CO2 laser irradiation for debonding ceramic orthodontic brackets

Abstract This study evaluated shear bond strength (SBS), adhesive remnant index (ARI) and fracture mode of chemically and mechanically retained ceramic brackets bonded with different composite resins and irradiated with CO2 laser. The null hypothesis was that ceramic brackets bonded with different composite resins and irradiated with CO2 laser would have similar SBS values. Ninety human premolars were divided into four experimental groups according to the combination of type of composite resin (Transbond XT and Z 250) and type of ceramic bracket (Fascination and Mystique), and two control groups (n=15). In the four experimental groups, the brackets were irradiated with CO2 laser at 10 W for 3 seconds before SBS testing. Enamel surface ARI was calculated after debonding under electron microscopy scanning. ANOVA and the Mann-Whitney test were used for statistical analysis. The laser groups had lower SBS values than the non-irradiated groups (control) (p<0.05). The mechanically retained brackets (Mystique) had the higher (p<0.05) and Z250 had the lower SBS values after CO2 laser irradiation. The groups bonded with Z250 had the highest ARI. Adhesive fractures were the most prevalent. The null hypothesis was rejected. CO2 laser decreased SBS efficiently and facilitated debonding of mechanically and chemically retained ceramic brackets.

Resumo O objetivo do estudo foi avaliar a resistência de união ao cisalhamento da colagem (RCC), o índice de remanescente de adesivo (IRA) e o modo de fratura de bráquetes cerâmicos com retenção química e mecânica colados com diferentes compositos e irradiados com laser de CO2. A hipótese nula testada foi que bráquetes colados com diferentes compósitos e irradiados com laser de CO2 apresentam valores semelhantes de RCC. Noventa pré-molares humanos foram divididos em 6 grupos (n=15): 2 controles e 4 experimentais que se diferenciaram pelo tipo de bráquete ceramic (Fascination and Mystique) e pelo compósito de fixação (Transbond XT e Z 250). Nos quatro grupos experimentais, os bráquetes foram irradiados com laser de CO2 com 10W por 3 segundos anteriormente ao teste de RCC. O IRA das superficies de esmalte foram avaliados após a descolagem e submetidos a análise em microscopia electrônica de varredura (MEV). Para análise estatística foram utilizados ANOVA e o teste de mann-Whitney. Os grupos laser mostraram valores de RCC menores que os grupos não irradiados (controles) (p<0.05). Os bráquetes com retenção mecânica (Mystique) mostraram alta RCC (p<0.05) e o compósito Z 250 obteve os mais baixos valores de RCC após irradiação com laser. Os grupos colados com o compósito Z 250 apresentaram os mais altos escores do IRA. O modo de fratura mais prevalente foi a adesiva. A hipótese nula foi rejeitada. O laser de CO2 foi eficaz para diminuir os valores de RCC e facilitou a descolagem dos bráquetes cerâmicos de retenção química e mecânica

Effect of the different debonding strength of metal and ceramic brackets on the degree of enamel microcrack healing

ABSTRACT Objective: This study aims to determine shear debonding strength of metal and ceramic brackets, and the degree of enamel crack healing. Material and Methods: Extracted human maxillary premolars were flattened on the buccal surface, and randomly separated into five groups (n = 15). In control groups (groups 1 and 2), metal and ceramic brackets were bonded on flat polished enamel, while in experimental groups (groups 3 and 4), metal and ceramic brackets were bonded on the surface with boundary where corner cracks were created. Additionally, fifteen specimens (group 5) were also prepared for an indentation procedure with no bracket installation. The degree of crack healing was measured. All brackets were detached with a universal testing machine, and the adhesive remnant index (ARI) was also identified. Healing degree and apparent fracture toughness were then calculated. Results: Between groups with similar bracket types, there was no statistically significant difference in debonding strength. Regarding bracket types, ceramic brackets provided significantly higher debonding strength than metal brackets. There was a significant difference in ARI scores between metal and ceramic brackets. The corner cracks showed signs of healing in both horizontal and vertical directions. No statistically significant difference in the healing rates among the groups was found and the apparent fracture toughness increased from the initial to the final measurement. Conclusions: Within the limitations of this study, even though ceramic brackets required significantly higher debonding force compared to metal brackets, debonding stress was limited to the bonding site and did not affect the surrounding cracks on enamel.

