Efficacy of Lasers in Debonding Ceramic Brackets: Exploring the Rationale and Methods.

The development of ceramic brackets in orthodontics three decades ago emerged as a response to the increasing patient demand for less visible orthodontic appliances. While these brackets provide superior aesthetics, they are characterized by lower fracture toughness and higher bond strength in contrast to metal brackets. These properties present challenges during the debonding step, including the risk of enamel micro-fractures and cracks. Historically, various strategies have been developed to address challenges associated with debonding, reduce patient discomfort, and ensure that the bond failure site is confined to the bracket-adhesive interface. This included the use of specially designed debonding pliers, electrothermal debonding, ultrasonic technique, and chemical agents. Recently, there has been a shift towards utilizing different types of laser irradiation for this purpose. The burgeoning strategy, however, requires diligent scientific scrutiny to establish a standardized protocol with particular laser parameters and ultimately achieve the goal of enhancing the patient experience by reducing discomfort. This article offers a narrative review of laser-aided debonding of ceramic brackets, aimed at comparing different laser types, presenting their benefits and downsides, validating the efficiency of each method, and summarizing the published literature on this subject. It also provides insights for orthodontists on reducing patient discomfort that usually accompanies debonding ceramic brackets by delving into the science behind the use of lasers for this purpose.

Corrigendum: The possibility of clinical bonding between metal/ceramic brackets to zirconia: in vitro study.

[This corrects the article DOI: 10.3389/fbioe.2024.1354241.].

The possibility of clinical bonding between metal/ceramic brackets to zirconia: in vitro study.

Objective: The present study aimed to assess the bond strength and durability of six bonding agents concerning their application to metal or ceramic brackets and zirconia. Materials and Methods: Six resin cement bonding agents (XT, XTS, RSBU, RGBU, SBPM, and GMP) were chosen for this investigation. Specimens were either stored in distilled water at 37°C for 24 h or subjected to 5,000 thermocycles before conducting a Shear Bond Strength (SBS) test. Statistical analysis of the SBS data was performed using three-way ANOVA and Games-Howell tests (α = 0.05). The Adhesive Remnant Index was examined, and the debonding surface details on brackets and zirconia were observed. Results: For metal brackets, all groups demonstrated clinically acceptable bond strength, irrespective of storage conditions, except for the XT group. Regarding ceramic brackets, all groups displayed acceptable bond strength after 24 h of water storage. However, following thermocycling, a significant decrease in SBS was noted across all groups (p < 0.05), with SBPM exhibiting a higher bond strength. Three-way ANOVA analysis indicated that SBS values were notably influenced by each factor, and an interaction among the three independent variables was observed (p = 0.000). Conclusion: The reliable bond strength between ceramic brackets and zirconia was significantly lower after thermocycling compared to that of metal brackets and zirconia. SBPM exhibited consistent and robust bond strength between ceramic/metal brackets and zirconia across various storage conditions. Furthermore, the HEMA-free adhesive demonstrated a potentially more consistent bonding performance compared to the HEMA-containing adhesive employed in this study.

The effect of different mechanical retention forms on shear bond strength of rebonding of ceramic brackets.

The objective of this study is to compare the shear bond strength (SBS) and the morphological characteristics and chemical compositions of the base surface of newly bonded and rebonded ceramic brackets with different mechanical retention bases. Sixty extracted human premolars were divided into the newly bonded and rebonded groups. Ceramic brackets with patterned, laser-etched, and particle-coated patterned bases were randomly bonded to the tooth samples in each group (n=10 per base type). The rebonded brackets exhibited significantly lower SBS than the newly bonded brackets (p<0.05). The main chemical composition of the brackets in both groups was aluminum on the energy-dispersive X-ray spectroscopy. Scanning electron microscopy imaging showed the presence of regular-shaped undercuts or irregular micro-undercuts on the bracket bases which mostly remained intact even after debonding and sandblasting, while coated particles disappeared. The rebonded ceramic brackets with mechanical retention bases exhibited clinically acceptable bond strength regardless of retentive forms.

Static friction, surface roughness, and antibacterial activity of orthodontic brackets coated with silver and silver chitosan nanoparticles.

