Microleakage under metallic and ceramic brackets bonded with orthodontic self-etching primer systems

Assessing the physico-mechanical, anti-bacterial, and anti-demineralization properties of orthodontic resin composite containing different concentrations of photoactivated zinc oxide nanoparticles on Streptococcus mutans biofilm around ceramic and metal orthodontic brackets: An ex vivo study

BACKGROUND AND PURPOSE

The aim of this study was to evaluate the physico-mechanical, anti-bacterial, and anti-demineralization properties of orthodontic resin composite containing photoactivated zinc oxide nanoparticles (ZnONPs) on Streptococcus mutans biofilm around ceramic and metal brackets.

MATERIAL AND METHODS

Following the minimum inhibitory concentration (MIC) determination for ZnONPs, shear bond strength (SBS) was tested for composites containing different concentrations of ZnONPs. The chosen concentration was used to evaluate the microleakage, anti-bacterial, and anti-demineralization properties.

RESULTS

Adding 50μg/mL of ZnONPs to the orthodontic composite did not negatively affect its physico-mechanical properties. ZnONPs (50μg/mL)-mediated aPDT and 0.2% chlorhexidine significantly (P=0.000) reduced S. mutans biofilms compared to the phosphate-buffered saline (PBS) groups (metal/PBS=7.47±0.7×106, and ceramic/PBS=7.47±0.7×106), with the lowest colony count observed in these groups (metal/chlorhexidine=1.06±0.4×105, ceramic/chlorhexidine=1±0.2×105, metal/ZnONPs-mediated aPDT=1.33±0.3×105, and ceramic/ZnONPs-mediated aPDT=1.2±0.3×105). Sodium fluoride varnish and ZnONPs-mediated aPDT showed the highest efficacy in anti-demineralization and significantly improving the enamel surface microhardness compared to the artificial saliva, especially in ceramic bracket groups (524.17±42.78N and 441.00±29.48N, 394.17±46.83N, P=0.000, and P=0.003, respectively).

CONCLUSION

ZnONPs (50μg/mL)-mediated aPDT effectively inhibited S. mutans biofilm and promoted anti-demineralization without adverse effects on the physico-mechanical properties of the composite resin. These results suggest the potential of this method in preventing white spot lesions during orthodontic treatment.

Comparison of microleakage under orthodontic brackets bonded with five different adhesive systems: in vitro study

BACKGROUND

Orthodontic treatment is associated with numerous adverse side effects, such as enamel discoloration, demineralization or even caries. The presence of microleakage between the enamel and the adhesive and between the adhesive and the base of the orthodontic bracket allows penetration of the bacteria, molecules, and liquids into the enamel and can lead to unpleasant "white spot lesions" or secondary caries beneath and around the brackets. The aim of this in vitro study was to evaluate microleakage in five adhesive systems commonly used in orthodontic practice for bonding brackets.

METHODS

One hundred extracted premolars were divided into five groups of twenty teeth. Stainless steel Legend medium metal brackets were bonded to teeth using five adhesive systems: resin-reinforced glass ionomer cement GC Fuji Ortho LC (GCF) and composite materials Light Bond (LB), Transbond XT (TB), Trulock™ Light Activated Adhesive (TL), and GC Ortho Connect (GCO). The specimens were subjected to thermal cycling, stained with 2% methylene blue, sectioned with low-speed diamond saw Isomet and evaluated under a digital microscope. Microleakage was detected at the enamel-adhesive and adhesive-bracket interfaces from occlusal and gingival margins. Statistical analysis was performed using generalized linear mixed models with beta error distribution.

RESULTS

Microleakage was observed in all materials, with GCF showing the highest amount of microleakage. Composite materials GCO, TB, and LB exhibited the lowest amount of microleakage with no statistical difference between them, while TL showed a statistically significantly higher amount of microleakage (p < 0.001). The enamel-adhesive interface had more microleakage in all composite materials (GCO, LB, TB, and TL) than the adhesive bracket-interface (p < 0.001). The highest amount of microleakage occurred in the gingival region in all materials.

CONCLUSION

Composite materials showed better adhesive properties than a resin-reinforced glass ionomer cement. The presence of microleakage at the enamel-adhesive interface facilitates the penetration of various substances into enamel surfaces, causing enamel demineralization and the development of dental caries.

