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Item A Comparison of Three Debonding Techniques Employing Two Methods of Tooth Preparation(2003) Long, Robert W.; Katona, Thomas R.; Baldwin, James J.; Hohlt, William F.; Moore, B. Keith; Shanks, James C.Traditionally, orthodontic adhesive systems consisted of three separate agents: an enamel conditioner, a primer solution, and an adhesive resin. Newer systems have combined the conditioning and priming agents into a single acidic primer solution. The purpose of this investigation is to evaluate the three debonding techniques (shear-peel, tension, torsion) using stainless steel brackets and two different methods of tooth preparation (37% phosphoric acid+ primer vs. self-etching primer). The null hypotheses of this investigation are (1) the method of tooth preparation will not have a significant effect on the bond strengths and (2) the relative shear-peel, tensile and torsional bond strengths will show consistent results. One hundred and fifty bovine incisors were randomly assigned to 6 groups of 25 specimens per group. Teeth were prepared for bonding by employing either (1) acid-etching with 37% phosphoric acid+ primer or (2) self-etching primer. The brackets were bonded with a resin composite adhesive under controlled temperature and humidity conditions at 74°F ± 2 and 54% ± 5 RH. In addition, specimens were bonded utilizing a bonding jig that held the thickness of the adhesive constant at 0.152 mm. All groups were tested to failure using the MTS Bionix machine. Results from this study showed that the prime-etching method of tooth preparation had significantly greater mean shear-peel bond strength than did the self-etch method and that the prime-etching method had significantly less mean tensile bond strength than did the self-etch method; however there were no significant differences in torque strengths between the two methods of tooth preparation. In addition, results for the true ratio of mean forces showed shear-peel bond strengths lies clearly above the confidence intervals for the other debonding measures, thus the three measures of debonding are dissimilar in the comparison of the two tooth preparation methods. Thus, both null hypotheses were rejected.Item Comparative Tensile Strengths of Brackets Bonded to Porcelain with Orthodontic Adhesives and Porcelain Repair Systems(1986) Eustaquio, Robert I.; Garner, LaForrest D.; Barton, Paul; Hennon, David K.; Moore, B. Keith; Muñoz, Carlos; Shanks, James C.This study evaluated the feasibility of bonding brackets to porcelain for orthodontic purposes by measuring and comparing tensile strengths of five silane-based adhesive systems. Each adhesive system bonded mesh pad brackets to 10 glazed and 10 deglazed metal-ceramic crowns and the specimens were then thermocycled between 16 degrees and 56 degrees for 2500 cycles. Clinically relevant bond strengths, comparable to those of adhesives bonding brackets to enamel, were recorded for four of the systems compared. System l+ and Porcelain Primer had the highest mean values followed by Lee's Enamelite 500, then Vivadent's Silanit, Contact-Resin and Isopast, then 3M's Concise and Scotchprime. Most, if not all, failure sites for the four were at the bracket-resin interface. Two-way factorial analysis of variance demonstrated significant differences at P<.001 among the four adhesives but no contribution of surface effect, whether glazed or deglazed, was suggested statistically. Neuman-Keul sequential range tests showed significant differences between System l+ and the three other systems but no significant differences among the three were detected. Den-Mat's Ultrabond recorded extremely low tensile strength values and was of dubious clinical value. A t-test suggested that deglazing porcelain contributed no significant difference in strength compared with intact, glazed porcelain. All failure sites were at the porcelain-resin interface for this product. Since resin may remain bonded to porcelain following debonding, George Taub's diamond polishing paste and Shofu porcelain polishing wheels were compared as to their ability in restoring the porcelain to its original state. Because of the great adhesive bond of the resin to porcelain, craters, pits or tears may be created when resin is cleaned from porcelain with conventional scalers and pliers. The diamond paste gave a better restorative finish than the stones but the end result depended on the extent of original damage following cleaning. Orthodontists should take this point into account when considering bonding to porcelain crowns or veneers for esthetics sake where final risks may outweigh initial benefits. In a limited survey of 100 orthodontists responding to a questionnaire, 89% indicated that they have bonded or contemplated bonding to composite restored teeth, and 83% indicated that they have bonded or contemplated bonding to porcelain.Item Comparison of Tensile Bond Strengths of Glass Ionomer Cements Using Hydroxyapatite Coated and Uncoated Orthodontic Brackets(1993) Ng, Richard I. Cheng Hin; Hohlt, William F.; Moore, B. Keith; Oshida, Yoshiki; Garetto, Lawrence