An overview of current evaluation methods of postgraduate dental specialty residents.

PURPOSE: A lack of contemporary dental literature exists on evaluating dental residents in postgraduate education, with no standardized criteria or information on technology adoption. This study aims to understand current evaluation methods in dental residency programs and compare them to existing literature. METHODS: A survey with 22 questions was sent to program directors of 749 ADA/CODA (American Dental Association/Commission on Dental Accreditation)-accredited postgraduate dental residencies. The questions focused on evaluation frequency, faculty involvement, submission methods, and electronic software usage. RESULTS: The survey response rate was 30.2% (226 responses). Results show that 98% of program directors are involved in evaluations, but require more support from auxiliary faculty. Evaluations are typically submitted twice or four times a year, with 12% of programs wanting increased frequency. Face-to-face delivery of feedback is considered crucial. While desktop computers are widely used for evaluation submission, 55% of programs utilize mobile devices, which correlates with higher program director satisfaction. The most popular evaluation software includes New Innovations, MEd Hub, and Qualtrics. Overall, 86.96% of program directors are satisfied with current evaluation practices. Areas needing improvement are non-program director faculty involvement, resident response/feedback, and software navigation. CONCLUSION: This study found that a majority of program directors of the postgraduate dental education system are using electronic technology for their resident evaluation systems and are satisfied with their current mechanism of evaluation.

A survey of white spot lesion prevention and resolution in the US dental school curricula.

PURPOSE/OBJECTIVES: White spot lesions (WSLs) are opaque white lesions on smooth tooth surfaces as a result of demineralization. Proven methods of prevention and resolution of these lesions are available yet the incidence rate, especially in orthodontic patients, is still high. Perhaps the way dental schools are educating students on the topic is insufficient. The purpose of this study was to determine if and how predoctoral dental students are taught about the prevention and resolution of WSLs. METHODS: An electronic survey was developed and sent out to each of the 66 accredited dental schools in the United States and Puerto Rico. The survey consisted of 13 questions and inquired about whether the school includes instruction of WSLs in its predoctoral curriculum. If the school indicated instruction WSLs was in the predoctoral curriculum, further questions were asked pertaining to the content and method of the instruction. Demographic data was also gathered from each institution. RESULTS: Twenty-eight of the 66 schools responded for a 42% response rate. Eighty-two percent of schools indicated they were teaching about prevention of WSLs, while 50% indicated they were teaching about resolution, or treatment, of WSLs. The most commonly taught methods were patient education, over-the-counter fluoride mouthrinse, toothpaste, or gel, and high fluoride content toothpaste. CONCLUSION: The majority of responding dental schools are at least including some instruction of WSLs in the predoctoral curriculum. Many of the known prevention and treatment measures available, however, are not routinely taught.

The prevalence of developmental dental and eruption anomalies assessed using panoramic radiographs: a retrospective study.

Developmental dental anomalies are a common finding in adolescent populations. The objective of this study was to utilize panoramic radiographs to determine the prevalence of dental anomalies and developmental disturbances in a heterogenous adolescent orthodontic patient population seeking care at a North American orthodontic residency program. A total of 1042 panoramic radiographs of 457 male and 585 female orthodontic patients aged 10 to 18 years were evaluated. Developmental and eruption anomalies were recorded and categorized, and chi-square and Fisher exact tests were used for statistical analysis. The evaluation revealed that 40.88% of patients had at least 1 anomalous finding. The most common finding overall was agenesis (12.00%), followed by deviations in eruption path (9.12%), delayed eruption (7.39%), and impaction (7.29%). There was no difference in the prevalence of having any anomalous finding or the prevalence of any specific category of anomalies based on the sex or Angle classification of the patients. Comparison of developmental dental anomalies in 3 age groups (10 to 12, 13 to 15, or 16 to 18 years) revealed no statistically significant difference in the overall prevalence of anomalous findings. Statistically significant differences for some specific categories of anomalies were explainable by correlating dental development with chronologic age, such as a greater frequency of blocked out teeth and eruption path deviation among patients aged 10 to 12 years. Black patients were found to have a significantly greater prevalence of impactions (P = 0.030), and Asian patients had a significantly greater prevalence of anomalies categorized as "other pathology," which could not be definitively diagnosed by panoramic radiograph alone (P = 0.007).

