Six-month bracket failure rate with a flowable composite: A split-mouth randomized controlled trial

ABSTRACT INTRODUCTION: The use of flowable composites as an orthodontic bonding adhesive merits great attention because of their adequate bond strength, ease of clinical handling and reduced number of steps in bonding. OBJECTIVE: The aim of this Randomized Controlled Trial was to comparatively evaluate over a 6-month period the bond failure rate of a flowable composite (Heliosit Orthodontic, Ivoclar Vivadent AG, Schaan) and a conventional orthodontic bonding adhesive (Transbond XT, 3M Unitek). METHODS: 53 consecutive patients (23 males and 30 females) who fulfilled the inclusion and exclusion criteria were included in the study. A total of 891 brackets were analyzed, where 444 brackets were bonded using Heliosit Orthodontic and 447 brackets were bonded using Transbond XT. The survival rates of brackets were estimated with the Kaplan-Meier analysis. Bracket survival distributions for bonding adhesives, tooth location and dental arch were compared with the log-rank test. RESULTS: The failure rates of the Transbond XT and the Heliosit Orthodontic groups were 8.1% and 6% respectively. No significant differences in the survival rates were observed between them (p= 0.242). There was no statistically significant difference in the bond failure rates when the clinical performance of the maxillary versus the mandibular arches and the anterior versus the posterior segments were compared. CONCLUSIONS: Both systems had clinically acceptable bond failure rates and are adequate for orthodontic bonding needs.

RESUMO INTRODUÇÃO: o uso de resinas compostas fluidas como agentes de cimentação em Ortodontia tem merecido grande atenção, em função de sua adequada capacidade adesiva, facilidade de uso clínico e número reduzido de etapas de colagem. OBJETIVO: o objetivo deste estudo randomizado controlado foi avaliar o índice de falhas nos 6 meses após a colagem com uma resina composta fluida (Heliosit Orthodontic, Ivoclar Vivadent AG, Schaan), em comparação com um adesivo ortodôntico convencional (Transbond XT, 3M Unitek). MÉTODOS: 53 pacientes consecutivos (23 homens e 30 mulheres) que se enquadravam nos critérios de inclusão adotados foram incluídos no presente estudo. No total, 891 braquetes foram analisados, sendo 444 colados com o Heliosit Orthodontic e 447 colados com o Transbond XT. As taxas de sobrevivência dos braquetes foram estimadas por meio da análise de Kaplan-Meier. As distribuições das taxas de sobrevivência dos braquetes em função do adesivo usado, do dente e da arcada dentária em questão foram comparadas por meio do teste de log-rank. RESULTADOS: os índices de falhas para os grupos Transbond XT e Heliosit Orthodontic foram, respectivamente, de 8,1% e 6%. Não foram observadas diferenças significativas entre os grupos quanto às taxas de sobrevivência dos braquetes (p= 0,242). Também não foram observadas diferenças estatisticamente significativas quanto aos índices de falhas quando se comparou a performance clínica nas arcadas dentárias superior e inferior, e nos segmentos anterior e posterior da boca. CONCLUSÕES: ambos os sistemas apresentaram índices de falhas clinicamente aceitáveis, podendo ser considerados adequados para a colagem ortodôntica.

Colagem indireta: uma excelente alternativa para a técnica vestibular / Indirect bonding: an excellent alternative for vestibular technique

A etapa de colagem dos bráquetes é uma fase crítica no tratamento ortodôntico, cabendo exclusivamente ao profissional o correto posicionamento dessas peças. A técnica de colagem indireta vestibular pode auxiliar a colagem dos bráquetes, facilitando a visualização, fornecendo maior precisão e permitindo alcançar tratamentos com maior qualidade. O presente artigo tem como objetivo evidenciar a viabilidade da colagem indireta vestibular na clínica ortodôntica moderna, utilizando uma técnica simplificada (técnica 1) e uma convencional (técnica 2), determinando o tempo e o custo laboratorial de cada uma delas, e apresentando a aplicação clínica da mais viável à Ortodontia moderna. A técnica 1 teve custo e tempo laboratorial menores que a técnica 2. A técnica de colagem indireta representa um excelente recurso para a clínica ortodôntica moderna, cabendo ao cirurgião dentista despender de apenas alguns minutos para realizá-la.

