Evaluation of enamel roughness after orthodontic debonding and clean-up procedures using zirconia, tungsten carbide, and white stone burs: an in vitro study.

BACKGROUND: The main goal of orthodontic debonding is to restore the enamel surface as closely as possible to its pretreatment condition without iatrogenic damage. This study aimed to compare the effects of different adhesive removal burs; zirconia burs, tungsten carbide burs, and white stone burs on enamel surface roughness. MATERIALS AND METHODS: Total sample of 72 extracted premolars was randomly divided into three equal groups (n = 24) depending on the method of adhesive removal: zirconia burs (ZB); tungsten carbide burs (TC); and white stones (WS). The metal brackets were bonded using Transbond XT orthodontic adhesive (3 M Unitek, Monrovia, CA, USA) and debonded after 24 h using a debonding plier, then the ARI was assessed. The adhesive remnants were removed using the different burs and Final polishing was performed using Sof-lex discs and spirals. Thirteen samples from each group were evaluated using a Mitutoyo SJ-210 profilometer to determine average surface roughness (Ra) and three samples from each group were examined under Scanning Electron Microscopy (SEM) to determine EDI score. The evaluations were performed at three time points; before bonding (T0), after adhesive removal (T1) and after polishing (T2) and the time consumed for adhesive removal by burs was recorded in seconds. The data were analyzed statistically by ANOVA, Tukey's test and Kruskal-Wallis H-test. RESULTS: Kruskal-Wallis H-test showed no statistically significant difference of ARI in all studied groups (p = 0.845) and two-way mixed ANOVA revealed that all burs significantly increased surface roughness at T1 compared to T0 (p < 0.001) in all groups with the lowest Ra values were observed in the ZB group, followed by the TC group, and WS group. The fastest procedure was performed with WS, followed by ZB, then TC bur (p < 0.001). After polishing (T2), Ra values showed no significant difference in ZB group (P = 0.428) and TC group (P = 1.000) as compared to T0, while it was significant in WS group (p < 0.001). CONCLUSION: zirconia bur was comparable to tungsten carbide bur and can be considered as alternative to white stone which caused severe enamel damage. The polishing step created smoother surface regardless of the bur used for resin removal.

Effect of mold enclosure and chisel design on fatigue bond strength of dental adhesive systems.

To examine the effect of mold enclosure and chisel design on macro shear fatigue bond strengths of dental adhesive systems. The fatigue bond strength testing was conducted with two commercially available dental adhesive systems, (1) OptiBond eXTRa and (2) Scotchbond Universal, for bonding a resin composite (Filtek Supreme Ultra) to both enamel and dentin using a mold enclosure and a non-mold enclosure with a knife-edge and two sized notched-edge chisel assemblies for loading. As a loading reference for the fatigue testing, macro shear bond strengths of the adhesive systems to enamel and dentin were conducted using a mold enclosure and a knife-edge chisel assembly. The shear bond strengths with the mold enclosure using knife-edge chisel assembly did not exhibit a significant difference between the adhesive systems for either enamel or dentin. The fatigue bond strengths of bonded specimens demonstrated significant differences when comparing the mold enclosure and non-mold enclosure, but not between knife-edge and notched-edge chisel assemblies. The fatigue bond strengths of dental adhesive systems demonstrated significantly higher values when using mold-enclosed bonded specimens than a non-mold enclosure, regardless of type of chisel assembly.

Bonding and wear properties of self-adhesive flowable restorative materials.

The purpose of this study was to evaluate the bonding and wear properties of self-adhesive flowable restorative materials. Five self-adhesive flowable restorative materials were used. The study parameters were: (i) shear bond strengths; (ii) microleakage; (iii) occlusal wear; and (iv) qualitative evaluation of the bonding interface. The range of shear bond strengths of the materials was as follows: 7.4-12.2 MPa to ground enamel, 22.5-32.5 MPa to etched enamel, and 1.3-4.2 MPa to dentin. The microleakage scores of the materials did not show any statistically significant differences regardless of the presence or absence of etching. The wear facets on the materials showed 0.099-0.447 mm3 of volume loss and 148.6-365.3 µm maximum depth, with statistically significant differences between materials. Scanning electron microscopic images of the interfaces of the materials showed good adaptation regardless of substrate. The bonding and wear properties of self-adhesive flowable restorative materials were still limited and showed lower values than previously reported results for nanofilled composites with an adhesive system. Selective enamel etching can improve the bonding performance of these materials.