BACKGROUND: To determine the effect of silver and silver chitosan nanocoatings on monocrystalline ceramic, polycrystalline ceramic, and metallic brackets regarding friction, roughness, and antibacterial effect against Streptococcus mutans. METHODS: A total of 99 upper right premolar brackets with a 0.022 × 0.025 -inch slot were divided into three groups, each 33 according to coating material; the non-coated group, silver nanoparticles (AgNPs), and silver chitosan nanoparticles (Ag-CsNPs) groups. Each group was equally subdivided into the following three subgroups regarding bracket materials: monocrystalline ceramic, polycrystalline ceramic, and metallic brackets. A universal testing machine determined static friction on a custom-made acrylic jig. Then a profilometer machine was used to collect roughness data, and finally, the anti-cariogenic effect was measured with the disc diffusion technique's "minimum zone of inhibition" against Streptococcus mutans. Two-way ANOVA was used to compare data between groups and subgroups, followed by the Bonferroni test for multiple pair-wise comparisons. RESULTS: The nanocoating effect on ceramic brackets' static friction was non-significant. The AgNPs and Ag-CsNPs coated metallic group revealed a significant increase in static friction-a significant effect of the nanocoating in the surface roughness of monocrystalline and polycrystalline ceramic brackets. A significant favorable effect of AgNPs and Ag-CsNPs against Streptococcus mutans was observed. CONCLUSIONS: AgNPs and Ag-CsNPs coats are unsuitable for decreasing friction in metallic brackets or improving roughness in polycrystalline ceramic brackets. Nano coating can improve roughness in monocrystalline ceramic brackets. Coating brackets with AgNPs and Ag-CsNPs has a tremendous antibacterial effect on Streptococcus mutans, a substantial factor in the incidence of dental caries.

The best method of reconditioning ceramic brackets to get an optimum shear bond strength compared with new ceramic brackets - Systematic review and meta-analysis of in vitro studies.

PURPOSE: Bracket debonding is an undesirable problem during fixed orthodontic treatment. As ceramic brackets have no flexibility, there is no change in the slot dimension. So, reconditioning a ceramic bracket can be done without compromising the quality of treatment and could be a cost-effective measure. The objective of this systematic review is to deduce and validate the best method of reconditioning ceramic bracket in order to get optimum clinical shear bond strength. MATERIAL AND METHODS: Studies such as randomized controlled trials (RCTs); In vitro studies comparing different interventions with control group, cross sectional studies were included. Electronic databases such as Cochrane database, PubMed, Web of Science, Embase were searched up to July 2022. Grey literature search and cross-referencing/snowballing methods were also used. Two reviewers independently selected studies and assessed the risk of bias using amalgamation of five tools for in vitro studies. Then meta-analysis was performed using random effects model. RESULTS: Eleven studies were included in which ten studies were considered as good quality studies. According the meta-analysis performed, the best performance in terms of shear bond strength was of new brackets. Among the different reconditioning methods, the meta-analysis showed that the method with the closest bond strength to the new brackets was silicatisation with a mean difference of 6.35MPa (95% CI between 2.39 and 10.31) followed by sandblasting+silane application with a mean difference of 3.36MPa (95% CI between 0.3 and 6.96) compared to other methods. CONCLUSIONS: Due to the lack of in vivo studies, only in vitro studies were evaluated. The data available from the in vitro studies was considered to be of good quality, leading to the conclusion that the best method for reconditioning debonded ceramic brackets is silicatisation followed by sandblasting and silane application.

In Vitro Evaluation of the Effects of Different Chemical Solvent Agents on Shear Bond Strength of Ceramic Orthodontic Brackets.

