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There is a significant change in the bacterial plaque populations in the oral cavity during and after orthodontic treatment. Numerous studies have demonstrated that 2−96% of patients could increase the risk of white spot lesions. Streptococcus mutans and Lactobacilli ssp. are responsible for these white spot lesions. In this work, silver nanoparticles (AgNPs) with a diameter of 11 nm and dispersed in water were impregnated onto three different commercial orthodontic adhesives at 535 µg/mL. The shear bond strength (SBS) was assessed on 180 human premolars and metallic brackets. The premolars were divided into six groups (three groups for the commercial adhesives and three groups for the adhesives with AgNPs). All the groups were tested for their bactericidal properties, and their MIC, MBC, and agar template diffusion assays were measured. After adding AgNPs, the SBS was not significantly modified for any adhesive (p > 0.05), and the forces measured during the SBS did not exceed the threshold of 6 to 8 MPa for clinical acceptability in all groups. An increase in the bactericidal properties against both S. mutans and L. acidophilus was measured when the adhesives were supplemented with AgNPs. It was concluded that AgNPs can be supplement commercial orthodontic adhesives without modifying their mechanical properties with improved bactericidal activity.

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Despite being associated with more accuracy, the indirect bonding procedure is not yet the gold standard, probably because of sensitivity of the numerous variables that must be controlled. The aim of this article was to present a modified, standardized, and low-cost indirect bonding technique that allows this procedure to be performed successfully. The technique covers an initial clinical stage, to obtain the models; a laboratory stage, which involves placement of brackets on the models following the facial axis of the clinical crown and the labial projection of the marginal ridges of the posterior teeth and construction of transfer tray using hot glue; and a second clinical stage, to properly transfer the brackets to patient's teeth. Hot glue used to build the tray molds the teeth and perfectly adapts to the teeth, having enough stiffness to maintain their anatomy and the position of the brackets, but also presenting adequate flexibility to allow removal of the tray avoiding excessive stress over the brackets. In conclusion, the new simplified indirect bonding technique presented here provides a precise placement of brackets on the models, a cheaper way to transfer them to patient, and an easy removal of transfer tray, being a very simple and cost-effective method.

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ABSTRACT: Orthodontic accessories bonding in tooth enamel has been a critical step since the introduction of direct bonding techniques due to the importance of bracket stability. The aim of this study was to evaluate adhesion strength of different adhesive systems used for bracket bonding on dental surface. The present in vitro study was made from the analysis of shear strength of steel and ceramic brackets bonding with six different types of orthodontic adhesives. The brackets were bonded to 120 human extracted first premolar teeth with Orthocem®, Orthocem® + Ambar Universal® primer, Orthobond Plus®, Biofix®, Transbond XT®, Ortholink VLC®. Shear strength tests were performed on a universal testing machine EZ-Test-Shimadzu® and the data were analyzed using ANOVA test with Post-Hoc Bonferroni and 95 % statistical significance (p <0.05). Transbond XT® and Ortholink VLC® resin values showed greater shear resistance for steel brackets bonding and Transbond XT® and Orthobond Plus® adhesives showed better adhesion results for ceramic brackets bonding.

RESUMEN: La unión de accesorios de ortodoncia en el esmalte dental ha sido un paso crítico desde la introducción de las técnicas de unión directa debido a la importancia de la estabilidad del soporte. El objetivo de este estudio fue evaluar la fuerza de adhesión de diferentes sistemas adhesivos utilizados para la unión de brackets en la superficie dental. El presente estudio in vitro se realizó a partir del análisis de la resistencia al corte de brackets de acero y de cerámica unidos con seis tipos diferentes de adhesivos de ortodoncia. Los brackets se unieron a 120 primeros premolares extraídos con los adhesivos Orthocem®, Orthocem® + Ambar Universal® primer, Orthobond Plus®, Biofix®, Transbond XT®, Ortholink VLC®. Las pruebas de resistencia al corte se realizaron en una máquina de prueba universal EZ-Test-Shimadzu® y los datos se analizaron usando la prueba ANOVA con Bonferroni Post-Hoc y 95 % de significación estadística (p <0,05). Los valores de resina Transbond XT® y Ortholink VLC® mostraron una mayor resistencia al corte para la unión de brackets de acero y los adhesivos Transbond XT® y Orthobond Plus® mostraron mejores resultados de adhesión para la unión de brackets cerámicos.