A comparison of traditional orthodontic polishing systems with composite polishing systems following orthodontic debonding.

INTRODUCTION: At the completion of treatment, the orthodontic practitioner's goal is to effectively remove all traces of adhesive and return enamel to its initial state. With the advent of new polishing systems being released each year, there may be one product that is superior to others. AIM: The purpose of this study is to determine the efficacy of new polishing systems (in the last 5-10 years) used in general dentistry on enamel surface roughness following debond utilizing profilometery and scanning electron microscopy and compare them to established orthodontic polishing systems results. METHODS: Fifty-two mandibular incisors were randomly assigned to one of five test groups (N = 10) and two incisors (untreated enamel) were used for profilometer and scanning electron microscopy analysis at the end of testing. After bracket removal, the teeth were polished using traditional polishing products (Komet H48L bur, Reliance 'Renew' point) and newer polishing products (Coltene Spiral Composite Plus Polisher, Ultradent Jiffy Composite Polishing Spiral or 3M Sof-Lex™ Diamond Polishing System). The results were evaluated using a profilometer and scanning electron microscopy images. RESULTS: The results of a one-way analysis of variance (ANOVA) determined that the mean change in enamel surface roughness was not statistically different both in the traditional and novel groups. Tukey's Honestly Significant Difference (HSD) test found that there was no statistically significant difference in the change in enamel surface roughness between instrument groups. CONCLUSIONS: There was no statistically significant difference in enamel surface roughness after polishing between traditional orthodontic polishing systems and the selected novel polishing systems. SEM analysis revealed similar findings. This supports previous research suggesting that a wide variety of polishing systems or none at all, may be used to restore enamel smoothness after removal of orthodontic appliances.

Prevalence of Molar-Incisor Hypomineralization Within an Orthodontic Department in the United States.

Purpose: The purpose of this study was to determine the prevalence and severity of molar-incisor hypomineralization (MIH) by examining standard orthodontic intraoral photographs. Methods: A total of 690 patients were evaluated retrospectively for the presence or absence and extent of MIH using standardized assessment criteria. Results: Fourteen percent of all patients examined presented with MIH on at least one tooth. There was no significant difference in the presence of MIH when compared to age, race, or gender. MIH is most commonly presented on maxillary molars and maxillary central incisors as demarcated opacities with less than one-third of the tooth affected. More severe clinical status groups were associated with higher average age and were more commonly seen in molars than incisors. Conclusions: At 14 percent, the prevalence is reflective of the worldwide prevalence previously determined from other studies. MIH most commonly presents in its mildest form; however, older individuals tend to present with more severe forms, indicating that it continues to cause problems as patients age. Future studies should extend to further areas to continue to ascertain the extent and severity of this condition.

Comparison of tensile bond strength of new and rebonded Symetri Clear™ ceramic brackets with Transbond™ XT or BluGloo™, with or without surface treatment: An in vitro study.

OBJECTIVES: This study sought to determine the bond strength of the Symetri Clear™ bracket after rebonding (reused) for a second and third time. MATERIALS AND METHODS: Symetri Clear™ mandibular incisor brackets were bonded to bovine incisors and divided into six experimental groups. Two groups underwent tensile bond strength testing, and the remaining four groups were debonded using the manufacturer's recommended plier. Two groups were rebonded twice following surface preparation with Ortho SoloTM and two groups were rebonded twice without surface preparation. The rebonded brackets also underwent tensile bond strength testing after each rebonding event as well as receiving an Adhesive Remnant Index score. RESULTS: One-way ANOVA found a statistically significant difference in bond strength among the six groups (P<0.0001). Tukey's Studentized Range (HSD, honestly significant difference) Test found significant differences in tensile bond strength of groups which did not undergo surface preparation prior to rebonding. One-way ANOVA found a P-value of 0.2563 and thus no significant difference in ARI among the different groups. CONCLUSIONS: There was no significant difference in the tensile bond strength of Symetri ClearTM brackets initially bonded with either Transbond™ XT or BluGloo™ and no significant difference between the initial tensile bond strength and the first or second rebond tensile bond strength. Rebonding Symetri Clear™ brackets without surface treatment did show significantly reduced tensile bond strength.

In vitro comparison of shear bond strengths of ceramic orthodontic brackets with ceramic crowns using an aluminium oxide air abrasion etchant.

