Effects of the conventional, soft start, and pulse delay modes produced by light-emitting diode device on microleakage beneath metal brackets: An in vitro comparative study

BACKGROUND

This study aimed to evaluate microleakage beneath metal brackets cured by different light curing modes.

MATERIALS AND METHODS

Sixty extracted human premolars were randomly divided into three groups according to the light curing mode. Metal brackets were bonded in all groups according to the manufacturer's recommendations with a light-emitting diode device. Light curing was applied as follows: group 1: conventional mode (10 s mesial+10 s distal); group 2: soft start mode (15 s mesial+15 s distal); group 3: pulse delay mode (3 s mesial+3 s distal, followed by 3min of no photoactivation, then 9 s mesial+9 s distal). Radiant exposure was the same in all study groups. After curing, the teeth were incubated at 37 degrees for 24hours, then thermocycled 500 times. Next, they were sealed with nail varnish, immersed in methylene blue 1% for 24hours, sectioned, and examined under a stereomicroscope. Microleakage was measured at both enamel-adhesive and bracket-adhesive interfaces, and the total microleakage for each tooth was computed. Statistical analyses were performed using Kruskal-Wallis and Welch test for comparing microleakage among groups. Wilcoxon signed ranks test was used for comparing microleakage between the bracket-adhesive and enamel-adhesive interfaces.

RESULTS

There was no significant difference in microleakage at the bracket-adhesive interface among study groups. At the enamel-adhesive interface and total microleakage, the pulse delay group exhibited significantly lower microleakage than the conventional group. Whereas there was no significant difference between the soft start group and other study groups. In all study groups, microleakage at the enamel-adhesive interface was greater than that at the bracket-adhesive interface.

CONCLUSION

The pulse delay mode caused lesser microleakage than the conventional mode. This supports the use of this mode in orthodontic bonding.

Comparative Evaluation of Microleakage Under APC Plus, APC Flash-Free and Conventional Stainless Steel Brackets: An In Vitro Study

Aim:

The aim of the study was to compare and evaluate the microleakage under the Adhesive Precoated Plus (APCP), APC Flash-Free (APCF), and conventional stainless steel (SLS) brackets on the occlusal and gingival sides of the bracket base.

Materials and Methods:

66 extracted premolar teeth were collected and divided equally into 3 groups. Bonding was done with APCP, APCF, and conventional SLS brackets using Transbond XT. After bonding, the samples were stored in a distilled water and thermocycled for 3000 cycles, followed by immersion in a 2% methylene blue for 24 h. After cleaning, the teeth were mounted in acrylic and sectioned longitudinally at about the center of the bracket in a buccolingual direction. Microleakage was recorded using a stereomicroscope.

Results:

Kruskal–Wallis H test showed a significant difference ( P < .005) in the microleakage scores between the 3 groups. Mann–Whitney U test showed a significant difference between group 1 to group 2 and group 1 to group 3 ( P < .005) and an insignificant difference between group 2 and group 3 on the occlusal side ( P = .116) and on the gingival side ( P = .063).

Conclusion:

Conventional SLS bracket group exhibited greater microleakage scores at both occlusal and gingival sides, when compared with APCP and APCF groups.

Anti-bacterial and anti-microbial aging effects of resin-based sealant modified by quaternary ammonium monomers

OBJECTIVES

Pit and fissure sealant is used in the prevention of dental caries. However, commercial pit and fissure sealant lacks persistent antibacterial properties. Dimethylaminododecyl methacrylate (DMADDM) was added to pit and fissure sealants to give it sustainable antibacterial properties and anti-microbial aging properties.

METHODS

Resin-based sealant was used as a control. Novel sealants were made with DMADDM. Atomic force microscope observation, curing depth, cytotoxicity, lactic acid measurement, hardness and microleakage were measured. Saliva-derived biofilms were grown on sealants. Biofilm metabolic activity, lactic acid production and biomass accumulation were measured.

RESULTS

Incorporating DMADDM did not increase the cytotoxicity or change the physical properties when the mass fraction of the DMADDM was 2.5-10%. The modification decreased the amount of bacterial biofilm, metabolic activity, lactic acid production and exopolysaccharide (EPS) in the saliva biofilms. It also provided anti-microbial aging properties.

