Bond strength of metal brackets to feldspathic ceramic treated with different surface conditioning methods: an in vitro study

Effect of different surface conditioning methods and low pH solutions on the shear bond strength of orthodontic brackets to newly introduced CAD/CAM materials

Aim

To evaluate the shear bond strength (SBS) of ceramic and metallic orthodontic brackets bonded to lithium disilicate ceramics or hybrid ceramics and subjected to different surface conditioning treatments.

Materials and methods

In total, 300 specimens were fabricated from GC LiSi (lithium disilicate) and GC Cerasmart (hybrid) ceramic blocks. The specimens were divided into four groups according to the following surface treatments: hydrofluoric acid (HF); sandblasting with 50 μm aluminum oxide; Monobond Etch and Prime; and erbium-doped yttrium aluminum garnet (Er-YAG) laser. Metal (Victory Series) and ceramic (Clarity) brackets were bonded using an orthodontic adhesive resin (Transbond XT; 3M Unitek, CA, USA). The specimens were then stored in three different mediums (artificial saliva, mouth rinse, and gastric juice) and thermocycled. An SBS test was performed after 1 week. The surface morphology was examined after the conditioning treatments using a scanning electron microscope. Data were analyzed using analysis of variance, t-test, and Duncan test.

Results

The SBS data revealed that the type of computer-aided design/computer-aided manufacturing (CAD/CAM) block and surface conditioning method significantly affected the SBS. The highest SBS was recorded (10.112 MPa) for the HF-treated hybrid ceramic blocks stored in the saliva medium, while the lowest SBS (1.862 MPa) was reported for the Er-YAG laser-treated lithium disilicate ceramic blocks stored in the gastric juice medium. GC Cerasmart exhibited better bond strength than that of GC LiSi; however, no significant difference was observed between the ceramic and metal brackets.

Conclusion

The CAD/CAM material, surface conditioning method, and medium affect the SBS.

What Is the Most Effective Technique for Bonding Brackets on Ceramic-A Systematic Review and Meta-Analysis

Background: There has been an increase in demand for orthodontic treatment within the adult population, who likely receive restorative treatments using ceramic structures. The current state of the art regarding the most effective method to achieve an appropriate bond strength of brackets on ceramic surfaces isn’t consensual. This systematic review aims to compare the available surface treatments to ceramics and determine the one that allows to obtain the best bond strength. Methods: This systematic review followed the PRISMA guidelines and the PICO methodology was used, with the question “What is the most effective technique for bonding brackets on ceramic crowns or veneers?”. The research was carried out in PubMed, Web of Science, Embase and Cochrane Library databases. In vitro and ex vivo studies were included. The methodological quality was evaluated using the guidelines for reporting of preclinical studies on dental materials by Faggion Jr. Results: A total of 655 articles searched in various databases were initially scrutinized. Sevety one articles were chosen for quality analysis. The risk of bias was considered medium to high in most studies. The use of hydrofluoric acid (HF), silane and laser afforded the overall best results. HF and HF plus laser achieved significantly highest bond strength scores in felsdphatic porcelain, while laser was the best treatment in lithium disilicate ceramics. Conclusions: The most effective technique for bonding brackets on ceramic is dependent on the type of ceramic.

Orthodontic bonding to silicate ceramics: impact of different pretreatment methods on shear bond strength between ceramic restorations and ceramic brackets

Objective

The study aims to investigate the shear bond strength (SBS) between silicate ceramic restorations and ceramic brackets after different pretreatments and aging methods.

Material and methods

Leucite (LEU) and lithium disilicate (LiSi) specimens were pretreated with (i) 4% hydrofluoric acid + silane (HF), (ii) Monobond Etch&Prime (MEP), (iii) silicatization + silane (CoJet), and (iv) SiC grinder + silane (SiC). Molars etched (phosphoric acid) and conditioned acted as comparison group. SBS was measured after 24 h (distilled water, 37 °C), 500 × thermocycling (5/55 °C), and 90 days (distilled water, 37 °C). Data was analyzed using Shapiro–Wilk, Kruskal–Wallis with Dunn’s post hoc test and Bonferroni correction, Mann–Whitney U, and Chi² test (p < 0.05). The adhesive remnant index (ARI) was determined.

Results

LEU pretreated with MEP showed lower SBS than pretreated with HF, CoJet, or SiC. LiSi pretreated with MEP resulted in lower initial SBS than pretreated with HF or SiC. After thermocycling, pretreatment using MEP led to lower SBS than with CoJet. Within LiSi group, after 90 days, the pretreatment using SiC resulted in lowest SBS values. After HF and MEP pretreatment, LEU showed lower initial SBS than LiSi. After 90 days of water storage, within specimens pretreated using CoJet or SiC showed LEU higher SBS than LiSi. Enamel presented higher or comparable SBS values to LEU and LiSi. With exception of MEP pretreatment, ARI 3 was predominantly observed, regardless the substrate, pretreatment, and aging level.

Conclusions

MEP pretreatment presented the lowest SBS values, regardless the silicate ceramic and aging level. Further research is necessary.

Clinical relevance

There is no need for intraoral application of HF for orthodontic treatment.