Al-Daher Mohammad Saeed, Sultan Kinda, Hajeer Mohammad Y, Burhan Ahmad S
Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR.
Cureus. 2024 Aug 5;16(8):e66210. doi: 10.7759/cureus.66210. eCollection 2024 Aug.
Enamel conditioning with 37% phosphoric acid is the most common technique during orthodontic bracket bonding procedures. However, due to the repeated de-bonding of the orthodontic brackets during treatment, other methods were needed to condition the enamel surface and increase the bond strength. This study aimed to compare the effect of conditioning the enamel surface by sandblasting with aluminum oxide particles or 5.25% sodium hypochlorite gel in combination with acid etching compared to acid etching alone on shear bond strength (SBS).
One hundred eight extracted upper premolars were randomly divided into three groups according to the conditioning enamel surface method. After the first and second bonding of metal brackets, new metal brackets were bonded with a total-etching adhesive after enamel conditioning using different methods: acid etching only (37% phosphoric acid for 30 seconds) (AE group), sodium hypochlorite associated with acid etching (5.25% NaOCl gel for 60 seconds and then acid etching for 30 seconds) (NaOCl-AE group), and sandblasting associated with acid etching (sandblasting for five seconds and then acid etching for 30 seconds) (SB-AE group). The shear bond strengths of the brackets were tested with a universal testing machine. One-way analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) tests were used to detect significant differences in shear bond strength among groups at the third bonding. Repeated-measure ANOVA and Bonferroni's tests were used to detect significant differences in shear bond strength among the bonding attempts within each group.
5.25% sodium hypochlorite associated with the acid etching method produced significantly greater shear bond strength than sandblasting associated with acid etching and acid etching only methods at the third bonding (16.40 ± 5.80 MPa, 13.60.47 ± 6.40 MPa, and 9.90 ± 4.40 MPa, respectively; P < 0.001). However, there was no significant difference between the AE and SB-AE groups (P = 0.247). In addition, we found a significant decrease in the shear bond strength within each group after each bonding attempt.
Conditioning the enamel surface with 5.25% sodium hypochlorite associated with acid etching produced greater bond strength than conditioning by sandblasting associated with acid etching and acid etching only at the third bonding. The bond strength of the metal bracket decreased with increasing bonding attempts, even with the application of enamel surface conditioning methods.
在正畸托槽粘结过程中，用37%磷酸对牙釉质进行酸蚀处理是最常用的技术。然而，由于正畸治疗过程中托槽需要反复拆除，因此需要其他方法来处理牙釉质表面并提高粘结强度。本研究旨在比较与单独酸蚀相比，用氧化铝颗粒喷砂或5.25%次氯酸钠凝胶联合酸蚀处理牙釉质表面对剪切粘结强度（SBS）的影响。
根据牙釉质表面处理方法，将108颗拔除的上颌前磨牙随机分为三组。在金属托槽第一次和第二次粘结后，使用不同方法对牙釉质进行处理后，用全酸蚀粘结剂粘结新的金属托槽：仅酸蚀（37%磷酸处理30秒）（AE组）、次氯酸钠联合酸蚀（5.25%次氯酸钠凝胶处理60秒，然后酸蚀30秒）（NaOCl-AE组）、喷砂联合酸蚀（喷砂5秒，然后酸蚀30秒）（SB-AE组）。用万能试验机测试托槽的剪切粘结强度。采用单因素方差分析（ANOVA）和Tukey's真实显著性差异（HSD）检验来检测三组在第三次粘结时剪切粘结强度的显著差异。采用重复测量方差分析和Bonferroni检验来检测每组粘结尝试之间剪切粘结强度的显著差异。
在第三次粘结时，与酸蚀联合使用的5.25%次氯酸钠处理产生的剪切粘结强度显著高于喷砂联合酸蚀和仅酸蚀处理（分别为16.40±5.80MPa、13.60.47±6.40MPa和9.90±4.40MPa；P<0.001）。然而，AE组和SB-AE组之间没有显著差异（P=0.247）。此外，我们发现每组在每次粘结尝试后剪切粘结强度均有显著下降。
在第三次粘结时，与酸蚀联合使用5.25%次氯酸钠处理牙釉质表面产生的粘结强度高于喷砂联合酸蚀和仅酸蚀处理。即使应用了牙釉质表面处理方法，金属托槽的粘结强度也会随着粘结尝试次数的增加而降低。