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OBJECTIVE: The goal was to evaluate the adhesive shear bond strength (SBS) of orthodontic tubes bonded to molar teeth and reinforced with Transbond XT (3M Science, St. Paul, MN, USA) and flowable resin. MATERIALS AND METHODS: In all, 120 molar teeth, previously extracted from patients with a mean age of 30 were included. Orthodontic molar tubes were bonded on the vestibular surface of these teeth with one of two types of adhesive (Transbond XT [3M Science, St. Paul, MN, USA] or Orthobond [Morelli, Sorocaba, Brazil]). Each of these groups was subsequently divided into four further groups: control and those subjected to the use of resin reinforcement on the occlusal surface of the bonded tubes with one of three materials (Transbond XT, Tetric N Flow [Ivoclar Vivadent, Ellwangen, Germany], Z 350 Flow [3M Science, St. Paul, MN, USA]). SBS and adhesive remnant index tests were performed to evaluate bond strength and type of fracture of the tubes bonded with the different methods. RESULTS: The use of resin reinforcement with Transbond XT significantly increased the SBS of tubes bonded with both materials. Flowable composites did not increase the SBS when used as a reinforcement. Less than 50% of the adhesive remained on the vestibular surface after the SBS test in most samples of all groups. CONCLUSION: Transbond XT orthodontic adhesive and Orthobond adhesive had appropriate bonding strengths for clinical use. Furthermore, the use of a resinous reinforcement with Transbond XT significantly increased the SBS of tubes bonded. However this technique with flowable adhesives (Tetric N Flow and Z350 Flow) did not significantly increase SBS when orthodontic tubes were bonded with Transbond XT or Orthobond.

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INTRODUCTION: A reliable adhesion between fixed devices and dental surfaces is a key factor for the clinical success of any orthodontic treatment. Adhesion preparation is associated with damages related to abrasive cleaning, enamel structure defacing caused by etching, enamel loss when removing resin remnants at orthodontic treatment finishing stage or when conditioning surface for adhesive failure and fractures at bracket removal. AIM: The objective of this study was to compare the shear bond strength of metallic brackets to enamel adhered with a novel non-damaging and remineralizing material for enamel versus the traditional 37% phosphoric acid etching. MATERIAL AND METHODS: 75 Premolars collected from 15- to 40-years old healthy donors requiring extraction were collected. The teeth were then randomly divided into three groups (n = 25). One group was used for the experimental new method (EX), the second for the conventional phosphoric acid etching (PA) method and the third group was left without any treatment (NT). The metallic brackets were fixed with Transbond® XT adhesive and composite resin polymerized for 40 s with a halogen photocuring lamp. The shear bond strength was quantified by means of a universal testing machine at 1 mm/min crosshead speed and a load cell of 1 kN. STATISTICAL ANALYSIS USED: Tests of normality, adjustment of the data to a root square, a one-way ANOVA and Tukey tests were performed. RESULTS: Statistically significant differences between the NT (1.4 MPa), PA (32.1 MPa) and EX (9.7 MPa) groups were observed. CONCLUSIONS: The experimental material for conditioning human enamel induces calcium phosphates crystals on the enamel surface and improves the bond strength in comparison to the NT group.

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ABSTRACT Objective: The purpose of this study was to evaluate the effect of the Yd:YAG laser irradiation on orthodontic bracket base surface. Shear bond strength (SBS) values and sites of the bonding failure interfaces were quantified. Methods: Brackets were divided into two groups: OP (One Piece - integral sandblast base) and OPL (One Piece - laser irradiation). The brackets were randomly bonded on an intact enamel surface of 40 bovine incisors. The SBS tests were carry out using a universal test machine. A stereomicroscopy was used to evaluate the adhesive remnant index (ARI), and surface characterization was performed by scanning electron microscopy (SEM). Student's t-test was used to compare the SBS between the two groups (p< 0.05). Frequencies and chi-square analysis were applied to evaluate the ARI scores. Results: OPL group showed higher value (p< 0.001) of SBS than OP group (43.95 MPa and 34.81 MPa, respectively). ARI showed significant difference (p< 0.001) between OPL group (ARI 0 = 100%) and OP group (ARI 0 = 15%). SEM showed a higher affinity between the adhesive and the irradiated laser base surface. Conclusions: Yd:YAG laser irradiation on bracket base increased SBS values, showing that bonding failure occurs at the enamel/adhesive interface. Laser-etched bracket base may be used instead of conventional bases in cases where higher adhesion is required, reducing bracket-bonding failure.

