Comparison of Tensile Bond Strengths of Glass Ionomer Cements Using Hydroxyapatite Coated and Uncoated Orthodontic Brackets

Abstract

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.