RESUMO Objetivo: O presente estudo teve como objetivo determinar a resistência ao cisalhamento de braquetes metálicos e cerâmicos, e o grau de reparo de fraturas no esmalte. Métodos: Pré-molares superiores, extraídos de humanos, foram aplainados na face vestibular e aleatoriamente divididos em cinco grupos (n = 15). Nos grupos controle (Grupos 1 e 2), os braquetes metálicos e cerâmicos foram colados em esmalte liso e polido; enquanto nos grupos experimentais (Grupos 3 e 4), os braquetes metálicos e cerâmicos foram colados em superfície delimitada, em cujos cantos foram criadas fissuras. Adicionalmente, foram também preparados 15 espécimes (Grupo 5) para um teste com indentação, sem a instalação de braquetes. O grau de reparo das fraturas foi avaliado. Todos os braquetes foram descolados usando uma máquina universal de testes, e o índice de adesivo remanescente (ARI) também foi avaliado. O grau de reparo e a tenacidade à fratura aparente foram então calculados. Resultados: Entre os grupos com o mesmo tipo de braquetes, não houve diferença estatisticamente significativa na força de descolagem. Com relação aos tipos de braquetes, os cerâmicos apresentaram uma força de descolagem significativamente maior do que os metálicos. Houve uma diferença significativa nos escores ARI entre os braquetes metálicos e os cerâmicos. As fraturas de canto mostraram sinais de reparo nos sentidos horizontal e vertical. Não foi detectada diferença estatisticamente significativa no grau de reparo entre os grupos, e a tenacidade à fratura aparente aumentou da mensuração inicial para a final. Conclusão: Considerando-se as limitações desse estudo, apesar de os braquetes cerâmicos necessitarem de força de descolagem significativamente maior do que os braquetes metálicos, a tensão de descolagem foi limitada ao sítio de colagem, não afetando as fraturas de esmalte ao redor.

Fracture strength of monocrystalline and polycrystalline ceramic brackets during archwire torque / Resistencia à fratura de braquetes cerâmicos

Abstract Introduction In recent years, there has been an increasing demand for esthetic treatments, especially among orthodontic patients. Objective This study determined the fracture strength of monocrystalline and polycrystalline ceramic brackets of different manufacturers during archwire torque. Material and method Sixty ceramic brackets (Roth, right upper central incisors, 0.022 x 0.028-inch slot) were allocated into two groups (30 specimens per group) according to the type of ceramics: monocrystalline and polycrystalline. Subsequently, the groups were divided into three subgroups (n = 10) according to the manufacturer: Orthometric, Eurodonto and Ortho Technology. Sixty PVC cylinders were filled with chemically activated acrylic resin (CAAR), the brackets were fixed with CAAR onto the cylinder surface and the excess material was used to partially cover the base of the bracket. After 24h, the U-shaped wire base (0.019 x 0.025 inches; 6 mm height and width) was inserted into the bracket slot and fixed thereon with a stainless-steel wire. Vertical folds were made at the ends of the "U" to support the universal test machine chisel. The fracture strength test was performed at a speed of 1.0 mm/min until fracture into a universal test machine (Instron). The data were recorded, transformed into g.mm and submitted to two-way ANOVA followed by Tukey's post-hoc test (SAS Institute Inc., Cary, NC, USA, version 9.3) (α=5%). Result Monocrystalline brackets showed a higher fracture strength than polycrystalline brackets, regardless of the manufacturer (p<0.05). The highest fracture strength values were observed in Ortho Technology and Orthometric brackets, with no significant difference between them (p>0.05). Conclusion Monocrystalline ceramic brackets have a higher fracture strength than polycrystalline brackets, with significant manufacturer-dependent differences.

Resumo Introdução A demanda por tratamentos estéticos tem crescido nos últimos anos, sendo cada vez mais forte a preocupação com a estética por parte dos pacientes que buscam o tratamento ortodôntico. Objetivo Este estudo avaliou a resistência à fratura de bráquetes cerâmicos monocristalinos e policristalinos de diferentes fabricantes quando submetidos ao torque do fio. Material e método Sessenta bráquetes cerâmicos (Roth, incisivos centrais superiores direito, canaleta 0,022 x 0,028 polegadas) foram divididos em 2 grupos (30 espécimes por grupo) de acordo com o tipo da cerâmica: monocristalina e policristalina. Posteriomente estes grupos foram divididos em 3 sub-grupos (n=10) de acordo com o fabricante: Orthometric, Eurodonto e Ortho Technology. Segmentos de fio de aço inoxidável retangular (0,019 x 0,025 polegadas) foram dobrados em forma de "U", sendo que a base do "U" foi inserida na canaleta do bráquete e fixado com fio de amarilho em aço inoxidável (0,008mm). Nas extremidades do "U" foram realizadas dobras verticais para servir de apoio para o cinzel da máquina de ensaio universal Instron. O ensaio de resistência à fratura foi realizado à velocidade de 1,0 mm/min até ocorrer a fratura. Os dados foram registrados, transformados em g.mm e submetidos à ANOVA dois fatores e ao teste de Tukey (SAS Institute Inc., Cary, NC, USA, version 9.3) (α=5%). Resultado Os bráquetes monocristalinos apresentaram maior resistência à fratura em relação aos policristalinos, independente do fabricante (p<0,05). Os maiores valores de resistência à fratura foram obtidos com os bráquetes da Ortho Technology e Orthometric, os quais não diferiram estatisticamente entre si (p>0,05). Conclusão Bráquetes monocristalinos possuem maior resistência à fratura em relação aos policristalinos com diferenças na resistência à fratura entre os diferentes fabricantes.