Influence of resin infiltration pretreatment on the microleakage under orthodontic bracket (an in vitro study)

OBJECTIVES

In order to assess the changes in tooth orthodontic adhesive interface microleakage after applying a caries resin penetrated to the sound enamel tooth surface in different storage media.

MATERIALS AND METHODS

A total of 60 human maxillary first premolars (orthodontic extraction) were collected by random separation of the teeth into two equal groups. The control group was classified into three subgroups (n = 10) (control in deionized water, control in milk, and control in energy drink), while the experimental one (treated with ICON) was categorized into three subgroups (n = 10) (ICON in deionized water, ICON in milk, and ICON in energy drink) incubation phase lasted three weeks in total.

RESULTS

A one-way analysis of variance (ANOVA) yielded a significant difference between all experimental subgroups (ICON in deionized water, ICON in milk, and ICON in energy drink) and control subgroups (control in deionized water, control in milk, and control in energy drink). The control group in the energy drink subgroup had the highest mean microleakage value when compared to the other subgroups, whereas the resin-infiltrated group in deionized water had the lowest mean value. According to the results of the T-test, ICON pre-treatment tooth samples had significantly lower mean values of microleakage than non-ICON tooth samples.

CONCLUSIONS

The adhesive system (control group) revealed that a resin infiltrate on a sound enamel surface prior to orthodontic bracket bonding reduced bracket tooth interface microleakage in all examined samples. The ICON-infiltrated surface was discovered to provide a secondary preventive strategy against white spot lesion development by reducing microleakage under brackets.

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.

Comparison of demineralization around orthodontic brackets cured by conventional method and transillumination technique-an in vitro evaluation

OBJECTIVE

To compare demineralization around orthodontic brackets cured by conventional method and transillumination method.

MATERIALS AND METHOD

Sixty freshly extracted human premolar teeth were divided into four groups. Group 1: Brackets bonded with conventional method of bonding by curing labially for 40 sec. Group 2: Brackets bonded with transillumination method of bonding for 50 sec. Group 3: Brackets bonded with conventional method of bonding by curing labially for 20 sec followed by 30 sec of transillumination. Group 4: Brackets bonded with transillumination method of bonding for 30 sec followed by labial curing for 20 sec. Ground sections were prepared of each tooth and microleakage was evaluated using a binocular microscope at 40× magnification (Olympus BX53) and an image was taken using a digital camera (Olympus EPL3) connected to the microscope. The images were analyzed using Magnus Pro Image software. Scores were assigned to different degrees of microleakage at the demineralization zone around enamel-adhesive-bracket complex at the occlusal, middle, and gingival margins using linear measurement tool. Data obtained was subjected to statistical analysis using SPSS software (Version 20.0). Level of significance was kept at 5%. Intragroup comparison was done using Kruskal-Wallis test followed by Mann-Whitney U-tests for pairwise comparison.

RESULTS

Group 4 showed least mean demineralization in occlusal, middle, and cervical areas as compared to other groups and the results were statistically significant (P < 0.05).

CONCLUSION

Transillumination can be employed as a method synergistically with conventional curing to achieve minimum amount of demineralization during fixed orthodontic treatment.

Effects of one-step orthodontic adhesive on microleakage and bracket bond strength: An in vitro comparative study

OBJECTIVE

To evaluate the effects of one-step orthodontic composite combined with primer on microleakage and shear bond strength (SBS) of metal and ceramic brackets.

MATERIALS AND METHODS

This in vitro study included 144 extracted premolar teeth. Teeth were divided into two main groups according to the bracket type (metal and ceramic). In each group, brackets were bonded with three different bonding systems: two-step total-etch (37% phosphoric acid+Transbond XT primer+Transbond XT light cure adhesive), one-step self-etch (Transbond Plus self-etch primer+Transbond XT light cure adhesive), and one-step orthodontic adhesive (37% phosphoric acid+GC Ortho Connect light cure adhesive). A total of 6 groups (n=12) were performed for each evaluation. All samples were subjected to thermal cycling. After dye penetration, sections were prepared and assessed under stereomicroscope. After SBS test, adhesive remnant index (ARI) scores were determined. Data were analyzed statistically.

RESULTS

There were no significant differences between total-etch and one-step orthodontic adhesive for microleakage. Self-etch adhesive showed more microleakage at occlusal interfaces (P<0.05). The highest and lowest mean SBS values were found in ceramic brackets bonded with total- and self-etch adhesives, respectively. No significant differences were found among the SBS values of the groups. However, the differences between ARI scores were found statistically significant (P<0.05).

