Clinic of Stomatology, Institution Shared with St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Pekařská 53, Brno, 656 91, Czech Republic.
Faculty of Science, Palacky University Olomouc, 17. listopadu 1192/12, Olomouc, 779 00, Czech Republic.
BMC Oral Health. 2023 Sep 5;23(1):637. doi: 10.1186/s12903-023-03368-2.
Orthodontic treatment is associated with numerous adverse side effects, such as enamel discoloration, demineralization or even caries. The presence of microleakage between the enamel and the adhesive and between the adhesive and the base of the orthodontic bracket allows penetration of the bacteria, molecules, and liquids into the enamel and can lead to unpleasant "white spot lesions" or secondary caries beneath and around the brackets. The aim of this in vitro study was to evaluate microleakage in five adhesive systems commonly used in orthodontic practice for bonding brackets.
One hundred extracted premolars were divided into five groups of twenty teeth. Stainless steel Legend medium metal brackets were bonded to teeth using five adhesive systems: resin-reinforced glass ionomer cement GC Fuji Ortho LC (GCF) and composite materials Light Bond (LB), Transbond XT (TB), Trulock™ Light Activated Adhesive (TL), and GC Ortho Connect (GCO). The specimens were subjected to thermal cycling, stained with 2% methylene blue, sectioned with low-speed diamond saw Isomet and evaluated under a digital microscope. Microleakage was detected at the enamel-adhesive and adhesive-bracket interfaces from occlusal and gingival margins. Statistical analysis was performed using generalized linear mixed models with beta error distribution.
Microleakage was observed in all materials, with GCF showing the highest amount of microleakage. Composite materials GCO, TB, and LB exhibited the lowest amount of microleakage with no statistical difference between them, while TL showed a statistically significantly higher amount of microleakage (p < 0.001). The enamel-adhesive interface had more microleakage in all composite materials (GCO, LB, TB, and TL) than the adhesive bracket-interface (p < 0.001). The highest amount of microleakage occurred in the gingival region in all materials.
Composite materials showed better adhesive properties than a resin-reinforced glass ionomer cement. The presence of microleakage at the enamel-adhesive interface facilitates the penetration of various substances into enamel surfaces, causing enamel demineralization and the development of dental caries.
正畸治疗会引起许多不良反应，如釉质变色、脱矿甚至龋齿。釉质与黏结剂之间以及黏结剂与正畸托槽基底之间存在微渗漏，允许细菌、分子和液体渗透到釉质中，导致不愉快的“白垩斑”或托槽下方和周围的继发龋。本体外研究旨在评估正畸临床常用的五种黏结系统的微渗漏。
将 100 颗拔除的前磨牙分为五组，每组 20 颗牙。使用五种黏结系统将不锈钢 Legend 中金属托槽黏结到牙齿上：树脂增强型玻璃离子水门汀 GC Fuji Ortho LC（GCF）和复合材料 Light Bond（LB）、Transbond XT（TB）、Trulock Light Activated Adhesive（TL）和 GC Ortho Connect（GCO）。标本进行热循环后，用 2%亚甲蓝染色，用低速金刚石锯 Isomet 切片，在数码显微镜下观察。从咬合和龈缘检测釉质-黏结剂和黏结剂-托槽界面的微渗漏。使用具有β误差分布的广义线性混合模型进行统计分析。
所有材料均观察到微渗漏，GCF 显示出最高的微渗漏量。复合材料 GCO、TB 和 LB 显示出最低的微渗漏量，它们之间没有统计学差异，而 TL 显示出统计学上显著更高的微渗漏量（p<0.001）。所有复合树脂材料（GCO、LB、TB 和 TL）的釉质-黏结剂界面的微渗漏量均高于黏结剂-托槽界面（p<0.001）。所有材料中，龈缘处的微渗漏量最高。
复合材料的黏附性能优于树脂增强型玻璃离子水门汀。釉质-黏结剂界面存在微渗漏，有利于各种物质渗透到釉质表面，导致釉质脱矿和龋齿的发生。
