Impact of fluoride-releasing orthodontic adhesives on the shear bond strength of orthodontic brackets to eroded enamel following different surface treatment protocols

Evaluation of the remineralizing effect of the chicken eggshell paste after removal of the fixed orthodontic appliance: An in vitro study

BACKGROUND

Demineralization of the enamel surface, which appears as white spot lesions during and after removal of the fixed orthodontic appliance, is the most common disadvantage of the orthodontic treatment course. Using the remineralizing agents during and after orthodontic treatment helps to avoid those enamel defects.

OBJECTIVE

The present study aims to assess the remineralizing effect of the chicken eggshell powder on the demineralized enamel surfaces after debonding the orthodontic bracket system.

MATERIALS AND METHODS

The current study was performed on 80 prepared premolar crowns embedded into acrylic molds. The samples were prepared to receive routine steps of the bonding process for the bracket system. The paste of the chicken eggshell powder was added to the samples after the debonding process. Scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) were used to evaluate the remineralization effect of the chicken eggshell powder. Also, the Vickers microhardness tester was used to assess the enamel surface microhardness.

RESULTS

It was found that the mean value of the Ca/P ratio for the samples before bonding of the orthodontic bracket system was (4.17 ± 2.2). This value significantly decreased to (2 ± 1.3) after debonding of the orthodontic bracket system and then showed a significant increase to (4.79 ± 2.65) after remineralization. These results were assured by the values of the Vickers microhardness tester.

CONCLUSION

The chicken eggshell powder has an excellent remineralization effect for the demineralized enamel surface after debonding the orthodontic enamel surface.

Shear bond strength of a RMGIC for orthodontic bracket bonding to enamel

OBJECTIVE

To evaluate the shear bond strength (SBS) of a restorative resin-modified glass ionomer cement (RMGIC) for orthodontic bracket bonding.

MATERIALS AND METHODS

One hundred twenty-one human teeth were randomly divided into 11 groups (n = 11) according to the surface treatment applied (H3PO4 ± Transbond Plus (TSEP) or Scotchbond Universal (SU)), and the adhesive used (Riva LC HV (RIVA), Fuji Ortho (FUJI), and Transbond XT (TXT)). For each sample, a metal button was bonded. SBS tests were performed at 1 week and debonded specimens were observed for failure modes determination. One-way ANOVA followed by Tukey's post hoc test was used to compare SBS differences and Fisher's exact test to analyze the failure modes (p < 0.05).

RESULTS

TSEP + FUJI and H3PO4 + SU + TXT showed the highest SBS values while H3PO4 + TSEP + RIVA showed the lowest value. Cohesive failure and mixed failure were found in the groups with SU and TXT and adhesive failure in the other groups.

DISCUSSION/CONCLUSIONS

The bonding of orthodontic attachments to enamel could be performed with any of the three materials studied. The use of a universal adhesive in the bonding protocol could optimize the adhesion values. Clinical studies would be needed to confirm the results obtained.

Fluoridated orthodontic adhesives: Implications of release and recharge and their impact on shear bond strength in demineralized tooth surfaces

Background

This study measured fluoride release from a light-cured orthodontic adhesive resin (Vega type) at three time intervals (one day, one week, and one month), investigated the rechargeability of the resin, and assessed its impact on shear bond strength in demineralized tooth surfaces.

Methods

This study used 30 recently extracted upper premolar teeth to explore the effects of fluoride release over specific time intervals. The teeth underwent demineralization and were categorized into groups based on time intervals: one day, one week, and one month. Subgroups within each interval underwent fluoride recharging through fluoride varnish application. Fluoride release and shear bond strength were assessed after etching with phosphoric acid gel, applying the orthodontic adhesive, and curing. The samples were stored in deionized water. Fluoride quantification used a selective electrode, while shear bond strength assessment employed a universal testing machine. Finally, statistical analysis of the data was performed using SPSS 22.