P.; Roberts, W. Eugene; Shanks, James C.The use of glass ionomer cements (GIC) in orthodontics as a bonding agent has been receiving considerable attention due to its favorable properties, ie., physico-chemical adhesion to enamel, fluoride leaching capabilities and less traumatic bonding procedure to tooth structure. GIC ability to bond to the hydroxyapatite (HA) in the tooth enamel was tested utilizing an HA coated bracket developed by American Orthodontics. This study compared in vitro tensile bond strengths of four dental adhesives: Ketac-cem™ (KC), Vitrebond™ (VB), Transbond™ (TB) or Unite™ (UN), when used to bond to HA coated brackets and non-HA coated brackets. Bovine incisors were divided into eight groups of 20 specimens each. Each group included either an HA coated or non-HA coated bracket and one of the four adhesives. The brackets are manufactured with a Tricalcium Phosphate (TPC) coating, which is converted to an HA coating by the addition of -OH during autoclaving. The coated and non-coated brackets were bonded to the bovine teeth, which were embedded in epoxy resin blocks to fabricate the testing specimen. All of the specimens were stored in distilled water at room temperature for two weeks. This was followed by thermocycling after which the specimens were returned to water storage for an additional two weeks. The specimens were tested in tension on an lnstron Testing Machine until bond failure occurred. Mode of bond failure was determined visually by light microscope. The mean tensile bond strengths for KC and VB were each significantly less (p< 0.05) than the other three materials, while UN and TB were not significantly different. KC was the weakest at 0.68± 0.31 MPa, while UN was the strongest, 4.38±0.84 MPa. When comparing the GIG alone, there was a significant difference (p<0.0001) between the VB and the KC. The resins were not significantly different from each other. Differences between coated and non-coated were significant at p<0.05 with the noncoated brackets having the higher strength. Adhesive failure at the bracket interface for the two bracket types showed no difference for KC. TB and UN showed this type of failure significantly more with the coated brackets (p<0.05), and VB showed the opposite and more failure with non-coated brackets (p<0.01). The tensile bond strength of GIG continues to be significantly less than those of existing resins. The bond failure also revealed a high degree of within group variability. Trends relating failure mode to tensile bond strength could not be established. Greater bond strengths with the coated brackets and the GIG were not shown; however in the case of VB, the tendency for the coated brackets to fail less frequently at the bracket adhesive interface shows some promise. Further studies of these coated brackets are still warranted.Item Effect of Adherent Contour on Orthodontic Tensile Bond Strength(2001) Alvarez, Edwin; Katona, Thomas R.; Baldwin, James J.; Hohlt, William F.; Moore, B. Keith; Shanks, James C.Many factors may affect orthodontic bond strength study results. An important variant to consider is the bonding surface contour. Contour alters the proximity of adherent surfaces, the surface area available for adhesion, and the stress distribution. It was the purpose of this study to determine if bracket base or enamel contour affect in vitro bond strengths. Orthos Mini-Diamond (ORMCO Corp.) .0 018" slot central incisor brackets with flattened or unaltered curved bases were bonded (System 1 + self cure resin cement by ORMCO, Corp.) to unaltered and flattened bovine central incisors. Bond strengths were determined by debonding on a Bionix 858 (MTS System Corp.) testing machine. The results showed that unaltered bracket bases bonded on unaltered enamel surfaces (the closest approximation to a clinical situation) had the significantly (p< 0.0002) lowest tensile bond strength among the three combinations. The adhesive remnant index evaluation demonstrated that unaltered bracket base/ unaltered enamel surface (Group II) had significantly higher ARI (less adhesive remaining on enamel) than any of the other groups. A negative correlation between ARI scores and mean bond strength was found. There was not a significant difference between flattened bracket base / flattened enamel surface (Group I) and unaltered bracket base/ flattened enamel surface. The results suggest that the surface convexity and texture of enamel are important variables that can affect bond strength tests results. Standardization of testing protocols and control of the different variables that can affect bond strength are important factors in the testing of orthodontic brackets.Item Effect of Hydrofluoric Acid Etching Followed by Unfilled Resin Application on the Biaxial Flexural Strength of a Glass-based Ceramic(2012) Posritong, Sumana, 1974-; Bottino, Marco C.; Brown, David T.; Hovijitra, Suteera, 1944-; Chu, Tien-Min Gabriel; Levon, John A.Background: Numerous studies have reported the use of hydrofluoric (HF) acid as one of the most effective methods for the achievement of a durable bond between glass-based ceramics and resin cements. Nevertheless, there