In vitro analysis of femtosecond laser as an alternative to acid etching for achieving suitable bond strength of brackets to human enamel.

This study aims to evaluate the effect of laser irradiation and orthophosphoric acid etching on the shear bond strength (SBS) of orthodontic brackets to enamel. Three groups (n = 20) of extracted premolar teeth were randomly established depending on the laser treatment performed on the buccal surfaces: (1) no laser (control); (2) Er:YAG laser (2,940 nm, 0.8 W, 100 µs/pulse, 10 Hz) and; (3) Ti:Sapphire laser (795 nm, 1 W, 120 fs/pulse, 1 kHz). Each group was divided into two subgroups according to whether 37%-orthophosphoric acid etching was made after laser irradiation or not. Brackets were randomly luted with Transbond(TM) XT adhesive resin. After 72 h, a SBS test was developed in a universal testing machine (crosshead speed, 0.5 mm/min). Representative specimens from each experimental subgroup were examined by means of scanning electron microscopy. Cement residuals remaining on the premolar surfaces were assessed using the adhesive remnant index. ANOVA, post-hoc tests for intergroup comparisons, chi-square test and linear regression were run for data analyses (α = 0.05). After acid etching, SBS values did not differ regardless the laser treatment. When phosphoric acid was not applied, the SBS values of the femtosecond laser group were significantly higher than for the other groups. Femtosecond laser without acid seems to be the most suitable method to improve bond strengths at the bracket/enamel interface, thus avoiding the disadvantages inherent to acid etching.