Objective: In this study, the effects of different chemical solvents such as acetone, ethanol, dimethyl sulfoxide (DMSO), peppermint oil, and hot water on the shear bond strength (SBS) of mechanically and chemically bonded ceramic brackets were examined. Their use for facilitation of the debonding process in practice was evaluated regarding the purposes of this study. Methods: One hundred and thirty-two human premolar teeth extracted for orthodontic purposes were randomly divided into 11 groups. SBS were applied using a universal test machine. The amount of residual adhesives was determined through adhesive remnant index scoring. Scanning electron microscopy (SEM) images were examined to determine the effects of solvents on the enamel surface. Results: In all test groups, the highest SBS values were found in the ethanol 5- and 15-minutes groups. SEM examination showed micro-cracks in all groups. Increased SBS values were also found in 5- and 15-minutes groups of hot water and DMSO, while both peppermint oil groups had similar SBS values as the control group. SBS values of both acetone 5- and 15-minutes groups were found to be lower than the control and other groups. Conclusion: Acetone application for 5 or 15 minutes before debonding of ceramic brackets could be an alternative clinical approach to prevent enamel damage and facilitate debonding.

Shear Bond Strength of Polypropylene Fiber in Orthodontic Adhesive on Glazed Monolithic Zirconia.

This study aims to compare shear bond strength (SBS) and mode of failure (MOF) between ceramic and metal orthodontic brackets on glazed monolithic zirconia using non-woven polypropylene fiber adhesive. Sixty glazed and sintered zirconia blocks were divided into six groups and attached with orthodontic brackets as follows: CS, ceramic bracket with silane; CB, ceramic bracket with bonding agent; CBS, ceramic bracket with bonding agent and silane; MS, metal bracket with silane; MB, metal bracket with bonding agent; and MBS, metal bracket with bonding agent and silane. There was a statistically significant difference in mean SBS values (p < 0.001). The CS group showed the highest SBS value (23.42 ± 3.88 MPa). On the other hand, the lowest was found in the MB group, which was not statistically different from the CB group (3.26 ± 0.76 and 5.09 ± 1.50 MPa, respectively). The MS, MBS, and CBS groups showed no statistical difference compared to each other (15.57 ± 4.01, 13.23 ± 5.47, and 12.77 ± 4.43 MPa, respectively). SBS is highest when a ceramic bracket with silane is bonded to glazed monolithic zirconia.

Effect of fine particle shot peening on surface friction of stainless steel and ceramic bracket slots.

This study aims to compare the static friction of untreated and fine particle shot peening (FPSP) treated stainless steel and ceramic bracket slots. A total of 60 pieces of stainless steel and 60 pieces of ceramic brackets (Roth prescription, 0.022×0.028 in2) were divided into 3 groups: control (n=20), silica glass bead particle surface treatment (n=20) and stainless steel (SUS316L) particle surface treatment (n=20). Ten brackets of each group were combined with 0.019×0.025 in2 orthodontic stainless steel arch wires and were analyzed for static friction. The remaining 10 brackets of each group were tested for slot surface roughness and hardness. The result shows that stainless steel brackets treated with FPSP exhibited lower static friction, with smoother and harder surfaces than the control group (p<0.05). In contrast, treated ceramic brackets showed no difference from the control group in terms of static friction, roughness, and hardness (p>0.05).

Comparative Evaluation of Frictional Resistance Between Different Types of Ceramic Brackets and Stainless Steel Brackets With Teflon-Coated Stainless Steel and Stainless Steel Archwires: An In-Vitro Study.