Influence of 38% silver diamine fluoride application on bond stability to enamel and dentin using universal adhesives in self-etch mode.

In order to evaluate the influence of 38% silver diamine fluoride (SDF) application on enamel and dentin bond stability of universal adhesives in self-etch mode, a 38% SDF and three universal adhesives were used in this study. Initial shear bond strength (ISBS), fatigue bond strength (FBS), and shear bond strength of survivors (SBSS) to enamel and dentin of universal adhesives in self-etch mode, with and without SDF application, were determined. SDF was applied to the polished enamel or dentin surface for 1 min, water-rinsed and air-dried for comparison with controls. The universal adhesives were applied to the prepared samples and composite resin was bonded using a mold-enclosed method. Enamel bond stability of universal adhesives with SDF (ISBS: 14.7-20.4 MPa; FBS: 5.5-7.4 MPa and SBSS: 14.4-21.5 MPa) was significantly weaker than those without SDF (ISBS: 28.0-29.2 MPa; FBS: 12.1-15.6 MPa and SBSS: 28.4-34.4 MPa). Dentin bond stability with SDF (ISBS: 14.8-20.9 MPa; FBS: 7.1-8.2 MPa and SBSS: 17.3-21.8 MPa) was also significantly weaker than without SDF (ISBS: 19.3-36.1 MPa; FBS: 11.0-13.7 MPa and SBSS: 22.2-34.6 MPa). The results suggest that SDF application on enamel and dentin reduces the bond stability of universal adhesives in self-etch mode.

Influence of surface wetness on bonding effectiveness of universal adhesives in etch-and-rinse mode.

The purpose of this study was to evaluate whether surface wetness would influence the bonding effectiveness of universal adhesives in etch-and-rinse mode. All-Bond Universal (AB), G-Premio Bond (GP), Prime & Bond Active (PB), and Scotchbond Universal Adhesive (SU) were evaluated. Initial bond strengths and bond-fatigue strengths of universal adhesives to both wet and dry enamel and dentin in etch-and-rinse mode were determined. Scanning electron microscopy observations of the adhesive interfaces were also conducted. The bond-fatigue durability of universal adhesive to enamel in etch-and-rinse mode was influenced by the surface wetness, unlike that to dentin. The bond fatigue durability of AB and GP to dentin in etch-and-rinse mode was different depending on the surface wetness, unlike that of PB and SU. The thicknesses of the adhesive or hybrid layer of resin-dentin interfaces were not influenced by the surface wetness, but the length of resin tags in the wet group was longer than in the dry group. Some universal adhesives with the addition of specific components and optimization of water content can achieve stable bonds regardless of surface wetness, but the surface wetness of dentin is still a significant factor for universal adhesive bonding in etch-and rinse mode, unlike that of enamel.

Shear fatigue strength of resin composite bonded to dentin at physiological frequency.

The purpose of this study was to examine the shear fatigue strengths of a resin composite bonded to dentin. Three adhesive systems - a two-step self-etch adhesive (OptiBond XTR; Kerr) and two universal adhesives [Scotchbond Universal (3M ESPE) and G-Premio Bond (GC)] - were used in self-etch mode to bond a resin composite to dentin at a physiologic frequency of 2 Hz over 50,000, 100,000, and 1,000,000 cycles. A staircase method of fatigue testing was used. Twenty specimens were used for each test condition. There was no significant difference in shear fatigue strength across the cycling periods for the three individual adhesives. Differences in shear fatigue strength were found among the three adhesives within each cycling period. Regardless of the adhesive used in self-etch mode for bonding a resin composite to dentin, shear fatigue strength was not influenced by the number of cycles used for testing.

Relationship between enamel bond fatigue durability and surface free-energy characteristics with universal adhesives.