CONCLUSION

The incorporation of DMADDM improved the antibacterial and anti-microbial aging effects of the material. It demonstrated a sustained antibacterial effect. The antibacterial and anti-microbial aging modification might be a potential choice for future clinical applications to inhibit dental caries, especially for children at high caries risk.

CLINICAL SIGNIFICANCE

The antibacterial and anti-microbial aging modification might be a potential choice for future clinical applications to prevent dental caries, especially for individuals at high caries risk.

Decalcification prevention around orthodontic brackets bonded to bleached enamel using different topical agents

BACKGROUND

The present study was conducted to evaluate the effect of different topical agents utilized for prevention of enamel decalcification around orthodontic brackets bonded to bleached and non-bleached enamel.

METHODS

Human maxillary premolars (n = 120) were divided into two equal groups. Teeth in group I were left without bleaching while those in group II were bleached with Vivastyle gel. Metal brackets were bonded to all the teeth using light-cured adhesive. Each group was divided into six equal subgroups (A, B, C, D, E, and F). In subgroup A, no material was applied (control). In subgroups B, C, D, E, and F, the following materials were applied respectively: Profluorid varnish, Enamel Pro Varnish, Ortho-Choice Ortho-Coat, GC Tooth Mousse, and GC MI Paste Plus. All teeth were cycled in a demineralization solution/artificial saliva for 15 days. Laser fluorescence was used to measure the level of enamel mineralization. The data were statistically analyzed.

RESULTS

Regarding the non-bleaching subgroups, all studied material revealed significant demineralization reduction in comparison to the control subgroup (P < 0.05). Ortho-Choice Ortho-Coat revealed the highest significant effect while GC Tooth Mousse showed the least effect. In bleached subgroups, Profluorid varnish, Enamel Pro Varnish, and Ortho-Choice Ortho-Coat significantly reduced demineralization (P < 0.05) while either GC MI Paste Plus or GC Tooth Mousse had no significant effects (P > 0.05).

CONCLUSIONS

Ortho-Choice Ortho-Coat, and Profluorid and Enamel Pro varnishes could be utilized successfully to reduce enamel demineralization around brackets bonded to either bleached or non-bleached enamel. GC MI Paste Plus and GC Tooth Mousse were effective only in non-bleached enamel.

Relevance of Micro-leakage to Orthodontic Bonding - a Review

As it is seen, by passing the evolutionary process of banding of orthodontic attachments to the bonding ones, orthodontics have witnessed many developments, such as application of new adhesives, optimized base designs, new bracket materials, curing methods and more efficient primers. The studies often address the morphological, micro-leakage, and shear bond tests to evaluate bond efficacy. Among studies endeavored to develop the bond strength of brackets, some observed the reduction of micro-leakage of bracket-adhesive and enamel-adhesive interfaces. Owing to the importance of micro-leakage in orthodontics, this study aimed at reviewing the micro-leakage values directly relevant to the enamel decay and debonding of the brackets. To reach the best bond strength, the researchers tried to design different studies to evaluate the effect of variables and prevent any possible side effects in clinical situations. It is noticed that most studies have mainly focused on adhesives, enamel preparation and methods of curing which are discussed in this review. The literature was reviewed by searching databases, using micro-leakage and orthodontic bonding as the keywords . Having found the relevant studies, the researchers entered them into the database. After reviewing numerous studies conducted in this field, the type of adhesive or curing method was not found to have determinative role in the value of micro-leakage although more standardized studies are needed.

Microleakage under ceramic flash-free orthodontic brackets after thermal cycling

OBJECTIVE

To compare microleakage under 3M Unitek's APC Flash-Free Adhesive Coated System bracket and the APC PLUS Adhesive Coated System bracket after thermal cycling.

MATERIALS AND METHODS

Forty freshly extracted human maxillary premolars were randomly divided into two groups and bonded with either a Flash-Free bracket or a PLUS bracket. After bonding, the samples were incubated in a water bath at 37°C for 24 hours and thermocycled for 5000 cycles between 5°C and 50°C. All teeth were immersed in a 2% methylene blue solution for 24 hours, embedded in acrylic and sectioned in a buccolingual direction at approximately the center of the bracket. Microleakage was observed at the enamel-adhesive interface from the occlusal and gingival margins of the bracket base. Statistical analysis was conducted using the Mann-Whitney U-test.

RESULTS

The median microleakage was higher in the Flash-Free group, but the difference between the two groups was not statistically significant (P > .05).

