An ex vivo assessment of a resin-modified glass ionomer cement in relation to bonding technique

Evaluation of a novel fixed-space maintainer made of light-cured acrylic resin: an in vitro study

To evaluate a fixed-space maintainer made of light-cure acrylic resin (LCAR) for its flexural and shear bond strength using different bonding systems to the enamel. 45 extracted primary teeth were selected. They were randomly divided into three equal groups (n = 15) along with the type of adhesive system (Tetric Flow, Transbond XT, and Fuji Ortho LC) used for bonding (LCAR) to the tooth surface. Surfaces were treated; LCAR was attached to the treated surfaces using a split Teflon mold. For flexural strength testing, ten bars of LCAR were made using another Teflon-split mold. Shear bond strength and mean flexural strength values were evaluated by a universal testing machine. The highest values of bond strength were recorded for Transbond XT, followed by Tetric Flow, while the lowest values were for Fuji Ortho LC. Various groups had a significant difference as investigated by ANOVA. ARI scores showed no significant difference in debond sites. Mean value and standard deviation of flexural strength for LCAR were 82.83  ± 5.2. LCAR has superior mechanical properties and could be an alternative to currently-in-use space maintainer though in vivo and in vitro trials are needed to progress the ultimate design of LCAR.

Resin-modified glass ionomer cement vs composite for orthodontic bonding: A multicenter, single-blind, randomized controlled trial

INTRODUCTION

In this study, we aimed to compare the incidence of new demineralized lesions and bond failures between 2 groups of participants wearing fixed orthodontic appliances bonded with either light-cured resin-modified glass ionomer cement or light-cured composite.

METHODS

This trial was a multicenter (6 centers: 2 teaching hospitals, 4 specialist orthodontic practices), single-blinded, randomized controlled trial with 2 parallel groups. Patients aged 11 years or older, in the permanent dentition, and about to start fixed orthodontic treatment in these 6 centers were randomly allocated to have either resin-modified glass ionomer cement or light-cured composite for bonding brackets, forward of the first molars. Pretreatment and day-of-debond digital photographic images were taken of the teeth and assessed by up to 5 clinical and 3 lay assessors for the presence or absence of new demineralized lesions and the esthetic impact. The assessors were masked as to group allocation.

RESULTS

We randomized 210 participants, and 197 completed the trial. There were 173 with complete before-and after-digital images of the teeth. The incidence of new demineralized lesions was 24%; but when the esthetic impact was taken into account, this was considerably lower (9%). There was no statistically significant difference between the bracket adhesives in the numbers with at least 1 new demineralized lesion (risk ratio,1.25; 95% confidence interval, 0.74-2.13; P = 0.403) or first-time bracket failure (risk ratio,0.88; 95% confidence interval, 0.67-1.16; P = 0.35). There were no adverse effects.

CONCLUSIONS

There is no evidence that the use of resin modified glass ionomer cement over light-cured composite for bonding brackets reduces the incidence of new demineralized lesions or bond failures. There might be other reasons for using resin modified glass ionomer cement.

REGISTRATION

This trial was registered at ClinicalTrials.govNCT01925924.

PROTOCOL

The protocol is available from the corresponding author on request.

Deproteinization of tooth enamel surfaces to prevent white spot lesions and bracket bond failure: A revolution in orthodontic bonding

Orthodontic treatment success is jeopardized by the risk of development of white spot lesions (WSLs) around orthodontic brackets. Unfortunately, the formation of WSLs still remains a common complication during treatment in patients with poor oral hygiene. Nearly 75% of orthodontic patients are reported to develop enamel decalcification because of prolonged plaque retention around brackets. It is the orthodontist’s responsibility to minimize the risk of patients having enamel decalcifications as a consequence of orthodontic treatment. This can be achieved by using hybrid, fluoride-releasing, glass ionomer cement to bond brackets, with deproteinization of the enamel surface before phosphoric acid etching.

Anex vivoassessment of a bonding technique using a self-etching primer

OBJECTIVE

This study assessed a new self-etch/priming system for use in orthodontic bonding.

SETTING

An ex vivo study.

METHOD

Three groups of 20 extracted premolar teeth were bonded with metal orthodontic brackets. Group 1 was bonded with Transbond using the conventional technique (control). Group 2 was bonded using the new Transbond-Plus combined etch/primer system to wet enamel and Group 3 to dry enamel. The teeth were debonded using an Instron Universal Testing Machine. The mean debond force was calculated for each group and compared statistically. The teeth were examined under the stereomicroscope to assess the site of debond and adhesive remnant index.