The relationship between enamel bond fatigue durability and surface free-energy characteristics with universal adhesives was investigated. The initial shear bond strengths and shear fatigue strengths of five universal adhesives to enamel were determined with and without phosphoric acid pre-etching. The surface free-energy characteristics of adhesive-treated enamel with and without pre-etching were also determined. The initial shear bond strength and shear fatigue strength of universal adhesive to pre-etched enamel were higher than those to ground enamel. The initial shear bond strength and shear fatigue strength of universal adhesive to pre-etched enamel were material dependent, unlike those to ground enamel. The surface free-energy of the solid (γS ) and the hydrogen-bonding force (γSh) of universal adhesive-treated enamel were different depending on the adhesive, regardless of the presence or absence of pre-etching. The bond fatigue durability of universal adhesives was higher to pre-etched enamel than to ground enamel. In addition, the bond fatigue durability to pre-etched enamel was material dependent, unlike that to ground enamel. The surface free-energy characteristics of universal adhesive-treated enamel were influenced by the adhesive type, regardless of the presence or absence of pre-etching. The surface free-energy characteristics of universal adhesive-treated enamel were related to the results of the bond fatigue durability.

In Vitro Study on the Influence of the Buccal Surface Convexity of the Tooth upon Enamel Loss after Bracket Removal.

Polishing after the removal of brackets is the final step in orthodontic treatment. It is simple to perform, though some studies have reported that polishing causes damage to the enamel surface. An in vitro study was made of the influence of the buccal surface convexity of the tooth upon possible enamel loss when the remaining resin and adhesive are removed after bracket decementing using two different polishing modes: a tungsten carbide bur at low and high speeds. The convexity of the buccal surface was quantified in 30 incisors and 30 premolars. A stereoscopic microscope was used to obtain photographs of the profile of the crown, and Image J software was used to calculate convexity by dividing the length of a line from the cementoenamel junction to the incisal margin by another line from the mentioned junction to the maximum convexity of the buccal surface. Brackets were cemented on all the teeth and were decemented 24 h later. In both groups, the residual composite was removed with a tungsten carbide bur at a low speed in one-half of the teeth and at a high speed in the other half. The buccal surface of each tooth was then photographed again, and the convexity was calculated and compared against the baseline value. The difference between the two values were taken to represent the enamel loss. The convexity of the premolars was significantly greater than that of the incisors, but this did not result in greater enamel loss when the same polishing mode was used. However, the tungsten carbide bur at a high speed proved more aggressive, causing significantly greater enamel loss than when used at a low speed.

Enamel Evaluation after Debonding of Fixed Retention and Polishing Treatment with Three Different Methods.

Lack of standardization of the retention phase has led to many studies of stability of movements and characteristic of retainers, disregarding the enamel repercussions of fixed retention on this phase. This study aimed to analyze different methods of enamel polishing after detachment of orthodontic retainers. Forty-five healthy premolars were divided into three groups according to the polishing bur after debonding, and four specimens without intervention were used as control. A 0.038 × 0.015 inches gold chain was bonded between the premolars and then removed. The adhesive remnant was removed with three types of burs according to the study groups (Group 1: white stone at high speed; Group 2: high-speed handpiece with a 30-blade tungsten carbide bur; Group 3: low-speed handpiece and a 30-blade tungsten bur). After debonding and polishing, all samples were analyzed with a confocal microscopy on surface roughness parameters: Sa: Arithmetic mean of the height of the surface. Rq: Square mean of the height of the surface and Sz: Maximum surface height. Mechanical tests were carried out to determine the bonding stress of the retention adhered to the teeth using an electromechanical testing machine. The adhesion stress was 8.23 MPa (±0.87). The quality of the refinement of the enamel after debonding is essential in order to preserve its integrity. The use of the 30-blade tungsten carbide bur provides a smooth enamel surface after polishing.

Comparison of Enamel Surface Integrity after De-Bracketing as Affected by Seven Different Orthodontic Residual Cement Removal Systems.