CONCLUSION

In a laboratory setting, there is no significant difference between the extent of microleakage under the APC Flash-Free Adhesive Coated System bracket and the APC PLUS Adhesive Coated System bracket after thermal cycling.

Micro-CT evaluation of microleakage under orthodontic ceramic brackets bonded with different bonding techniques and adhesives

AIM

The aim of this study was to evaluate microleakage under orthodontic ceramic brackets bonded with direct and different indirect bonding techniques and adhesives using micro-computed tomography.

MATERIALS AND METHODS

A total of 30 human maxillary premolars were randomly separated into five groups with six teeth in each group. In group I, teeth were bonded directly with Transbond XT (3M Unitek). In group II, group III, group IV, and group V, teeth were bonded through an indirect technique with Custom I.Q. (Reliance Orthodontic Products), Sondhi Rapid-Set (3M Unitek), RMbond (RMO), and Transbond IDB (3M Unitek), respectively, following the manufacturer's instructions. Micro-CT system model 1172 of Skyscan (Kontich, Belgium) was used to scan all samples. NRecon (Skyscan) version 1.6, CT-Analyser V.1.11 (Skyscan), and TView (SkyScan, Bvba) software programs were used for microleakage evaluation. Microleakage values between the test groups were assessed using the Kruskal-Wallis test, while the Wilcoxon signed rank test was used for within-group comparisons. The level of significance was set at P < 0.05.

RESULTS

According to the Kruskal-Wallis analysis of variance test, there were no significant differences among the tested groups, with regard to volume and percentage (microleakage/region of interest × 100) of microleakage values (P < 0.05). The Wilcoxon signed rank test showed that coronal microleakage volume and percentage values significantly differed for RMbond and Transbond IDB groups.

LIMITATIONS

In the study, only ceramic brackets were used and microleakage into mini gaps did not show up on the micro-CT image because 50% silver nitrate solution could not penetrate into mini gaps which are smaller than silver nitrate particles.

CONCLUSION

Use of direct and indirect bonding techniques with different adhesives did not significantly affect the amount of microleakage.

Microleakage under orthodontic brackets bonded with different adhesive systems

OBJECTIVE

This in vitro study aimed to compare the microleakage of orthodontic brackets between enamel-adhesive and adhesive-bracket interfaces at the occlusal and gingival margins bonded with different adhesive systems.

MATERIALS AND METHODS

A total of 144 human maxillary premolar teeth extracted for orthodontic reasons was randomly divided into four groups. Each group was then further divided into three sub-groups. Three total-etching bonding systems (Transbond XT, Greengloo and Kurasper F), three one-step self-etching bonding systems (Transbond Plus SEP, Bond Force and Clearfil S3), three two-step self-etching bonding systems (Clearfil SE Bond, Clearfil Protectbond and Clearfil Liner Bond), and three self-adhesive resin cements (Maxcem Elite, Relyx U 100 and Clearfil SA Cement) were used to bond the brackets to the teeth. After bonding, all teeth were sealed with nail varnish and stained with 0.5% basic fuchsine for 24 h. All samples were sectioned and examined under a stereomicroscope to score for microleakage at the adhesive-enamel and adhesive-bracket interfaces from both occlusal and gingival margins.

STATISTICAL ANALYSIS USED

Statistical analyses were performed with Kruskal-Wallis and Wilcoxon signed-rank tests.

RESULTS

The results indicate no statistically significant differences between the microleakage scores of the adhesives; microleakage was detected in all groups. Comparison of the average values of the microleakage scores in the enamel-adhesive and adhesive-bracket interfaces indicated statistically significant differences (P < 0.05). The amount of the microleakage was higher at the enamel-adhesive interface than at the bracket-adhesive interface.

CONCLUSIONS

All of the brackets exhibited some amount of microleakage. This result means that microleakage does not depend on the type of adhesive used.