Bracket bonding is a critical step of orthodontic treatment and the professional is the only responsible for the precise positioning of these parts. The indirect vestibular bonding technique can improve the bonding of the brackets, facilitating the visualization, providing high precision and enabling better treatments. The present article aimed to highlight the viability of indirect vestibular bonding in the modern orthodontic clinic, by using one simplified technique (technique 1) and a conventional (technique 2), determining the time and laboratorial cost of each of them, and presenting the most viable clinical application to the modern Orthodontic clinic. Technique 1 had lower laboratorial time and cost in cmparison to technique 2. The indirect bonding technique represents an excellent resource for the modern orthodontic clinic, requiring only a few minutes to be performed by the dental surgeon.

Comparison of shear bond strength of orthodontic brackets bonded using two different hydrophilic primers: An in vitro study.

Context: Salivary control and maintenance of a dry operating field is a prime requisite of orthodontic bonding. Moisture insensitive primer (MIP) with a clinical significant bond strength values have a better edge over the conventional hydrophobic bonding systems. Aim: The aim of this study is to investigate the effectiveness of two hydrophilic primers with respect to conventional hydrophobic primer by comparing their shear bond strength (SBS) and adhesive-failure locations after contamination with saliva and saliva substitute. Materials and Methods: A total of 150 extracted human premolars were randomly divided into five group s ; Group A (Transbond MIP/saliva substitute), Group B (Opal Primo/saliva substitute), Group C (Transbond MIP/natural saliva), Group D (Opal Primo/natural saliva), control group - Group E (Transbond XT/dry), adhesive-Transbond XT used for all five groups and bonded using stainless steel brackets. Shear forces were applied to the samples with a universal testing machine. SBSs was measured in megapascals. The mode of bond failure was determined using the adhesive remnant index (ARI). Results: The mean SBS produced by Transbond MIP was higher than Opal Primo, which was statistically significant according to one-way analysis of variance. Both the tested groups showed lesser bond strength values than Transbond XT (the control). ARI scores revealed that there was no statistically significant difference in the site of bond failure between study groups. ARI scores were found to be lower for study groups suggesting adhesive failure, compared to higher ARI scores for the control group suggesting cohesive failure. Conclusion: Transbond XT adhesive with Transbond MIP or Opal Primo have clinically acceptable bond strength in wet fields. Opal Primo is a viable option to use as a hydrophilic primer clinically.

Avaliação in vitro da dureza, da resistência adesiva e do índice de adesivo remanescente de três resinas ortodônticas / In vitro evaluation of hardness, adhesive resistance and adhesive remnant index of three orthodontic resins

Este estudo avaliou a Dureza Vickers (HV), a resistência adesiva (RA) e o índice de adesivo remanescente (IAR) de três resinas ortodônticas: Concise (CO), Transbond XT (TB) e a Aqualite (AQ). Para a análise da HV foram confeccionados 30 corpos de prova em matrizes metálicas pré-fabricadas com diâmetro de 0,5 mm e 0,2 mm de espessura. Os valores de HV foram CO = 43,29 ± 1,66, TB = 43,69 ± 1.37 e AQ = 43,51 ± 1,30. Os resultados para HV foram analisados pelo teste ANOVA one-way e pós-teste de Tukey, onde não foram encontradas diferenças estatísticas significativas (p>0,05). Para a RA foram utilizados 60 pré-molares e confeccionados corpos de prova, os quais foram divididos em 3 grupos (n= 20) para a colagem de bráquetes metálicos com as resinas Concise (CO), Transbond XT (TB) e Aqualite (AQ). Os bráquetes após a colagem foram submetidos aos ensaios mecânicos de cisalhamento em máquina de ensaio universal SHIMADZU, com velocidade de carga de 0,5 mm/min. A avaliação dos resultados do cisalhamento foram analisados pelo teste de variância ANOVA, e mostraram RA médias para CO de 18,21 ± 6,21 MPa; para TB de 25,02 ± 9,29 MPa e para AQ de 14,31 ± 8,25 MPa. A ANOVA demonstrou diferença estatística entre AQ/TB e CO/TB (p<0,05) e sem diferença estatística significante entre AQ/CO. Para avaliação do IAR utilizou-se o teste não paramétrico de Kruskal-Wallis, seguido do teste de Dunn, sem diferenças estatísticas significativas (p>0,05). Conclui-se que a resina TB apresentou maior RA em relação à CO e AQ. Não existe diferença entre a HV e o IAR entre as resinas.