Preparation and antimicrobial assay of ceramic brackets coated with TiO2 thin films / 대한치과교정학회지

OBJECTIVE: Different methods have been utilized to prevent enamel demineralization and other complications during orthodontic treatment. However, none of these methods can offer long-lasting and effective prevention of orthodontic complications or interventions after complications occur. Considering the photocatalytic effect of TiO2 on organic compounds, we hoped to synthesize a novel bracket with a TiO2 thin film to develop a photocatalytic antimicrobial effect. METHODS: The sol-gel dip coating method was used to prepare TiO2 thin films on ceramic bracket surfaces. Twenty groups of samples were composed according to the experimental parameters. Crystalline structure and surface morphology were characterized by X-ray diffraction and scanning electron microscopy, respectively; film thickness was examined with a surface ellipsometer. The photocatalytic properties under ultraviolet (UV) light irradiation were analyzed by evaluating the degradation ratio of methylene blue (MB) at a certain time. Antibacterial activities of selected thin films were also tested against Lactobacillus acidophilus and Candida albicans. RESULTS: Films with 5 coating layers annealed at 700℃ showed the greatest photocatalytic activity in terms of MB decomposition under UV light irradiation. TiO2 thin films with 5 coating layers annealed at 700℃ exhibited the greatest antimicrobial activity under UV-A light irradiation. CONCLUSIONS: These results provide promising guidance in prevention of demineralization by increasing antimicrobial activities of film coated brackets.

Histological evaluation after electrothermal debonding of ceramic brackets.

Aim: To evaluate the histological changes following electrothermal debonding (ETD) of ceramic brackets. Materials and Methods: A total of 50 first premolar teeth from 14 patients were divided into two groups: Group I consisted of 20 teeth which served as control, and the brackets were debonded using conventional pliers. (7 teeth were extracted 24 hours after conventional debonding, 7 teeth were extracted 28 to 32 days after conventional debonding and 6 teeth were extracted 56-60 days after conventional debonding). Group II consisted of 30 teeth and the brackets were debonded using the ETD unit. (10 teeth were extracted 24 hours after ETD, 10 teeth were extracted 28 to 32 days after ETD and 10 teeth were extracted 56-60 days after ETD. Immediately after extraction, the teeth were sectioned and prepared for histological examination. Results: The pulp was normal in most samples of the control group. In group II, mild inflammation was observed in the 24 hour sample while the 28 to 32 day sample showed signs of healing. The 56-60 day sample showed that the pulp was similar to the control group in 6 out of the 10 samples. Conclusion: The ETD of ceramic brackets did not affect the pulp and the changes which were observed, were reversible in nature

Análise comparativa de diferentes bráquetes ortodônticos cerâmicos relativo ao teste de cisalhamento / Comparative analysis of different ceramic orthodontic brackets on shear test

A força de adesão constitui-se em uma das principais características a ser analisada, quando da seleção de determinado bráquete como instrumento para a prática ortodôntica. Sabe-se que tanto a composição quanto as características estruturais da base dos bráquetes influenciam na retenção química e mecânica dos mesmos à superfície dentária. Assim, propôs-se verificar comparativamente mediante ensaio de cisalhamento 3 marcas comerciais (Abzil®, Eurodonto® e Morelli®) de bráquetes estéticos cerâmicos policristalinos quanto a força de adesão. Foram utilizados 45 pré-molares humanos divididos aleatoriamente em 3 grupos de 15 dentes cada. Os dentes foram incluídos em resina acrílica com a face vestibular perpendicular à base do troquel, e os bráquetes foram colados com sistema adesivo ortodôntico Transbond XT® (3M Unitek) e submetidos ao cisalhamento em máquina de ensaio universal (EMIC DL 30000). A força de adesão foi computada no momento da cisão pelo software TESC, versão 1.01, medida em Megapascal (MPa). Os resultados demonstraram resistência adesiva para o Grupo I de 28,01 MPa (± 9,88), Grupo II 20,23 MPa (± 7,06) e Grupo III 22,35 Mpa (± 7,86). Em relação ao índice de remanescente resinoso, o Grupo I e III apresentou fratura na interface bráquete/adesivo, enquanto que o Grupo II apresentou a interface de fratura no esmalte/adesivo.

