Effects of Plasma Treatment on the Strength of Bonding to Ceramic Surfaces in Orthodontics-A Comprehensive Review

Over the past several decades, orthodontic treatment has been increasingly sought out by adults, many of whom have undergone restorative dental procedures that cover enamel. Because the characteristics of restorative materials differ from those of enamel, typical bonding techniques do not yield excellent restoration-bracket bonding strengths. Plasma treatment is an emerging surface treatment that could potentially improve bonding properties. The purpose of this paper is to evaluate currently available studies assessing the effect of plasma treatment on the shear bond strength (SBS) and failure mode of resin cement/composite on the surface of ceramic materials. PubMed and Google Scholar databases were searched for relevant studies, which were categorized by restorative material and plasma treatment types that were evaluated. It was determined that cold atmospheric plasma (CAP) treatment using helium and H2O gas was effective at raising the SBS of feldspathic porcelain to a bonding agent, while CAP treatment using helium gas might also be a potential treatment method for zirconia and other types of ceramics. More importantly, CAP treatment using helium has the potential for being carried out chairside due to its non-toxicity, low temperature, and short treatment time. However, because all the studies were conducted in vitro and not tested in an orthodontic setting, further research must be conducted to ascertain the effectiveness of specific plasma treatments in comparison to current orthodontic bonding treatments in vivo.