is little information available regarding the potential deleterious effect on the ceramic mechanical strength. Objectives: (1) to investigate the effect of HF acid etching regimens on the biaxial flexural strength of a low-fusing nanofluorapatite glass-ceramic (IPS e.max ZirPress, Ivoclar Vivadent), (2) to study the ability of an unfilled resin (UR) to restore the initial (i.e., before etching) mechanical strength, and (3) to evaluate the effect of HF acid etching on the ceramic surface morphology before and after UR treatment via scanning electron microscopy (SEM). Methods: One hundred and forty-four disc-shaped (15 ± 1 mm in diameter and 0.8 ± 0.1 mm in thickness) IPS e.max ZirPress specimens were allocated into 12 groups, as follows: G1-control (no etching), G2-30 s, G3-60 s, G4-90 s, G5-120 s, G6- 60 + 60 s. Meanwhile, groups (G7- G12) were treated in the same fashion as G1-G6, but followed by silane and UR applications. Surface morphology evaluation of non-etched and etched IPS e.max ZirPress (G1-G12) was carried out by scanning electron microscopy (SEM). The flexural strength was determined by biaxial testing as described in ISO 6872. Statistics were performed using two-way ANOVA and the Sidak multiple comparisons (α = 0.05). In addition, the Weibull statistics were estimated. Results: A significant effect of etching time (p=0.0290) on biaxial flexural strength was observed. Indeed, G4 led to a significantly (p=0.0392) higher flexural strength than G1. Correspondingly, G10 revealed a considerably higher flexural strength than G7 (p=0.0392). Furthermore, biaxial flexural strength was significantly higher for G7 – G12 than for G1 – G6 (p<0.0001). For G1 – G6, G4 showed the highest Weibull characteristic strength while the lowest Weibull characteristic strength was seen in G6. In G7 – G12, the highest Weibull characteristic strength was presented in G10 whereas G7 had the lowest. Finally, the SEM data revealed that the HF acid etching affected the surface of IPS e.max ZirPress by generating pores and irregularities and more importantly that the UR was able to penetrate into the ceramic microstructure. Conclusion: Within the limitations of this study, HF acid etching time did not show a damaging effect on the biaxial flexural strength of the IPS e.max ZirPress ceramic. Moreover, the ceramic biaxial flexural strength could be enhanced after UR treatment.Item Effect of surface treatments on microtensile bond strength of repaired aged silorane resin composite(2010) Palasuk, Jadesada; Platt, Jeffrey A., 1958-; Levon, John A.; Brown, David T.; Hovijitra, Suteera, 1944-; Cho, Sopanis D.Background: A silorane based resin composite, Filtek LS restorative, has been introduced to overcome the polymerization shrinkage of the methacrylate based resin composite. The repair of resin composite may hold clinical advantages. Currently, there is no available information regarding the repair potential of silorane resin composite with either silorane or methacrylate based resin composite. Objectives: The purpose of this study was to compare the repaired microtensile bond strength of aged silorane resin composite using different surface treatments and either silorane or methacrylate based resin composite. Methods: One hundred and eight silorane resin composite blocks (Filtek LS) were fabricated and aged by thermocycling between 8oC and 48oC (5000 cycles). A control (solid resin composite) and four surface treatment groups (no treatment, acid treatment, aluminum oxide sandblasting and diamond bur abrasion) were tested. Each treatment group was randomly divided in half and repaired with either silorane resin composite (LS adhesive) or methacrylate based resin composite (Filtek Z250/Single Bond Plus). Specimens were 12 blocks and 108 beams per group. After 24 hours in 37oC distilled water, microtensile bond strength testing was performed using a non-trimming technique. Fracture surfaces were examined using an optical microscopy (20X) to determine failure mode. Data was analyzed using Weibull-distribution survival analysis. Results: Aluminum oxide sandblasting followed by silorane or methacrylate based resin composite and acid treatment with methacrylate based resin composite provided insignificant differences from the control (p>0.05). All other groups were significantly lower than the control. Failure was primarily adhesive in all groups. Conclusion: Aluminum oxide sandblasting produced comparable microtensile bond strength compared to the cohesive strength of silorane resin composite. After aluminum oxide sandblasting, aged silorane resin composite can be repaired with either silorane resin composite with LS system adhesive or methacrylate based resin composite with methacrylate based dentin adhesive.Item Evaluation of Tensile Bond Strength of a Fluoride-Releasing Resin Adhesive with Ceramic Brackets(1991) Lehman, David Alan; Roberts, W. Eugene; Moore, B. Keith; Shanks, James C.; Arbuckle, Gordon R.; Miller, James R.The increased attention to the esthetics of orthodontic appliances has led to the popularity of ceramic brackets in the last decade. Although the bonding of ceramic brackets has become