This study used seven different adhesive removal systems to evaluate and compare enamel surface integrity, heat generation, and time consumed during residual cement removal after de-bracketing. The sample size was 140 human premolars. Teeth were cleaned, mounted, and prepared for orthodontic bracket bonding. Brackets were then debonded using bracket-removing pliers. Teeth were randomly assigned to seven groups based on the residual cement removal system: Group 1: Stainbuster bur, Group 2: Renew diamond bur #129, Group 3: Renew carbide bur, Group 4: OneGloss Complete system, Group 5: Sof-Lex system, Group 6: Enhance Finishing and PoGo Polishing complete kit, and Group 7: Renew friction grip points. The enamel surface was evaluated for roughness before bracketing and after residual cement removal using surface profilometry. The time taken for cement removal was recorded using a digital timer, and heat generation was measured using a laser thermometer before and after cement removal. One-way ANOVA compared the pre- and post-values for enamel surface roughness, temperature, and time consumed. When comparing the difference between the post- and pre-finishing roughness using one-way ANOVA, the Renew diamond bur produced the roughest enamel surface post-removal with a mean of 4.716 µm, while the Sof-Lex recorded the lowest at 0.760 µm. The highest mean temperature was recorded with the Stainbuster bur at 5.545 °C, and the lowest temperature was recorded with the Enhance bur at 2.260 °C. The time for cement removal was the shortest with the Enhance bur at 12.2 s, whereas the time was the longest with the Renew diamond bur at 30.4 s. In conclusion, all the residual cement removal systems used in this clinically simulated study were not able to restore the original enamel surface smoothness. However, the 3M Sof-Lex produced the lowest enamel roughness but with more time consumption and heat generation. When selecting the best residual cement removal system to be used, clinicians should weigh the merits and demerits of each system based on the clinical judgement of the operator.

Comparison of shear bond strength of rebonded stainless steel brackets with three different enamel surface conditioning methods.

Background: During the orthodontic bonding process, the need for repositioning or rebonding of orthodontic brackets on the enamel surface occurs frequently. The aim of this study is to compare the shear bond strength (SBS) in rebonding orthodontic stainless steel brackets with three different methods of enamel surface conditioning methods. Materials and Methods: In this in vitro study, 80 human premolars that were extracted for orthodontic purposes were randomly divided into four groups and underwent orthodontic bonding procedure (N = 20). Except for the control group, three other groups underwent debonding and rebonding process in which after removing the remaining adhesive with tungsten-carbide bur, enamel surface conditioned by three different methods including re-etching with phosphoric acid, sandblasting + acid etching, and Erbium-doped Yttrium-Aluminum-Garnet laser. Then, the SBS of the bracket to the enamel surface was compared between different groups. Scanning Electron microscopy images were also obtained from a number of samples. Statistical analysis was performed by Kruskal-Wallis and Mann-Whitney tests. Results: The highest SBS was observed in the primary bond (control group) with an average of 29,440 MPa. There was a significant difference between the studied groups (P < 0.001) and only the group that was re-etched with phosphoric acid had no significant difference with the control group (P = 0.708) ∝ =0.05. Conclusion: Rebonding of brackets using phosphoric acid for reconditioning of the enamel surface creates bond strength comparable to the primary bond. Other groups had significantly lower SBS than the control group.

Shear Bond Strength and Bracket Base Morphology of New and Rebonded Orthodontic Ceramic Brackets.

The objectives of this study were to (1) to evaluate the shear bond strength (SBS) of two ceramic brackets when new and when rebonded following various bracket base conditioning methods, and (2) to determine bond failure mode relative to bracket base morphology. 100 Symetri ClearTM (SC) and 100 Radiance Plus® (RP) ceramic brackets were bonded to bovine incisors and divided into five groups: one group served as controls and four had brackets rebonded following conditioning by: no surface treatment, sealant, sandblasting, and flame then steam. SBS, adhesive remnant index, and bracket base morphology were evaluated. SBS showed no statistical difference between new and rebonded with no surface treatment or sealant (SC brackets) and with sealant or flame and steam (RP brackets). When comparing SC to RP, SBS was higher with SC, no surface treatment, and sandblasted groups. All groups had varying amounts of adhesive left on the tooth, with the sandblasted group having the most. SEM analysis showed that sandblasting damaged the retention features of bracket bases. In conclusion, when rebonded, the SBS of SC brackets that had no surface treatment and both SC and RP brackets that had sealant showed no significant differences to new brackets. Sandblasting damaged the retention features of SC and RP bracket bases, resulting in low SBS.

Bond Durability of Two-Step HEMA-Free Universal Adhesive.

