Comparison of the failure rate, bonding time and ARI score of two orthodontic bonding systems: Self-Etch Primer and Conventional Etching Primer: A systematic review and meta-analysis

OBJECTIVE

This study aimed to evaluate the failure incidence of brackets with at least six months follow-up between self-etch primer and conventional etch/primer, as well as to investigate the clinical duration of the bonding process and the amount of adhesive remnant index (ARI).

METHODS

Electronic search was conducted in databases including PubMed, Scopus, Web of Science, ProQuest, ClinicalTrials.gov, and ICTRP (International Clinical Trials Registry Platform). The electronic search targeted only randomized clinical trials and was limited from January 2000 to June 2021. Delphi list is used to evaluate the risk of bias and Stata Version14.2 software was used. This systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and recorded on the Ethics Committee of Research Institute of Dental Sciences, SBMU (IR.SBMU.DRC.REC.1398.240).

RESULTS

Out of 2288 extracted studies, 30 of them entered the full-text evaluation process. According to the inclusion criteria, 15 studies entered this systematic review. Containing 607 participants and 10,563 brackets/teeth. All the included studies were of randomized clinical trials (RCT) design with either parallel or split-mouth design. Comparing the two groups, the risk difference effect (RD)=0.007 CI 95% (-0.004,0.018) indicated a neglectable difference in the risk of bracket failure during treatment between the two groups. The index I²=53.9% indicated moderate heterogeneity in the results. Furthermore, the P-value=0.007 indicated statistical insignificance between the two interventions in terms of failure rate. The clinical duration of bonding time analysis were equal to SMD _Cohen=-2.67 CI95% (-3.49, -1.85), which indicated a statistically significant reduction in clinical process time, using the self-etch primer. Data synthesis for adhesive remnant index could not be conducted due to heterogeneity among included studies.

CONCLUSIONS

There was no difference between the self-etch primer and conventional etch/primer in bracket debonding at a medium level of evidence, However, there was statistically significant reduction in clinical bonding time using self-etch primer.

Comparison of Microtensile Bond Strength of Silorane-Based Composite with the Conventional Methacrylate Composite to the Dentin of Primary Teeth

STATEMENT OF PROBLEM

The bond strength between restorative material and tooth structure is so important for conduction of durable restoration. Considering the recent attention to low shrinkage composite resins, evaluation of micro tensile bond strength of these materials would be valuable.

OBJECTIVES

To compare the microtensile bond strength of silorane composite resin (Filtek P90) with the conventional methacrylate composite (Filtek Z250) with and without applying acid etch before application of bonding system.

MATERIALS AND METHODS

In this experimental study, 24 intact primary canines were used. After the dentin was exposed, the teeth were randomly divided into four groups as follows: the first group (silorane bond system + composite Filtek P90); the second group (etch + silorane bond system + composite Filtek P90); the third group (Single bond + composite Filtek Z250); and the fourth group (etch + Single bond + composite Filtek Z250). The teeth were cut on the longitudinal axis and the interface between the composite and dentin were grinded buccolingually and mesiodistally. The samples were subjected to a microtensile force until breakage. The obtained values were recorded in MPa; data were analyzed using One-way ANOVA and Tamhane's T2 statistical tests.

RESULTS

The average microtensile bond strength in all groups had a statistically significant difference with each other (all p < 0.05). The highest bond strength belonged to the second group (etch + silorane bond system + composite Filtek P90) and the lowest value was related to the third group (Single bond + composite Filtek Z250).

CONCLUSIONS

As the second group (etch + silorane bond system + composite Filtek P90) exhibited higher microtensile bond strength, it may prove that using composite Filtek P90 is preferable to be used in primary dentin in comparison with composite Filtek Z250, and using etch + silorane bond system is more advantageous than single bond system.