This study evaluated Vickers hardness (HV), adhesive resistance and adhesive remnant index (ARI) on three orthodontic resins: Concise (CO), Transbond XT (TB), and Aqualite (AQ). For the HV analysis, 30 specimens were prepared with pre-manufactured matrixes with a 0.5 mm width and 0.2 mm thick. HV values were CO = 43.29 ± 1.66, TB = 43.69 ± 1.37 e AQ = 43.51 ± 1.30. Those values were evaluated by the one-way ANOVA test following Tukey test, and no significant statistical differences (p>0.05) were observed. For the RA evaluation, 60 pre-molar specimens were used, divided in 3 groups (n=20) and the metallic brackets were bonded with Concise (CO), Transbond XT (TB), and Aqualite (AQ). After bonding the brackets were submitted to shear bond strength mechanic trials with a SHIMADZU universal testing machine, with a cross-head speed of 0.5 mm per minute. The results of the shear bond strength were evaluated by the ANOVA and revealed RA means for CO values of 18.21 ± 6.21 MPa; 25.02 ± 9.29 MPa for TB, and 14.31 ± 8.25 MPa for AQ. ANOVA showed statistical differences between AQ/TB and CO/TB (p<0.05) while no statistical differences were observed between AQ/CO. For the ARI evaluation, the Kruskal-Wallis non parametric test was performed following the Dunn’s test, without any statistical significant differences (p>0.05). It was concluded that the TB resin presented higher RA values in relation to CO and AQ. There are no differences between the HV and IAR in the studied resins.

Avaliação da resistência ao cisalhamento de tubos de colagem ortodônticos / Shear bond strength evaluation of orthodontic molar tubes

O objetivo do presente trabalho é avaliar a resistência ao cisalhamento de tubos de colagem ortodônticos de diferentes marcas comerciais. Foram utilizados 30 tubos de colagem ortodônticos divididos em cinco grupos (n = 6): I (Rocky Mountain Orthodontics, Colorado, USA), II (Ormco Corporation, Glendora, Califórnia), III (3M-Unitek, Minnesota, USA), IV (G&H Wire Company, Hanover, Alemanha) e V (Dentsplay GAC International, NY, USA). Os mesmos foram colados no ponto mais convexo e centralizados na face do dente bovino e levados à máquina universal de ensaios mecânicos Emic DL 2000, a uma velocidade de 0,5 mm por minuto. Foi avaliada a força necessária para descolar os tubos ortodônticos. Os dados foram analisados pela análise de variância (ANO-VA) e teste de Fisher. Os tubos ortodônticos do grupo III necessitaram de uma força maior para que ocorresse a descolagem, esses resultados foram estatisticamente significantes em relação aos demais (p < 0,01), que se descolaram com força menor. O grupo IV apresentou os menores valores para descolar, entretanto, sem diferença estatística com o grupo V (p > 0,01). Conclui-se que tubos ortodônticos podem ser utilizados como alternativa para a bandagem dos molares. Três das cinco marcas comerciais suportaram tanto a força ortodôntica como a mastigatória, enquanto que duas marcas comerciais suportaram somente as forças ortodônticas.

The purpose of this study is to evaluate the shear bond strength (SBS) of orthodontic molar tubes from different trademarks. Thirty molar tubes were divided into five groups (n = 6): I (Rocky Mountain Orthodontics, Colorado, USA), II (Ormco Corporation, Glendora, Califórnia), III (3M-Unitek, Minnesota, USA), IV (G&H Wire Company, Hanover, Alemanha) e V (Dentsplay GAC International, NY, USA). The tubes were bonded to bovine teeth and placed on an Emic DL2000 testing machine with a crosshead speed of 0.5 mm/minute. The amount of force required to debond the tubes was assessed. Data were analyzed using two-way variance analysis (ANOVA) and the Fisher test. There was a statistically significant difference (p < 0.001) on shear bond strength. Othodontic tubes of group III presented thehigher SBS, while group IV showed the lower SBS, with no statistical difference in relation to group V (p > 0.01). It was concluded that bonding tubes may be used as an alternative to molar bands. Three of the five brands assessed in this study, supported both, orthodontic and masticatory forces, while two of them supported only the orthodontic forces.

Análise química e morfológica do esmalte dentário humano tratado com laser argônio durante a colagem ortodôntica / Chemical and morphological analysis of the human dental enamel treated with argon laser during orthodontic bonding