The purpose of this study is to compare bond durability, in terms of fatigue bond strength, of a two-step HEMA-free universal adhesive and representative adhesives in each systematic category. The adhesives used in this study were OptiBond FL, Prime&Bond NT, Clearfil SE Bond 2, G2-Bond Universal, and Scotchbond Universal Plus Adhesive. Fatigue bond strength testing and scanning electron microscopy analysis of adhesively bonded enamel and dentin interfaces were performed. For the adhesives in etch-and-rinse mode, the enamel fatigue bond strength of the G2-Bond Universal adhesive was significantly higher than those of other adhesives, and the dentin fatigue bond strength of Prime&Bond NT was significantly lower than the others. For adhesives in self-etch mode, the enamel fatigue bond strengths of Clearfil SE Bond 2 and G2-Bond Universal were significantly higher than that of the Scotchbond Universal Plus Adhesive, and the dentin fatigue bond strength of G2-Bond Universal was significantly higher than Clearfil SE Bond 2 and the Scotchbond Universal Plus Adhesive. The two-step HEMA-free universal adhesive showed higher enamel and higher or equal dentin fatigue bond strength than other selected representative adhesive systems in etch-and-rinse mode and higher or equal enamel and higher dentin fatigue bond strength than adhesive systems in self-etch mode.

Influence of different acid etching times on the shear bond strength of brackets bonded to bovine enamel.

INTRODUCTION: The most used product for surface acid conditioning for enamel is 37-40% phosphoric acid, which promotes greater mechanical retention. AIM: The objective of this study was to compare the shear bond strength (SBS) of brackets bonded to bovine enamel with different acid conditioning protocols and to analyze the surface morphology. MATERIALS AND METHODS: 169 teeth (n = 13) were divided into 4 groups: control group without conditioning (G1), Dental Gel 37% phosphoric acid (Dentsply) (G2), Ultra Etch 35% (Ultradent) (G3) and Attaque gel 37% (Biodinâmica) (G4). Groups G2, G3 and G4 were subdivided according to the conditioning time into: 10 s (a), 15 s (b), 30 s (c) and 60 s (d). The superficial enamel morphology (n = 3) was analyzed using a scanning electron microscopy (SEM) to analyze the depth of the microporosities. The samples were submitted to the shear test (SBS) with the aid of a universal testing machine (INSTRON) with a speed of 1 mm/min. The enamel after debonding was analyzed to determine the adhesive remnant index (ARI) in a stereoscopic magnifying glass. STATISTICAL ANALYSIS USED: The SBS data were analyzed using two-way ANOVA. ARI data were analyzed using generalized linear models and SEM measurements were analyzed using Kruskal Wallis and Dunn tests. The 95% significance level was used. RESULTS: The SBS within G2, G3 and G4 ranged from 11.11 to 12.66 MPa. ARI score 3 was observed in 35% of the samples. The samples analyzed in the SEM showed microporosity depth rangingfrom 1.28 to 2.48 µm. CONCLUSIONS: There was no difference between the acids and times evaluated for SBS. The ARI analysis showed that the studied acids provide protection to the enamel surface, keeping the adhesive attached to the buccal surface after debonding. The increase in conditioning time is directly proportional to the deterioration of the prismatic and interprismatic content.

Comparison of the failure rate, bonding time and ARI score of two orthodontic bonding systems: Self-Etch Primer and Conventional Etching Primer: A systematic review and meta-analysis.

OBJECTIVE: This study aimed to evaluate the failure incidence of brackets with at least six months follow-up between self-etch primer and conventional etch/primer, as well as to investigate the clinical duration of the bonding process and the amount of adhesive remnant index (ARI). METHODS: Electronic search was conducted in databases including PubMed, Scopus, Web of Science, ProQuest, ClinicalTrials.gov, and ICTRP (International Clinical Trials Registry Platform). The electronic search targeted only randomized clinical trials and was limited from January 2000 to June 2021. Delphi list is used to evaluate the risk of bias and Stata Version14.2 software was used. This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and recorded on the Ethics Committee of Research Institute of Dental Sciences, SBMU (IR.SBMU.DRC.REC.1398.240). RESULTS: Out of 2288 extracted studies, 30 of them entered the full-text evaluation process. According to the inclusion criteria, 15 studies entered this systematic review. Containing 607 participants and 10,563 brackets/teeth. All the included studies were of randomized clinical trials (RCT) design with either parallel or split-mouth design. Comparing the two groups, the risk difference effect (RD)=0.007 CI 95% (-0.004,0.018) indicated a neglectable difference in the risk of bracket failure during treatment between the two groups. The index I2=53.9% indicated moderate heterogeneity in the results. Furthermore, the P-value=0.007 indicated statistical insignificance between the two interventions in terms of failure rate. The clinical duration of bonding time analysis were equal to SMD _Cohen=-2.67 CI95% (-3.49, -1.85), which indicated a statistically significant reduction in clinical process time, using the self-etch primer. Data synthesis for adhesive remnant index could not be conducted due to heterogeneity among included studies. CONCLUSIONS: There was no difference between the self-etch primer and conventional etch/primer in bracket debonding at a medium level of evidence, However, there was statistically significant reduction in clinical bonding time using self-etch primer.