OBJECTIVE: The aim of this study was to determine if there are differences between the shear bond strengths of 3 types of ceramic brackets when bonded to different ceramic substrates using an aluminium oxide air abrasion etchant protocol. MATERIALS AND METHODS: Substrate groups consisting of thirty-six lithium disilicate (e.max® CAD) samples and thirty-six lithium silicate infused with zirconia (CELTRA® DUO) samples were fabricated to replicate the facial surface of a left maxillary central incisor. The surface of all samples was prepared with an aluminium oxide air abrasion etchant protocol. Each substrate group was split into three test groups (n=12). Each test group was bonded using a different brand of ceramic orthodontic bracket. Shear bond strength (SBS) testing was conducted and the mean SBS values for each group were calculated and recorded in MPa. An Adhesive Resin Index (ARI) score was also assigned to each sample to assess the location of bond failure. RESULTS: Mean SBS of the e.max® CAD groups were significantly less than the CELTRA® DUO groups. Symetri brackets showed significantly higher shear bond strengths to both substrates than both of the other brackets tested. ARI scores of the e.max® CAD groups were significantly less than the CELTRA® DUO groups. CONCLUSION: The Symetri bracket was the only bracket that was effective for both substrates (mean SBS>6mPa). The Etch Master protocol does not appear effective for e.max® CAD.

Dental Student and Faculty Perceptions of Uncivil Behavior by Faculty Members in Classroom and Clinic.

Uncivil behavior by a faculty member or student can threaten a classroom environment and make it less conducive to learning. The aim of this study was to explore faculty behaviors that dental faculty and students perceive to be uncivil when exhibited in the classroom and clinic. In 2015, all faculty, administrators, and students at a single academic dental institution were invited to participate in an electronic survey that used a five-point Likert scale for respondents to indicate their agreement that 33 faculty behaviors were uncivil. Response rates were 49% for faculty and 59% for students. Significant differences were found between student and faculty responses on 22 of the 33 behavioral items. None of the three category composite scores differed significantly for students compared to faculty respondents. The category composite scores were not significantly associated with gender, ethnicity, or age for faculty or students. Overall, this study found significant differences between students and faculty about perceived uncivil faculty behaviors, though not for categories of behaviors.

Porcelain surface conditioning protocols and shear bond strength of orthodontic brackets.

AIM: The objective of the present study was to determine which of six bonding protocols yielded a clinically acceptable shear bond strength (SBS) of metal orthodontic brackets to CAD/CAM lithium disilicate porcelain restorations. A secondary aim was to determine which bonding protocol produced the least surface damage at debond. METHODS: Sixty lithium disilicate samples were fabricated to replicate the facial surface of a mandibular first molar using a CEREC CAD/CAM machine. The samples were split into six test groups, each of which received different mechanical/chemical pretreatment protocols to roughen the porcelain surface prior to bonding a molar orthodontic attachment. Shear bond strength testing was conducted using an Instron machine. The mean, maximum, minimal, and standard deviation SBS values for each sample group including an enamel control were calculated. A t-test was used to evaluate the statistical significance between the groups. RESULTS: No significant differences were found in SBS values, with the exception of surface roughening with a green stone prior to HFA and silane treatment. This protocol yielded slightly higher bond strength which was statistically significant. CONCLUSION: Chemical treatment alone with HFA/silane yielded SBS values within an acceptable clinical range to withstand forces applied by orthodontic treatment and potentially eliminates the need to mechanically roughen the ceramic surface.

Comparison of traditional orthodontic polishing systems with novel non-orthodontic methods for residual adhesive removal.

BACKGROUND: Following the debonding of orthodontic brackets, the removal of residual adhesive from the enamel surface is required. Published adhesive removal protocols present conflicting advice. AIMS: The present study evaluated the surface roughness of enamel after debonding and instrumentation with non-traditional orthodontic polishing systems. METHODS: The facial aspects of 35 extracted human incisor teeth were scanned with a surface profilometer for surface roughness prior to the bonding of orthodontic brackets. After debonding, residual adhesive was removed with a 12-fluted titanium carbide bur. The teeth were randomly divided into seven groups (N = 5 per group) and the enamel surface was polished with one of seven products. All samples were re-scanned for surface roughness and subjectively evaluated via SEM. RESULTS: There was no significant difference in enamel surface roughness between the groups when compared using surface profilometry. Visual observations from the SEM evaluations demonstrated differences in the enamel surface at the microscopic level that were not detected by profilometric analysis. CONCLUSIONS: The present study found no statistically significant difference in mean enamel smoothness change from pretreatment to post-treatment between the seven polishing methods studied via profilometer surface reading measurements. An SEM analysis showed visual differences in enamel striations viewed at 1000x magnification in a comparison of traditional versus non- traditional polishing methods.

