Microleakage beneath ceramic and metal brackets photopolymerized with LED or conventional light curing units

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.

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.

Microleakage beneath orthodontic brackets in high field magnetic resonance imaging (MRI) AT 1.5 & 3 tesla

OBJECTIVES

The aim of the present study was to evaluate the effects of 1.5 T and 3 T MRI on the adhesion between the orthodontic brackets and the teeth by evaluating the microleakage between theenamel, adhesive and brackets interfaces.

METHODS

Fifty-eight extracted human premolars which were received a standard bracket bonding procedure were randomly divided into three groups; control group (n = 20; no MRI), 1.5 T MRI group (n = 19; 20 min MRI exposure of 1.5 T) and 3 T MRI group (n = 19; 20 min MRI exposure of 3 T). The teeth were kept in distiled water for 2 weeks, and thereafter subjected to 500 thermal cycles. Then specimens were sealed with nail varnish, stained with 0.5% basic fuchsin for 24 h, sectioned and photographed under a stereomicroscope. Microleakage was scored with regard to the adhesive-enamel and bracket-adhesive interfaces at the occlusal and gingival levels. Statistical analysis was accomplished by Kruskal-Wallis and Bonferroni-Dunn tests.

RESULTS

All of the groups exhibited statistically similar microleakage scores in the adhesive-enamel interface along occlusal margins (p>0.05, p = 0.331). The mean microleakage scores along gingival margins in the 3 T MRI group was significantly higher compared to the control group both in the adhesiv-enamel and bracket-adhesive interfaces (p<0.05, p = 0.019 and p = 0.020 respectively). The microleakage scores along the gingival margins were also significantly higher than the occlusal margins in the 3 T MRI group (p<0.05, p = 0.029).

CONCLUSIONS

3 T MRI may weaken the adhesion between the enamel and the stainless steel orthodontic brackets.

Biophysical and Fluoride Release Properties of a Resin Modified Glass Ionomer Cement Enriched with Bioactive Glasses

The aim of this study was to evaluate the bond strength, microleakage, cytotoxicity, cell migration and fluoride ion release over time from a resin-modified glass-ionomer cement (RMGIC) enriched with bioactive glasses (BAGs) and a nanohybrid restorative polymer resin agent used as adhesion material in the cemented brackets. One hundred and twenty bovine lower incisors were divided into three groups: (Transbond Plus Self Etching Primer (TSEP)/Transbond XT (TXT), TSEP/ACTIVA, orthophosphoric acid gel/ACTIVA) and brackets were bonded. A bond strength test and microleakage test were applied. A fluoride release test was applied after 60 days for the TXT and ACTIVA group. To evaluate cytotoxicity and cell migration, a cell viability and scratch migration assay were done for each group. p values < 0.05 were considered significant. Regarding bond strength and microleakage test, no significant differences were found between TSEP/TXT and TSEP/ACTIVA. At 6.4 pH, ACTIVA showed a higher degree of fluoride ion release, which increased with acid pH (3.5), with a maximum fluoride secretion at 30 days. MTT assay revealed that TXT reduces the viability of gingival cells with significant differences (p < 0.001) compared to the untreated cells (control group). ACTIVA provides optimal adhesive and microfiltration properties, releases substantial amounts of fluoride ions in both acid and neutral media, and its biocompatibility is greater than that of traditional composite resin adhesive systems.

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.

Clinical performance of uncoated and precoated polymer mesh base ceramic brackets

Background

To evaluate the clinical performance of the two types of InVu ceramic brackets. The clinical performance of these brackets was measured by determining failure as well as survival rates and tie-wing fractures. Enamel surface evaluation following bracket and remnant removal was performed.