In vitro evaluation of enamel surface roughness and morphology after orthodontic debonding: Traditional cleanup systems versus polymer bur.

INTRODUCTION: The primary aim of this randomized in vitro study was to compare the effectiveness of carbide, fibreglass and polymer burs on resinous remnant removal after bracket debonding, by the evaluation of enamel surface roughness and morphology. The secondary objective was to compare the time dispended on the procedures. METHODS: The buccal surfaces of 28 bovine incisors were analysed by a profilometer to initial roughness measurement (Ra-T1). Brackets were bonded with a light-cured resin and debonded with a debonding plier. The samples were randomly divided into four groups, according to the bur used (n=7): A-Tungsten carbide; B-Fibreglass; C-Polymer; D-Polymer with 75% ethanol pre-treatment. The second roughness measurements were made after resin removal (Ra-T2). Time for removal procedures was also recorded. The third measurements were made after polishing (Ra-T3). Scanning Electronic Microscopy was performed in two samples of each group: after resin removal and after polishing. Results of roughness and time measurements were statically analysed by analysis of variance with post-hoc Bonferroni. RESULTS: After polishing, tungsten carbide (P=0.1555) and fibreglass burs provided final surface roughness statistically similar to the baseline condition (P=1.0000). Yet, polymer burs, associated (P<0.0001) or not to alcohol (P<0.0001), provided surface roughness significantly higher when compared to baseline values. Polymer burs were more time-consuming on resinous remnant removal than tungsten carbide and fibreglass burs (P<0.05). CONCLUSION: Polymer burs were less effective and more time-consuming to remove the remaining resin than tungsten carbide and fibreglass burs. The polishing step created smoother surfaces regardless of the burs used for resin removal.

Experimental study of brackets adhesion with a novel enamel-protective material compared with conventional etching.

INTRODUCTION: A reliable adhesion between fixed devices and dental surfaces is a key factor for the clinical success of any orthodontic treatment. Adhesion preparation is associated with damages related to abrasive cleaning, enamel structure defacing caused by etching, enamel loss when removing resin remnants at orthodontic treatment finishing stage or when conditioning surface for adhesive failure and fractures at bracket removal. AIM: The objective of this study was to compare the shear bond strength of metallic brackets to enamel adhered with a novel non-damaging and remineralizing material for enamel versus the traditional 37% phosphoric acid etching. MATERIAL AND METHODS: 75 Premolars collected from 15- to 40-years old healthy donors requiring extraction were collected. The teeth were then randomly divided into three groups (n = 25). One group was used for the experimental new method (EX), the second for the conventional phosphoric acid etching (PA) method and the third group was left without any treatment (NT). The metallic brackets were fixed with Transbond® XT adhesive and composite resin polymerized for 40 s with a halogen photocuring lamp. The shear bond strength was quantified by means of a universal testing machine at 1 mm/min crosshead speed and a load cell of 1 kN. STATISTICAL ANALYSIS USED: Tests of normality, adjustment of the data to a root square, a one-way ANOVA and Tukey tests were performed. RESULTS: Statistically significant differences between the NT (1.4 MPa), PA (32.1 MPa) and EX (9.7 MPa) groups were observed. CONCLUSIONS: The experimental material for conditioning human enamel induces calcium phosphates crystals on the enamel surface and improves the bond strength in comparison to the NT group.

Effect of an Er,Cr:YSGG Laser on the Debonding of Lithium Disilicate Veneers With Four Different Thicknesses.

