In vitro bleaching effect of hydrogen peroxide with different time of exposition and concentration on shear bond strength of orthodontic brackets to human enamel: A meta-analysis of in vitro studies

Abstract

Controversy exists regarding the effect of bleaching on shear bond strength (SBS) of orthodontic brackets to enamel. This study aims to do a review and meta-analysis on the effect of bleaching with hydrogen peroxide on SBS according to the interval between bleaching and bonding to human enamel and the concentration of Hydrogen Peroxide. An electronic search of the literature was performed in Scopus, PubMed and Cochrane databases including CENTRAL and Cochrane library for relevant in vitro studies on the effect of bleaching with hydrogen peroxide on shear bond strength of human enamel, published until June 2018. Modified Cochrane Risk of Bias tool was used to assess the quality of the individual studies. AMSTAR tool was used for assessing the quality of the study. Nineteen studies were included in the qualitative analysis. Regardless of the interval between bleaching and bonding, reduction in SBS was not statistically significant when the hydrogen peroxide of less than 35% is used. Bleaching with 35% hydrogen reduces SBS when the bonding is conducted immediately (P<0.0001) or the time interval was shorter than one day (P<0.0005). On the other hand, use of high dose hydrogen peroxide resulted in a statistically significant reduction in SBS irrespective of the time interval between the procedures (P<0.05 for all categories of time interval). Bleaching with hydrogen peroxide decreases the SBS of brackets in patients undergoing orthodontic treatment especially if the time interval between bleaching and bonding procedures is short and a high concentration of hydrogen peroxide is used.