Metallic vs Ceramic Bracket Failures After 12 Months of Treatment: A Prospective Clinical Trial

INTRODUCTION

Orthodontic treatment with fixed vestibular appliances is still widely used worldwide. When choosing the aesthetic alternative of ceramic brackets, the possibility of failure and cracking of braces should be considered. Therefore, the aim of the present study was to compare the failure rates of ceramic and metal brackets in a 12-month clinical study.

METHODS

Eighty patients undergoing fixed orthodontic treatment with vestibular appliances were enrolled and divided into 2 equal groups: MET for metal brackets and CER for ceramic brackets. After bonding, bracket failures were recorded for 12 months, along with the archwire placed at the time of failure. Angle's dental class, skeletal class, Wits appraisal, Little's irregularity index, overjet, overbite, age, and gender of the patients were recorded from pretreatment cephalometric tracings and study casts. The data were statistically analysed (P < .05).

RESULTS

Significantly higher failure rates were found for ceramic brackets in the overall analysis, in the mandibular arch, and in the posterior region. Regression analysis revealed a significant influence of round nickel-titanium archwires on higher failure rates, whilst a significant influence of rectangular archwires was found on lower failure rates.

CONCLUSIONS

Ceramic brackets showed higher failure rates. Patients should be aware that orthodontic treatment with ceramic brackets may involve delays and inconvenience due to the higher failure rate compared to metal brackets.

Bond assessment of enamel conditioned with Er, Cr: YSGG laser and methylene blue photosensitizer activated by photodynamic therapy to orthodontic metallic brackets

AIM

To assess bond integrity and failure mode after enamel pretreated with conventional and contemporary conditioning methods were bonded to metallic brackets (MB).

MATERIAL AND METHODS

Forty maxillary central incisors were selected and disinfected. All specimens were mounted up to the cement-o-enamel junction and divided into four experimental groups randomly based on the enamel conditioning technique. Photodynamic therapy (PDT) was used to condition enamel in group 1, Total-etch and rinse (TER) was used to treat samples in group 2, Specimens in group 3 were conditioned with ECL, and samples in group 4 surface pretreated with SEP. Bonding of MB was performed on the surfaces of all the specimens with a Transbond XT. Specimens from all investigated groups were positioned on a universal testing machine maintaining buccal surfaces similar to the direction of the force. After bracket debonding bond failure was assessed using ARI. The bond integrity of all four groups was compared using analysis of variance (ANOVA). Post hoc Tukey test was used for pairwise comparison among different groups.

RESULTS

Group 2, TER+MB (15.38±0.14 MPa) displayed the highest bond value whereas the lowest values of SBS were exhibited by group 1, PDT+MB (10.11±0.17 MPa). The inter-group comparison revealed that specimens of group 2 and group 3, ECL+MB (14.61±0.55 MPa) demonstrated comparable bond strength (p>0.05).

CONCLUSION

Enamel conditioned with TER and ECL demonstrated comparable SBS. However, bond integrity after PDT and SEP (self-etch primer) surface treatment of enamel bonded with MB significantly lowered bond values.

Influence of photodynamic therapy and different conventional methods on conditioning of lithium di silicate ceramics bonded to metallic brackets: An assessment of bond strength

AIM

The aim of the current study was to assess the effect of different conditioning methods on Lithium di silicate (LDC) employing conventional and contemporary regimes bonded to metallic brackets.

MATERIAL AND METHODS

70 discs of LDC were prepared and polished to attain smooth surface. Samples were allocated into seven groups according to ceramic surface conditioning. Group 1 surface treated with Er-YAG laser and saline (S), Group 2 PDT using MBP + S, Group 3 H F + S (control), Group 3 HF (Hydrofluoric acid) + saline, Group 4 HF (Hydrofluoric acid) + ultrasonic bath (UB) + S, Group 5 sand blasting the glass ceramic surface with 120 um Al₂O₃, Group 6 LDC surface conditioned with SECP(Etch and Prime) and Group 7 ECL(Laser) + S on was irradiated on LDC. Both chemical and mechanical surface treatments of LDC were followed by placement of metallic brackets. Samples were arranged in universal testing machine for shear bond strength (SBS) testing. Bond failure of brackets were assessed using ARI. To assess and compare the mean and standard deviations (SD) among experimental groups analysis of variance (ANOVA) was employed. All treatment combination means were compared using the post hoc Tukey's multiple comparison test at a significance level of (p ≤ 0.05).