Introduction: The objective of this study was to compare in vitro the resistance and type of failure in the debonding of lithium disilicate veneers with four different thicknesses using an erbium chromium yttrium-scandium gallium-garnet (Er,Cr:YSGG) laser. Methods: Sixty-eight bovine teeth were used to bond round lithium disilicate veneers with a 6-millimeter diameter and four different thicknesses: group 1 (0.4 mm), group 2 (0.8 mm), group 3 (1.2 mm) and group 4 (1.6 mm). Each sample was irradiated with an Er,Cr:YSGG laser with 4 W of power and a frequency of 50 Hz, during 60 seconds, scanning concentrically. The energy density per pulse or fluency applied was 5.33 J/cm2 for the four groups. The samples were subjected to a force in a universal testing machine and then observed under a microscope to determine the type of failure. Data were statistically analyzed with the non-parametric Kruskal-Wallis test. Results: The tendency in the results revealed that the thicker veneers showed more resistance to the debonding process. The debonding strength for group 3 was the highest (5.62 MPa), followed by group 4 (5.20 MPa), then group 2 (0.85 MPa) and finally group 1 (0.0 MPa). The most frequent type of failure was cohesive failure in cement (CC) for all groups, with 73.53% (P ≤ 0.083). Conclusion: Er,Cr:YSGG laser irradiation influences the debonding of lithium disilicate veneers with different thicknesses: the smaller thickness showed the greater debonding. The thickness of veneers was not associated with the type of failure.

Evaluation of the Shear Bond Strength and Adhesive Remnant Index in Debonding of Stainless Steel Brackets Assisted with Nd:YAG Laser Irradiation.

OBJECTIVES: The purpose was to compare shear bond strength (SBS), pulp temperature, and adhesive remnant index (ARI) in debonding of stainless steel brackets from enamel surface using neodymium-doped yttrium aluminum garnet (Nd:YAG) laser versus the conventional debonding method. MATERIALS AND METHODS: Forty-eight extracted premolars were bonded to stainless steel brackets. The samples were divided into three experimental groups and one control group. In the first three groups, Nd:YAG laser was used for debonding with the power of 1, 1.5, and 2 W, respectively, for 10 seconds. The SBS and ARI of the samples were assessed. Pulp temperature was recorded before and after irradiation. Two samples from each group were used for determining enamel morphology after debonding using scanning electron microscopy (SEM). RESULTS: The mean SBS in the groups was 33.05, 28.69, 24.37, and 31.53 MPa, respectively, with no statistically significant differences (P=0.205). Significant differences in post-irradiation temperature were noted among the lased groups (P=0.000). Debonding mainly occurred at the adhesive-enamel interface in the 1-W laser and control groups and at the bracket-adhesive interface in the 1.5-W and 2-W laser groups. Enamel structure was amorphous and irregular following laser irradiation. CONCLUSION: Based on the results of this study, the use of Nd:YAG laser could not significantly affect the SBS. Therefore, this laser would not be suitable for debonding of metal brackets. The use of a 2-W laser could significantly raise the pulpal temperature. Nd:YAG laser renders a more heterogeneous enamel morphology compared to conventional debonding methods.

Etch-and-rinse vs self-etch mode for dentin bonding effectiveness of universal adhesives.

In this study, dentin bond fatigue resistance and interfacial science characteristics of universal adhesives through etch-and-rinse and self-etch modes were investigated. Resin composite was bonded to human dentin with four universal adhesives, namely, Adhese Universal, All-Bond Universal, G-Premio Bond, and Scotchbond Universal Adhesive. The initial bond strengths, bond fatigue strengths, and interfacial science characteristics of the universal adhesives with dentin through etch-and-rinse and self-etch modes were determined. Bond fatigue resistance (initial bond strength and bond fatigue strength) of universal adhesives in etch-and-rinse mode showed no significant difference in contrast to that in self-etch mode and was material-dependent regardless of the etching mode. Although phosphoric acid conditioning of dentin did not have a strong impact on the bond fatigue resistance, surface free energy and parameters of dentin were significantly decreased by etching and by application of universal adhesives regardless of etching mode. Changes in γS and γSh for when universal adhesive was applied to etched and ground dentin were significantly different depending on the adhesive. The results suggest that bonding performance of universal adhesives was effective in both etching modes; however, bonding mechanisms may be different for each.