The Influence of Indirect Bonding Technique on Adhesion of Orthodontic Brackets and Post-Debonding Enamel Integrity—An In Vitro Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample Preparation
2.2. Preparation of Transfer Trays
2.3. Adhesive Preparation and Bracket Placement
2.4. SEM of the Bracket–Enamel Interface
2.5. Shear Bond Strength
2.6. ARI Score
2.7. SEM-EDS of Specimens after SBS
2.8. Statistical Analysis
3. Results
3.1. SEM of the Bracket–Enamel Interface
3.2. Shear Bond Strength
3.3. ARI Score
3.4. SEM EDS Specimens after SBS
4. Discussion
5. Conclusions
- The type of bracket (metal/ceramic) has a significant effect on the SBS in the indirect bonding technique.
- Ceramic-OPC brackets bonded indirectly to the enamel surface achieved the highest SBS; hence, the enamel damage was significantly higher than that of other brackets.
- Metal-APC brackets bonded indirectly may represent the most appropriate choice due to the relatively high bond SBS and favourable debonding pattern.
- Ceramic brackets can be an alternative for metal brackets in cases that require a high bond strength.
- In the present study, the mean ARI score in all the tested groups did not exceed 2, which is a compromise between having a strong adhesive connection to the enamel (more resistant to applied orthodontic forces during treatment) and reduced time required for enamel polishing.
- The debonding of orthodontic brackets with high SBS values can lead to enamel damage even when it is not noticeable clinically.
- There is a need for the standardization of perimeters in in vitro orthodontic research.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Group | Difference | SE | p-Value |
---|---|---|---|
Metal-OPC vs. Metal-APC | 3.542 | 0.5352 | 0.0002 |
Metal-OPC vs. Ceramic-OPC | 4.819 | 0.5352 | 0.0000 |
Metal-APC vs. Ceramic-OPC | 1.277 | 0.5352 | 0.2249 |
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Application Area | Procedure |
---|---|
Bracket | Application of Transbond XT Light Cure Adhesive * |
Light curing (15 s) | |
Cast | Bracket positioning |
Preparation of transfer trays from Emiluma and Lumaloc and placing the cast into the water for 30 min | |
Removal of transfer trays (with brackets inside) | |
Enamel | Etching (30 s), rinsing (30 s), and drying (30 s) |
Application of Sondhi Rapid Set System: | |
Placing the tray | |
Removal of the tray after material setting (2 min.) |
Material | Type of Material | Composition | Application Time | Area of Application |
---|---|---|---|---|
Scotchbond Universal Etchant (3M ESPE, St. Paul, MN, USA) | Acid | 32% wg. H3PO4 | 30 s | Enamel (cleaned) |
Transbond XT Primer (3M Unitek, Monrovia, CA, USA) | Polymerizable monomer | TEGDMA, Bis-GMA | NA | Enamel (etched, rinsed, dried) |
Transbond XT (3M Unitek, Monrovia, CA, USA) | Light cure adhesive resin with quartz filler | Silane-treated quartz, Bis-GMA, silane; 77% quartz filler | NA | Bracket base |
Sondhi Rapid Set Resin A (3M Unitek, Monrovia, CA, USA) | Chemical cure adhesive resin with silica filler | TEGDMA, Bis-GMA, silane treated silica, SbPh3, HQ | 3–5 s per tooth followed by a gentle air burst for 1–2 s | Enamel (etched, rinsed) |
Sondhi Rapid Set Resin B (3M Unitek, Monrovia, CA, USA) | Chemical cure adhesive resin | TEGDMA, Bis-GMA, silane treated silica, SbPh3, HQ, PTDE, dimethyl siloxane | NA | Bracket base |
Emiluma (Ultradent Products Inc., South Jordan, UT, USA) | Silicone | Vinyl polisiloxane | NA | Cast |
Lumaloc (Ultradent Products Inc., South Jordan, UT, USA) | Silicone | Quartz, silicone dioxide, tridecyl alcohol ethoxylated, dimethylsiloxane | Placed in water for 30 min after application | Cast (on the Emiluma layer) |
Study Group | Manufacturer | Bracket Type | Internal Structure | Prescription | Base Type | Base Area |
---|---|---|---|---|---|---|
Metal-OPC | Victory Series™ (3M, Unitek, Monrovia, CA, USA) | Metal | Austenitic stainless steel | .022″ MBT for upper premolar | Foil mesh | 8.97 mm2 |
Metal-APC | APC Plus™ Victory Series™ (3M, Unitek, Monrovia, CA, USA) | Metal | Austenitic stainless steel | .022″ MBT for upper premolar | Foil mesh covered with light cure adhesive | 8.97 mm2 |
