Leigh VonWald

Shear bond strength of composite, glass ionomer, and acidic primer adhesive systems

The purpose of this study was to determine the shear bond strengths of orthodontic brackets bonded with one of three methods: (1) a glass ionomer adhesive with a 20% polyacrylic acid enamel conditioner; (2) a composite resin adhesive used with 37% phosphoric acid etchant and a conventional primer; or (3) the same composite resin used with an acidic primer that combines the etchant with the primer in one application. The brackets were bonded to the teeth according to one of three protocols. Group I teeth were etched with 37% phosphoric acid and bonded with Transbond XT (3M Unitek, Monrovia, Calif) following the manufacturers instructions. Group I acted as the control group. Group II teeth were etched with an acidic primer (Clearfil Liner Bond 2. J.C. Moritta Kuraway, Japan) that contains both the acid (Phenyl-P) and the primer (HEMA and dimethacrylate) and was placed on the enamel for 30 seconds; the adhesive used to bond the brackets was Transbond XT as in Group I. Group III teeth were etched with 20% polyacrylic acid and the brackets were bonded with Fuji Bond LC (G.C. America, Chicago, Ill). A steel rod with one flattened end was attached to the crosshead of a Zwick test machine (Zwick GmbH & Co, Ulm, Germany). An occlusogingival load was applied to the bracket, producing a shear force at the bracket-tooth interface. The results indicated that the resin/phosphoric acid adhesive system (control group) provided the strongest shear bond strength x = 10.4 +/- 2.8 MPa). The glass ionomer adhesive system provided a significantly lower bond strength (x = 6.5 +/- 1.9 MPa). The least shear bond strength was present when the acidic primer was used with an orthodontic adhesive (x = 2.8 +/- 1.9 MPa). In the present study, the use of either a fluoride-releasing glass ionomer or an acidic primer in combination with an available orthodontic composite adhesive resulted in a significantly reduced shear bond strength when compared with that of the conventional composite resin adhesive system. At the present time, the orthodontist and the patient are better served by using phosphoric acid/composite resin adhesive system or other equivalent systems that provide a clinically reliable bond strength between the bracket, the adhesive, and the enamel surface.

Effect of an acidic primer on shear bond strength of orthodontic brackets

A unique characteristic of some new etching systems is that they combine the conditioning and priming agents into a single acidic primer solution. The purpose of this study was to determine the effects on the shear bond strength and the bracket/adhesive failure mode when an acidic primer and other enamel etchants were used to condition the enamel surface before bonding. The brackets were bonded to extracted human teeth according to one of four protocols following the manufacturers instructions. Group I, teeth were etched with 37% phosphoric acid, the brackets were then bonded with System 1+ adhesive (Ormco Corporation. Orange, Calif.); group II, teeth were etched with 10% maleic acid, the brackets were also bonded with System 1+ adhesive; group III, an acidic primer that contains both the acid (phenyl-P) and the primer (hema and dimethacrylate) were placed on the enamel for 30 seconds. The adhesive used on this group was a lightly filled resin that contains Bis-GMA and HEMA. (Clearfil Liner Bond 2. J.C. Moritta, Kuraway, Japan); Group IV, the same acidic primer was used as in group II, the adhesive used was highly filled (Panavia 21. J.C. Moritta) and contains Bis-GMA. The present in vitro findings indicated that the use of acidic primers to bond orthodontic brackets to the enamel surface could provide clinically acceptable shear bond forces (x = 10.4 +/- 4.4 MPa) when used with a highly (77%) filled adhesive (Panavia 21). These debonding forces were comparable to those obtained when the enamel was conditioned with either Phosphoric (x = 11.8 +/- 4.1 MPa) or Maleic (x = 10.9 +/- 4.4 MPa) acids. With the use of a lightly (10%) filled adhesive (Clearfil Liner Bond 2), the shear bond strength was significantly lower (x = 5.9 +/- 5.6 MPa). It is of interest to note that there was a tendency to have less residual adhesive remaining on the tooth when an acid primer was used than when phosphoric and maleic acids were used. This might be of advantage to the clinician because it will require less time to clean the teeth after debonding.