Background Orthodontic tooth movement relies on sliding mechanics usually achieved by sliding the archwire through brackets. Sliding causes friction which is a force resisting the relative motion of two contacting objects. Frictional resistance is undesirable in orthodontic tooth movement because the archwire might bind with the bracket and prevent tooth movement. In addition, friction causes bending of the archwire leading to unwanted tooth movement or space loss through anchorage interference, prolonging the treatment time and root resorption. This study was performed to compare the frictional resistance produced by different types of ceramic brackets and stainless steel brackets with Teflon-coated stainless steel and stainless steel archwires. The surface texture of the wire before and after friction test was also evaluated using a scanning electron microscope (SEM). Methodology A total of 48 samples were tested. In total, 12 premolar brackets each of stainless steel (Ortho technology, Carlsbad, CA, USA), monocrystalline ceramic (Ortho technology, Carlsbad, CA, USA), polycrystalline ceramic (Ortho technology, Carlsbad, CA, USA), and ceramic bracket with a metal slot (Ortho technology, Carlsbad, CA, USA) having an 0.022-inch slot were coupled with 0.019 × 0.025-inch stainless steel and Teflon-coated stainless steel wires. Each bracket-wire assembly was vertically mounted and clamped to the jaws of the universal testing machine. The wire was pulled across the bracket with a cross head speed of 10 mm per minute. The readings obtained were recorded. To evaluate the surface roughness, wires were examined using an SEM (in four magnifications 250×, 500×, 1,000×, and 5,000×) before and after testing. Results Under the testing conditions, the stainless steel bracket-stainless steel wire combination produced the least frictional resistance, and the polycrystalline ceramic bracket-stainless steel wire combination produced the highest frictional resistance. Ceramic brackets with a metal slot generated lesser friction than other types of ceramic brackets but more friction than stainless steel brackets. Moreover, for all bracket-archwire combinations, Teflon-coated wires generated reduced frictional resistance compared to stainless steel wires. The surface examination of Teflon-coated stainless steel wire and conventional uncoated stainless steel wire revealed that Teflon-coated wire had a smoother surface compared to uncoated stainless steel wire. Conclusions Within the limitations of this study, it was concluded that the stainless steel bracket produced the lowest frictional resistance and the polycrystalline ceramic bracket produced the highest frictional resistance. Ceramic brackets with a metal slot showed a coefficient of friction that was more than but comparable to that of stainless steel brackets. Monocrystalline ceramic brackets generated lesser friction compared to polycrystalline ceramic brackets. Further, Teflon coating of stainless steel archwires can reduce frictional resistance compared to conventional uncoated stainless steel archwires. The surface of Teflon-coated stainless steel wires was found to be smoother than uncoated stainless steel wires.

Orthodontic bonding to silicate ceramics: impact of different pretreatment methods on shear bond strength between ceramic restorations and ceramic brackets.

OBJECTIVE: The study aims to investigate the shear bond strength (SBS) between silicate ceramic restorations and ceramic brackets after different pretreatments and aging methods. MATERIAL AND METHODS: Leucite (LEU) and lithium disilicate (LiSi) specimens were pretreated with (i) 4% hydrofluoric acid + silane (HF), (ii) Monobond Etch&Prime (MEP), (iii) silicatization + silane (CoJet), and (iv) SiC grinder + silane (SiC). Molars etched (phosphoric acid) and conditioned acted as comparison group. SBS was measured after 24 h (distilled water, 37 °C), 500 × thermocycling (5/55 °C), and 90 days (distilled water, 37 °C). Data was analyzed using Shapiro-Wilk, Kruskal-Wallis with Dunn's post hoc test and Bonferroni correction, Mann-Whitney U, and Chi2 test (p < 0.05). The adhesive remnant index (ARI) was determined. RESULTS: LEU pretreated with MEP showed lower SBS than pretreated with HF, CoJet, or SiC. LiSi pretreated with MEP resulted in lower initial SBS than pretreated with HF or SiC. After thermocycling, pretreatment using MEP led to lower SBS than with CoJet. Within LiSi group, after 90 days, the pretreatment using SiC resulted in lowest SBS values. After HF and MEP pretreatment, LEU showed lower initial SBS than LiSi. After 90 days of water storage, within specimens pretreated using CoJet or SiC showed LEU higher SBS than LiSi. Enamel presented higher or comparable SBS values to LEU and LiSi. With exception of MEP pretreatment, ARI 3 was predominantly observed, regardless the substrate, pretreatment, and aging level. CONCLUSIONS: MEP pretreatment presented the lowest SBS values, regardless the silicate ceramic and aging level. Further research is necessary. CLINICAL RELEVANCE: There is no need for intraoral application of HF for orthodontic treatment.

Comparison of feldspathic veneer surface treatments on ceramic bracket SBS, ARI and surface roughness after different debonding/polishing methods: An in vitro study.

