ABSTRACT
OBJECTIVE: The aim of this study was to determine whether different types of adhesive systems and enamel-protective agents will affect the tensile bond strength of lingual brackets. METHODS: A total of 75 extracted mandibular incisors were randomly divided into 5 groups and lingual brackets were bonded. Group 1 specimens received Transbond XT (3M Unitek, Monrovia, CA, USA), Group 2 required the application of a fluoride-releasing resin (Ortho-coat, Pulpdent, Watertown, MA, USA) with Transbond XT, Group 3 specimens received a chlorhexidine varnish (Cervitec Plus, Ivoclar Vivadent, Schaan, Lichtenstein) with Transbond XT. In Group 4, a light-cured orthodontic adhesive (Aegis Ortho, Bosworth, Skokie, USA) was applied and in Group 5, an antimicrobial self-etching primer (Clearfil Protect Bond, Kuraray, Osaka, Japan) was used. RESULTS: There were no significant differences in bond strength whether fluoride-releasing resin or chlorhexidine varnish were used or not. Group 5 had significantly higher bond strength and adhesive remnant index (ARI) values than other groups (p < 0.001). The application of enamel-protective products did not have an adverse affect on the bond strength of lingual brackets. CONCLUSIONS: These products might provide benefits both for the patient and the clinician, by supporting the oral hygiene during lingual orthodontic treatment. The higher ARI score may be beneficial for Clearfil Protect Bond but its excessive bond strength should be considered in clinical practice, especially where the enamel is thin.