Effect of Nd:YAG Laser Bleaching and Antioxidizing Agents on the Shear Bond Strength of Brackets

Abstract

The aims of this study were to evaluate the effect of hydrogen peroxide bleaching agents, both nonactivated and activated by a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser, and of antioxidant treatment on the shear bond strength (SBS) of orthodontic brackets. Nd:YAG laser activation is expected to accelerate the bleaching therapy without decrease shear bond strength. Ninety extracted maxillary central incisors were divided into two experimental groups and a control group. Group I was the control group, Group II was bleached with 35% hydrogen peroxide and had no photoactivation, and Group III was bleached with 35% hydrogen peroxide with activation by a Nd:YAG laser (4.0 W, 60 Hz frequency, 1 mm distance, 20 sec). Each group was divided into two subgroups: Subgroup A was immersed in artificial saliva for 2 weeks, and then bonded using the total etch system, whereas subgroup B was treated with an antioxidant agent (10% sodium ascorbate) and then bonded using the same system. The samples were stored in water for 24 h at 37°C, and thermocycled. The SBS in megapascals (MPa) was determined by a shear test with 1 mm/min crosshead speed, and failure types were classified with modified adhesive remnant index scores. The data were analyzed with two way analyses of variance, Tukey, and χ(2) tests at the α = 0.05 level. In both Groups II and III, the SBSs of brackets bonded after bleaching (Group II 15.16, Group III 17.50 MPa) were significantly lower than those of brackets in the bonded unbleached group (Group I 22.13 MPa); however, sodium ascorbate treatment significantly increased the SBSs of brackets in the bleached groups (Group II 21.52, Group III 22.43 MPa), but had an insignificant effect on the SBS of the control group (Group I 23.66MPa). Hydrogen peroxide bleaching agents reduce the SBSs both with and without Nd:YAG laser activation; however, treatment of the bleached enamel surface with 10% sodium ascorbate prior to bonding negates the effect.