INTRODUÇÃO: as principais utilizações do laser argônio na Ortodontia são a redução do tempo de polimerização durante a colagem ortodôntica e o aumento da resistência à cárie do esmalte dentário. OBJETIVO: o objetivo deste trabalho foi avaliar as alterações químicas e morfológicas do esmalte dentário humano tratado com laser argônio nos parâmetros da colagem ortodôntica. MÉTODOS: quinze primeiros pré-molares hígidos, extraídos por indicação ortodôntica, foram selecionados e seccionados no sentido do longo eixo em dois segmentos iguais. Uma metade de cada elemento dentário foi tratada e a outra permaneceu sem tratamento. Um total de 30 amostras foi analisado, criando o grupo laser (n = 15) e o grupo controle (n = 15). O tratamento foi feito com laser argônio com 250mW de potência por 5 segundos, com densidade de energia de 8J/cm². RESULTADOS: a análise de difração de raios X demonstrou duas fases em ambos os grupos, as fases apatita e monetita. A redução da fase monetita foi significativa após o tratamento com laser, sugerindo maior cristalinidade. A análise de Espectroscopia de Energia Dispersiva (EDS) indicou aumento na razão cálcio-fósforo no grupo laser, compatível com a diminuição da fase monetita. A morfologia superficial do esmalte dentário apresentou-se mais lisa após o tratamento com laser argônio. CONCLUSÕES: o aumento de cristalinidade e a lisura superficial do esmalte no grupo laser são fatores sugestivos de aumento de resistência à cárie no esmalte dentário.

INTRODUCTION: The main utilities of the argon laser in orthodontics are the high speed curing process in orthodontic bonding and the caries resistance promotion of the tooth enamel. OBJECTIVE: The objective of this study was to evaluate the chemical and morphological changes in the tooth enamel treated with the argon laser in the orthodontic bonding parameters. METHODS: Fifteen sound human first premolars, removed for orthodontic reason, were selected and sectioned across the long axis in two equal segments. One section of each tooth was treated and the other remained untreated. A total of thirty samples was analyzed, creating the laser group (n =15) and the control group (n =15). The treatment was done with 250 mW argon laser beam for 5 seconds, with energy density of 8 J/cm². RESULTS: The X-ray analysis demonstrated two different phases in both groups, the apatite and the monetite phases. The reduction of the monetite phase was significant following laser treatment, suggesting higher crystallinity. The EDS analysis showed an increase in the calcium-phosphorus ratio in the laser group, linked with the decrease of the monetite phase. CONCLUSIONS: The surface morphology was smoother after the laser exposure. The results of high crystallinity and superficial enamel smoothness in the laser group are suggestive of the caries resistance increase of the tooth enamel.

An in vitro study of the effects of different enamel conditioners on the shear bond strength and the adhesive remnant index / 实用口腔医学杂志

Objective:To evaluate the effects of different enamel conditioners in combination with an adhesive on the shear bond strength and the adhesive remnant index in vitro.Methods:One hundred and eight permanent healthy premolars from orthodontic patients and fresh saliva from a healthy young volunteer were collected.The teeth were cleaned,dried and etched by phosphoric acid,polyacrylic acid or Transbond plus SEP respectively(36 teeth for each agent).Then the teeth were bonded to brachet by RMGICs with the presence of water,saliva on the tooth surface or without any of them respectively(12 teeth in each group).After bonding,all samples were tested on a testing machine of Instron.Shear bond strength and adhesive remnant index were recorded.Results:Highest mean shear bond strength was observed in the group of teeth etched by Traspond plus SEP and bonded by RMGICs with the presence of saliva.Higher mean shear bond strength was obtained with the presence of saliva or water on the tooth surface than without any of them.Conclusion:Transbond plus SEP conditioning followed by RMGICs bonding may produce high shear bond strength between moistured tooth surface and brachet.

Study of adhesive characteristics of two kinds of orthodontical light-curing adhesive agents / 实用口腔医学杂志

Objective: To investigate the adhesive characteristics of two kinds of light-curing resin that was used to bond teeth and orthodontics brackets. Methods: A total of 60 premolar teeth were randomly divided into six groups, and brackets were bonded according to the manufacturers' instructions. In group A1, A2 and A3, the teeth were prepared using 100 ml/L polyacrylic acid, and the brackets were bonded using Fuji Ortho LC. In group B1, B2 and B3, the teeth were using self-etching primer, and the brackets were bonded using Transbond Plus Self Etching Primer (TPSEP). After 30 min and 24 h under room temperature and received cold-heat cycle treatment respectively, bond strength was measured using a testing instrument (2000S, Lloyds Instruments, Fareham, England) at a speed of 1 mm/min, and the residual adhesive was quantified using a stereomicroscope. The adhesive interface was observed by scanning electron microscope. Results: The bond shear strength of TPSEP and Ortho Glass LC are more than 5 MPa. The bond shear strength of TPSEP is stronger than that of Ortho Glass LC after 24 h. However,The adhesive remnant index (ARI)of TPSEP is higher than that of Ortho Glass LC. Conclusion: Transbond Plus Self Etching Primer and Ortho Glass LC can satisfy the clinic need of orthodontics.