Are flowable resin-based composites a reliable material for metal orthodontic bracket bonding?

To compare the tensile bond strength (TBS) and adhesive remnant index (ARI) of three flowable resin-based composites and three orthodontic adhesive systems for metal bracket bonding.

Sixty bovine incisors were randomly divided into six groups. Enamel surfaces were etched with 37 percent phosphoric acid for 30 seconds and stainless steel orthodontic brackets were bonded using either flowable resin-based composites (3M Flow, FL; Tetric Flow, TF; and Wave, WA) or orthodontic bonding systems (Transbond XT, TX; Concise Orthodontic, CO; Fill Magic Ortodôntico, FM). All specimens were thermal cycled and stored in distilled water at 37°C for 24 hours, after which they were subsequently tested for TBS using a universal testing machine. ARI scores were determined after the failure of brackets. TBS and ARI data were submitted to ANOVA, Tukey, and Kruskal-Wallis tests (p=0.05), respectively.

Rankings of the resin-based composites based on TBS means (MPa) were TX (6.4 ± 2.1), followed by CO (4.5 ± 2.7), FM (3.7 ± 1.2), FL (3.6 ± 1.2), TF (3.3 ± 1.2), and WA (2.4 ± 0.6). CO exhibited the lowest ARI mean score (0.9 ± 1.2) which was significantly different from the other five materials: TX (2.8 ± 0.42), FM (2.8 ± 0.42), FL (2.9 ± 0.32), TF (2.9 ± 0.32), and WA (3.0 ± 0.01). However, there were no statistically significant differences among the other groups with mean scores of 2.8-3.0. A score of 3.0 indicated that all the resin remained bonded to the tooth surface.

The flowable resin-based composites tested (Fl, TF, and WA) used to bond metal orthodontic brackets to bovine enamel had low mean TBS values but acceptable ARI mean scores.

Flowable composites may not be appropriate for bracket bonding, unless the teeth to be bonded are not subjected to higher orthodontic stresses, such as those without an antagonist.