Metallic bracket to enamel bonding with a photopolymerizable resin-reinforced glass ionomer

Enamel acid etching plays an important role in treatment on direct bracket bonding. Several studies have been carried out concerning the damage this procedure causes to the enamel. A valuable alternative seems to be the use of photopolymerizable resin-reinforced glass ionomer without acid etching of enamel. This study compares the strength of bracket debonding, the amount of remnant adhesive on the tooth, and the enamel condition in 3 adhesive systems. Three groups were set; in the first group, a glass ionomer with a photopolymerizable resin reinforce and enamel etching with orthophosphoric acid at 37% was used; in the second group, the same ionomer was used but without acid etching; and in the third group, a photopolymerizable resin was used after etching enamel with orthophosphoric acid at 37%. Debonding strength was determined in MPa; a stereoscopic microscope was used to determine the amount of remnant adhesive on the tooth in accordance to ARI and a scanning electron microscope study was made to observe the enamel conditions, existing in debonding among groups (P <.0001), with etching and without etching. The remnant adhesive on the tooth did not show a significant difference (P = 1.000); greater irregularities were found in the enamel in the etching groups. It was demonstrated that the etching was a critical factor in obtaining adequate adhesion strength and that it alters the enamel conditions. Teeth with ionomer and etching had a greater material remnant.