Results

The study found that after one month, the adhesive had the highest fluoride release and shear bond strength mean values. There were significant differences in fluoride release and shear bond strength between the various groups studied.

Conclusion

The application of fluoride varnish around the orthodontic bracket resulted in a positive effect on the shear bond strength of the bracket.

Assessment of enamel surface roughness and hardness with metal and ceramic orthodontic brackets using different etching and adhesive systems: An in vitro study

Background

This study aimed to evaluate enamel surface roughness and microhardness following the use of different bracket materials (metal or ceramic), etchants (total- and self-etchants), and adhesive systems (precoated or flash-free).

Method

A total of 99 extracted human premolars were selected for the analysis. The surface roughness was first assessed (roughness control). One specimen from each subgroup was examined using a scanning electron microscope to illustrate the surface topography. Eighty-eight teeth were prepared using total- or self-etchants and bonded to precoated or flash-free adhesive metal or ceramic brackets. The remaining 11 specimens were not bonded to brackets (microhardness controls). The brackets were debonded after immersion in distilled water for 24 h. The specimens were again scanned for surface roughness and topography imaging. Finally, the microhardness was assessed using a micro-Vickers hardness test at a force of 200 g for 10 s.

Result

An overall statistically significant increase in surface roughness and reduced surface microhardness were observed in all experimental groups when compared with those in the control groups. The etchant type was the only variable found to contribute to the measured surface properties, with increased roughness and reduced microhardness introduced by total-etching compared to those by self-etching.

Conclusion

Orthodontic brackets introduced a significant increase in enamel surface roughness and reduce microhardness compared with untreated enamel, regardless of the bracket material, etchant type, and adhesive system. The etchant type was the only variable contributing to these changes, with total etching having a more pronounced effect.

Evaluation of the Shear Bond Strength of Chitosan Nanoparticles-Containing Orthodontic Primer: An In Vitro Study

Objectives

The present study was intended to investigate the effect of different concentrations of chitosan nanoparticles mixed with an orthodontic primer on the shear bond strength and bond failure of stainless steel brackets bonded to dental enamel.

Methods

Four concentrations of chitosan nanoparticles (0%, 1%, 5%, and 10%) were prepared and mixed with Transbond™ XT primer. Forty-eight extracted maxillary first premolars were bonded under a standardized procedure with stainless steel orthodontic brackets utilizing those different concentrations (12 teeth per each group). After the bonding procedure, the specimens were stored in deionized water (37°C for 24 hr) and then thermocycling 5,000 times before shear bond testing, which was performed using a universal testing device. Bond failure sites were examined under a stereomicroscope. Scanning electron microscopy and X-ray diffraction were also performed to verify and evaluate the phase of the nanopowder.

Results

The data were statistically analyzed using one-way analysis of variance) and Kruskal-Wallis H tests, and the findings revealed statistically nonsignificant group differences regarding the shear bond strength and adhesive remnant index (p > 0.05).

Conclusions

Primers containing varying concentrations of chitosan nanoparticles demonstrated acceptable shear bonding strength and adhesive remnant index.

Evaluation of shear bond strength and enamel remineralizing effect of experimental orthodontic composite containing nano-hydroxyapatite: An in vitro study

OBJECTIVE

The purpose of this study was to prepare an orthodontic composite containing hydroxyapatite nanoparticles to prevent demineralization and create a suitable environment for mineral deposition around orthodontic brackets, and to investigate the mechanical and remineralizing properties of the experimental adhesive composite.

METHODS

Experimental orthodontic composite were formulated using varying percentages of nano-hydroxyapatite particles. Assessments were based on four groups: a control group (3M™ Transbond™ XT) and experimental composites containing 2% (HA2), 5% (HA5) and 10% (HA10) hydroxyapatite. Vickers Microhardness test was performed to investigate the remineralizing effect in 3 stages: initial stage, after demineralization and after 4 weeks of exposure to artificial saliva. Scanning electron microscopy with energy dispersive X-ray spectroscopy analyser (SEM/EDAX) was used to evaluate hydroxyapatite precipitation and elemental composition of enamel surface. Shear Bond Strength tests were carried out using a universal testing machine and the debonding pattern was assessed using Adhesive Remnant Index (ARI).