Microleakage and shear bond strength of orthodontc brackets bonded to hypomineralized enamel following different surface preparations

Objectives: This study investigated the effects of several conditioning methods on shear bond strength (SBS) and microleakage of orthodontic brackets bonded to demineralized enamel. Study Design: One hundred premolars were selected and immersed in a cariogenic solution for 12 weeks. The teeth were randomly assigned into 5 groups. In groups 1 and 2, the teeth underwent acid etching for 30 and 120 seconds, respectively. In group 3, a combination of laser and acid etching was employed. A self-etch primer (SEP) was applied in group 4 and in group 5, the teeth were exposed to acidulated phosphate fluoride (APF) for 4 minutes before etching. After bracket bonding, the teeth were immersed in methylen blue for 12 hours and then were mounted in acrylic resin. SBS was determined with an Instron Universal Testing Machine and the amount of microleakage under the brackets was assessed under a stereomicroscope. Results: The lowest SBS was related to the SEP group and the highest one was observed in the specimens prepared by APF+acid etching. There was a significant difference in SBS (p=0.009), but not in microleakage (p=0.971) of the study groups. The SBS of the specimens treated with SEP was significantly Lower than the other groups, which were not significantly different from each other. The SEP group displayed a higher frequency of bond failure at the enamel-adhesive interface. Conclusions: Enamel preparation with SEP provided the lowest SBS among the groups. All groups showed some degree of microleakage. There was no significant correlation between SBS and microleakage.

Key words:Bond strength, microleakage, bonding, self-etch primer, Er:YAG laser.

The effect of different surface treatments of demineralised enamel on microleakage under metal orthodontic brackets

BACKGROUND

The aim of this investigation was to assess the effects of different treatments of demineralised enamel on microleakage under orthodontic brackets.

METHODS

Seventy-five intact premolars were randomly assigned to five groups. The teeth in groups 2 through 5 were immersed in a demineralising solution for 16 weeks. In groups 1 (control) and 2 (demineralised/control), conventional acid etching was used. In group 3, sodium hypochlorite (NaOCl) was applied on the enamel surface for 1 min after acid etching, and in group 4, Transbond Plus (3M Unitek, Monrovia, CA, USA) self-etching primer (SEP) was used. The teeth in group 5 were treated with 2% sodium fluoride (NaF) for 4 min before etching. After bracket bonding, the specimens were thermocycled, sealed with nail varnish, immersed in 0.5% basic fuchsine solution for 24 h and sectioned. Microleakage was measured under a stereomicroscope for the enamel-adhesive and adhesive-bracket interfaces of both occlusal and gingival sides.

RESULTS

Demineralised teeth showed more microleakage at the enamel-adhesive interface on both occlusal and gingival sides compared to sound teeth, but the difference was not significant (P>0.005). Treating the demineralised enamel with 5% NaOCl or Transbond Plus SEP was not effective in reducing microleakage. NaF treatment followed by acid etching of demineralised enamel resulted in significantly lower microleakage in most comparisons (P<0.005).

CONCLUSIONS

The use of 2% NaF on hypomineralised enamel before the bracket bonding procedure is an effective way to decrease microleakage.

Evaluation of bovine and human teeth exposed to thermocycling for microleakage under bonded metal brackets

INTRODUCTION

Bovine teeth are commonly used as substitutes for human teeth in scientific investigations. The present study was performed in vitro with the objective of comparing bovine and human enamel subjected to thermocycling for microleakage beneath metal brackets.

MATERIALS AND METHODS

A total of 50 bovine and human teeth (25 per group) void of defects or carious decay were extracted and stored in chloramine B (0.5%). A light-curing adhesive (Transbond™ XT) was used as instructed by the manufacturer (3M Unitek, Monrovia, CA, USA) to bond a metal bracket (discovery®; Dentaurum, Ispringen, Germany) to the surface of each tooth following 30 s of enamel etching (phosphoric acid 35%). After 24 h of dye penetration in methylene blue (0.5%), the cervical and incisal bracket surfaces were analyzed by light microscopy for excess bonding material, dye penetration, and microleakage at the bracket-adhesive and adhesive-enamel interfaces. Staining and evaluation was repeated after thermocycling (5000 cycles at 5/55 °C).

RESULTS

Before thermocycling, the number of human teeth showing marginal gaps was one-third the number of bovine teeth (p<0.001). After thermocycling, the distribution of gaps was similar (p=0.180). The adhesive-enamel interface was most frequently affected (on 74% of human and 64% of bovine teeth). No dye penetration in either group after examining a horizontal slice through the bracket basis was observed.

CONCLUSION

Immediately after bonding, less microleakage was observed around the base of metal brackets on human than bovine teeth. These marginal gaps were, however, superficial in both groups, none of them involving deep penetration of dye under the bracket base.