Subjects and methods

Forty non-extraction patients (31 females, 9 males) with a mean chronological age of 16 years 4 months composed this study. Bonding was performed with a split-mouth design using operator-coated and Readi-Base eXact InVu brackets. During the treatment period (45.89 ± 2.0 weeks), the failed brackets were recorded as well as the brackets with tie-wing fractures. Debracketing was undertaken with a ligature cutter (delamination technique) as recommended by the manufacturer. A modified remnant index (MRI) was used to visually evaluate the amount of remnants remaining on the tooth surface. Horizontal crack evaluation was carried out via transillumination.

Results

Operator-coated InVu brackets demonstrated a bond failure rate of 2.6%. This value was 6.8% for the Readi-Base eXact InVu brackets. Failure rates as well as survival rates presented a statistically significant difference (P = 0.006). A higher bond failure for the premolar teeth when compared to incisor teeth, as well as a higher bond failure in the lower arch when compared to the upper arch was found. These findings were statistically significant (P = 0.000 and P = 0.007, respectively). The effect of gender on bond failure rate (P = 0.508) and survival rate (P = 0.503) was not statistically significant. Both bracket types showed comparable results for tie-wing fractures (P = 0.174). A statistically significant difference was obtained for the MRI scores (P = 0.000). No horizontal enamel cracks were observed for both bracket types.

Conclusion

The operator-coated InVu brackets demonstrated a lower failure rate when compared to the Readi-Base eXact pre-applied adhesive InVu brackets. The debonding procedure was safe for both bracket types.

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.

A comparative evaluation of the effectiveness of erbium-doped yttrium aluminum garnet laser with other in house refurbishing methods for reconditioning stainless steel and ceramic brackets. An environmental scanning electron microscope and shear bond strength analysis: An in-vitro study

Introduction

Brackets can be recycled by sending them to a commercial recycling company but it is time consuming and the bracket cannot be bonded in the same appointment. Hence in-house methods for recycling of brackets would be beneficial to both the orthodontist and the patient.

Aim

In our study, we compared the shear bond strength of brackets after being recycled with erbium-doped yttrium aluminum garnet (ER:YAG) laser, sandblasting and the thermal method.

Materials and Methods

The study was carried out on 126 extracted premolars. The bonding procedure was performed with mandibular premolar metal and premolar ceramic brackets. Eighty-four teeth were subdivided into three groups for each method of recycling. These groups were further subdivided into two groups of 14 teeth each for the types of brackets used. Prior to the initial bonding the bracket was also viewed under an environmental scanning electron microscope to examine the meshwork of the brackets and once again after the respective recycling methods had been performed.

Results

We found that for stainless steel brackets, the sandblasting method was superior to the ER:YAG laser, as the recycled brackets showed a higher shear bond strength. For ceramic brackets the ER:YAG laser recycled group had the highest recycled shear bond strength therefore was the best method of recycling ceramic brackets.

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.

Are the low-shrinking composites suitable for orthodontic bracket bonding?

Purpose:

To evaluate the shear bond strength (SBS), adhesive remnant index (ARI), and microleakage of low-shrinking and conventional composites used as an orthodontic bracket bonding adhesive.

Materials and Methods:

A hundred twenty non-caries human premolars, extracted for orthodontic purposes, were used in this study. Sixty of them were separated into two groups. Brackets were bonded to the teeth in the test group with Silorane (3M-Espe) and control group with Transbond-XT (3M-Unitek). SBS values of these brackets were recorded in MPa using a universal testing machine. ARI scores were determined after the failure of brackets. The remaining 60 teeth were divided into two groups and microleakage was evaluated by the dye penetration method. Statistical analyses were performed by Wilcoxon, Pearson Chi-square, and Mann–Whitney U tests at P < 0.05 level.

Results:

The mean SBS for Transbond XT was significantly greater than low-shrinking composite (P < 0.001). Significant differences (χ² =29.60, P < 0.001) were present between the two groups for the ARI scores. Microleakage values were lower in low-shrinking composite than in the control group, and this difference was found to be statistically significant (P < 0.001).