The adhesion force is one of the main characteristics to be considered when selecting a particular bracket as an instrument for the orthodontic practice. It is known that both the composition and the structural characteristics of the brackets bases influence its chemical and mechanical retention over tooth surface. Therefore this study has proposed assessment by shear test to compare three commercial brands (Abzil ®, Morelli ® and Eurodonto ®) of polycrystalline ceramic aesthetic brackets regarding their adhesion strength. Forty-five human premolars were used and randomly divided into 3 groups of 15 teeth each. Teeth were embedded in acrylic resin with the vestibular face buccal perpendicular to the base of the tube. Brackets were bonded with orthodontic adhesive system Transbond XT ® (3M Unitek) and submitted to shear in an universal testing machine (EMIC DL 30000). Adhesion force was registered at the moment of split by TESC software, version 1.01, as Megapascal (MPa). The results showed bond strength of 28.01 MPa (± 9.88) for Group I, 20.23 MPa (± 7.06) for Group II, and 22.35 MPa (± 7 86) for Group III. Regarding the ARI (adhesive reminiscent index), Group I and III had a fracture at the interface bracket/adhesive, while Group II showed the interface fracture in the enamel/adhesive.

Influence of ceramic surface treatment on shear bond strength of ceramic brackets.

Objective: To compare four different surface treatment methods and determine which produces adequate bond strength between ceramic brackets and facets of porcelain (feldspathic), and evaluate the Adhesive Remnant Index (ARI) scores. Materials and Methods: Ten facets of porcelain specimens with glazed surfaces were used for each group. The specimens were randomly assigned to one of the following treatment conditions of the porcelain surface: (1) no surface treatment (control group), (2) fine diamond bur + orthophosphoric acid gel 37%, (3) hydrofluoric acid (HFL) 10%, and (4) HFL 10% + silane. Ceramic brackets were bonded with the adhesive cement Transbond XT. The shear bond strength values were measured on a universal testing machine at a crosshead speed of 0.5 mm/min. Results: There was a significant difference (P<0.05) between the control group and all other groups. There was no significant difference (P<0.05) between treated porcelain surface with diamond bur + orthophosphoric acid gel 37% (4.8 MPa) and HFL 10% (6.1 MPa), but the group treated with HFL 10% had clinically acceptable bond strength values. The group treated with HFL 10% + silane (17.5 MPa) resulted in a statistically significant higher tensile bond strength (P<0.05). In group 4, 20% of the porcelain facets displayed damage. Conclusion: Etching of the surface with HFL increased the bond strength values. Silane application was recommended to bond a ceramic bracket to the porcelain surface in order to achieve bond strengths that are clinically acceptable.

Shear Bond Strength of Laser Cured Composite Resin For Direct Bonding of Orthodontic Bracket - An In Vitro Comparitive Study.

Aim and objectives: To determine the shear bond strength of laser cured composite resin and compare with that of visible light cure resin and evaluate it’s clinical usefulness. Materials and methods: An argon laser with a wavelength of 488-500nm and a power density of 2.104 mW/cm2 and an optical diameter of 6mm with a curing time of 10 seconds was employed as against the visible light cure with a wave length of 450-500nm of the same optical diameter and curing time of 40 seconds and tested using a universal instron testing machine. Results: The bond strength between laser cured and visible light composite resin was not statistically significant. However the lesser curing time of laser reduces the chair side time. Conclusion: Laser curing of orthodontic brackets may not be a viable procedure due to the cost factor as the bond strength is clinically insignificant.

A comparative study of the shear bond strength of different ceramic brackets and adhesives / 대한치과교정학회지

The purpose of this study was to evaluate the shear bond strength of three kinds of different ceramic brackets with three different bonding adhesives. 5 specimens for each combination were tested for shear bond strength using Instron and for fracture site using SENL And 3 specimens were cross-sectioned for SEM examination of bonding pattern between bracket, resin and enamel surface. The results were as follows 1. The shear bond strength of chemical curing adhesives were higher than that of light curing adhesives. 2. The shear bond strength of Starfire bracket, chemical-bonded type, was lower than that of Transcend bracket, mechanical-bonded type, and Fascination bracket, combined type. 3. Fracture site of each bracket and tooth surface was examined under a light optical stereoscopic microscope, Transcend groups were mainly at the E/R intderface. Fascination groups were mainly at the COMB interface and Starfire groups were mainly at the R/B interface.