Effect of time on the shear bond strength of glass ionomer and composite orthodontic adhesives

The purpose of this study was to compare the effects of time on the shear bond strength of a resin-reinforced glass ionomer and a composite adhesive system specifically (1) within half an hour after bonding the bracket to the tooth and (2) at least 24 hours from the time of bonding when the adhesive has achieved most of its bond strength. Ninety-one freshly extracted human molars were collected and stored in a solution of 0.1% (weight/volume) thymol. The teeth were cleaned and polished. The teeth were randomly separated into four groups: Group I, glass ionomer adhesive debonded within 30 minutes from initial bonding; Group II, glass ionomer adhesive debonded after 24 hours immersion in deionized water at 37 degrees C; Group III, composite adhesive debonded within 30 minutes from initial bonding; Group IV, composite adhesive debonded after 24 hours immersion in deionized water at 37 degrees C. The results of the analysis of variance comparing the 4 experimental groups (F = 59. 3) indicated the presence of significant differences between the 4 groups (P =.0001). In general, the shear bond strengths were significantly greater in the 2 groups debonded after 24 hours. This was true for both the resin-modified glass ionomer (x = 8.8 +/- 3.6 MPa) and the composite (x = 10.4 +/- 2.8 MPa) adhesives. On the other hand, the shear bond strengths were significantly lower in the 2 groups debonded within 30 minutes of their initial bonding. The bond strength of the resin-modified glass ionomer adhesive (x = 0.4 +/- 1.0 MPa) was significantly lower than that for the composite (x = 5.2 +/- 2.9 MPa) adhesive. The present findings indicated that the resin reinforced glass ionomer adhesive has a significantly lower initial bond strength but increased more than 20-fold within 24 hours. In comparison, the composite adhesive has a significantly larger initial bond strength that doubled within 24 hours. The clinician needs to take these properties into consideration when ligating the initial arch wires.

The effect of repeated bonding on the shear bond strength of a composite resin orthodontic adhesive.

One of the problems clinicians face during treatment is bracket failure. This is usually the result either of the patients accidentally applying inappropriate forces to the bracket or of a poor bonding technique. As a result, a significant number of teeth have to be rebonded in a busy orthodontic practice. The purpose of this study was to evaluate the effect of repeated bonding on the shear bond strength of orthodontic brackets. Fifteen freshly extracted human molars were collected and stored in a solution of 0.1% (wt/vol) thymol. The teeth were cleaned, polished, and etched with a 37% phosphoric acid gel. The brackets were bonded with the adhesive and light cured for 20 seconds. The teeth were sequentially bonded and debonded 3 times with the same composite orthodontic adhesive. At each time, all 15 teeth were debonded within a half hour after bonding to simulate the clinical condition at which a newly bonded bracket is attached to the arch wire. The results of the analysis of variance comparing the shear bond strength at the 3 debonding attempts indicated the presence of no significant differences among the 3 groups (P = .104). However, when the overall change in shear bond strength within each tooth was evaluated between debonding sequences 1 and 3, 10 teeth had a significant (P = .001) decrease (mean +/- SD, -4.6+/-2.5 MPa) in bond strength, whereas 5 teeth had a significant (P = .02) increase (mean +/- SD, 2.8+/-1.6 MPa). The present findings indicated that in general, the highest values for shear bond strength were obtained after the initial bonding. Rebonded teeth have significantly lower and inconsistent shear bond strength; ie, bond strength may further decrease or increase after the second debonding, and the changes in bond strength may be related to the changes in the morphologic characteristics of the etched enamel surface as a result of the presence of adhesive remnants.

Comparison of the debonding characteristics of two innovative ceramic bracket designs

Two new ceramic brackets-one designed with a metal-lined arch wire slot and the other with an epoxy resin base-have been recently introduced. The new brackets are thought to combine the esthetic advantages of ceramics and the functional advantages of debonding metal brackets. The purpose of this study was to compare the following: 1) the shear bond strength of the 2 brackets, and 2) the bond failure location when the brackets are debonded with pliers. Sixty-one Clarity (3M Unitek) collapsible ceramic brackets and 66 MXi (TP Orthodontics, Inc) brackets were bonded to the teeth with the same bonding system. The Zwick Universal Test Machine (Zwick Gm bH & Co) was used to determine the shear bond strength force levels needed to debond the brackets. The appropriate pliers also were used to debond both types of brackets to determine the mode of bond failure that will be encountered clinically. After debonding, all the teeth and brackets were examined with 10x magnification. Any adhesive that remained after the bracket removal was assessed according to the Adhesive Remnant Index. The findings indicated that the shear bond strength of the Clarity ceramic brackets was significantly greater than that of the MXi ceramic brackets. However, both brackets exhibited forces that were adequate for clinical use. The Adhesive Remnant Index scores for both the shear test and the plier debonding indicated a similar bond failure pattern when the 2 ceramic brackets were compared with each other. This suggests that, when these brackets are debonded with the Weingart (Ormco) and ETM (Ormco) pliers, there was a greater tendency for most of the adhesive to remain on the enamel surface. In conclusion, the most efficient method to debond the MXi ceramic bracket is by placing the blades of the ETM 346 pliers between the bracket base and the enamel surface. On the other hand, the most efficient method of debonding the Clarity bracket is by using the Weingart pliers and applying pressure to the tiewings. When the 2 ceramic brackets were debonded as recommended here, most of the residual adhesive remained on the enamel surface, a pattern similar to the one observed previously with metal brackets. The failure at the bracket-adhesive interface decreases the probability of enamel damage but necessitates the removal of more residual adhesive after debonding.