Conclusions:

Although low-shrinking composite produced insufficient SBS and ARI scores, microleakage values were lower in low-shrinking composite than in the control group on the etched enamel surfaces, when used as a bracket bonding composite.

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.

Microleakage under orthodontic bands cemented with nano-hydroxyapatite-modified glass ionomer

OBJECTIVES

To estimate the in vivo effect of nano-hydroxyapatite (HA) modification of banding glass-ionomer cement on microleakage under orthodontic bands.

MATERIALS AND METHODS

Eighty noncarious premolars scheduled for extraction in 20 orthodontic patients were randomly divided into four groups. Grouping was based on the ratio of nano-HA (0%, 5%, 10%, 15% by weight) added to the luting glass-ionomer cement (GIC) Ketac-Cem, which was used for cementation of prefabricated micro-etched orthodontic bands. Dye penetration method was used for microleakage evaluation at the cement-band and cement-enamel interfaces. Statistical evaluation was performed with a Kruskal-Wallis test and a Mann-Whitney U-test, and a Bonferroni-adjusted significance level was calculated.

RESULTS

Bands cemented with conventional GIC showed the highest microleakage scores in comparison to those cemented with nano-HA-modified GIC. No significant difference was found between teeth banded with 10% and 15% modified GIC.

CONCLUSIONS

Modification of the banding GIC with 15% nano-HA revealed a positive effect on reducing microleakage around orthodontic bands.

Use of light-curing units in orthodontics

Because of their wide field of applications, light-curing units are now indispensable for orthodontists and general dentists; thus, it is important to be familiar with the various types of light-curing units, their history, specifications, advantages, and disadvantages. For this review, a search of the PubMed database (from 1966 to March 2010) was conducted using the search term "curing lights orthodontics". Eligibility of the selected studies was determined by reading the abstracts of articles identified by the search. All the articles that met the inclusion criteria were selected, and the articles collected. The reference lists of the retrieved articles were also hand searched for any applicable studies that might have been missed in the database searches. When selecting curing lights for an office, many variables need to be considered. Armed with knowledge about each curing-light category, orthodontists can evaluate their unique practice style and select the appropriate light/lights.

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.

Effects of high-intensity curing lights on microleakage under orthodontic bands

INTRODUCTION

Our objective was to compare the effects of 3 light-curing units (LCUs) (quartz-tungsten-halogen [QTH], light-emitting diode [LED], and plasma-arc curing [PAC]) on the microleakage patterns of a polyacid-modified composite (PAMC) for band cementation between the cement-enamel and the cement-band interfaces from the buccal, lingual, occlusal, and gingival margins.

METHODS

Sixty freshly extracted third molars were randomly divided into 3 groups of 20 teeth each. Microetched molar bands were cemented in all groups with the PAMC (Ultra Band-Lok, Reliance Orthodontic Products, Itasca, Ill) and cured for 30 seconds with the QTH (Hilux 350, Express Dental Products, Toronto, Ontario, Canada), for 20 seconds with the LED (Elipar Freelight 2, 3M Espe, Seefeld, Germany), or for 6 seconds with the PAC (Power-Pac, American Medical Technologies, Hannover, Germany). A dye penetration method was used for microleakage evaluation. Microleakage was determined with a stereomicroscope for the cement-band and cement-enamel interfaces from the buccal and lingual sides at the occlusal and gingival margins. Statistical analyses were performed with the Kruskal-Wallis and Mann-Whitney U tests. The level of significance was set at P <0.05.

RESULTS

The gingival sides in the LED and PAC groups had higher microleakage scores compared with those observed on the occlusal sides at both the cement-band and cement-enamel interfaces. The buccal sides had similar microleakage values compared with those on the lingual sides for the cement-enamel and cement-band interfaces in all LCU types. Statistical comparisons showed that there were statistically significant differences among the investigated LCUs at the cement-enamel interface (P <0.05). Post hoc comparisons showed statistically significant microleakage differences between the PAC (median, 0.950 mm), the QTH (median, 0.383 mm) (P <0.01), and the PAC and the LED (median, 0.558 mm) (P <0.05) LCUs at the cement-enamel interfaces.

