sixth, seventh) bonding agents for use with resin composites are commercially available in the United States. Innovations in bonding agents include: filled systems, release of fluoride and other agents, unit dose, self-cured catalyst, option of etching with either phosphoric acid or self-etching primer, and pH indicators. Factors that can affect in vitro bond strength to human dentin include substrate (superficial dentin, deep dentin; permanent versus primary teeth; artificial carious dentin), phosphoric acid versus acidic primers, preparation by air abrasion and laser, moisture, contaminants, desensitizing agents, astringents, and self-cured restorative materials. This article reviews studies conducted at the Houston Biomaterials Research Center from 1993 to 2003. Results show that in vitro bond strengths can be reduced by more than 50% when bonding conditions are not ideal.

Shear-peel bond strength of orthodontic primers in wet conditions

OBJECTIVE

The purpose of this in vitro study was to determine whether a hydrophilic primer (Transbond MIP, [MIP]) produces a significant difference in shear/peel bond strength compared with a traditional hydrophobic primer (Transbond XT, [XT]) in wet (W) or dry (D) conditions and if there is a difference in the site of bond failure.

DESIGN

A randomized blinded in vitro design.

SETTING AND SAMPLE POPULATION

The University of Missouri-Kansas City School of Dentistry. Forty extracted human premolars were divided into four test groups (n = 10 each): MIP-dry conditions (MIPD), MIP-wet conditions (MIPW), XT-dry (XTD) and XT-wet (XTW).

EXPERIMENTAL VARIABLE

Orthodontic brackets were bonded to the teeth according to the manufacturer's directions except XTW and MIPW were exposed to moisture.

OUTCOME MEASURE

Shear/peel test 24 h after bonding using an Instron at a crosshead speed of 0.5 mm/min and the adhesive remnant index to determine the site of bond failure.

RESULTS

The bond strengths (X +/- SD) in MPa were XTD = 8.3 +/- 2.3; XTW = 0.8 +/- 0.7; MIPD = 7.5 +/- 1.8 and MIPW = 7.9 +/- 1.7. The shear/peel bond strengths were significantly different: XTD = MIPD = MIPW > XTW (p < or = 0.01; two-way ANOVA; Tukey HSD). The ARI scores were also significantly different: XTD = MIPD = MIPW > XTW (p < or = 0.01; Chi-square).

CONCLUSIONS

Orthodontists who suspect moisture contamination should use a hydrophilic primer during bonding procedures to maintain shear/peel bond strength.