Direct bonding comparing a polyacrylic acid and a phosphoric acid technique.

The purpose of this study was to compare in vitro a polyacrylic acid technique (crystal bonding) with a conventional phosphoric acid-etch technique for the preparation of teeth for bonding. The potential value of the polyacrylic acid technique was evaluated for bond strength, enamel loss, cleanup, and fracture location--with and without the use of a sealant. Ninety-six premolars were evenly divided into two groups. Group A was preconditioned with polyacrylic acid and group B with phosphoric acid. Half of each group was treated with a sealant before direct bonding of orthodontic brackets. Sealant was not used on the other half of each group and brackets were bonded directly to the conditioned labial surfaces with a composite cement. Bonding and rebonding shear strength tests were carried out for both groups. Results indicated that shear bond strength values for the polyacrylic acid group were approximately one third those of the phosphoric acid group using a composite cement as the adhesive. Enamel loss was measured on the lingual surfaces of 30 of the 96 premolars. The lingual surfaces were conditioned with polyacrylic acid. Following debonding and cleanup procedures, the polyacrylic acid treated surface was left slightly pitted with no resin tags remaining. Cleanup procedures required only a rubber-cup silicate prophylaxis. The total enamel loss was minimal (4.5 micron), thus preserving most of the outermost fluoride-rich layer of enamel.