RESULTS

All groups showed clinically acceptable SBS values. The highest SBS was achieved in the HA2 group, followed by Transbond™ XT, HA5 and HA10. There was no significant difference in the ARI scores. In terms of microhardness properties, HA5 and HA10 demonstrated a significant increase after 4 weeks. The results of SEM analysis showed the precipitation of hydroxyapatite crystals and EDAX analysis indicated the increase of calcium and phosphate ion peaks compared to the demineralized sample. The data were analysed using one-way ANOVA and Tukey's Post-hoc test.

CONCLUSIONS

Addition of hydroxyapatite nanoparticles to orthodontic composite can increase the mineral content and microhardness of the adjacent enamel. However, increasing the amount of nanoparticles reduces shear bond strength in a decreasing trend. The above-mentioned findings showed that incremental increase of nanoparticles of HA can be incorporated in composite to a certain extent and limitations are determined by mechanical properties (SBS) required for bracket bonding.

Effect of Remineralizing Agents on Shear Bond Strength of Orthodontic Brackets-In Vitro Study

Orthodontic treatment can be effective only with the proper adhesion strength of the bonded elements on the teeth. The aim of the study was to analyze the influence of different remineralization products on the brackets (Evolve Low Profile Brackets 0.022 Roth prescription (DB Orthodontics Ltd., Silsden, England) shear bond strength (SBS)). In all, 40 teeth were investigated for this study; n = 30 demineralized (immersed in 0.1% citric acid for 30 min, twice a day, for 20 consecutive days) and n = 10 immersed only in artificial saliva. After the demineralization process, remineralization agents were applied to each group (n = 10): Group I: Elmex Sensitive professional^® toothpaste (CP, Gaba GmbH, Witten, Germany) and GC MI Paste Plus^® (GC, Leuven, Belgium), Group II: Elmex Sensitive professional^® toothpaste (CP, Gaba GmbH, Germany) and GC Tooth Mousse^® (Leuven, Belgium), Group III: Elmex Sensitive professional^® toothpaste (CP, Gaba GmbH, Germany). For the teeth in control group C, Elmex Sensitive professional^® toothpaste was used. SBS tests were performed by means of an advanced materials-testing machine that generated maximum load and tensile strength values. The data obtained underwent statistical analysis (ANOVA and Tuckey test) with a statistical threshold of p < 0.05. The SBS values were higher for group II (14.20 MPa) and I (10.36 MPa) and lower for group III (4.25 MPa) and C (4.11 MPa), with statistically significant differences between groups I and II when compared with groups III and C (p < 0.05). In conclusion, GC Tooth Mousse^® and MI-Paste Plus^® have no adverse effect on brackets SBS and are recommended to be used for enamel remineralization during orthodontic treatment.

Effects of an orthodontic primer containing amorphous fluorinated calcium phosphate nanoparticles on enamel white spot lesions

OBJECTIVES

The study investigated the effects of an orthodontic primer containing amorphous fluorinated calcium phosphate (AFCP) nanoparticles on enamel white spot lesions (WSLs).

MATERIALS AND METHODS

The AFCP nanoparticles were prepared and incorporated into Transbond XT Primer. Thirty-two human enamel slices were highly polished and randomly divided into four groups: no part covered (control), half covered with a primer containing 0 wt%, 25 wt%, and 35 wt% AFCP. Subsequently, samples were challenged by a modified pH-cycling and characterized by color measurement, micro-computed tomography, and scanning electron microscope (SEM). The bonding properties of the primers containing AFCP were assessed using shear bond strength test, and the mouse fibroblasts (L929) were employed to evaluate the cytotoxicity.