Effect of Using a New Cyanoacrylate Adhesive on the Shear Bond Strength of Orthodontic Brackets

During bonding of orthodontic brackets to enamel, conventional adhesive systems use three different agents: an enamel conditioner, a primer solution, and an adhesive resin. A unique characteristic of some new bonding systems is that they need neither a priming agent nor a curing light to bond brackets. Such an approach should be more cost-effective for the clinician and indirectly also for the patient. The purpose of this study was to determine the effects of using a cyanoacrylate adhesive on the shear bond strength of orthodontic brackets and on the bracket/adhesive failure mode. The brackets were bonded to extracted human teeth according to one of two protocols. Group 1: Teeth were etched with 37% phosphoric acid. After applying the primer, the brackets were bonded with Transbond XT (3M Unitek, Monrovia, Calif) and were light-cured for 20 seconds. Group 2: Teeth were etched with 35% phosphoric acid. The brackets were then bonded with Smartbond (Gestenco International, Göthenburg, Sweden). The present in vitro findings indicated that the use of the cyanoacrylate adhesive to bond orthodontic brackets to the enamel surface did not result in a significantly different (P = .24) shear bond force (mean = 5.8 +/- 2.4 MPa) as compared to the control group (mean = 5.2 +/- 2.9 MPa). The comparison of the Adhesive Remnant Index scores indicated that there was significantly (P = .006) less residual adhesive remaining on the tooth with the cyanoacrylate than on the tooth with the conventional adhesive system. In conclusion, the new adhesive has the potential to be used to bond orthodontic brackets while reducing the total bonding time.

Changes in root length from early to mid-adulthood: Resorption or apposition?

A significant number of adults are seeking orthodontic treatment, therefore, it is important to determine the normal changes in root length (resorption or apposition) that occur at this stage of maturation, specifically between early and mid-adulthood. The purpose of the study was to determine on a longitudinal basis the changes in root length between 25 and 45 years of age in a normative untreated population. Two sets of complete mouth surveys were available at early and mid-adulthood, on a total of 26 subjects (12 males and 14 females). Each set consisted of at least 18 periapical radiographs. On each set of radiographs, the roots of 28 teeth were measured including incisors, canines, premolars, and first and second molars, in both the maxillary and mandibular arches. Root length was measured as the perpendicular from the root apex to a line connecting the mesial and distal points of the cementoenamel junction of each tooth. A total of 1456 teeth (1664 roots) were measured; 672 teeth in males and 784 teeth in females. Allowable intraexaminer and interexaminer measurement variability was predetermined at 0.5 mm. Paired and Student t tests were used to determine: (1) whether significant changes occurred with age; (2) whether there were differences between males and females for the incisors, canines, premolars, and molars; and (3) whether there were differences between the right and left sides. Statistical significance was predetermined at P </=.05. The present findings indicated that there were no significant changes in root length for all tooth types evaluated between 25 and 45 years of age, in both males and females. These findings are important for the orthodontist to recognize because they provide some assurance that there is no systematic shortening of root length between early and mid-adulthood.

Effect of light-cure time on the initial shear bond strength of a glass-ionomer adhesive.

