Abstract
Objectives The aim of this study was to evaluate in vivo the bonding of metallic orthodontic brackets with different adhesive systems. Material and Methods Twenty patients (10.5-15.1 years old) who had sought corrective orthodontic treatment at a University Orthodontic Clinic were evaluated. Brackets were bonded from the right second premolar to the left second premolar in the upper and lower arches using: Orthodontic Concise, conventional Transbond XT, Transbond XT without primer, and Transbond XT associated with Transbond Plus Self-etching Primer (TPSEP). The 4 adhesive systems were used in all patients using a split-mouth design; each adhesive system was used in one quadrant of each dental arch, so that each group of 5 patients received the same bonding sequence. Initial archwires were inserted 1 week after bracket bonding. The number of bracket failures for each adhesive system was quantified over a 6-month period. Results The number of debonded brackets was: 8- Orthodontic Concise, 2- conventional Transbond XT, 9- Transbond XT without primer, and 1- Transbond XT + TPSEP. By using the Kaplan-Meier methods, statistically significant differences were found between the materials (p=0.0198), and the Logrank test identified these differences. Conventional Transbond XT and Transbond XT + TPSEP adhesive systems were statistically superior to Orthodontic Concise and Transbond XT without primer (p<0.05). There was no statistically significant difference between the dental arches (upper and lower), between the dental arch sides (right and left), and among the quadrants. Conclusions The largest number of bracket failures occurred with Orthodontic Concise and Transbond XT without primer systems and few bracket failures occurred with conventional Transbond XT and Transbond XT+TPSEP. More bracket failures were observed in the posterior region compared with the anterior region.
Highlights
Many commercially available orthodontic bonding materials have been experimentally evaluated in laboratories13,27,29, but not all were clinically tested WR FRQ¿UP WKHLU HI¿FLHQF\ DQG HIIHFWLYHQHVV 'HVSLWH the lack of clinical evaluation, these materials are commonly used by orthodontists for bonding orthodontic appliances
Logrank test b a b a SULPHU 2Q WKH RWKHU KDQG QR VWDWLVWLFDOO\ VLJQL¿FDQW differences were observed between conventional Transbond XT and Transbond XT+Transbond Plus Self-etching Primer (TPSEP) (p=0.0821) or between Orthodontic Concise and Transbond XT without primer (p=0.0773)
By analyzing the number of bond failures in both dental arches, 11 failures (55%) were recorded in the upper arch and 9 failures (45%) in the lower arch during the same evaluation period, with no VWDWLVWLFDOO\ VLJQL¿FDQW GLIIHUHQFHV S 7KH upper teeth affected by these bracket failures were the left and right second premolars with 5 events HDFK ZKHUHDV WKH OHIW ¿UVW SUHPRODU KDG RQO\ debonding
Summary
Amongst the most widely used materials for bonding orthodontic accessories directly to dental enamel, composite resins stand out. For bonding brackets using conventional composites, the enamel surface must be adequately prepared according to the following steps: prophylaxis with pumice/water. There is controversy about the use of SULPHUV VLQFH VRPH DXWKRUV GLG QRW ¿QG GLIIHUHQFHV in the adhesion of orthodontic accessories to enamel with or without previous priming of enamel surface. There is controversy about the use of SULPHUV VLQFH VRPH DXWKRUV GLG QRW ¿QG GLIIHUHQFHV in the adhesion of orthodontic accessories to enamel with or without previous priming of enamel surface16,20 This material moistens and penetrates the enamel and protects the etched tooth surface WKDW ZLOO QRW VXIIHU GHFDOFL¿FDWLRQ FDXVHG E\ SODTXH and food residues. Despite some advantages, eliminating the priming step would decrease chair WLPH NHHS WKH ZRUNLQJ ¿HOG GU\ DQG SRVVLEO\ reduce the bonding failure caused by contamination or moisture
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