Resistance of bonded premolars to four artificial ageing models post enamel conditioning with a novel calcium-phosphate paste

Ali I Ibrahim, Noor R Al-Hasani, Van P Thompson, Sanjukta Deb, Ali I Ibrahim, Noor R Al-Hasani, Van P Thompson, Sanjukta Deb

Abstract

Background: This in vitro study compares a novel calcium-phosphate etchant paste to conventional 37% phosphoric acid gel for bonding metal and ceramic brackets by evaluating the shear bond strength, remnant adhesive and enamel damage following water storage, acid challenge and fatigue loading.

Material and methods: Metal and ceramic brackets were bonded to 240 extracted human premolars using two enamel conditioning protocols: conventional 37% phosphoric acid (PA) gel (control), and an acidic calcium-phosphate (CaP) paste. The CaP paste was prepared from β-tricalcium phosphate and monocalcium phosphate monohydrate powders mixed with 37% phosphoric acid solution, and the resulting phase was confirmed using FTIR. The bonded premolars were exposed to four artificial ageing models to examine the shear bond strength (SBS), adhesive remnant index (ARI score), with stereomicroscopic evaluation of enamel damage.

Results: Metal and ceramic control subgroups yielded significantly higher (p < 0.05) SBS (17.1-31.8 MPa) than the CaP subgroups (11.4-23.8 MPa) post all artificial ageing protocols, coupled with higher ARI scores and evidence of enamel damage. In contrast, the CaP subgroups survived all artificial ageing tests by maintaining adequate SBS for clinical performance, with the advantages of leaving unblemished enamel surface and bracket failures at the enamel-adhesive interface.

Conclusions: Enamel conditioning with acidic CaP pastes attained adequate bond strengths with no or minimal adhesive residue and enamel damage, suggesting a suitable alternative to the conventional PA gel for orthodontic bonding. Key words:Enamel etching, calcium phosphate, bracket bond strength, adhesive residue, enamel damage.

Conflict of interest statement

Conflicts of interest None.

Copyright: © 2020 Medicina Oral S.L.

Figures

Figure 1
Figure 1
A schematic illustration of the study design. Bonded teeth with either metal or ceramic brackets were exposed to 4 separate artificial ageing tests: 24 hours water storage (24 h WS), 30 days acid challenge (30 AC), 30 days water storage (30 WS), and 5000 cycles of cyclic fatigue (CF). Each main metal or ceramic group was subdivided into two subgroups according to the type of enamel etchant: control (C) using 37% PA gel and experimental etchant paste (CaP).
Figure 2
Figure 2
FTIR spectra of the CaP formulation at two time points, depicting almost identical 4 distinctive bands. Both the immediately mixed paste and post-24 h ground powder elicited a P-O(H) peak at around 853 cm-1, two P-O peaks at around 952 cm-1 and 1079 cm-1, and the H-O-H bending mode of water at 1646 cm-1 indicating monocalcium phosphate monohydrate formation.
Figure 3
Figure 3
Fatigue staircase cyclic shear bond strength (CSBS) of premolars etched with 37% PA gel (control) or CaP paste, and bonded with metal or ceramic brackets. The fatigue analysis for each subgroup is based on the least frequent event [bracket failure (x) or non-failure (+)] throughout the test.

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Source: PubMed

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