Orthodontic bonding to several ceramic surfaces: are there acceptable alternatives to conventional methods?

The objectives of this study were to determine the effects of various surface conditioning methods on 3 types of ceramic materials (feldsphatic, leucite-based, and lithia disilicate-based) in orthodontic bonding.

A total of 210 ceramic disk samples were fabricated and divided into 3 groups. In each group, 5 subgroups were prepared by sandblasting; sandblasting and hydrofluoric (HF) acid; sandblasting and silane; sandblasting, HF acid, and silane; and tribochemical silica coating and silane. Mandibular incisor brackets were bonded with light-cured adhesive. The samples were stored in water for 24 hours at 37 degrees C and then thermocycled. Shear bond tests were performed, and the failure types were classified with adhesive remnant index scores.

In all 3 ceramic groups, the lowest shear bond strength values were found in the sandblasted-only samples. For the feldspathic and lithia disilicate-based ceramic, the highest bond strength values were obtained with silica coating (15.2 and 13.2 MPa, respectively). For the leucite-based ceramic, HF without silane produced the highest bond strength value (14.7 MPa), but comparable values were obtained with silicatization also (13.4 MPa).

The silica-coating technique could replace the other conditioning techniques in bonding brackets to ceramic. However, debonding must be done carefully because of the risk of porcelain fracture.