Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive

Ji-Yeon Lee; Jaechan Ahn; Sang In An; Jeong-won Park

doi:10.5395/rde.2018.43.e7

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Lee, Ahn, An, and Park: Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive

Research Article

Restor Dent Endod 2018;43(1):e7.

Published online: 4 February 2018

DOI: https://doi.org/10.5395/rde.2018.43.e7

Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive

Ji-Yeon Lee¹, Jaechan Ahn¹, Sang In An¹, Jeong-won Park^2,^*

¹Department of Orthodontics, National Health Insurance Service Ilsan Hospital, Goyang, Korea

²Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul, Korea

^*Correspondence to Jeong-won Park, DDS, PhD Professor, Department of Conservative Dentistry, College of Dentistry, Yonsei University, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea. E-mail: pjw@yuhs.ac

Received 13 October 2017 Accepted 5 December 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The aim of this study is to compare the shear bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and universal adhesive.

Materials and Methods

Fifty zirconia blocks (15 × 15 × 10 mm, Zpex, Tosoh Corporation) were polished with 1,000 grit sand paper and air-abraded with 50 µm Al₂ O₃ for 10 seconds (40 psi). They were divided into 5 groups: control (CO), Metal/Zirconia primer (MZ, Ivoclar Vivadent), Z-PRIME Plus (ZP, Bisco), Zirconia Liner (ZL, Sun Medical), and Scotchbond Universal adhesive (SU, 3M ESPE). Transbond XT Primer (used for CO, MZ, ZP, and ZL) and Transbond XT Paste was used for bracket bonding (Gemini clear ceramic brackets, 3M Unitek). After 24 hours at 37°C storage, specimens underwent 2,000 thermocycles, and then, shear bond strengths were measured (1 mm/min). An adhesive remnant index (ARI) score was calculated. The data were analyzed using one-way analysis of variance and the Bonferroni test (p = 0.05).

Results

Surface treatment with primers resulted in increased shear bond strength. The SU group showed the highest shear bond strength followed by the ZP, ZL, MZ, and CO groups, in that order. The median ARI scores were as follows: CO = 0, MZ = 0, ZP = 0, ZL = 0, and SU = 3 (p < 0.05).

Conclusions

Within this experiment, zirconia primer can increase the shear bond strength of bracket bonding. The highest shear bond strength is observed in SU group, even when no primer is used.

Keywords: Ceramic bracket, Multi-mode adhesive, Orthodontic bracket, Universal adhesive, Zirconia, Zirconia primer

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Figure 1.

Scanning electron micrographs (×100) of zirconia surface. (A, B) adhesive failure pattern; (C, D) mixed failure pattern; (E) cohesive failure pattern within the cement. The remnants of the cement were observed on the zirconia surface.

CO, control; MZ, Metal/Zirconia primer (Ivoclar Vivadent, Schaan, Liechtenstein); ZP, Z-PRIME Plus (Bisco, Schaumburg, IL, USA); ZL, Zirconia Liner (Sun Medical, Shiga, Japan); SU, Scotchbond Universal adhesive (3M ESPE, St. Paul, MN, USA).

Table 1.

Composition of primers and universal adhesive

Trade name (abbreviation)	Composition	Manufacturer
Metal/Zirconia Primer (MZ)	Tertiary butyl alcohol, methyl isobutyl ketone, phosphonic acid acrylate, benzoylperoxide	Ivoclar Vivadent, Schaan, Liechtenstein
Z-PRIME Plus (ZP)	Carboxylic acid monomer (BPDM), HEMA, ethanol, organophhosphate monomer (10-MDP)	Bisco, Schaumburg, IL, USA
Zirconia Liner (ZL)	MMA, 10-MDP, 4-methoxyphenol (HQME)	Sun Medical, Shiga, Japan
Scotchbond Universal adhesive (SU)	Organophosphate monomer (10-MDP), dimethacrylate resins (BisGMA, etc.), HEMA, Vitrebond copolymer, filler, ethanol, water, initiators, silane	3M ESPE, St. Paul, MN, USA

BPDM, biphenyl dimethacrylate; HEMA, hydroxyethyl methacrylate; BPDM, biphenyl dimethacrylate; 10-MDP, 10-methacryloyloxydecyl dihydrogen phosphate; MMA, methyl methacrylate; HQME, hydroquinone monomethyl ether.

Table 2.

Adhesive remnant index (ARI) scores

ARI score	Criteria
0	No adhesive left on the tooth.
1	Less than half of the adhesive left on the tooth.
2	More than half of the adhesive left on the tooth.
3	All adhesive left on the tooth, with distinct impression of the bracket mesh.

Table 3.

Shear bond strengths (SBSs) of ceramic brackets bonded to zirconia surface (MPa, n = 10)

Group	SBS	Minimum	Maximum
CO	1.07 ± 0.81 ^d	0.22	2.60
MZ	5.16 ± 0.83 ^c	4.08	6.51
ZP	10.47 ± 2.69 ^b	5.91	13.37
ZL	9.55 ± 1.75 ^b	7.09	12.32
SU	13.85 ± 1.48 ^a	11.20	16.47

Same superscript indicates that the bond strength was not significantly different between the materials. CO, control; MZ, Metal/Zirconia primer (Ivoclar Vivadent, Schaan, Liechtenstein); ZP, Z-PRIME Plus (Bisco, Schaumburg, IL, USA); ZL, Zirconia Liner (Sun Medical, Shiga, Japan); SU, Scotchbond Universal adhesive (3M ESPE, St. Paul, MN, USA).

Table 4.

Adhesive remnant index (ARI) scores calculated depending on the remnants of adhesive on the zirconia surface after debonding

Group	ARI score
Group	0	1	2	3	Median (Q1–Q3)	Mean ± SD
CO	9	1	–	–	0 (0–0)	0.10 ± 0.30
MZ	10	–	–	–	0 (0–0)	0.00 ± 0.00
ZP	6	4	–	–	0 (0–1)	0.40 ± 0.49
ZL	7	3	–	–	0 (0–1)	0.30 ± 0.46
SU	–	–	4	6	3 (2–3)^*	2.60 ± 0.49

Q1, first quartile; Q3, third quartile; SD, standard deviation; CO, control; MZ, Metal/Zirconia primer (Ivoclar Vivadent, Schaan, Liechtenstein); ZP, Z-PRIME Plus (Bisco, Schaumburg, IL, USA); ZL, Zirconia Liner (Sun Medical, Shiga, Japan); SU, Scotchbond Universal adhesive (3M ESPE, St. Paul, MN, USA).

* Statistically significant difference (Fisher's exact test; p < 0.05).

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