OBJECTIVES: To analyse, in vitro, surface properties and the shear bond strength after debonding and polishing procedures of ceramic brackets directly bonded to 0.3-0.5-mm thick feldspathic veneers. MATERIALS AND METHODS: Fifty six feldspathic ceramic veneers samples (0.3 to 0.5-mm thick) were allocated into groups according to veneers surface treatment procedures: (S) glaze layer was retained; (SHF) hydrofluoric (HF) acid etch; (SOXA) Al2O3 sandblasting; and (SB) diamond burs roughening. Specimens were treated with silane Monobond N® and ceramic brackets bonded with Transbond XT®. Shear bonding strength (SBS) was assessed with a universal testing machine and ARI evaluated under a stereomicroscopic coupled to a digital camera. Remaining bonding composite was removed using a porcelain polishing kit and surface roughness assessed with a stylus profilometer. RESULTS: No statistically significant differences were identified for SBS among the study groups (S, SHF, SOXA and SB) (P>0.05). The majority of the specimens presented ARI scores 3 and 2 (P>0.05). All of the study groups presented increased surface roughness after debonding and polishing procedures (P<0.05), with significant greater values observed in SB group (RaF: 1.27±0.41; RzF: 6.23±1.82), (P<0.05). CONCLUSIONS: Surface treatment with hydrofluoric acid etch, Al2O3 sandblasting and diamond bur did not enhance SBS of orthodontic brackets bonded to ceramic veneers. Ceramic surfaces treated with diamond burs presented significantly increased roughness after adhesive removal.

Effects of plastic bracket primer on the shear bond strengths of orthodontic brackets.

BACKGROUND/PURPOSE: To assess the usefulness of plastic bracket primer (PBP) for improving the bond strength of plastic brackets (PBs) using three types of orthodontic brackets, including PBs, metal brackets (MBs), and ceramic brackets (CBs). MATERIALS AND METHODS: A total of 162 premolars were gathered and divided equally into six groups of 27. Three groups were tested with the application of PBP (PB+, MB+, and CB+), and three groups were tested without primer (groups PB-, MB-, and CB-). All the groups were bonded using BeautiOrtho Bond II self-etching adhesive. The shear bond strength (SBS) was measured and the bond failure mode was evaluated using the adhesive remnant index after debonding. RESULTS: There were significant differences in the mean SBS between groups PB-, MB and CB-, between PB+ and CB+, and between MB+ and CB+. Group PB + had a significantly higher mean SBS than group PB-. The occurrence of bond failure at the enamel and adhesive interface was more frequent in groups PB+ and CB- than in group PB-; and in groups PB+ and CB + than in group MB+. CONCLUSION: Plastic bracket primer can increase the bond strength of PBs to the level of metal brackets, but not to the level of ceramic brackets.

To Compare the Accuracy of 0.022 Inch Slot of Stainless Steel and Ceramic Orthodontic Brackets Marketed by Different Manufacturers.

AIM OF THE STUDY: The aim of the present study was to analyze the accuracy of 0.022 inch slot of stainless steel and ceramic orthodontic brackets marketed by different manufacturers. MATERIALS AND METHODS: An in vitro study was done on upper left central incisor bracket of MBT 0.022 slot of American orthodontics (AO), 3M Unitek, Ormco with each 20 of stainless steel and ceramic brackets divided into six groups, and the total sample was 120. The brackets were scanned with stereo microscope of Magnus Company and Image Pro plus analysis software was used to evaluate the mesial face and base, distal face and base. RESULTS: Comparison in between the groups of stainless steel showed that 3M Unitek brackets showed higher slot widths as compared to AO and Ormco which was statistically significant (P < 0.05). Comparison in between the groups of ceramic brackets of AO brackets showed higher slot widths as compared to Ormco and 3M Unitek ceramic brackets which was statistically significant (P < 0.05). CONCLUSION: By this study, there was a difference between stated values and measured values of brackets displaying inaccuracies in dimension. A clear impreciseness about the appliance could be needed during the finishing and detailing stage to avoid loss of torque control due to slot oversize and the divergence of slot walls.

Primer-Treated Ceramic Bracket Increases Shear Bond Strength on Dental Zirconia Surface.