CONCLUSIONS

The high-intensity curing device PAC is associated with more microleakage than the LED and QTH at the cement-enamel interface.

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.

Microleakage under ceramic and metallic brackets bonded with resin-modified glass ionomer

OBJECTIVE

To test the null hypothesis that there is no significant difference between the microleakage of adhesive interferences at the occlusal and gingival margins of both ceramic and metallic brackets bonded with light-cured resin-modified glass ionomer and a conventional adhesive.

MATERIALS AND METHODS

Sixty freshly extracted human maxillary premolar teeth were randomly divided into four groups of 15 teeth each. Metal and ceramic brackets were bonded to groups 1 and 2 with resin-modified glass ionomer adhesive (RMGIA). Metal and ceramic brackets were bonded to group 3 and group 4 with a conventional adhesive (CA) system. A dye-penetration method was used for microleakage evaluation. Microleakage from the occlusal and gingival margins was determined by a stereomicroscope for the enamel-adhesive and bracket-adhesive interfaces. Statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U-test with a Bonferroni correction.

RESULTS

The gingival side of all groups exhibited higher microleakage scores compared with the occlusal side for both adhesive interfaces. All bracket and adhesive combinations displayed statistically significant differences in microleakage between the enamel-adhesive and adhesive-bracket interfaces at the occlusal and gingival sides of the brackets (P < .001). When the adhesive systems were compared, the RMGIA showed more microleakage than the CA between the different interfaces.

CONCLUSIONS

The hypothesis is rejected. RMGIA results in more microleakage between enamel-adhesive interfaces.

Microleakage beneath brackets bonded with flowable materials: effect of thermocycling

The purpose of this study was to evaluate the effects of thermocycling on microleakage beneath brackets bonded with an orthodontic composite and different flowable materials. Brackets were bonded to 200 bovine incisors divided into five groups: (1) Transbond XT, (2) X-Flow, (3) Dyract-Flow, (4) Admira-Flow, and (5) Beautiful-Flow. Half the teeth in each group were thermocycled. The specimens were dyed with 1 per cent methylene blue for 24 hours to determine the percentage of microleakage into the enamel-adhesive and adhesive-bracket interfaces using image analysis equipment. Data were analysed using the Kruskal-Wallis and Mann-Whitney U-tests (P < 0.05), applying Bonferroni correction when required (P < 0.005). Without thermocycling, microleakage at the enamel-adhesive interface was significantly greater for Admira-Flow than for X-Flow (P < 0.005). At the adhesive-bracket interface, there were no significant differences (P > 0.005). After thermocycling, microleakage of Beautiful-Flow at the enamel-adhesive interface was significantly less than for the other materials tested (P < 0.005), while at the adhesive-bracket interface, Admira-Flow and X-Flow showed significantly more microleakage than Beautiful-Flow and Transbond XT (P < 0.005). Analysis of the effect of thermocycling on each material showed that microleakage increased significantly at the enamel-adhesive interface with Transbond XT (P < 0.05), decreased with Beautiful-Flow (P < 0.05), increased significantly at both interfaces with X-Flow, but not to a statistically significant level with Dyract-Flow and Admira-Flow (P > 0.05). The giomer, Beautiful-Flow, demonstrated the best performance after thermocycling, while composite resins and, in particular, the flowables showed a poorer performance.

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

OBJECTIVE

To compare the in vitro microleakage of orthodontic brackets (metal and ceramic) between enamel-adhesive and adhesive-bracket interfaces at the occlusal and gingival sides produced by self-etching primer system with that of conventional acid etching and bonding.