RESULTS

Group 2 (etch/primer on wet enamel) had the lowest mean debond value at 5.2 MPa. ANOVA and Tukey tests confirmed that the bond strength results of Group 2 were significantly lower than Groups 1 (P < 0.01) and 3 (P < 0.05). The enamel/resin interface was the commonest site of bond failure for both etch/primer groups (Groups 2 and 3). They had less retained resin and significantly (P < 0.001) lower ARI scores compared with Group 1 (control).

CONCLUSIONS

The results of this ex vivo study suggest that the self-etch primer should achieve adequate bond strengths when applied to dry enamel surfaces. In addition there should be less retained resin requiring removal at debond.

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.

Effect of Prewarming and/or Delayed Light Activation on Resin-Modified Glass Ionomer Bond Strength to Tooth Structures

Bond strength might improve by delaying the light activation procedure when a cavity conditioner is used for bonding RMGI to enamel. Conversely, delaying the light activation and/or prewarming of RMGI compromises bond strength to dentin and should be avoided.

Comparison of in-vitro bond strengths between resin-modified glass ionomer, polyacid-modified composite resin, and giomer adhesive systems

INTRODUCTION

The purpose of this in-vitro study was to compare the shear bond strength of orthodontic brackets bonded to tooth enamel with 4 adhesives: a commercially available giomer material, a polyacid-modified composite resin (PMCR), a resin-modified glass ionomer (RMGI), and a standard resin-based composite (RBC) adhesive.

MATERIALS

Eighty extracted human molars were collected and divided into 4 groups (n = 20). Two stainless steel premolar brackets were bonded to each tooth with 1 of the 4 adhesives, according to each manufacturers' instructions. One bracket was tested for shear bond strength at 1 hour and the other at 7 days. A shear force was applied to the bracket/tooth interface with a chisel-shaped rod attached to a universal testing machine at a crosshead speed of 0.5-mm per minute until bracket failure. The force in newtons was recorded. Debonded enamel surfaces were examined under a stereomicroscope to assess the amount of residual adhesive.

RESULTS

A 2-factor analysis of variance detected significant differences among adhesive types and time of load test. The Tukey HSD test determined that the RBC and the RMGI adhesives had significantly higher shear bond strength than the giomer and the PMCR materials at both 1 hour and 7 days. The chi-square test detected a significant difference in adhesive remnant index scores. The bracket/resin interface was the most common site of failure for all groups except the RMGI group.

CONCLUSIONS

RMGI orthodontic cement provides acceptable bond strength in vitro. Further clinical research is needed to validate this laboratory finding.

A comparison of tungsten-quartz-halogen, plasma arc and light-emitting diode light sources for the polymerization of an orthodontic adhesive

This study investigated whether there were differences between the debond stress and adhesive remnant index (ARI) of an adhesive cured with three different orthodontic light sources. Sixty sound premolar teeth were divided into three groups of 20. A standard pre-adjusted edgewise premolar bracket (Victory Series) was bonded to each tooth using a light-cured orthodontic adhesive, Transbond X. Group 1 (control) specimens were cured with an Ortholux XT (tungsten-quartz-halogen bulb) light for 20 seconds, group 2 with an Ortho lite (plasma arc) for 6 seconds and group 3 with an Ortholux LED light-emitting diode for 10 seconds. The specimens were debonded 24 hours later using a universal mechanical testing machine, operating at a crosshead speed of 0.5 mm minute(-1). The Weibull modulus and a Logrank test showed no statistically significant differences between the three groups for debond stress. The ARI was assessed at x10 magnification. The ARI scores for group 2 were significantly different (P < 0.01) from those of groups 1 and 3 (between which there was no significant difference). For group 2 there was a greater tendency for failure to occur at the adhesive/tooth interface than for the other two groups. There appears to be no reason why any of the three types of light source cannot be used in orthodontics. Polymerization, as effective as that produced by conventional bulb light sources, was obtained with the short exposure times recommended for the plasma arc or light-emitting diode sources.

