Does enamel deproteinisation with 10% papain affect shear bond strength of orthodontic adhesives: a randomised controlled trial.

ABSTRACT

OBJECTIVE: To evaluate the effect of 10% papain as an enamel deproteinising agent on the shear bond strength (SBS) of three orthodontic adhesives Transbond XT, resin-modified glass ionomer cement (RMGIC) and Biofix. DESIGN: Single-centre, double-blinded, split-mouth randomised controlled trial. SETTING: Department of Orthodontics and Dentofacial Orthopaedics, Nair Hospital Dental College, Mumbai, India. PARTICIPANTS: A total of 20 participants requiring bilateral premolar extraction for fixed orthodontic treatment in both the maxillary and mandibular arches were included in this study. METHODS: In total, 80 premolars from the above-mentioned participants were divided into four groups as follows group A Transbond XT deproteinised with 10% papain gel; group B Biofix deproteinised with 10% papain gel; group C RMGIC deproteinised with 10% papain gel; and group D Transbond XT without enamel deproteinisation as a control group-bonded as instructed by the manufacturer. After deproteinisation, brackets were bonded and after a follow-up period of 28 days, the teeth were extracted. The SBS was then measured using the Universal Testing Machine. The force needed to shear the bracket was documented, and bond strengths were subsequently calculated in megapascals (MPa). The obtained results were subjected to statistical analysis and one-way ANOVA was performed to compare the mean SBS between the groups. Subsequently, pairwise comparisons were conducted using Tukey's post hoc test. RESULTS: There was a statistically significant difference in SBS among all groups (P = 0.002). The SBS of TransXT with deproteinisation increased significantly compared with TransXT without deproteinisation (P = 0.03). There was no statistically significant difference between the SBS of TransXT without deproteinisation and RMGIC (P = 0.47) and Biofix (P = 0.39), both with deproteinisation. CONCLUSION: The use of 10% papain for deproteinising enamel improved the SBS of all materials. Deproteinising improved the SBS of RMGIC and Biofix to the level of TransXT without deproteinisation.