Phosphoric acid incorporated with acidulated phosphate fluoride gel etchant effects on bracket bonding

The aim of this study was to evaluate the effects of etching with phosphoric acid incorporated in an acidulated phosphate fluoride (APF) gel on the bonding of a bracket and the loss of sound enamel. In the control group, the enamel was etched with 37% phosphoric acid for 30 seconds. In the experimental groups, the enamel was etched for 30 seconds with 37% phosphoric acid blended with 1.23% APF gel at various ratios (25%, 33%, 50%, 67%, and 75% APF gel). The brackets were bonded with Transbond XT light-cured orthodontic adhesive according to the manufacturer's instructions. The specimens were then treated under three different conditions: 37 degrees C for one hour, 37 degrees C for 24 hours, and thermocycling (2500 times) between 5 degrees C and 55 degrees C in deionized water. The shear bond strength of 10 specimens in each condition was measured and the results analyzed using a Tukey multiple comparison test (P = .05). The shear bond strength decreased significantly as the fraction of the APF gel increased in the experimental etchant. An apparent increase in the adhesive remnant index score was also observed in the large fraction of the APF gel. To minimize the damage of the sound enamel surface during the etching and debonding procedures, a mixture of phosphoric acid and an APF gel (50% and 67% APF fraction) can be used as an phosphoric acid etchant substitute without loss of the proper bracket bond strength.