Dental School, Vita-Salute San Raffaele University, I.R.C.C.S San Raffaele Hospital, Via Olgettina 58, Milan, 20132, Italy.
Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55042, Forte Dei Marmi, Italy.
BMC Oral Health. 2023 Oct 13;23(1):758. doi: 10.1186/s12903-023-03418-9.
Nowadays bleaching procedures have gained popularity in orthodontic patients. Peroxide and Carbamide acids are the common agents which are used in in-office and at home bleaching techniques. Consequently, the Bonding adhesion to the enamel can be influenced by the orthodontic phase and the residual peroxide might interfere with the polymerization and the adhesion of the brackets. Frequent debonding of the brackets from teeth after the bleaching procedure could cause the lengthening of the therapy and promote irregularities on enamel surface derived from an additional bonding phase of the brackets. The aim of this systematic review is to appraise the influence regarding the effect of the bleaching procedure on the bond strength of orthodontic brackets.
An electronic database search was performed. Search terms included: bleaching, brackets, adhesion; data were extracted and summarized. Risk of bias was assessed using the Chocrane risk of bias tool, adapted for in vitro studies.
A total of 8689 articles were screened and 11 studies met the inclusion criteria of this systematic review. 1000 teeth of human and bovine origin were analyzed for the shear bond strength (SBS) of stainless and ceramic brackets after the bleaching treatments. All the authors divided the groups in different subgroups with different bleaching agents and in different concentration. The SBS value allowed to demonstrate the necessity to delay the bonding of the brackets for two weeks after a bleaching treatment and its improvement when tooth mousse or antioxidants agents are used.
The SBS values and the delay of the bonding procedure must be considered in dental practice and clinical strategies are necessary in order to avoid drawbacks which could cause the debonding of the brackets after bleaching due to the alterations of the dental substrate, thus interfering with the orthodontic treatments.
如今，漂白程序在正畸患者中越来越受欢迎。过氧化物和酰胺酸是常用的试剂，用于诊室和家庭漂白技术。因此，正畸阶段会影响牙釉质的粘结，残留的过氧化物可能会干扰支架的聚合和粘结。漂白后支架频繁从牙齿上脱落会导致治疗时间延长，并由于支架的额外粘结阶段导致牙釉质表面出现不规则。本系统评价的目的是评估漂白程序对正畸托槽粘结强度的影响。
进行电子数据库检索。搜索词包括：漂白、托槽、附着力；提取并总结数据。使用 Chocrane 偏倚风险工具评估偏倚风险，适用于体外研究。
共筛选出 8689 篇文章，11 项研究符合本系统评价的纳入标准。对 1000 颗来自人和牛的牙齿进行了剪切粘结强度（SBS）分析，比较了不锈钢和陶瓷托槽在漂白处理后的粘结强度。所有作者都将这些组分成不同的亚组，使用不同的漂白剂和不同的浓度。SBS 值表明需要在漂白治疗后两周内延迟粘结托槽，并在使用牙膏或抗氧化剂时提高 SBS 值。
SBS 值和粘结程序的延迟必须在牙科实践中考虑，临床策略是必要的，以避免因牙齿基质的改变而导致漂白后支架脱落的缺点，从而干扰正畸治疗。
