In vitro evaluation of an alternative method to bond molar tubes

Evaluation of failure rate of molar tubes with a modified bonding technique: a randomized clinical trial

BACKGROUND

During orthodontic therapy, bond failure of molar tubes may delay treatment. With the high failure rate of molar tubes, alternative bonding techniques were tested to improve bond strength.

OBJECTIVES

To compare the failure rates of molar tubes bonded with conventional and alternative bonding techniques by adding a layer of compomer adhesive at the molar/tube interface.

TRIAL DESIGN

Single-centre, single-blinded, split-mouth, randomized clinical trial.

METHODS

Patients aged 12 years or older, who required fixed appliance orthodontic treatment without extraction and with no occlusal interference were eligible to participate. They were allocated randomly using a simple non-stratified split-mouth design with a 1:1 allocation ratio. Blinding was only possible for the patients and data analysts. Molar tubes bonded with the modified bonding technique had an additional layer of compomer at the occlusal molar/tube interface. The patients were followed-up for nine months. Outcome measures included the survival time of molar tubes and the number of molar tubes debonded. The bond failure of molar tubes was analyzed using Kaplan-Meier and Cox regression analysis (P < 0.05).

RESULTS

Thirty patients were recruited, randomized, and analyzed (mean age 20.33 years). The failure rate of molar tubes bonded with the modified bonding technique was 4.2 per cent and that of molar tubes bonded with the conventional bonding technique was 6.7 per cent. This difference was not statistically significant (P > 0.05). The dental arch and molar type were found to be as significant predictors for molar tube failure rate. No harm was detected during treatment.

LIMITATIONS

The effect of compomer to reduce enamel demineralization was not tested.

CONCLUSIONS AND IMPLICATIONS

The modified bonding technique did not significantly reduce the failure rate of molar tubes. The molar tubes bonded on the upper arch and second molars are more susceptible to debond.

REGISTRATION

The trial was registered with ClinicalTrials.gov on 21 May 2022 (Registration number: NCT05391386).

FUNDING

This research did not receive any funding.

Evaluation of bond strength of molar orthodontic tubes subjected to reinforcement with flowable and bonding resins

OBJECTIVE

The goal was to evaluate the adhesive shear bond strength (SBS) of orthodontic tubes bonded to molar teeth and reinforced with Transbond XT (3M Science, St. Paul, MN, USA) and flowable resin.

MATERIALS AND METHODS

In all, 120 molar teeth, previously extracted from patients with a mean age of 30 were included. Orthodontic molar tubes were bonded on the vestibular surface of these teeth with one of two types of adhesive (Transbond XT [3M Science, St. Paul, MN, USA] or Orthobond [Morelli, Sorocaba, Brazil]). Each of these groups was subsequently divided into four further groups: control and those subjected to the use of resin reinforcement on the occlusal surface of the bonded tubes with one of three materials (Transbond XT, Tetric N Flow [Ivoclar Vivadent, Ellwangen, Germany], Z 350 Flow [3M Science, St. Paul, MN, USA]). SBS and adhesive remnant index tests were performed to evaluate bond strength and type of fracture of the tubes bonded with the different methods.

RESULTS

The use of resin reinforcement with Transbond XT significantly increased the SBS of tubes bonded with both materials. Flowable composites did not increase the SBS when used as a reinforcement. Less than 50% of the adhesive remained on the vestibular surface after the SBS test in most samples of all groups.

CONCLUSION

Transbond XT orthodontic adhesive and Orthobond adhesive had appropriate bonding strengths for clinical use. Furthermore, the use of a resinous reinforcement with Transbond XT significantly increased the SBS of tubes bonded. However this technique with flowable adhesives (Tetric N Flow and Z350 Flow) did not significantly increase SBS when orthodontic tubes were bonded with Transbond XT or Orthobond.

An Ex-vivo Shear and tensile bond strengths of orthodontic molar tubes bonded using different techniques

BACKGROUND

Molar bonding procedures need continuous improvement to be widely accepted clinically and eventually replace molar bands.

MATERIAL AND METHODS

The purpose of this study was to determine the effects of enamel micro-abrasion and silane coating of the base of molar tubes on shear and tensile bond strengths of orthodontic molar tubes. A total of 200 third molars were randomly allocated into five groups of 40 teeth as follows: group 1: molar tubes bonded to etched teeth (37% phosphoric acid gel; control group); group 2: molar tubes bonded to etched teeth (37% phosphoric acid) with the addition of silane to the base of molar tubes; group 3: molar tubes bonded to teeth pre-treated with 18% hydrochloric acid and pumice (micro-abrasion); group 4: molar tubes bonded to teeth pre-treated with microabrasion with the addition of silane to the base of molar tubes; group 5: molar tubes bonded to teeth pre-treated with microabrasion before conventional acid etching combined with the addition of silane to the base of molar tubes. The bond strength testing was performed using a computer control electromechanical universal testing machine.

RESULTS

The highest mean shear and tensile bond strengths were recorded in group 5 (13.81±2.54MPa and 13.97±2.29 MPa, respectively). Micro-abrasion alone (group 3) and the combination of enamel micro-abrasion and the addition of silane (group 4) produced bond strength values comparable to the control.

CONCLUSIONS

Enamel surface pre-treatment (micro abrasion) before conventional acid etching combined with the addition of silane to the base of the molar tube produced the highest bond strengths among all tested groups. Key words:Molar, shear strength, tensile strength, orthodontic appliances.

Estudo in vitro da resistência ao cisalhamento da colagem direta de tubos ortodônticos em molares

INTRODUÇÃO: apesar da colagem direta despender menor tempo clínico, com maior preservação da integridade gengival, ainda hoje se observa uma alta incidência de bandagem dos molares. Portanto, torna-se interessante a idealização de recursos para o aumento da eficiência desse procedimento para dentes submetidos a maiores impactos mastigatórios, como, por exemplo, os molares. OBJETIVO: esse estudo teve o propósito de avaliar se a resistência à adesão com a aplicação de uma camada de resina adicional na região oclusal da interface tubo/dente aumenta a qualidade do procedimento de colagem direta de tubos em molares. MÉTODOS: selecionou-se uma amostra composta por 40 terceiros molares inferiores, que foram aleatoriamente divididos em 2 grupos: Grupo 1 - colagem direta convencional, seguida pela aplicação de uma camada de resina na oclusal da interface tubo/dente; e Grupo 2 - colagem direta convencional. O teste de resistência ao cisalhamento foi realizado 24 horas após a colagem, utilizando-se uma máquina de ensaio universal, operando a uma velocidade de 0,5mm/min. Os resultados foram analisados por meio do teste t independente. RESULTADOS: os valores médios obtidos nos testes de cisalhamento foram: 17,08MPa para o Grupo 1 e 12,60MPa para o Grupo 2. O Grupo 1 apresentou uma resistência ao cisalhamento estatisticamente significativa mais alta do que o Grupo 2. CONCLUSÃO: a aplicação de uma camada adicional de resina na oclusal da interface tubo/dente aumenta a qualidade da adesão do procedimento de colagem direta de tubos ortodônticos em molares.