RESUMO Objetivo: O objetivo do presente estudo foi avaliar o efeito da aplicação do laser Yd:YAG sobre a superfície metálica da base de braquetes ortodônticos, a resistência da colagem ao cisalhamento (RU) e os locais das falhas nas interfaces adesivas. Métodos: Os braquetes foram divididos em dois grupos, de acordo com o tipo de base: OP (One Piece - monobloco, base jateada) e OPL (One Piece - monobloco, base irradiada a laser). Foram selecionados 40 incisivos bovinos hígidos para a colagem de braquetes na superfície do esmalte. Os testes de RU foram realizados por meio de uma máquina de ensaio universal EMIC DL1000. O Índice de Adesivo Remanescente (ARI) e a caracterização das superfícies foram realizados empregando-se estereomicroscópio e microscópio eletrônico de varredura (MEV). O teste t de Student foi aplicado para comparar a RU entre os dois grupos (p< 0,05). O ARI foi avaliado por meio da análise de Frequência e teste do Qui-quadrado. Resultados: O grupo OPL obteve maiores valores de RU (p<0,001) do que o grupo OP (43,95 MPa e 34,81 MPa, respectivamente), e o ARI obteve diferença significativa (p<0,001) entre os grupos OPL (ARI 0 = 100%) e OP (ARI 0 = 15%). A análise proveniente do MEV mostrou alta interação adesiva entre a resina e a superfície metálica da base irradiada pelo feixe de laser. Conclusões: A irradiação com laser Yd:YAG sobre a superfície da base de braquetes metálicos aumentou os valores da RU, demonstrando que as falhas adesivas ocorreram na interface esmalte/adesivo. O uso de braquetes modificados com irradiação a laser pode ser adotado como alternativa aos braquetes com bases convencionais nos casos em que uma maior retentividade for requerida para reduzir as falhas de adesividade.

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CONTEXT: The aims of this study were (i) to evaluate the color stability of two orthodontic adhesives and (ii) to evaluate the color stability of enamel and ceramic brackets bonded with orthodontic adhesives after exposure to different staining agents. MATERIALS AND METHODS: Disks were prepared with two orthodontic adhesives (Transbond and Enlight). Color stability evaluation was performed with a spectrophotometer using CIELab parameters. The specimens were divided into four groups and immersed in the following staining agents (n = 5): distilled water (control), coffee, red wine, and cola soft drink, for 1 h/day for 120 days. Twenty molar crowns were also used. The baseline color of enamel was obtained and ceramic brackets were bonded with the orthodontic adhesives. The enamel specimens were divided into four groups and immersed in the same staining agents. After 120 days, another color reading with the brackets in position was taken. The brackets were then removed and the enamel color was again evaluated. Color difference (ΔE) in different time periods was determined and the data were analyzed by ANOVA and Tukey's test (α = 5%). RESULTS: Transbond showed lower ΔE than Enlight. Water, cola, and coffee had the lowest ΔE values. Immersion in wine showed the highest ΔE values. For time, the lower ΔE values were found for 24 h and 7 days. Storage times of 60, 90, and 120 days showed the highest ΔE values. ΔE for enamel showed significant differences only for time. CONCLUSION: Adhesive, staining agents, and storage time influenced the color stability of orthodontic adhesives.

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Antimicrobial orthodontic adhesives aim to reduce white spot lesions' incidence in orthodontic patients, but they should not jeopardizing its properties. Systematic review and meta-analysis were performed to answer the question whether the association of antimicrobial agents with orthodontic adhesives compromises its mechanical properties and whether there is a superior antimicrobial agent. PubMed and Scopus databases. In vitro studies comparing shear bond strength of conventional photo-activated orthodontic adhesives to antimicrobial photo-activated orthodontic adhesives were considered eligible. Search terms included the following: orthodontics, orthodontic, antimicrobial, antibacterial, bactericidal, adhesive, resin, resin composite, bonding agent, bonding system, and bond strength. The searches yielded 494 citations, which turned into 467 after duplicates were discarded. Titles and abstracts were read and 13 publications were selected for full-text reading. Twelve studies were included in the meta-analysis. The global analysis showed no statistically significant difference between control and experimental groups. In the subgroup analysis, only the chlorhexidine subgroup showed a statistically significant difference, where the control groups had higher bond strength than the experimental groups. Many studies on in vitro orthodontic bond strength fail to report test conditions that could affect their outcomes. The pooled in vitro data suggest that adding an antimicrobial agent to an orthodontic adhesive system does not influence bond strength to enamel. It is not possible to state which antimicrobial agent is better to be associated.

