Master of Science (M.S.) in Dentistry
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College of Dental Medicine
Jeffrey Y Thompson
Publication Date / Copyright Date
Nova Southeastern University
Elliott Katz. 2018. Effect of Air-abrasion Preparation on Shear Bond Strength of Orthodontic Brackets to Enamel Surface. Master's thesis. Nova Southeastern University. Retrieved from NSUWorks, College of Dental Medicine. (75)
Introduction: An optimal orthodontic bonding system must minimize damage to the enamel during conditioning, have enough bond strength to prevent bracket de-bonding during treatment, and allow bracket removal at treatment completion, such that minimal damage is inflicted to the tooth.1 Pumice followed by acid etching has been the standard for many years; however, Groman Inc. (Margate, FL, USA) has stated that using their air-abrasion product will result in a tripling of bond strength. This method claims a three-fold increase in bond strength compared to traditional acid etching techniques by substituting air-abrasion using the EtchMaster® (Groman Inc., Margate, FL) 50 μm aluminum oxide in place of pumice prophy prior to acid etching. The purpose of this study is to see if this combination does in fact triple shear bond strength, and if so, what impact it has on the residual enamel surface after bracket removal, or de-bonding. Methods: Ninety recently extracted bovine incisors were randomly divided into three groups. Each of the three groups underwent different conditioning methods prior to bracket bonding. Group A: pumice + acid etch (N=30), Group B: air-abrasion + acid etch (N=30), and Group C: air-abrasion only (N=30). Enamel surface conditions were characterized using a Quanta 200 Scanning Electron Microscope (SEM) (FEI, Hillsboro, OR) and a SZX7 Stereomicroscope System (Olympus, Center Valley, PA). American Orthodontics Master Series System twin MBT mandibular incisor brackets (Sheboygan, WI, USA) were then bonded to each tooth. Following bonding, teeth were stored for twenty-four hours in water at 37°C +/- 2°C. All groups then underwent thermocycling of five hundred cycles in water baths set at five and fifty-five degrees Celsius. Next, the samples were mounted in dental stone and brackets de-bonded using a universal testing machine (Instron, Canton, MA) to obtain shear bond strength (SBS) values. SEM and optical stereomicroscopy were again utilized to evaluate the enamel surface and determine the adhesive remnant index (ARI) was score of each specimen. Results: The mean of Group A (pumice + acid etch) was 21.52 MPa with a standard deviation of 4.97 MPa. The mean of Group B (air-abrasion + acid etch) was 21.83 MPa with a standard deviation of 7.55 Mpa. The mean of Group C (air-abrasion only) was 8.12 MPa with a standard deviation of 3.05 MPa. Analysis of variance showed a main effect of Group on MPa, F(2, 87) = 60.66, p < 0.001, ηp2= 0.58. Post-hoc analyses using Tukey’s HSD indicated that SBS values were higher for teeth in Group A than for those in Group C (p < 0.001), teeth in Group B had higher SBS values than those in Group C (p < 0.001), but no difference was found for SBS between teeth in Group A and Group B (p =0.981). Results from the Fisher’s Exact test, where we controlled the Type I error using a Bonferroni correction, reveals that ARI scores differed by group (p < 0.001). Stereomicroscope images at 38.75x magnification obtained following enamel conditioning show Groups A (P+AE) and B (AA+AE) are almost indistinguishable; however, Group C (AA) has visual differences. Group C had a speckled reflective property that appeared to be residual aluminum oxide particles. Following de-bond, stereomicroscopic and SEM images showed no enamel defects on the tooth. Conclusions: SBS was not significantly different between Group A (pumice + acid etch) and Group B (air-abrasion + acid etch). SBS was significantly different between Groups A and B, and Group C (air-abrasion only). This means there is not a three-fold increase in SBS when using air-abrasion and acid etch, when compared to pumice and acid etch, as claimed by the manufacturer of the air-abrasion unit used in this study. Additionally, the air-abrasion only group displayed a significantly lower SBS than Group A and B. Air-abrasion only is not a suitable enamel preparation method for orthodontic bonding. Images obtained from the stereomicroscope and SEM reveal no observational damage to the enamel surface topography after de-bonding for any group.
Health and environmental sciences, Air-abrasion, Orthodontics, Shear bond strength
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