CONCLUSIONS

Orthodontic composite integrated with primer can be used safely instead of two-step total-etch adhesives during the bonding of metal and ceramic brackets due to less microleakage and adequate SBS values.

Laser-Aided Enamel Conditioning: A Comparison of Microleakage Under Brackets Following Different Aging Procedures

Objective:

To evaluate microleakage under the orthodontic adhesives applied following two version of erbium:yttrium aluminum garnet (Er:YAG) laser-aided enamel conditioning after thermal and thermomechanical simulators.

Materials and Methods:

A comparative analytical study based on metal braces bonded on the enamel of extracted teeth ( n = 160) etched with acid, Er:YAG laser and Er:YAG laser with an X-Runner handpiece, and self-etch adhesives. An arch wire was ligatured to samples which were embedded in acrylic blocks by two with periodontal ligaments. The specimens were subdivided into two groups: those aged with thermal cycling and thermomechanical aging procedures. The samples were immersed in basic fuchsin solution (0.5%) for 24 h. Buccolingual sections were performed on the mesial and distal wings of the braces. The color penetration at the gingival and occlusal margins of the adhesive-bracket and enamel-adhesive was evaluated under a stereomicroscope. The median and mean values of microleakage in both groups were evaluated with Kruskal–Wallis and Mann–Whitney U tests ( P < .05).

Results:

The highest microleakage was recorded in the gingival part of the samples aged with the thermomechanical aging procedure ( P = .001). The amount of microleakage generally increased in the samples subjected to thermomechanical loading, but the only significant difference was recorded in the gingival part in each four different conditioning methods.

Conclusion:

Microleakage of the phosphoric acid-etched groups was recorded with lower values for both aging methods. Thermomechanical aging should be included to microleakage studies due to increased microleakage on gingival side for all etching groups.

In vitro evaluation of microleakage under orthodontic brackets bonded with different adhesive systems

OBJECTIVE

Adhesives systems have a drawback when utilized for bonding orthodontic brackets: they shrink during photopolymerization creating microleakage. The aim of this study was to assess the stability of different orthodontic adhesives around brackets and enamel.

MATERIALS AND METHODS

Sixty noncarious mandibular premolars extracted for orthodontic reasons were randomly divided into six groups of adhesives used for bonding brackets to dental enamel: NeoBond^® Light Cure Adhesive Kit, Transbond™ Plus Self-Etching, Victory V-Slot APC PLUS^® + Transbond™ MIP, Rely-A-Bond^® Kit, Light Cure Orthodontic Adhesive Kit (OptiBond^®), and Transbond™ MIP. Following bonding, all teeth underwent 2500 cycles of thermal cycling in baths ranging from 5°C to 55°C before being immersed in 2% methylene blue for 24 h. All samples were examined under a binocular microscope to assess the degree of microleakage at the "bracket-adhesive" and "adhesive-enamel" interfaces in the gingival and occlusal regions of the bracket.

RESULTS

A significant difference was found at the "occlusal bracket-adhesive" interface. The highest microleakage values were found in the occlusal region, although no significant. Microleakage was observed in all groups.

CONCLUSION

Group 2 had the highest microleakage values whereas Group 6 had the lowest values.

Shear bond strength of ceramic and metallic orthodontic brackets bonded with self-etching primer and conventional bonding adhesives

Introduction

Adult patients typically require high-quality orthodontic treatment for ceramic brackets, but some clinicians remain concerned about the bond strength of these brackets. Therefore, the aim of this study was to determine the shear bond strength and de-bonding characteristics of metallic and ceramic brackets bonded with two types of bonding agents.

Methods

In an experimental study done in 2013 in Babol, Iran, 120 extracted human maxillary premolar teeth were randomly divided into four groups as follows: HM group: metallic bracket/conventional bonding agent; SM group: metallic bracket/Transbond self-etching primer; HC group: ceramic bracket/conventional bonding agent; SC group: ceramic bracket/Transbond self-etching primer. Twenty-four hours after thermocycling (1000 cycle, 5 °C–55 °C), the shear bond strength values were measured. The amount of resin remaining on the tooth surface (adhesive remnant index: ARI) was determined under a stereomicroscope. Enamel detachment index was evaluated under a scanning electron microscope. To perform statistical analysis, ANOVA, Kruskal–Wallis, and Tukey post-hoc tests were applied. The level of significance was set at p <0.05.