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Objective: evaluate the shear bond strength of metallic brackets bonded with two adhesive systems to eroded enamel surfaces. Methods: sixty bovine incisors were used and divided into four groups (n = 15). The bonding procedures were performed with metallic brackets and 37% phosphoric acid etching, and divided as follows: Group 1, healthy enamel with Transbond XT adhesive system (3M Unitek, Monrovia, USA); Group 2, eroded enamel with Transbond XT adhesive system; Group 3, healthy enamel with Orthoprimer/Orthobond adhesive system (Dental Morelli Ltda, Sorocaba, Brazil); and Group 4, eroded enamel with Orthoprimer/Orthobond adhesive system. Teeth erosion was performed with Classic CokeTM during 14 days. After 24 h of bonding procedures, specimens were subjected to shear loading using a universal machine for mechanical testing at a crosshead speed of 1 mm/min. Results: the shear bond strength means were: Group 1, 19.04(3.24) MPa; Group 2, 18.6(4.25) MPa; Group 3, 12.76(2.78) MPa; and Group 4, 13.01(3.22) MPa. No statistically significant differences were found between groups 1 and 2, and between groups 3 and 4. Statistically significant differences were found between groups 1 and 3, and between groups 2 and 4. The adhesive remnant index (ARI) scores indicated no significant differences among the tested groups. Conclusions: acid erosion did not change shear bond strength of metallic brackets bonded with both adhesive systems. Transbond XT adhesive system showed higher shear bond strength than Orthoprimer/Orthobond adhesive system.

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OBJECTIVE: To compare in vitro shear bond strength (SBS) of different orthodontic adhesives in bonding and repeatedly rebonding metal brackets, and to evaluate the bond failure site with the adhesive remnant index (ARI). METHODS: Specimens consisted of 90 extracted human first premolars, randomly divided into three groups (n=30). The adhesives Alpha Plast (AP), ConciseTM (CO) and TransbondTM XT (TB) were used in each group. Three SBS tests were performed, i.e., one at T0 (initial) and the other two at T1 and T2 (first and second rebondings, respectively), observing a 24-hour interval. The tests were performed in a Shimadzu AG-I (10kN) SBS testing machine, at a speed of 0.5 mm/min. RESULTS: SBS data were subjected to ANOVA, Tukey's test and Bonferroni test (p<0.05). For the ARI, the Kruskal Wallis test was performed, followed by the Dunn test. The results revealed that at T0 groups AP and CO showed SBS values that were near, but above TB values; and at T1 and T2, the highest SBS values were observed for the AP group, followed by the CO and TB groups. CONCLUSION: Statistically significant differences were found in SBS between groups AP, CO and TB during bonding and repeated rebondings of unused metal brackets, with group AP achieving the highest SBS value. Regarding ARI, adhesive AP exhibited bond failure at the enamel-adhesive interface, with a higher enamel fracture frequency.

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ABSTRACT OBJECTIVE: The objective of the present study was to verify the hypothesis that no difference in biocompatibility exists between different orthodontic adhesives. MATERIAL AND METHODS: Thirty male Wistar rats were used in this study and divided into five groups (n=6): Group 1 (control, distilled water), Group 2 (Concise), Group 3 (Xeno III), Group 4 (Transbond XT), and Group 5 (Transbond plus Self-Etching Primer). Two cavities were performed in the subcutaneous dorsum of each animal to place a polyvinyl sponge soaked with 2 drops of the respective adhesive in each surgical loci. Two animals of each group were sacrificed after 7, 15, and 30 days, and their tissues were analyzed by using an optical microscope. RESULTS: At day 7, Groups 3 (Transbond XT) and 4 (Xeno III) showed intense mono- and polymorphonuclear inflammatory infiltrate with no differences between them, whereas Groups 1 (control) and 2 (Concise) showed moderate mononuclear inflammatory infiltrate. At day 15, severe inflammation was observed in Group 3 (Transbond XT) compared to other groups. At day 30, the same group showed a more expressive mononuclear inflammatory infiltrate compared to other groups. CONCLUSION: Among the orthodontic adhesive analyzed, it may be concluded that Transbond XT exhibited the worst biocompatibility. However, one cannot interpret the specificity of the data generated in vivo animal models as a human response.

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