The purpose of this study is to evaluate the shear bond strength (SBS) of a primer-treated ceramic bracket on dental zirconia and to compare it with conventional ceramic bracket bonding on surface-treated zirconia. Sintered and finished dental zirconia was sandblasted. Samples were divided according to the treated surfaces: no treatment (X), ceramic primer on zirconia (Z), ceramic primer on bracket base (B), and ceramic primer on both zirconia and bracket base (ZB). The ceramic bracket was bonded on zirconia and SBS was measured before (T0) and after 10,000 cycles of thermocycling (Tf). The failed surfaces were examined under field emission scanning electron microscope (FE-SEM), and adhesive remnant index (ARI) was evaluated. SBS was significantly higher in ZB and significantly lower in X in both T0 and Tf. There was no significant difference between Z and B. In X and B, adhesive failure occurred while ZB showed mixed failures. There was no apparent change in the zirconia surface except for the existence of some adhesive and resin remnants. The application of ceramic primer on the bracket base increased the bonding strength to the level of conventional bonding with fewer adhesive remnants. The highest bonding strength was obtained when the primer-treated bracket was bonded on the primer-treated zirconia.

In vitro evaluation of a ceramic bracket with a laser-structured base.

BACKGROUND: The purpose of this study was the assessment of shear bond strength (SBS), adhesive remnant characteristics, integrity of the enamel, integrity of Discovery Pearl as well as the integrity of Fascination 2 ceramic brackets following SBS testing. METHODS: Sixty maxillary first premolars were randomly assigned into two groups. These groups were bonded with their respective brackets. The samples underwent thermocycling (1000 cycles), SBS testing and assessment of the residual adhesive. The statistical analyses used were the independent samples t-test, the Weibull analysis and the chi-square test. RESULTS: The independent samples t-test for the comparison of the mean SBS resulted in significant differences between Fascination 2 (10.50 ± 2.61 MPa) and Pearl (13.01 ± 2.50 MPa) brackets (p = 0.0003). The results of the chi-square test for ARI demonstrated a significant difference (p = 0.000) between the groups. A higher frequency of ARI scores of 2 and 3 for Pearl brackets existed. Enamel damage and bracket fracturing was not observed. CONCLUSIONS: The mean bond strength value, the adhesive remnant characteristics, the integrity of the enamel and the ceramic brackets as well as the Weibull analyses outcomes were highly encouraging during this in vitro screening. The way is paved for an in vivo investigation with the Pearl ceramic bracket.

Effect of antioxidant on orthodontic bracket bond strength after vital bleaching.

OBJECTIVES: : The objective of this study is to compare the neutralization effect of various antioxidant agents on the bond strength of composite resins on stainless steel and ceramic brackets immediately bonded to previously bleached teeth. MATERIALS AND METHODS: One hundred and sixty human maxillary premolars were used for the study. Teeth were divided into four groups (n = 40): Group 1 (control), Group 2 (bleached), Group 3 (sodium ascorbate), and Group 4 (tocopherol acetate). Each group was divided into two subgroups, one was bonded with stainless steel and other with ceramic brackets using 3M Transbond XT. Universal testing machine was used to determine the shear bond strength (SBS). RESULTS: Among the metal brackets, Group 1A had the highest SBS (12.18 + 1.41 MPa) and Group 2A had the least SBS (6.18 + 1.49 MPa). Weibull analysis indicated that bond strength for a 90% probability of failure was highest for Group 1A (13.99 MPa) and lowest for Group 2A (8.49 MPa). For ceramic brackets, Group 1B had the highest SBS (13.80 + 1.69 MPa) and Group 2B had the least SBS (8.05 + 1.85 MPa). Weibull analysis indicated that bond strength for a 90% probability of failure was highest for Group 1B (14.61 MPa) and lowest for Group 2B (8.85MPa). CONCLUSION: The in vitro study showed that bleaching reduced the SBS significantly, and this could be effectively reversed by the application of antioxidants in both metal and ceramic brackets.

An analysis on the potential of diode-pumped solid-state lasers for dental materials.