Ceramic-OPC | Clarity™ Advanced (3M, Unitek, Monrovia, CA, USA) | Ceramic | Polycrystalline | .022″ MBT for upper premolar | Microcrystalline mechanical | 11.69 mm2 |
Amount of Adhesive on Bracket Base [25] | BARI Score [25] | ARI Score [24] | Adhesive Left on the Tooth [24] |
---|---|---|---|
0% | 1 | 3 | 100% (Distinct impression of the bracket mesh) |
<25% | 2 | 2 | >50% |
>25% and <50% | 3 | 2 | |
>75% | 4 | 1 | <50% |
100% | 5 | 0 | 0% |
Bracket Type | Element | Weight% | Atomic% |
---|---|---|---|
Metal OPC | C | 8.94 | 30.99 |
Al | 0.13 | 0.20 | |
Si | 0.35 | 0.52 | |
Cr | 15.61 | 12.50 | |
Mn | 1.16 | 0.88 | |
Fe | 70.07 | 52.26 | |
Ni | 3.74 | 2.65 | |
Ceramic-OPC | O | 44.60 | 57.58 |
Al. | 55.40 | 42.42 |
Bracket Type | Element | Weight% | Atomic% |
---|---|---|---|
Metal-OPC | C | 58.88 | 66.94 |
O | 34.96 | 29.84 | |
F | 0.69 | 0.0 | |
Na | 0.50 | 0.30 | |
Al | 0.47 | 0.24 | |
Si | 4.50 | 2.19 | |
P | 0.00 | 0.00 | |
Metal-APC | C | 28.00 | 41.23 |
O | 27.83 | 30.76 | |
F | 6.80 | 6.33 | |
Al. | 7.09 | 4.64 | |
Si | 21.97 | 13.83 | |
P | 3.20 | 1.83 | |
Zn | 5.12 | 1.38 | |
Ceramic-OPC | C | 39.40 | 47.59 |
O | 54.27 | 49.21 | |
Al | 1.21 | 0.65 | |
Si | 4.06 | 2.09 | |
P | 0.67 | 0.32 | |
Ca | 0.38 | 0.14 |
Author | Number of Specimens | Type of Brackets | Conclusions |
---|---|---|---|
Guzman et al. (2013) [27] | 90 | Metal-OPC vs. Metal-APC | NSD |
González-Serrano et al. (2019) [8] | 120 | Ceramic-OPC vs. Ceramic-APC | NSD |
Marc et al. 2018 [29] | 45 | Ceramic-OPC vs. Ceramic-APC | NSD |
Ansari et al. (2016) [30] | 50 | Ceramic-OPC vs. Ceramic-APC | SBS in APC significantly lower than in OPC |
Lee et al. (2015) [31] | 36 | Ceramic-OPC vs. Ceramic-APC | SBS in APC significantly higher than in OPC |
Abdelaziz (2020) [28] | 96 | Metal-OPC vs. Metal-APC | NSD between APC and OPC, SBS in ER significantly higher than in SE |
Author (Year) | Type of Brackets | Mean mARI Converted to Artun’s Index | Interpretation | Author’s Conclusion |
---|---|---|---|---|
Lee et al. (2015) [31] | Ceramic APC Plus | 2.66 | >50% of adhesive left on the tooth in 100% APC specimens | NSD in ARI of APC Plus and OPC |
Ceramic OPC | 2.58 | |||
Ansari et al. (2016) [30] | Ceramic APC Flash Free | 2.3 | >50% of adhesive left on the tooth in 80% APC specimens | Both brackets achieved safe bracket failure pattern |
Ceramic OPC | 2.8 | |||
González-Serrano et al. (2019) [8] | Ceramic APC Flash Free | 0.85 * without thermocycling | <50% of adhesive left on the tooth in 100% APC specimens | APC left significantly lower amount of adhesive on the tooth surface after debonding |
Ceramic OPC | 1.75 * without thermocycling | |||
Abdelaziz (2020) [28] | Metal APC Plus, E&R | 0.58 | <50% adhesive left on the tooth in 80% APC specimens | NSD in ARI of APC and OPC |
Metal OPC, E&R | 0.79 | |||
Guzman et al. (2013) [27] | Metal ACP | 1.47 | <50% adhesive left on the tooth in 50% APC specimens | APC left significantly lower amount of adhesive than OPC |
Metal OPC | 1.97 |
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Nawrocka, A.; Piwonski, I.; Nowak, J.; Sauro, S.; García-Esparza, M.A.; Hardan, L.; Lukomska-Szymanska, M. The Influence of Indirect Bonding Technique on Adhesion of Orthodontic Brackets and Post-Debonding Enamel Integrity—An In Vitro Study. Materials 2023, 16, 7202. https://doi.org/10.3390/ma16227202
Nawrocka A, Piwonski I, Nowak J, Sauro S, García-Esparza MA, Hardan L, Lukomska-Szymanska M. The Influence of Indirect Bonding Technique on Adhesion of Orthodontic Brackets and Post-Debonding Enamel Integrity—An In Vitro Study. Materials. 2023; 16(22):7202. https://doi.org/10.3390/ma16227202
Chicago/Turabian StyleNawrocka, Agnieszka, Ireneusz Piwonski, Joanna Nowak, Salvatore Sauro, María Angeles García-Esparza, Louis Hardan, and Monika Lukomska-Szymanska. 2023. "The Influence of Indirect Bonding Technique on Adhesion of Orthodontic Brackets and Post-Debonding Enamel Integrity—An In Vitro Study" Materials 16, no. 22: 7202. https://doi.org/10.3390/ma16227202