With the introduction of photosensitive (light-cured) restorative materials in dentistry, various methods were suggested to enhance the polymerization of these materials including layering and the use of more powerful light-curing devices. The purpose of this study was to determine the effects of increasing the light-cure time on the initial shear bond strength (in the first half hour) of a resin-modified glass-ionomer adhesive. Eighty-six teeth were divided into 4 groups according to either; (1) the adhesive system used, namely resin, reinforced glass ionomer, or composite, and (2) the light-cure time for the glass ionomer adhesive, namely 40, 45, and 50 seconds. The bonding approach followed the manufacturers instructions unless otherwise specified. The results of the analysis of variance comparing the 4 experimental groups (F = 19.4) indicated the presence of significant differences between the groups (P =. 0001). In general, the shear bond strength was greater for the composite adhesive system (¿x(-) = 5.2 +/- 2.9 MPa), followed by the 2 groups bonded with the resin-reinforced glass-ionomer adhesive and light cured for 50 seconds (¿x(-) = 3.8 +/- 1.1 MPa) and 45 seconds (¿x(-) = 3.4 +/- 2.7 MPa). On the other hand, the shear bond strength was significantly lower for the group bonded with the glass ionomer adhesive and light cured for 40 seconds only (¿x(-) = 0.4 +/- 1.0 MPa). The present findings indicated the following: (1) the resin-reinforced glass-ionomer adhesive has a significantly lower shear bond strength in the first half hour after bonding when compared to a composite resin adhesive; (2) the initial bond strength of the glass-ionomer adhesive was significantly increased by increasing the light-cure time for an additional 5 to 10 seconds; (3) the mean increase in the shear bond strength between 5 and 10 seconds of additional light curing was not significant but the variability was less with the longer cure time.

Effects of different types of light guides on shear bond strength

With the introduction of photosensitive (light cured) restorative materials in dentistry, various methods were suggested to enhance their polymerization including layering and the use of more powerful light-curing devices. The purpose of this study was to determine whether the use of different light guides, specifically the standard curved versus the mini turbo light guides, has different effects on the shear bond strength of orthodontic adhesives immediately after bonding. The light-curing apparatus used was the Optilux 500 (Demetron/Kerr, Danbury, Conn) that has a number of accessories. The two light guides used in the present study were the 11 mm diameter Standard Curved Light Guide (#20898) and the 4 mm diameter curved Mini Turbo Light Guide (#21185). The bonding adhesive system used was Transbond XT (3M Unitek, Monrovia, Calif). Regardless of the light guide used, the adhesive was cured for 30 seconds. The teeth were randomly divided into three groups according to the light guide tip used and the time of bracket removal after the bonding procedure was completed. The findings indicated that the two groups that were debonded within 30 minutes after being light cured with either the Standard (x = 7.6 +/- 3.9 MPa) or Turbo (x = 5.8 +/- 2.8 MPa) Light Guides were not significantly different from each other. On the other hand, both groups had significantly lower shear bond strength than the control group cured with the Standard Light Guide and debonded after 72 hours (x = 12.1 +/- 4.3 MPa). As a result, the use of the Mini Turbo Light Guide did not seem to significantly influence either the shear bond strength or the bracket/adhesive/enamel failure site. Therefore it can be concluded that there is no added advantage in using the Mini Turbo Light over the Standard Light Guide when bonding orthodontic metal brackets.

Evaluation of nonrinse conditioning solution and a compomer as an alternative method of bonding orthodontic bracket.

Damage to the enamel surface during bonding and debonding of orthodontic brackets is a clinical concern. Alternative bonding methods that minimize enamel surface damage while maintaining a clinically useful bond strength are an aim of current research. The purpose of this study was to compare the effects of using two enamel conditioners and adhesives on the shear bond strength and bracket failure location. Forty freshly extracted human molars were pumiced and randomly divided into two groups of 20 teeth. Metal orthodontic brackets were bonded to the enamel surface by one of two protocols: 37% phosphoric acid with a composite adhesive (Transbond XT) or a nonrinse conditioner with a compomer adhesive (Dyract flow). The teeth were mounted in phenolic rings and stored in deionized water at 37 degrees C for 24 hours. A Zwick Universal Testing Machine was used to determine shear bond strengths in MegaPascals. The residual adhesive on the enamel surface was evaluated using the Adhesive Remnant Index. Student t-test and chi2-test were used to compare the two groups. Significance was predetermined at P < or = .05. The results of the t-tests indicated that there were significant differences between the two adhesive systems (t = 11.18 and P = .001) with the nonrinse conditioner/compomer system having lower shear bond strength (X = 1.7 +/- 0.9 MPa) than the phosphoric acid/composite adhesive (X = 10.4 +/- 2.8 MPa). The results of the Chi Square test evaluating the residual adhesives on the enamel surfaces also revealed significant differences between the two groups (chi2 = 7.62, P = .022). In conclusion, a nonrinse conditioner used with a compomer adhesive had significantly lower shear bond strength than a phosphoric acid/composite adhesive system.