Reduction of surface treatment time by combination of citric acid and ascorbic acid while restoring shear bond strength of metal brackets bonded to bleached enamel: a pilot study.

BACKGROUND: To investigate the effect of a 50% ascorbic acid with 50% citric acid solution on the immediate shear bond strength (SBS) of metallic brackets after tooth bleaching. The enamel etching pattern and the required quantity of these combined acids as antioxidants following 35% hydrogen peroxide (HP) bleaching were also determined. METHODS: The stability of the solution at room temperature was assessed at various time intervals. Fifty teeth were randomly divided into five groups: non-bleached (G1), bleached then acid etched (G2), bleached followed by a 10-minute treatment with 10% sodium ascorbate and acid etched (G3), 5-minute treatment with 50% ascorbic acid (G4), and 5-minute treatment with a combination of 50% ascorbic acid and 50% citric acid (G5). Groups G2, G3, G4 and G5 were bleached by 35% HP gel for a total of 32 min. Acid etching in groups G1, G2, and G3 was performed using 37% phosphoric acid (Ormco®, Orange, CA, USA) for 15 s. In all groups, metal brackets were immediately bonded using Transbond™ XT primer and Transbond™ PLUS adhesive, with light curing for 40 s. The SBS was tested with a universal testing machine, and statistical analysis was conducted using one-way ANOVA followed by Tukey's HSD test. The level of significance was set at p < 0.05 for all statistical tests. RESULTS: Stability tests demonstrated that the combined acids remained effective for up to 21 days. Group G5 significantly increased the SBS of bleached teeth to the level of G1 (p < 0.05), while G3 did not achieve the same increase in SBS (p > 0.05). SEM analysis revealed enamel etching patterns similar to those of both control groups (G1 and G2). Kinetic studies at 6 min indicated that the antioxidation in G5 reacted 0.2 mmole lower than in G3 and G4. CONCLUSION: 5-minute application of the combined acids enhanced the SBS of bleached teeth comparable to unbleached teeth. The combined acids remain stable over two weeks, presenting a time-efficient, single-step solution for antioxidant application and enamel etching in orthodontic bracket bonding.

One-Step Surface-Treatment Reagent (35% 3-O-Ethyl-l-ascorbic Acid Plus 50% Citric Acid Solution) Restores the Shear Bond Strength of Metal Brackets Bonded to Bleached Human Enamel: An In Vitro Study.

This study investigates how a new substance, composed of ethyl ascorbic acid and citric acid, affects the shear bond strength (SBS) of metal brackets when bonded to bleached teeth. Forty maxillary premolar teeth were used and randomly placed into four groups (n = 10): the control group did not undergo bleaching; the remaining groups underwent bleached using 35% hydrogen peroxide. In group A, 37% phosphoric acid was applied after bleaching. In group B, 10% sodium ascorbate was used for ten minutes before 37% phosphoric acid. In group C, 35%3-O-ethyl-l-ascorbic acid plus 50% citric acid solution (35EA/50CA) was applied for 5 min. The subgroups were bonded immediately after bleaching. The SBS was determined with a universal testing machine and analyzed using one-way ANOVA and then Tukey's HSD tests. Adhesive remnant index (ARI) scores were determined with a stereomicroscope and analyzed with a chi-squared test. The significance level was 0.05. Group C demonstrated significantly higher SBS values than group A (p < 0.001), but was not significantly different than the control group or group C (p > 0.05). The ARI scores were significantly different among the groups (p < 0.001). In conclusion, enamel surface treatment using 35EA/50CA improved the reduced SBS to an acceptable clinical level and reduced the clinical chair time.

Differential expression of epithelial cell adhesion molecule in salivary gland neoplasms.

Epithelial cell adhesion molecule (EpCAM) is the epithelial-specific molecule expressed on various epithelial cell types. The function of EpCAM involves cellular adhesion, proliferation, and signaling in both normal tissues and cancers. The purposes of this study were to investigate the EpCAM expression in salivary gland neoplasms and examine its relationship with pathologic characteristics. Forty-two cases of salivary gland neoplasms, including 20 mucoepidermoid carcinomas (MECs), 11 adenoid cystic carcinomas (ACCs), 9 pleomorphic adenomas (PAs), and 2 polymorphous low-grade adenocarcinomas (PLGAs) were enrolled. Epithelial cell adhesion molecule expression was analyzed immunohistochemically using MOC-31 and BerEP4 antibodies. Results showed that the majority of MECs and all PLGAs showed EpCAM expression in more than 50% of neoplastic cells, whereas most PAs and ACCs did not express this protein. In MECs, most EpCAM-positive neoplastic cells were clear cells, glandular epithelial cells, and intermediate cells, whereas squamous cells and mucous cells were largely negative. The expression was limited to ductal epithelium in EpCAM-positive PAs and ACCs. The decreased EpCAM expression in MECs was significantly associated with microscopically diminished cystic components, the presence of small nest invasion at invasive front, cellular anaplasia, vascular invasion, and high pathologic grade. These data suggested that EpCAM showed different expression pattern among salivary gland neoplasms and in different grades of MECs.