An investigation into the bonding of orthodontic attachments to porcelain

This study assessed bonding of orthodontic brackets to porcelain teeth using two different surface preparation techniques and comparing two bonding systems, Fuji Ortho L.C. and Transbond. Four groups of 20 porcelain premolar teeth were bonded with metal orthodontic brackets (0.022 inch Minitwin, 3M Unitek) according to the following protocol: Transbond with a phosphoric acid etch (group 1), Transbond with a hydrofluoric acid etch (group 2), Fuji Ortho L.C. with a hydrofluoric acid etch (group 3), and Fuji Ortho L.C. with a phosphoric acid etch (group 4). All groups were bonded with a silane coupling agent. The teeth were debonded with an Instron universal testing machine. Bond strength, site of bond failure and adhesive remnant index (ARI) were recorded for each group. Differences between groups were analysed statistically. The composite resin groups (groups 1 and 2) had the highest mean bond strength values at 7.9 and 9.7 MPa, respectively. The resin-modified glass ionomer cement groups (RMGIC; groups 3 and 4) had the lowest mean bond strength values at 6.3 and 1.8 MPa, respectively. The mean bond strength of group 3 was significantly lower than all other groups (P < 0.0001). The Fuji groups had also significantly (P < 0.001) lower ARI scores than the composite groups (groups 1 and 2). Most samples experienced porcelain surface damage, except group 4. In conclusion, the highest bond strength levels were achieved with a conventional composite resin cement (groups 1 and 2). No significant differences in bond strength were found between the hydrofluoric and phosphoric acid etch technique.

In vivo debonding strength and enamel damage in two orthodontic debonding methods

Bracket debonding strength related to diverse debonding methods and enamel damage has not been assessed in vivo. The study hypothetized a direct relationship between these three parameters. Debonding strength was measured clinically in the wings method and base method on 50 patients in a split mouth method using a calibrated debonding plier. Brackets from 30 of these patients were scanned in SEM and EDAX for adhesive remnant index and enamel calcium remnants. Base method debonding force was significantly greater than wings method (163.5+/-68.7 N, 106.1+/-66.2 N, respectively, p < 0.001). A positive adhesive remnant index score was found in both methods (68.7%, 66.7%, respectively). Debonding strength vs. adhesive remnant index or calcium index scores were not correlated. However, the latter two were significantly correlated (0.524 < R < 0.895, p < 0.031). Half of the debonding failures developed at the adhesive enamel interface. The results warnts the potential of enamel damage during debonding.

Anex vivoassessment of gingivally offset lower premolar brackets

OBJECTIVES

To compare the force to failure of standard premolar brackets to that of gingivally offset brackets and evaluate the site of bond failure between the two bracket types through the use of the Adhesive Remnant Index (ARI).

DESIGN

An ex vivo study.

SETTING

Dental Materials Science Laboratory, Dundee Dental School, Dundee.

MATERIALS AND METHODS

Forty extracted lower premolar teeth (caries free, extracted as part of orthodontic treatment, all donors living in a non-fluoridated area), divided into two equal size sample groups, as follows: Group 1: Victory Series (3M Unitek, Monrovia CA, USA) lower premolar brackets bonded to buccal surfaces with Transbond XT (3M Unitek, Monrovia CA). Group 2: Victory Series Gingivally Offset Bicuspid Brackets (3M Unitek, Monrovia CA) bonded to buccal surfaces with Transbond XT (3M Unitek, Monrovia CA). Force was applied in the occluso-gingival direction using an Instron Model 4469 Universal Testing Machine (Instron Ltd, High Wycombe, UK) operating at a cross-head speed of 0.5 mm/min and its value at failure determined. Following debond, the site of bond failure and ARI were recorded.

OUTCOME

Force to failure, site of bond failure and adhesive remnant index.

RESULTS

The Weibull analysis gave higher values for the force to failure at 5% level (200 v. 159 N) and at all other levels of probability of failure for the gingivally offset bracket. The non-parametric survival analysis using Gehan-Wilcoxon tests with Breslow's algorithm (p < 0.0001) showed significant difference in force to failure between bracket types. Chi-square tests showed no significant (p = 0.55) relationship between the site of bond failure and the bracket types.

CONCLUSION

Ex vivo testing suggests that there is a significant difference in the force to failure between gingivally offset and standard lower premolar brackets when force application is from an occluso-gingival direction. The site of failure (as given by the ARI) is insensitive to bracket types and force to failure.