Results

The mean shear bond strength values (MPa ± SD) were group HM=12.59, group SM=11.15, group HC=7.7, and group SC=7.41. Bond strength differences between groups HM and SM (p=0.063) and between HC and SC (p=0.091) were not statistically significant. There were significant differences between HM and HC and between SM and SC groups (p < 0.05). Insignificant differences were found in ARI among all groups.

Conclusion

Our findings indicated that the metallic brackets had higher bond strengths in comparison with ceramic brackets. In addition, self-etching primer was able to produce fewer bonds compared with the conventional technique. Many samples showed the bracket-adhesive interface failure or failure inside the adhesive.

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.

Comparison of Microleakage under Rebonded Stainless Steel Orthodontic Brackets Using Two Methods of Adhesive Removal: Sandblast and Laser

OBJECTIVES

Debonding is a common occurrence in orthodontic treatment and a considerable number of orthodontists prefer to rebond the detached brackets because of economic issues. The aim of this study was to compare the microleakage beneath rebonded stainless steel brackets using two methods of adhesive removal namely sandblast and laser.

MATERIALS AND METHODS

Sixty human premolar teeth were randomly divided into three groups. Following bonding the brackets, group 1 served as the control group. Brackets in groups 2 and 3 were debonded, and adhesive removal from the bracket bases was done by means of sandblasting and Er-YAG laser, respectively. After rebonding, teeth in each group were stained with 2% methylene blue for 24 hours, sectioned and examined under a stereomicroscope. Marginal microleakage at the adhesive-enamel and bracket-adhesive interfaces in the occlusal and gingival margins was determined. Statistical analysis was done using the Kruskal-Wallis test.

RESULTS

Comparison of the microleakage scores among the three groups revealed no statistically significant difference (P > 0.05). At the enamel-adhesive interface, the gingival margins in all groups showed higher microleakage while in the adhesive-bracket interface, the occlusal margin exhibited greater microleakage.

CONCLUSION

Er-YAG laser irradiation and sandblasting for adhesive removal from the debonded brackets yielded clinically acceptable microleakage scores.

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.

In vitro evaluation of microleakage under ceramic and metal brackets bonded with LED and plasma arc curing

AIM

The aim of the present study was to evaluate these two high intensity light curing units regarding microleakage beneath metal and ceramic brackets.

MATERIALS AND METHODS

A total of 60 freshly extracted human premolar teeth were randomly divided into four groups of 15 samples; group I: Metal bracket + LED cured, group II: Ceramic bracket + LED cured, group III: Metal bracket + plasma arc cured, group IV: Ceramic bracket + plasma arc cured. After photopolymerization, the teeth were immersed in water and thermocycled (500 cycles between 5 and 55). Specimens were further sealed with nail varnish and stained with 5% basic fuchsin for 24 hours. All of the teeth were sectioned with two parallel longitudinal occlusogingival cuts and examined under a stereomicroscope. The microleakage was measured with a digital caliper and scored from 0 to 3 for marginal microleakage at the bracket-adhesive and adhesive-enamel interfaces from both the occlusal and gingival margins.

RESULTS

Microleakage was detected in all groups. The plasma arc cured group showed less microleakage than light emitting diode (LED) cured in all samples at the enamel-adhesive interface at the gingival margin (ceramic brackets, p = 0.009 and metal brackets, p = 0.005). The plasma arc cured samples showed less microleakage than LED cured in metal brackets at the adhesive-brackets interface at the occlusal margin (p = 0.033). While curing with an LED unit, ceramic brackets displayed significantly less microleakage than metal ones at the gingival margin of adhesive-enamel interface (p = 0.013). The gingival margin in all groups exhibited higher microleakage compared with those observed in occlusal sides in all sample groups (p < 0.001).

CONCLUSION

1. LED units cause more microleakage than plasma arc units. 2. In all groups the microleakage at the gingival margin is greater than the occlusal margin.

CLINICAL SIGNIFICANCE

The microleakage formation permits the passage of bacteria and oral fluids initiating white spot lesions beneath the bracket base.

Microleakage between composite/wire and composite/enamel interfaces of flexible spiral wire retainers: direct versus indirect application methods

OBJECTIVE

The aim of this in vitro study was to compare the microleakage of flexible spiral wire retainers (FSWR) at composite/wire and composite/enamel interfaces produced by an indirect application method to that of a conventional direct application method.

