The effect of carbamide peroxide bleach on the tensile bond strength of ceramic brackets: an in vitro study.

Recent advances in cosmetic dentistry have led to the development of a variety of new products and techniques including vital bleaching and ceramic brackets. Therefore this study was conducted to see whether the use of an at-home carbamide peroxide bleaching agent before bonding affected the tensile bond strength of a precoated ceramic orthodontic bracket. Sixty extracted human premolar teeth were randomly separated into three groups of 20. Group 1 was a control group that was etched and bonded in the usual manner. Group 2 was immersed in a carbamide peroxide home bleaching agent for 72 hours before pumicing and bonding. Group 3 was also bleached for 72 hours but was immersed in distilled water for 1 week before bonding. The results indicated that recently bleached teeth have significantly reduced bond strength values when compared with both groups 1 and 3. We suggest that if a patient is using a tooth whitening product, that they discontinue its use at least 1 week before the bonding of orthodontic attachments.