Effect of adhesive resin flexibility on enamel fracture during metal bracket debonding: an ex vivo study.

OBJECTIVE To test the null hypothesis that neither the flexural properties of orthodontic adhesive resins nor the enamel pre-treatment methods would affect metal bracket debonding behaviours, including enamel fracture. MATERIALS AND METHODS A dimethacrylate-based resin (Transbond XT, TX) and two methyl methacrylate (MMA)-based resins (Super-Bond C&B, SB; an experimental light-cured resin, EXP) were tested. Flexural strength and flexural modulus for each resin were measured by a three-point-bending test. Metal brackets were bonded to human enamel pretreated with total-etch (TE) or self-etch adhesive using one of the three resins (a total of six groups, n = 15). After 24 hours of storage in water at 37°C, a shear bond strength (SBS) test was performed using the wire loop method. After debonding, remaining resin on the enamel surfaces and occurrence of enamel fracture were assessed. Statistical significance was set at P < 0.05. RESULTS The two MMA resins exhibited substantially lower flexural strength and modulus values than the TX resin. The mean SBS values of all groups (10.15-11.09MPa) were statistically equivalent to one another (P > 0.05), except for the TE-TX group (13.51MPa, P < 0.05). The two EXP groups showed less resin remnant. Only in the two TX groups were enamel fractures observed (three cases for each group). LIMITATIONS The results were drawn only from ex vivo experiments. CONCLUSIONS The hypothesis is rejected. This study suggests that a more flexible MMA resin is favourable for avoiding enamel fracture during metal bracket debonding.

[1]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[2]  Y. K. Kim,et al.  Polymerization kinetics of dual-curing adhesive systems when used solely or in conjunction with chemically-cured resin cement. , 2013, The journal of adhesive dentistry.

[3]  Y. K. Kim,et al.  Cure mechanisms in materials for use in esthetic dentistry. , 2012, Journal of investigative and clinical dentistry.

[4]  A. Lussi,et al.  Enamel loss and adhesive remnants following bracket removal and various clean-up procedures in vitro. , 2012, European journal of orthodontics.

[5]  J. Li Effect of flexural strength of orthodontic resin cement on bond strength of metal brackets to enamel surfaces. , 2011, European journal of orthodontics.

[6]  Y. K. Kim,et al.  Antibacterial effects of 4-META/MMA-TBB resin containing chlorhexidine. , 2009, Journal of biomedical materials research. Part B, Applied biomaterials.

[7]  N. Kitai,et al.  Shear bond strength of orthodontic brackets bonded with different self-etching adhesives. , 2009, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[8]  J. Miguel,et al.  Bond failure rates with a self-etching primer: a randomized controlled trial. , 2009, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[9]  K. Kim,et al.  Use of flowable composites for orthodontic bracket bonding. , 2008, The Angle orthodontist.

[10]  J. Mucha,et al.  Assessment of enamel damage after removal of ceramic brackets. , 2008, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[11]  T. Uysal,et al.  Conventional and high intensity halogen light effects on water sorption and microhardness of orthodontic adhesives. , 2008, The Angle orthodontist.

[12]  T. Hooshmand,et al.  Comparison of debonding characteristics of metal and ceramic orthodontic brackets to enamel: an in-vitro study. , 2007, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[13]  N. Shimizu,et al.  Development of an easy-debonding orthodontic adhesive using thermal heating. , 2007, Dental materials journal.

[14]  J. Miguel,et al.  Scanning electron microscopy evaluation of the bonding mechanism of a self-etching primer on enamel. , 2009, The Angle orthodontist.

[15]  M. Akhoundi,et al.  Comparison of wire loop and shear blade as the 2 most common methods for testing orthodontic shear bond strength. , 2006, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[16]  D. F. Nouer,et al.  Shear bond strength of metallic orthodontic brackets bonded to enamel prepared with Self-Etching Primer. , 2009, The Angle orthodontist.

[17]  J. Powers,et al.  Influence of polymerization mode on flexural properties of esthetic resin luting agents. , 2005, The Journal of prosthetic dentistry.

[18]  T. Eliades,et al.  Light-cured or chemically cured orthodontic adhesive resins? A selection based on the degree of cure, monomer leaching, and cytotoxicity. , 2005, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[19]  M. Skrifvars,et al.  Dendrimer/methyl methacrylate co-polymers: residual methyl methacrylate and degree of conversion , 2005, Journal of biomaterials science. Polymer edition.

[20]  T. Hayakawa,et al.  Bonding durability between orthodontic brackets and human enamel treated with megabond self-etching primer using 4-META/MMA-TBB resin cement. , 2004, Dental materials journal.

[21]  R. Carvalho,et al.  Durability of resin dentin interfaces: effects of surface moisture and adhesive solvent component. , 2004, Dental materials : official publication of the Academy of Dental Materials.

[22]  M. Makou,et al.  Enamel surface roughness following debonding using two resin grinding methods. , 2004, European journal of orthodontics.

[23]  A. Jacobson,et al.  Evaluation of the debonding characteristics of 2 ceramic brackets: an in vitro study. , 2004, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[24]  T. Hayakawa,et al.  Assessing the performance of a methyl methacrylate-based resin cement with self-etching primer for bonding orthodontic brackets. , 2009, The Angle orthodontist.

[25]  Y. Imai,et al.  Studies on MMA-tBB resin. I. Comparison of TBB and other initiators in the polymerization of PMMA/MMA resin. , 2002, Dental materials journal.

[26]  M. Burrow,et al.  Bond strength of two adhesive systems to primary and permanent enamel. , 2002, Operative dentistry.

[27]  J. Warren,et al.  Effect of a self-etch primer/adhesive on the shear bond strength of orthodontic brackets. , 2001, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[28]  S. Bishara,et al.  Shear bond strength of composite, glass ionomer, and acidic primer adhesive systems. , 1999, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[29]  T R Katona,et al.  A comparison of the stresses developed in tension, shear peel, and torsion strength testing of direct bonded orthodontic brackets. , 1997, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[30]  Y. Imai,et al.  Effect of adding ethylene glycol dimethacrylate to resin cements: durability against thermal stress of adhesion to titanium. , 1997, Dental materials journal.

[31]  J. McCabe,et al.  Applied Dental Materials , 1985 .

[32]  D. Retief Failure at the dental adhesive-etched enamel interface. , 1974, Journal of oral rehabilitation.