MATERIALS AND METHODS

Forty freshly extracted human mandibular incisor teeth were randomly divided into two equal groups. Group 1 was bonded directly according to the manufacturer's recommendations. Group 2 consisted of 20 teeth bonded indirectly with Transbond LR as the adhesive and Sondhi Rapid Set A/B Primer (3M Unitek, Monrovia, CA, USA), a filled resin primer. After bonding, specimens were further sealed with nail varnish, stained with 0.5% basic fuchsine for 24 h, sectioned and examined under a stereomicroscope that measured microleakage at the composite/wire and composite/enamel interfaces from both mesial and distal margins. Statistical analyses were performed using Wilcoxon and Mann-Whitney U-tests with Bonferroni correction.

RESULTS

Statistical comparisons indicated that no statistically significant differences were observed between composite/wire and composite/enamel interfaces for direct vs. indirect application procedures (Direct method p = 0.630 and Indirect method p = 0.930). Comparisons of the microleakage scores between direct and indirect FSWR application groups at composite/wire and composite/enamel interfaces indicated no statistically significant microleakage differences at mesial or distal margins (Composite/enamel interface p = 0.361 and Composite/wire interface p = 0.270).

CONCLUSION

The type of FSWR application procedures (direct vs. indirect) did not significantly affect the amount of microleakage at the enamel/composite/wire complex.

Microleakage under orthodontic brackets bonded with the custom base indirect bonding technique

The aim of this in vitro study was to compare microleakage of orthodontic brackets between enamel-composite and composite-bracket interfaces at the occlusal and gingival margins, bonded using indirect bonding systems with that of a conventional direct bonding method. Forty freshly extracted human maxillary premolar teeth were randomly divided into two groups. In group 1, the brackets were bonded to teeth directly according to the manufacturer's recommendations. Group 2 consisted of 20 teeth bonded indirectly with Transbond XT (3M-Unitek), as the adhesive, and Sondhi Rapid Set A/B Primer (3M-Unitek), a filled resin primer. After bonding, the specimens were further sealed with nail varnish, stained with 0.5 per cent basic fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage at the enamel-composite and composite-bracket interfaces from both the occlusal and gingival margins. Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests with Bonferroni correction. The gingival sides of group 1 displayed a higher median microleakage score than the occlusal side at the enamel-composite interface but this was not statistically significant (P > 0.05). All occlusal margins in both groups showed no microleakage under orthodontic brackets at the enamel-composite or composite-bracket interfaces. Comparisons of the microleakage scores between the direct and the indirect bonding groups at the enamel-composite and composite-bracket interfaces indicated no statistically significant microleakage differences at the gingival and occlusal margins (P > 0.05). The type of bonding method (direct versus indirect) did not significantly affect the amount of microleakage at the enamel-composite-bracket complex.

In vitro evaluation of microleakage under orthodontic brackets using two different laser etching, self etching and acid etching methods

This study evaluated the microleakage of brackets bonded by four different enamel etching techniques. Forty freshly extracted human premolars were divided randomly into four equal groups and received the following treatment: group 1, acid etching; group 2, self-etching primer (SEP); group 3, erbium:yttrium-aluminum-garnet (Er:YAG) laser etching; and group 4, erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser etching. After photopolymerization, the teeth were kept in distilled water for 1 month and then subjected to 500 thermal cycles. Then, the specimens were sealed with nail varnish, stained with 0.5% basic fuchsin for 24 h, sectioned, and examined under a stereomicroscope. In addition, they were scored for marginal microleakage at the adhesive-enamel and bracket-adhesive interfaces from the incisal and gingival margins. Statistical analyses consisted of the Kruskal-Wallis test and the Mann-Whitney U test with Bonferroni correction. Microleakage occurred between the adhesive-enamel and bracket-adhesive interfaces in all groups. For the adhesive-enamel surface, a significant difference was observed between group 1 and groups 2 (P = 0.011), 3 (P = 0.002), and 4 (P = 0.000) on the gingival side. Overall, significant differences were observed between group 1 and groups 3 (P = 0.003) and 4 (P = 0.000). In dental bonding procedures, acid etching was found to result in the least microleakage. Since etching with a laser decreases the risk of caries and is time-saving, it may serve as an alternative to acid etching.