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Updated: May 19, 2026

Quasistatic Mechanical Testing for Computer-Aided Design and Manufacturing Occlusal Veneers Cemented to Milled Dentin Analog Material

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Twelve-month bracket failure rate with amorphous calcium phosphate bonding system.

Shaza M Hammad¹, Mai S El Banna, Shaymaa E Elsaka

¹Department of Orthodontics, Faculty of Dentistry, Mansoura University.

European Journal of Orthodontics

|September 4, 2012

Summary

Amorphous calcium phosphate (ACP) bonding systems show comparable survival rates to conventional adhesives for orthodontic brackets. ACP adhesive is a viable alternative, though bond failure rates were slightly higher in males and on canine/premolar teeth.

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Area of Science:

Orthodontics
Dental Materials Science
Biomaterials

Background:

Orthodontic bracket survival is crucial for treatment efficiency.
Conventional adhesives have limitations, necessitating exploration of alternatives.
Amorphous calcium phosphate (ACP) presents potential benefits in dental adhesion.

Purpose of the Study:

To compare the 12-month survival rate of orthodontic brackets bonded with an amorphous calcium phosphate (ACP) system versus a conventional adhesive (CA).
To evaluate factors influencing bracket survival, including bonding procedure, dental arch, tooth type, and patient gender.
To assess bond failure characteristics using the Adhesive Remnant Index (ARI).

Main Methods:

A split-mouth design was employed with 138 brackets bonded in 30 patients (mean age 15y 7m).
Kaplan-Meier analysis estimated bracket survival rates.
Log-rank tests compared survival distributions across different variables, and ARI assessed bond failure interface.

Main Results:

No significant difference in bond failure rates between ACP and CA systems (2.67% vs 3.8%, P > 0.05).
Survival rates did not differ significantly between upper and lower arches (P > 0.05).
Lower survival rates were observed for canine and premolar teeth compared to incisors (P < 0.05), and higher failure rates in males (P < 0.05).
Significant differences in ARI scores indicated more ACP adhesive remaining on teeth post-debonding (P = 0.028).

Conclusions:

ACP-containing adhesives are effective for bonding orthodontic brackets, offering a practical alternative to conventional adhesives.
While ACP systems demonstrate comparable survival rates, specific tooth types and patient gender may influence bond durability.
Further research into optimizing ACP adhesive formulations could enhance bond retention and clinical outcomes.