Enamel surface roughness of preferred debonding and polishing protocols.

OBJECTIVE: This study investigated the surface roughness of enamel after debonding and instrumentation with commonly used methods. METHODS: Part I: a survey was sent to active members of the American Association of Orthodontists to determine popular bonding, debonding, and polishing protocols. Part II: brackets were bonded to the buccal surface of 30 extracted human premolar teeth. After debonding, residual adhesive was removed with 12-, 16-, and 20-fluted titanium carbide burs as based upon the survey results. The teeth were scanned with a surface profilometer for surface roughness. Part III: the teeth were further polished using a Reliance Renew polishing point or a prophy cup with pumice and rescanned for surface roughness. RESULTS: Part I: the majority of respondents used a generic bracket-removing plier to remove fixed appliances (53%) and a high-speed handpiece for adhesive removal (85%). The most popular bur was a 12-fluted carbide bur without water spray. The majority of respondents used pumice paste and/or Reliance Renew points after adhesive removal. Part II: there was a significant difference in enamel surface roughness when 12-, 16-, and 20-fluted carbide burs were compared via surface profilometry. Part III: further polishing with a Reliance Renew point or a prophy cup and pumice did not provide a significantly smoother surface. CONCLUSIONS: The results show large variation in debonding and polishing techniques. Creating a smooth enamel surface is equally possible with 12- or 20-fluted carbide burs. Further polishing with pumice and prophy cup or Renew point does not provide an enamel smoother surface.

Perceptions of uncivil student behavior in dental education.

Students and faculty members in the health professions classroom are expected to exhibit professional behaviors that are conducive to maintaining a positive learning environment, but there is little published research concerning incivility in the area of dental education. The aim of this study was to evaluate differences in perceptions of incivility between dental faculty and students, between students in different courses of study, and between students in different years of dental study. The study utilized an anonymous electronic survey of all dental faculty and administrators and all dental, dental hygiene, and dental laboratory technology students at a single institution. The survey instrument contained questions concerning perceived uncivil behavior in the classroom and clinical settings. Response rates were 54% for faculty and administrators and ranged from 60% to 97% for students in various years and programs. The results were analyzed based on gender, course of study, year of study, and ethnicity. Significant differences were found regarding perceptions of civil behaviour between faculty and students, male and female students, the year of study, and the course of study. These differences point to the need for further research as well as administrative leadership and faculty development to define guidelines in this area in order to ensure a positive learning environment.

Evaluation of 3 commercially available materials for resolution of white spot lesions.

INTRODUCTION: White spot lesions are often seen on the teeth after orthodontic treatment, resulting in unpleasant esthetics. The aim of this in-vitro study was to compare subjectively and objectively the esthetic outcomes of white spot lesions treated with 3 commercially available products that have been reported to have a positive effect on the remineralization of enamel. METHODS: Forty extracted premolars were randomly allocated into 1 of 4 groups (n = 10). The teeth were exposed to a demineralization solution at 37°C for 14 days to produce white spot lesions that were about 100 µm deep. Each group was then randomly assigned to receive either control treatment with artificial saliva or treatment with 1 of the 3 commercially available products: Restore toothpaste (Dr. Collins Inc, Orange County, Calif), which contains NovaMin (Dr. Collins Inc); Prevident 5000 (Colgate, New York, NY); and MI Paste Plus (GC America, Alsip, Ill). All groups were evaluated 5 times at 6 time points during the study. RESULTS: The subjective and objective results were mixed within groups and between groups for the products tested. CONCLUSIONS: We found no conclusive evidence that any of these 3 materials produced more favorable esthetic white spot lesion remineralization results.

Evaluation of postgraduate dental specialty residents: a survey of program directors.