RESULTS

When the enamel was challenged by pH cycling, 25 wt% and 35 wt% AFCP groups exhibited less color change (ΔE) and less mineral loss than the control and 0 wt% AFCP groups. The SEM images showed that the original microstructural integrity and mineral deposition rate of the enamel surface were better in the 25 wt% and 35 wt% AFCP groups. In particular, the 35 wt% AFCP group exhibited the best performance after 3 weeks of pH cycling. The shear bond strength and cell viability revealed no significant difference among the tested groups (P > 0.05).

CONCLUSION

Using the primer containing 35 wt% AFCP might be a promising strategy for preventing the occurrence and development of WSLs during orthodontic treatment.

Comparative Evaluation of Two Bracket Systems' Bond Strength: Conventional and Self-Ligating

Adhesion remains a key element in dentistry, whether approached in prosthetics, odontology, or orthodontics. It is a continuously researched aspect, as improved materials and adhesive methods keep emerging in the market. No orthodontic treatment can be effective without the proper adhesion strength of the bonded elements on the teeth. The objective of this research, in the broad context of self-ligating versus conventional brackets, was to compare active and passive self-ligating systems with a conventional one by conducting an in vitro study on human-extracted premolars. Shear bond strength tests were executed by means of an advanced materials-testing machine that generated maximum load and tensile strength values. The data obtained underwent statistical analysis with a statistical threshold of p < 0.05. The results regarding the statistical significance were acquired when comparing the passive self-ligating system with the active self-ligating and conventional systems (load-at-maximum-load mean 204.9, SD 91.09, and p < 0.05). In this study, the passive self-ligating bracket system appears to present increased shear bond strength.

A remineralizing orthodontic etchant that utilizes calcium phosphate ion clusters

This study aimed to investigate whether a phosphoric acid (H3PO4) solution containing calcium phosphate ion clusters (CPICs) could minimize enamel damage during long-term bracket bonding by dissolving the enamel surface and promoting enamel remineralization. The experimental design is as follows: first, three experimental etchants (H3PO4, CPICs-incorporated H3PO4 solution-I, and CPICs-incorporated H3PO4 solution-II) and two bonding resins (conventional orthodontic resin and self-adhesive orthodontic resin) were used in combination to create six groups, respectively. Each of these six groups was then divided into two sub-groups based on the presence or absence of thermocycling (TC). Twenty samples were assigned to each of the 12 groups (independent variables), and thus a total of 240 metal bracket-attached human premolars were used in this experiment. Bracket debonding was performed on each of 20 premolars in 12 groups, and shear bond strength (SBS) and adhesive remnant index (ARI) values were measured as dependent variables. Next, the three experimental etchants were applied (independent variables) to each of the three enamel samples, and the remineralization of the enamel surface was investigated as a dependent variable. The enamel surface was observed using electron scanning and atomic force microscopy. Furthermore, X-ray diffraction, energy dispersive spectroscopy (EDX) spectrum X-ray spectroscopy, and elemental mapping were performed, and the Knoop microhardness scale was measured. Therefore, the experiment was performed in two steps: SBS and ARI measurements for 12 groups, followed by observation of the enamel surface and microhardness measurements, according to the three types of etchants. As a result of the experiment, first, when the bracket was debonded, SBS did not decrease, and residual adhesive was hardly observed in the C2A group (before TC), C2A, and C1C groups (after TC) (p &lt; 0.001). Second, the experimental etchant containing CPICs achieved remineralization while demineralizing the enamel. This was verified through SEM/EDX, element mapping, XRD, and AFM. Also, the roughness and microhardness of the enamel surface were better in the remineralized surface by the experimental etchant containing CPICs (p &lt; 0.017). The CPICs-incorporated H3PO4 solution reduced ARI while maintaining SBS during bracket debonding, regardless of whether TC was performed or the type of resin. The etchant containing CPICs was also shown to remineralize the enamel and increase its microhardness.