Effect of surface treatments on the adhesive properties of metallic brackets on fluorotic enamel

Effectiveness of sodium hypochlorite treatment on the bonding of four adhesive systems to fluorotic enamel

The study evaluated the effect of sodium hypochlorite (NaOCl) treatment on fluorotic enamel bonding of four adhesive systems. They were Single Bond 2 (SB2), Prime&Bond NT (PBN), Clearfil SE Bond (CSB), and Single Bond Universal (SBU). One hundred eighteen extracted moderate fluorotic molars were divided into eight groups according to NaOCl pretreatment and four adhesive systems. The microshear bond strength (μSBS), etching pattern, and penetration depth (PD) were observed. The statistical method was two-way ANOVA and least significant difference (LSD) test (α=0.05). The application of NaOCl significantly increased the μSBS of PBN and SBU (p<0.05). The enamel-etching pattern of CSB and SBU was deeper under SEM. A noticeable increase of PD was in SB2 and SBU after the application of NaOCl (p<0.05). Pretreatment of 5.25% NaOCl for the 60 s can increase μSBS of PBN and SBU, PD of SB2 and SBU, and improve enamel-etching pattern of CSB and SBU to fluorotic enamel.

Efficacy of Bracket Adhesive Remnant Removal by a Fluorescence-Aided Identification Technique with a UV Light Handpiece: In Vitro Study

Objective

This study aims to analyze the fluorescence-aided identification technique efficacy on adhesive remnant removal from the enamel surface after orthodontic bracket debonding.

Materials and Methods

Forty-five extracted human upper central incisors were divided into 3 groups (n = 15) according to the kind of adhesive for bracket bonding and the use or absence of near UV light for remnant removal: BF/UV- fluorescent adhesive/UV light, BF/0-fluorescent adhesive/no UV light, and TB/0-nonfluorescent adhesive/no UV light. For all teeth, 100% of the adhesive used remained on the enamel surface after debonding. Fifteen dentists performed adhesive removal on the enamel surface using a carbide bur. The specimens were analyzed by a stereomicroscope, and the adhesive remnant percentage from each specimen was calculated. The time used by each dentist to perform the removal was recorded. The data were analyzed by one-way ANOVA and Tukey's test.

Results

Significant differences were observed among groups for adhesive remnant (p=0.0008) and for time (p=0.0001). The means of adhesive remnant were BF/UV (5.84), BF/0 (34.37), and TB/0 (37.02). The mean times necessary to remove adhesive were BF/UV (1 min 40 s), BF/0 (3 min 03 s), and TB/0 (2 min 46 s). For the BF/UV group, significantly lower values of adhesive remnants and time for debonding were found (p < 0.05).

Conclusion

The fluorescence-aided identification technique significantly reduced the amount of adhesive remnant, and the time necessary to perform this clinical procedure.

Comparison of shear bond strength of orthodontic brackets bonded to human teeth with and without fluorotic enamel: a systematic review and meta-analysis of experimental in vitro studies

OBJECTIVE

The aim of this systematic review was to compare the shear bond strength (SBS) of orthodontic brackets bonded to human teeth with and without enamel fluorosis (EF) using conventional bonding interventions/techniques.

MATERIALS AND METHODS

An unrestricted search of indexed databases was performed with the following eligibility criteria: (a) human fluorotic teeth (experimental-group); (b) human teeth without fluorosis (control-group); (c) studies using phosphoric acid (PA) etching without air abrasion (AA), PA etching combined with AA, and application of self-etching primer (SEP) alone as bonding interventions/techniques; and (d) measuring SBS in megapascals (MPa). Data screening, selection, and extraction were performed by two reviewers. The risk of bias (rob) was assessed using the JBI Critical appraisal tool for Quasi-Experimental Studies. Meta-analyses were performed using a random effects model. The quality of available evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.

RESULTS

Ten in vitro studies were included. Subgroup analyses were performed for each intervention type. The SBS was significantly lower in fluorotic teeth when PA was used without AA (mean difference = 3.26 MPa, confidence interval: [1.00, 5.52]); and there were no significant differences for the PA combined with AA, and SEP interventions. All studies had a low rob. The overall level of evidence was at best low.

CONCLUSIONS

The SBS is lower in teeth with EF when traditional PA is used. No significant differences were found in SBS between teeth with and without EF when PA is used with AA or when SEP is used alone.

Effect of Enamel Pretreatment with Pastes Presenting Different Relative Dentin Abrasivity (RDA) Values on Orthodontic Bracket Bonding Efficacy of Microfilled Composite Resin: In Vitro Investigation and Randomized Clinical Trial

Bonding failure is a clinical issue frequently encountered in orthodontic practice. The aim of this study was to evaluate enamel pretreatment both in vitro and clinically using agents with different RDA values before brackets’ bonding, to assess if RDA can affect the Shear Bond Strength (SBS), Adhesive Remnant Index (ARI) and clinical failure rate of orthodontic brackets. For the in vitro study, 220 bovine teeth were pretreated with agents with different RDA values. Subsequently, brackets were bonded. For the clinical study, 20 patients underwent bonding of 20 brackets each with a split-mouth design. Low and high RDA toothpastes were used for enamel pretreatment. SBS, ARI and failures were recorded. Higher SBS values were found for teeth pretreated with lower RDA agents; conversely, lower SBS values were found for teeth pretreated with higher RDA agents (p < 0.05). For high ARI values, RDA increased too (p > 0.05). In the clinical study, a significantly lower failure rate was reported for teeth pretreated with low RDA toothpaste (2.5% in low RDA group, 7.0% in high RDA group; p < 0.05). No significant differences were assessed comparing the two dental arches and anterior and posterior sites. Enamel pretreatment with low RDA toothpastes could increase brackets’ survival rate. Further in vitro and clinical studies would be welcomed to confirm these findings.