MATERIALS AND METHOD

Sixty freshly extracted human mandibular premolar teeth were used in this study. The teeth were separated into four groups of 15 teeth each and received the following treatments: Group 1, 37% phosphoric acid gel + Transbond XT liquid primer + stainless steel bracket; Group 2, Transbond Plus Self-Etching Primer (TSEP) + stainless steel bracket; Group 3, 37% phosphoric acid gel + Transbond XT liquid primer + ceramic bracket; Group 4, TSEP + ceramic bracket. After curing, specimens were further sealed with nail varnish, stained with 0.5% basic fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage for the enamel-adhesive and bracket-adhesive interfaces from both occlusal and gingival margins. Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney U tests.

RESULTS

The gingival sides in all groups exhibited higher microleakage scores compared with those observed in occlusal sides for both adhesive interfaces. Enamel-adhesive interfaces exhibited more microleakage than did the adhesive-bracket interfaces. Brackets bonded with self-etching primer system showed significantly higher microleakage at the enamel-adhesive interface of the gingival side.

CONCLUSIONS

TSEP causes more microleakage between enamel-adhesive interfaces, which may lead to lower bond strength and/or white-spot lesions.

Microleakage under Orthodontic Brackets Using High-Intensity Curing Lights

Objective: To compare the microleakage of the enamel-adhesive-bracket complex at the occlusal and gingival margins of brackets bonded with high-intensity light curing lights and conventional halogen lights.

Materials and Methods: Forty-five freshly extracted human maxillary premolar teeth were randomly separated into three groups of 15 teeth each. Stainless steel brackets were bonded in all groups according to the manufacturer's recommendations. Specimens (15 per group) were cured for 40 seconds with a conventional halogen light, 20 seconds with light-emitting diode (LED), and 6 seconds with plasma arc curing light (PAC). After curing, the specimens were further sealed with nail varnish, stained with 0.5% basic-fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage for the enamel-adhesive and bracket-adhesive interfaces from both the occlusal and gingival margins. Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests with a Bonferroni correction.

Results: The type of light curing unit did not significantly affect the amount of microleakage at the gingival or occlusal margins of investigated interfaces (P &gt;.05). The gingival sides in the LED and PAC groups exhibited higher microleakage scores compared with those observed on occlusal sides for the enamel-adhesive and adhesive-bracket interfaces. The halogen light source showed similar microleakage at the gingival and occlusal sides between both adhesive interfaces.

Conclusions: High-intensity curing units did not cause more microleakage than conventional halogen lights. This supports the use of all these curing units in routine orthodontic practice.

Different Lingual Retainer Composites and the Microleakage between Enamel-Composite and Wire-Composite Interfaces

Objective: To assess microleakage of enamel-composite and wire-composite interfaces when retainer wires were bonded with two orthodontic and a flowable composites.

Materials and Methods: Forty-five freshly extracted human mandibular canine teeth were used in this study. Teeth were separated into three groups of 15 teeth each. Round stainless-steel wire of 0.36-in. diameter in three groups was bonded to enamel by Transbond XT (3M Unitek), Transbond LR (3M Unitek), and Venus Flow (Heraeus Kulzer) composites. Specimens were further sealed with nail varnish, stained with 0.5% basic fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage for the enamel-composite and wire-composite interfaces from mesial and distal margins. Statistical analysis was performed by Kruskal-Wallis and Mann-Whitney U-tests.

Results: Little or no microleakage was determined at the mesial and distal sides for three composites in two different interfaces, and these findings were not statistically significant (P &gt; .05). No statistically significant differences were observed among all composite groups for the microleakage with either of the interfaces. Venus Flow in the enamel-composite interface and Transbond LR in the wire-composite interface exhibited no microleakage.

Conclusion: The presence of wire in the mesial portion of the lingual retainer did not increase the microleakage at the enamel-composite and wire-composite interfaces in all groups. The microleakage results in this study support the use of all these composites in routine orthodontic practice.