The Enamel Surface and Bonding in Orthodontics
Section snippets
The Sound Enamel Surface
Enamel is characterized by a high mineral content (96 wt%) and by a low content of organic matter (0.4-0.8 wt%) and water (3.2-3.6 wt%). The mineral phase is generally described as calcium hydroxyapatite, which belongs to an isomorphous series of compounds known as apatites. The tightly packed, hexagonal, needle-shaped crystallites of the hydroxyapatite are the real units of enamel and are arranged into prisms. The appearance of the “keyhole” shaped prisms radiating from the dentinoenamel
Cleaning
Pumicing the enamel surface before conditioning has generally been considered a prerequisite for obtaining optimal bond strength. The rationale behind pumicing is that organic material like plaque and the acquired pellicle may inhibit optimal etching. Rotary instruments like rubber cups or polishing brushes are used. Typically, the pumicing process results in enamel loss of 5-14 μm, depending on the time and type of instruments used to clean the surface.12 Recently, Hosein et al13 using a
The Enamel Surface After Debonding
Debonding orthodontic attachments and removal of residual bonding material from the enamel surface include critical steps in the overall orthodontic management.5 Usually metal brackets can be debonded relatively easily by applying forces that peels the bracket base away from the tooth. Most often, such forces cause bond failure at the adhesive-bracket interface and most of the adhesive remain on the enamel surface after debonding.
The debonding and removal of ceramic brackets have in particular
Conclusion
The cumulative enamel loss of pumicing, bonding, debonding, and clean ups may appear relatively low compared with the thickness of the enamel surface (1500-2000 μm). More important is, however, whether residual adhesive persists in surface enamel after debonding. Resin tags can reach more than 20 μm into the enamel after bonding based on the acid-etching principle, and alteration of the prism structure even further. Using tungsten carbide burs in slow-speed handpiece or using debonding pliers
References (71)
Epoxy adhesives for orthodontic attachments: progress report
Am J Orthod
(1965)- et al.
The direct bonding of orthodontic attachments to teeth by means of an epoxy resin adhesive
Am J Orthod
(1970) Enamel alterations from bracket bonding and debonding: a study with the scanning electron microscope
Am J Orthod
(1981)- et al.
Scanning electron microscopic evaluation of enamel surfaces exposed to 3 orthodontic bonding systems
Am J Orthod Dentofacial Orthop
(2006) - et al.
Enamel loss due to orthodontic bonding with filled and unfilled resins using various clean-up techniques
Am J Orthod
(1980) - et al.
Enamel loss during bonding, debonding, and cleanup with use of self-etching primer
Am J Orthod Dentofacial Orthop
(2004) - et al.
Enamel loss due to prophylaxis and multiple bonding/debonding of orthodontic brackets
Am J Orthod
(1981) - et al.
Effect of pumice prophylaxis on the bond strength of orthodontic brackets
Am J Orthod Dentofacial Orthop
(1997) - et al.
An in vivo investigation into bond failure rates with a new self-etching primer system
Am J Orthod Dentofacial Orthop
(2003) - et al.
Effects of etchant concentration and duration on the retention of orthodontic brackets: an in vivo study
Am J Orthod Dentofacial Orthop
(1990)
Effect of phosphoric acid concentration on the shear bond strength of brackets
Am J Orthod Dentofacial Orthop
Orthodontic adhesives and bond strength
Semin Orthod
Clinical trials with crystal growth conditioning as an alternative to acid-etch enamel pretreatment
Am J Orthod
Tensile bond strength of orthodontic brackets bonded directly to fluorotic and non-fluorotic teeth
Am J Orthod Dentofacial Orthop
Phosphoric acid penetration during direct bonding
Am J Orthod
Effects of phosphoric acid concentration and etch duration on enamel depth of etch: an in vitro study
Am J Orthod Dentofacial Orthop
Effect of self-etchant pH on the shear bond strength of orthodontic brackets
Am J Orthod Dentofacial Orthop
An in vivo study on the merits of two glass ionomers for the cementation of orthodontic bands
Am J Orthod Dentofacial Orthop
Light-activated glass polyalkenoate (ionomer) cements: the setting reaction
J Dent Res
Comparison of the shear bond strength of a light-cured glass ionomer and a chemically cured glass ionomer for use as an orthodontic bonding agent
Am J Orthod Dentofacial Orthop
Comparison of bond strength of three adhesives: composite resin, hybrid GIC, and glass-filled GIC
Am J Orthod Dentofacial Orthop
Effect of changing enamel conditioner concentration on the shear bond strength of a resin-modified glass ionomer adhesive
Am J Orthod Dentofacial Orthop
Enamel preparation for orthodontic bonding: a comparison between the use of a sandblaster and current technique
Am J Orthod Dentofacial Orthop
Enamel surface evaluation after removal of orthodontic composite remnants by intraoral sandblasting: a 3-dimensional surface profilometry study
Am J Orthod Dentofacial Orthop
Laser etching of enamel for orthodontic bonding
Am J Orthod Dentofacial Orthop
Clinical trials with crystal growth conditioning as an alternative to acid-etch enamel pretreatment
Am J Orthod
White spot lesions during orthodontic treatment: mechanisms and fluoride preventive aspects
Semin Orthod
A simple method of increasing the adhesion of acrylic filling materials to enamel surface
J Dent Res
Bonding plastic orthodontic attachments to tooth enamel
J NJ Dent Soc
Comparison of enamel colour changes associated with orthodontic bonding using two different adhesives
Eur J Orthod
Enamel effects during bonding–debonding and treatment with fixed appliances
Dental enamel
Circumferential continuity of perikymata in human dental enamel investigated by scanning electron microscopy
Scand J Dent Res
SEM and microradiographic investigation of initial enamel caries
Scand J Dent Res
Enamel loss during orthodontic bonding and subsequent loss during removal of filled and unfilled adhesives
Am J Orthod
Cited by (39)
Effects of one-step orthodontic adhesive on microleakage and bracket bond strength: An in vitro comparative study
2020, International OrthodonticsCitation Excerpt :Orthodontic attachments bonded to the enamel surfaces are applied for a certain time. The bond strengths of adhesives should be high enough to hold the bracket on the tooth surface but low enough to cause no damage on the enamel surface during debonding and to allow easy cleaning of the remnant adhesive [13]. In orthodontic practice, microleakage between the enamel and adhesive layers can cause white spot lesions with the decalcification of enamel, and microleakage between the adhesive-bracket interfaces decreases the bond strength and increases the probability of bracket failure [14,15].
Experimental study of brackets adhesion with a novel enamel-protective material compared with conventional etching
2020, Saudi Dental JournalCitation Excerpt :The idea of protecting the enamel is not new. The protection arises from the growth of crystals on the surface to act as an adhesion substrate for cementing agents for orthodontics as an alternative to elude crystals dissolution inherent to phosphoric acid etching (Øgaard and Fjeld, 2010). Maijer and Smith, 1979, reported that a mixture of polyacrylic acid and 40% ammonium persulfate as initiator used for 2–6 min was effective for inducing the precipitation of salts crystals on upper premolars enamel yielding adhesions tensile strength similar to the values attained with one minute of 36% phosphoric acid.
Quantitative analysis of enamel on debonded orthodontic brackets
2017, American Journal of Orthodontics and Dentofacial OrthopedicsAssessing adhesive remnant removal and enamel damage with ultraviolet light: An in-vitro study
2017, American Journal of Orthodontics and Dentofacial OrthopedicsInfluence of different bonding agents on the color stability of enamel after orthodontic bracket removal
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