The professional dental literature is lacking in information concerning the use of technology in evaluation procedures utilized in postgraduate dental education. The purpose of this study was to identify the methods of evaluation of U.S. postgraduate specialty residents currently in place. The study also sought to determine if there were any patterns among programs more likely to utilize electronic submission in the evaluation process. An electronic survey consisting of eighteen questions was sent to the program directors of all accredited U.S. dental specialty programs (n=416). The survey yielded 150 responses, for a 36 percent response rate. The results showed that the majority of responding program directors (68 percent) evaluate their residents using a hardcopy evaluation instrument, while a minority of directors (32 percent) reported using an electronic evaluation instrument. The majority of respondents (58 percent) said they require faculty members to formally evaluate residents semiannually. Fifty percent of responding program directors reported a need for improvement in their current evaluation system. Those reporting a need for improvement were less likely to be using an electronic format. There was no statistical significance between faculty responsiveness and the mode of evaluation used. With many program directors reporting room for improvement in their current evaluation system, innovation in the evaluation systems of postgraduate dental education is needed.

Three-point bending test comparison of fiber-reinforced composite archwires to nickel-titanium archwires.

AIM: Various alternatives to metal orthodontic archwires have produced varied successes over the years. This study sought to evaluate the bending properties of fiber-reinforced polymeric composite (FRC) archwires compared with similarly sized nickel-titanium (Ni-Ti) archwires. METHODS: Two different 0.018-inch translucent FRC orthodontic wires (Translucent Archwire I and Translucent Archwire II) were tested against 0.014-, 0.016-, and 0.018-inch nonsuperelastic nickel titanium orthodontic wires. The wires in each group (n = 10) were evaluated with three-point bending using a universal testing machine. Wire segments were deflected at midspan to 3.1 mm at a rate of 2 mm/min. Loading and unloading slope and modulus were calculated, as were force values during activation and deactivation and elastic recovery. RESULTS: It was found that the 0.018-inch Ni-Ti archwire demonstrated the highest force values at different deflection distances followed by Translucent Archwire II, 0.016-inch Ni-Ti, Translucent Archwire I, and finally 0.014-inch Ni-Ti. 0.016-inch Ni-Ti exhibited the highest modulus value, followed by 0.018-inch Ni-Ti, 0.014-inch Ni-Ti, Translucent Archwire II, and finally Translucent Archwire I. During deactivation, the elastic recovery of 0.014-inch Ni-Ti and 0.016-inch Ni-Ti was significantly greater than Translucent Archwire II. CONCLUSION: The bending properties of BioMer's FRC archwires were found to be comparable to Ni-Ti, as advertised by the manufacturer.

Application data as an indicator for post-Katrina recovery of LSU Postdoctoral dental programs.

Devastated by the aftermath of Hurricane Katrina in August 2005, the New Orleans campus of the Louisiana State University School of Dentistry was closed for two years. With help from the university's Systems Office, the school created a temporary campus in Baton Rouge, seventy-five miles from the New Orleans campus. The eight postdoctoral education programs, however, were forced to find clinic and seminar space in other facilities and cities. Of the seventy-nine students in these programs, only sixteen did not continue after the storm. This article describes how each program maintained its curriculum while the main campus was closed. By comparing numbers of student applications to these programs in each year since Hurricane Katrina with the average baseline for each in the ten years preceding the storm, this article illustrates the current viability of these residency programs. Total applications in 2005-07 were significantly lower than baseline measures, but applications in 2008 and 2009 have returned to pre-storm levels. A comparison of these application numbers with national trends also demonstrates that these programs have rebounded from the effects of Hurricane Katrina.

Force decay of elastomeric chains - a mechanical design and product comparison study.

OBJECTIVES: To evaluate the percentage force decay of elastomeric chain products utilizing three different design mechanisms simulating canine retraction; and to evaluate the percentage force decay of elastomeric chain products from four different companies. DESIGN: In vitro, laboratory study. SETTING: LSUHSC Dental School, New Orleans, LA, USA. METHODS: Closed (non-spaced), grey elastomeric chains from four companies were selected for the study. Three acrylic resin jigs were constructed to provide a framework for three simulated space closure mechanisms. The 6-5-3, the chain loop, and the 6-3 were the configuration mechanisms used in the study. OUTCOME MEASURES: An electronic force gauge was used to measure the percentage force decay associated with each elastomeric chain over 28 days at preselected times. RESULTS: There was a significant difference in the mean percentage force decay for the three different mechanisms (P < 0·001). For all four companies, the 6-3 mechanical design had the smallest mean percentage force decay. There was a significant difference in the mean percentage force decay for the different companies (P < 0·001). For all three mechanisms, Ormco had the smallest percentage force decay while Unitek had the highest percentage force decay. CONCLUSIONS: The significant difference in the mean percentage force decay for the different mechanisms suggests that the 6-3 design is a more efficient means of closing extraction spaces utilizing elastomeric chains.