Material structure-property relationship is strongly related to the employed process technology. Over the past years, laser processing of engineering materials has been proposed in many fields and different uses for diode lasers have been found in dentistry. In this contest, the potential of GaN- and InGaN-based laser diodes to cure dental materials was analysed. Two wavelengths of 405 nm and 445 nm were used as heat or light sources for warm condensation of gutta-percha, light transmission in dental posts and brackets or light curing of dental composites. Additive manufacturing approach was considered to fabricate 3D root analogues, suitable supports, positioning systems and moulds for optical measurements. A three-axis CAD/CAM system was implemented for positioning and aligning the laser beam. The ability of diode-pumped solid-state lasers to cure dental materials or to transmit light was compared to that of a traditional instrument. Temperature profile at the apex of an additive manufactured root canal sealed with gutta-percha, light transmission through translucent quartz fiber post or through aesthetic ceramic bracket, bending properties and morphological features of light cured dental composites (Gradia Direct - GC Corporation and Venus Diamond - Heraeus Kulzer) were measured. Results showed a very high potential of diode-pumped solid-state lasers to be used in endodontics, orthodontics and restorative dentistry.

Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive.

OBJECTIVES: The aim of this study is to compare the shear bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and universal adhesive. MATERIALS AND METHODS: Fifty zirconia blocks (15 × 15 × 10 mm, Zpex, Tosoh Corporation) were polished with 1,000 grit sand paper and air-abraded with 50 µm Al2O3 for 10 seconds (40 psi). They were divided into 5 groups: control (CO), Metal/Zirconia primer (MZ, Ivoclar Vivadent), Z-PRIME Plus (ZP, Bisco), Zirconia Liner (ZL, Sun Medical), and Scotchbond Universal adhesive (SU, 3M ESPE). Transbond XT Primer (used for CO, MZ, ZP, and ZL) and Transbond XT Paste was used for bracket bonding (Gemini clear ceramic brackets, 3M Unitek). After 24 hours at 37°C storage, specimens underwent 2,000 thermocycles, and then, shear bond strengths were measured (1 mm/min). An adhesive remnant index (ARI) score was calculated. The data were analyzed using one-way analysis of variance and the Bonferroni test (p = 0.05). RESULTS: Surface treatment with primers resulted in increased shear bond strength. The SU group showed the highest shear bond strength followed by the ZP, ZL, MZ, and CO groups, in that order. The median ARI scores were as follows: CO = 0, MZ = 0, ZP = 0, ZL = 0, and SU = 3 (p < 0.05). CONCLUSIONS: Within this experiment, zirconia primer can increase the shear bond strength of bracket bonding. The highest shear bond strength is observed in SU group, even when no primer is used.

Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive

OBJECTIVES: The aim of this study is to compare the shear bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and universal adhesive. MATERIALS AND METHODS: Fifty zirconia blocks (15 × 15 × 10 mm, Zpex, Tosoh Corporation) were polished with 1,000 grit sand paper and air-abraded with 50 µm Al2O3 for 10 seconds (40 psi). They were divided into 5 groups: control (CO), Metal/Zirconia primer (MZ, Ivoclar Vivadent), Z-PRIME Plus (ZP, Bisco), Zirconia Liner (ZL, Sun Medical), and Scotchbond Universal adhesive (SU, 3M ESPE). Transbond XT Primer (used for CO, MZ, ZP, and ZL) and Transbond XT Paste was used for bracket bonding (Gemini clear ceramic brackets, 3M Unitek). After 24 hours at 37°C storage, specimens underwent 2,000 thermocycles, and then, shear bond strengths were measured (1 mm/min). An adhesive remnant index (ARI) score was calculated. The data were analyzed using one-way analysis of variance and the Bonferroni test (p = 0.05). RESULTS: Surface treatment with primers resulted in increased shear bond strength. The SU group showed the highest shear bond strength followed by the ZP, ZL, MZ, and CO groups, in that order. The median ARI scores were as follows: CO = 0, MZ = 0, ZP = 0, ZL = 0, and SU = 3 (p < 0.05). CONCLUSIONS: Within this experiment, zirconia primer can increase the shear bond strength of bracket bonding. The highest shear bond strength is observed in SU group, even when no primer is used.