predictably successful, the extreme brittleness of ceramics coupled with higher bond strengths has caused significant clinical problems in debonding and risk of enamel damage. This study evaluated an experimental bonding resin with different levels of fluoride concentration, linking the therapeutic property of long-term fluoride release to the benefit of decreased bond strength to ceramic brackets. Four groups of 40 Transcend™ ceramic brackets each were bonded to bovine teeth, using 0, 3, 6, and 12 percent fluoride concentrations. At two weeks, one-half of each group was tested for tensile bond strength in an lnstron machine. The remaining half were tested at six months. In the groups broken at two weeks, the bond strength peaked around 6 percent fluoride, but the three top groups were not significantly different. In the groups tested at six months, peak strength was observed at 3 percent fluoride and was significantly greater than the others. The overall mean at six months than at two weeks. The study found bond strength values in the range of 25-50 kg/cm2. Although minimum values have not been established, the low values reported in this study are likely to be within acceptable clinical limits. Following debonding, the mode of bond failure was determined by viewing enamel specimens and bracket bases under a light microscope. In all but one group, 95 percent of the bond failure occurred at the bracket base/adhesive interface. No bracket failure occurred and no enamel damage could be observed under the light microscope. In a parallel study of physical properties, Knoop hardness was measured at one hour, 24 hours, and six months, and compressive strength was tested at one week and six months. While physical properties generally decreased over the period of study, bond strength was significantly greater in the six-month group. The results of this study regarding the correlation of these properties to bond strength is inconclusive. In addition, results of fluoride-release data by SISCO Inc. indicate that the 12 percent group was shown to release greater than 10 μg/g/day at six months. This was comparable to amounts known to have the clinical benefit of reducing demineralization, and equaled or exceeded other commercially available fluoride-releasing adhesives. The results of this study indicate that a fluoride-releasing resin can release clinically significant amounts of fluoride ions, and still have adequate bond strength.Item Evaluation of Tensile Bond Strength of Glass Ionomer Cements for Orthodontic Bonding(1992) Sprayberry, W. Ray; Katona, Thomas R.; Arbuckle, Gordon R.; Moore, B. Keith; Roberts, W. Eugene; Shanks, James C.Glass ionomer cements offer advantages over conventional composite resins when used for orthodontic bonding. These include chemical bonding to enamel, fluoride release, and ease of removal from enamel upon debonding. This study evaluated the tensile bond strengths of three Type I (luting) and three Type II (restorative) glass ionomer cements when used to bond a standard stainless steel orthodontic bracket to teeth. Bovine incisors were divided into six groups of 20 each. Each group had brackets bonded with one of the following glass ionomer cements: SHOFU ® Glasionomer Type I, Fuji I™, Ketac ®-cem, SHOFU ® Glasionomer Type II, Fuji II ™, and Ketac®-fil. A new regimen of specimen preparation was used in an attempt to align the brackets so that true tensile forces could be generated at testing. After the specimens were prepared, they were stored in room temperature water for two weeks, thermocycled, returned to water storage for two additional weeks, and then tested in tension on an lnstron Testing Machine until bond failure occurred. The type bond failure was determined with light microscopic analysis of the debonded bracket bases. The finite element method was used to further evaluate the bracket/adhesive/enamel complex with varying angulation of force application at debonding. The mean tensile bond strength value of 0.82 ± 0.36 MPa for SHOFU® Glasionomer Type I was significantly less (p<0.05) than the values of 1.13 ± 0.33 MPa for Ketac®-cem and 1.26 ± 0.40 MPa for Fuji I™. For the Type II glass ionomer cements, the mean tensile bond strengths of 2.00 ± 0.28 MPa for Ketac®-fil and 1.97 ± 0.29 MPa for Fuji II™ were significantly greater (p<0.05) than the 0.95 ± 0.35 MPa for SHOFU® Glasionomer Type II. The Ketac® and Fuji™ Type II cements developed bond strengths which were significantly greater (p<0.0001) than the Type I cements. Light microscopic analysis of bond failure revealed a high degree of within group variability. As a result, trends relating failure mode to tensile bond strength could not be established. The finite element method study showed that even a slight alteration in angulation of the force applied to the bracket greatly affected the maximum principal stress developed in the adhesive layer. An increase in maximum principal stress of ≈1,000 MPa was seen when a true tensile debonding force (0° offset) was adjusted to 12° of offset. The results of this study indicate that Type II glass ionomers have potential for clinical orthodontic use