Ceramic bracket bonding: a comparison of bond strength with polyacrylic acid and phosphoric acid enamel conditioning

The purpose of this study was to compare in vitro shear bond strength with three different enamel surface preparations: (1) 37% phosphoric acid etch, (2) sulfated polyacrylic acid etch with removal of crystals by vigorous rinsing and (3) polyacrylic acid etch with crystal growth. Forty extracted human premolar teeth were divided into four groups of ten. Ceramic brackets were bonded to teeth in each of three groups. The fourth group used was bonded with metal brackets and a phosphoric acid enamel preparation. The same lightly filled resin cement was used for all groups. A shearing force was applied to the teeth. The results demonstrated that the shear force needed to debond with ceramic brackets was 21% greater than the shear force with metal brackets. The polyacrylic acid crystal growth group had shear bond strength values approximately one half as great as the phosphoric acid etch group when ceramic brackets were used. Bond failures in the phosphoric acid etch group were at the bracket/resin interface with the bulk of the resin remaining on the tooth compared with the polyacrylic acid crystal growth group in which the bond failure was at the enamel resin interface. Enamel fractures were not found when healthy nonrestored teeth were subjected to the shearing force. In a preliminary test using phosphoric acid etch and teeth with compromised enamel (large restorations involving three or more surfaces), half of the teeth fractured during debonding. The study demonstrated that a polyacrylic acid conditioning of the enamel surface produces different retentive surfaces, depending on the presence or absence of crystal growth.(ABSTRACT TRUNCATED AT 250 WORDS)