RESULTS

SBS values of Group 2 H F acid + S displayed highest bond durability (22.28 ± 1.09 MPa). Whereas, specimens in Group 4 surface treated with 120 μm Al₂O₃ displayed lowest SBS scores (11.81 ± 0.55 MPa) and these bond scores were comparable to PDT using MBP + S (12.54 ± 1.09 MPa) (p > 0.05). LDC surface treated by ECL + S (21.11 ± 3.85 MPa), HF + UB + S (19.28 ± 0.52 MPa) exhibited results comparable to HF acid + S (p > 0.05).

CONCLUSION

LDC conditioned with HFS still remains as gold standard. Use of PDT for surface treatment of LDC and bonded to metallic bracket is not recommended as it results in decreased bond durability. Use of ECL-S and HF + UB + S has a potential to be used alternatively to HFS for LDC conditioning.

Different pulse modes of Er:YAG laser irradiation: effects on bond strength achieved with self-etching primers

OBJECTIVE

The aim of this study was to compare the effects of different pulse modes of Er:YAG laser on shear bond strength (SBS) of orthodontic brackets bonded with self-etching primers (SEP) and phosphoric acid etching.

MATERIALS AND METHODS

A total of 120 human mandibular third molars were randomly assigned to 3 groups of 40 specimens depending on the bonding procedure to be used. The groups were divided into two subgroups according to the pulse mode of the erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation as medium-short pulse (MSP) mode and quantum-square pulse (QSP) mode at 120 mJ, 10 Hz, 1.2 W. In each subgroup, the mesio- or distobuccal tooth surfaces were randomly assigned as experimental or control sides. After surface preparation with different modes of Er:YAG laser on experimental side, whole buccal tooth surfaces were treated with phosphoric acid etching or two different SEPs. Then metallic brackets were bonded with Transbond XT (3 M Unitek, Monrovia, CA, USA) or Kurasper F (Kuraray, Okayama, Japan). SBS values and the amount of adhesive remaining on the tooth after debonding were assessed. One-way analysis of variance (ANOVA) was used to evaluate the changes in mean SBS between groups resulting from laser etching, followed by post hoc test of Tukey.

RESULTS

There were statistically significant differences between the experimental and control sides of all groups (p < 0.05).

CONCLUSION

Laser etching with QSP and MSP modes increases the SBS of metallic brackets and Er:YAG laser irradiation with QSP mode increases the SBS of SEPs.

Comparison of the Debonding Characteristics of Conventional and New Debonding Instrument used for Ceramic, Composite and Metallic Brackets - An Invitro Study

BACKGROUND

Debonding procedure is time consuming and damaging to the enamel if performed with improper technique. Various debonding methods include: the conventional methods that use pliers or wrenches, an ultrasonic method, electrothermal devices, air pressure impulse devices, diamond burs to grind the brackets off the tooth surface and lasers. Among all these methods, using debonding pliers is most convenient and effective method but has been reported to cause damage to the teeth. Recently, a New Debonding Instrument designed specifically for ceramic and composite brackets has been introduced. As this is a new instrument, little information is available on efficacy of this instrument. The purpose of this study was to evaluate the debonding characteristics of both "the conventional debonding Pliers" and "the New debonding instrument" when removing ceramic, composite and metallic brackets.

MATERIALS AND METHODS

One Hundred Thirty eight extracted maxillary premolar teeth were collected and divided into two Groups: Group A and Group B (n = 69) respectively. They were further divided into 3 subGroups (n = 23) each according to the types of brackets to be bonded. In subGroups A1 and B1{stainless steel};A2 and B2{ceramic};A3 and B3{composite}adhesive precoated maxillary premolar brackets were used. Among them {ceramic and composite} adhesive pre-coated maxillary premolar brackets were bonded. All the teeth were etched using 37% phosphoric acid for 15 seconds and the brackets were bonded using Transbond XT primer. Brackets were debonded using Conventional Debonding Plier and New Debonding Instrument (Group B). After debonding, the enamel surface of each tooth was examined under stereo microscope (10X magnifications). Amodifiedadhesive remnant index (ARI) was used to quantify the amount of remaining adhesive on each tooth.

RESULTS

The observations demonstrate that the results of New Debonding Instrument for debonding of metal, ceramic and composite brackets were statistically significantly different (p = 0.04) and superior from the results of conventional debonding Pliers.

CONCLUSION

The debonding efficiency of New Debonding Instrument is better than the debonding efficiency of Conventional Debonding Pliers for use of metal, ceramic and composite brackets respectively.