and that special attention should be given to the angulation of force applied to brackets in laboratory bonding studies.Item Evaluation of Tensile Bond Strength, Fluoride Release, Hardness, and Solubility of a Fluoride Containing Adhesive Resin(1994) Brandt, Marybeth; Moore, B. Keith; Zeldin, Martel; Katona, Thomas R.; Garetto, Lawrence P.; Roberts, W. EugeneDirect bonding of orthodontic brackets often results in decalcification of tooth structure surrounding bracket sites. Glass ionomer cements, while typically leaching fluoride over time, often exhibit a significantly lower bond strength. Fluoride-containing resins generally release high concentrations of fluoride for a short time, then cease to release any significant amount. The purpose of this study was to evaluate the tensile bond strength, fluoride release, hardness, solubility, and sorption of a newly formulated fluoride containing resin. The experimental resins were prepared with 5% and 7.5% fluoride (F-) monomer, and were compared to a fluoride-free control adhesive (Rely-a-Bond Phase II™, Reliance Orthodontics Inc ., Itasca, Ill .). To evaluate tensile bond strength, orthodontic brackets were bonded to bovine teeth and debonded using an lnstron machine. Fluoride release was tested using resin disks stored in deionized water. The fluoride content of the water was determined with an ion-specific electrode. Hardness, solubility, and sorption were tested using disks made of each material. Comparison of experimental and control resins by ANOVA followed by General Linear Models multiple comparisons revealed the control to show a statistically significant difference (p<.0001) for tensile bond strength. Experimental Control 5%F- 7.5%F- Peak Stress (MPa) 4.48±0.65 3.83±0.76 5.31±0.97. Fluoride continued to be released from the experimental resins (5% and 7.5% F-) at 18 days. The control was significantly harder than either of the experimental resins at 1 hour, 24 hours, 1 week, and 1 month (p<.0001). The 5% F- resin exhibited slight solubility (0.10 percent), while the 7.5%F- resin and the control exhibited very little solubility (0.01 percent). Phase II™ exhibited significantly lower sorption at 21 days (0.60 percent, p<.001) than either the 5%F- resin (1.69 percent) or the 7.5%F- resin (1.63 percent). These results indicate that while the experimental resin had lower bond strength, lower hardness, and higher sorption than the control, measurable fluoride was released from the experimental resins for up to 18 days. Further testing is indicated to determine the clinical acceptability of this adhesive.Item Evaluation of the Tensile Bond Strength of Orthodontic Bracket Bases Using Glass Ionomer Cement as an Adhesive(1992) Burns, Richard D., Jr.; Roberts, W. Eugene, Jr.; Garetto, Lawrence P.; Moore, B. Keith; Miller, James R.; Shanks, James C., Jr.; Hennon, David K.The search for an orthodontic bonding adhesive that has chemical adhesion to enamel and releases fluoride into the oral environment has led to experimentation with glass ionomer cements. This study compared the tensile bond strength of eight different orthodontic bracket base designs in vitro and assessed the amount of adhesive remaining on the bracket pad after debonding. Each bracket base design included in this study had unique characteristics warranting their inclusion. The groups contained brackets with 60, 80, and 100 gauge mesh pads; 100 gauge mesh sandblasted pads; perforated metal bases; Micro-Lock™ photo-etched bases; Dyna-Lock™ integral bracket/bases; and ceramic silane-coated bracket pads. Groups contained 20 to 22 specimens that were bonded to bovine incisor teeth embedded in a self-curing acrylic block that could be held in the testing machine. Pre-encapsulated glass ionomer cement (Ketac-Fil™) was the experimental adhesive. The adhesive was mixed according to the manufacturer's instructions in a dental amalgamator. The specimens were thermocycled between water oaths of 15°C and 55°C. The specimens spent 30 seconds in each bath for a total of 2,500 cycles and were stored in a humidor until debonding. After 14 days, the specimens were subjected to a tensile force using an Instron mechanical testing machine until failure occurred. The Micro-Loc™ photo-etched base had significantly higher mean tensile bond strength (p<0.05) than all other brackets tested. The ceramic brackets were unable to be tested due to the extremely weak bond strength which did not allow preparation of the samples for debonding. Following debonding, the percentage of adhesive remaining attached to the bracket base was determined using a grid in the ocular of a light microscope. In general, the site of bond failure involved the base/adhesive interface. The Dyna-Lock™ integral bracket/base and 80 gauge mesh base had a greater mean percent of adhesive remaining attached to the base. (Dyna-Lock™ 45 percent and 80 gauge mesh 43 percent vs. all other < 20 percent.) The results indicate that the bracket base design can influence the bond strength when GIC is used as an orthodontic adhesive and suggests that development of GIC with increased fracture toughness might increase bond strength.