Methods used by accredited dental specialty programs to advertise faculty positions: results of a national survey.

The various reasons for the current and projected shortages of dental faculty members in the United States have received much attention. Dental school deans have reported that the top three factors impacting their ability to fill faculty positions are meeting the requirements of the position, lack of response to position announcement, and salary/budget limitations. An electronic survey sent to program directors of specialty programs at all accredited U.S. dental schools inquired about the number of vacant positions, advertised vacant positions, reasons for not advertising, selection of advertising medium, results of advertising, and assistance from professional dental organizations. A total of seventy-three permanently funded full-time faculty positions were reported vacant, with 89.0 percent of these positions having been advertised in nationally recognized professional journals and newsletters. Networking or word-of-mouth was reported as the most successful method for advertising. The majority of those responding reported that professional dental organizations did not help with filling vacant faculty positions, but that they would utilize the American Dental Association's website or their specialty organization's website to post faculty positions if they were easy to use and update.

Bond strengths and debonding characteristics of two types of polycrystalline ceramic brackets.

OBJECTIVES: To compare the shear bond strengths and modes of failure of three orthodontic brackets: a polycrystalline ceramic bracket, a collapsible polycrystalline ceramic bracket and a metal bracket. METHODS: Ninety extracted human premolar teeth were selected and examined at x3 magnification for any enamel defects. Three types of brackets and one orthodontic adhesive were used. One half of the sample was tested in a universal testing machine to determine the shear bond strength. The other half was debonded with the appropriate pliers and the tooth surface examined at x5 magnification. The site of failure was scored with the modified Adhesive Remnant Index (ARI). Teeth with an ARI grade of zero were examined in a SEM to determine any enamel fracture. RESULTS: No statistically significant differences in bond strength among the samples were found (p > 0.159). The modes of failure after debonding with pliers were predominantly at the bracket-adhesive interface. The mean shear bond strength of the Clarity bracket was 10.78 +/- 2.74 MPa, the InVu bracket was 12.43 +/- 2.40 MPa and the metal bracket was 11.89 +/- 1.83 MPa. There were significant differences in the mean rank of the ARI grade between the three groups (p = 0.006). The Clarity and InVu (p = 0.011) and the Clarity and metal brackets (p = 0.005) were significantly different, but there was no difference between the InVu and metal brackets (p = 0.187). CONCLUSIONS: All three samples had similar bond strengths. The risk of ceramic fracture on debonding was greatest for the InVu ceramic bracket.

Shear bond strengths of molar tubes bonded with different adhesives.

AIMS: This study determined which molar base retentive designs produced the greatest shear bond strength (SBS) to human molars when using different adhesives. METHODS: One hundred and fifty extracted human molars were divided into 15 groups of 10. The tested molar tube bases included two stainless steel experimental base designs, a titanium single mesh 80 gauge base, a stainless steel double mesh 150 gauge under 80 gauge base and a stainless steel single mesh 80 gauge base. Each base was bonded with Transbond XT, Pad Lock and Light Bond. One primer, Assure, was used for all specimens. Bonded specimens were stored in water for 7 days and SBS was measured on an Instron testing machine with a crosshead speed of 1 mm/minute. Two-way ANOVA were performed with post-hoc comparisons of the means to determine any statistical differences in SBS. The significance level was set at 5 per cent. RESULTS: The brackets, adhesives and combinations of brackets and adhesives used had a significant effect on SBS (Bracket: p < 0.001; Adhesive: p = 0.020; Interaction: p = 0.005). Mean SBS differed significantly for the adhesives: Light Bond, Pad Lock and Transbond (p < 0.001, p = 0.001 and p < 0.001, respectively). In general, the stainless steel single mesh 80 gauge base and Light Bond adhesive produced the greatest SBS. CONCLUSION: The clinician's choice of bracket and adhesive affect the SBS of bonded molar attachments.