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Related Concept Videos

Teeth01:15

Teeth

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The formation of teeth, also known as odontogenesis, is a complex process that begins in utero, around the sixth week of embryonic development. There are three stages to this process: the bud stage, the cap stage, and the bell stage.
In the bud stage, the tooth germ (an aggregation of cells) starts to form in the developing jawbone. During the cap stage, the tooth germ differentiates into enamel organ, dental papilla, and dental sac, which will later develop into the tooth's enamel, dentin...
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Oral Biofilm Formation on Different Materials for Dental Implants
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Enamel etching for bonding fixed orthodontic braces.

Haikun Hu1, Chunjie Li, Fan Li

  • 1Department of Orthodontics, State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University, No. 14, Section Three, Ren Min Nan Road, Chengdu, Sichuan, China, 610041.

The Cochrane Database of Systematic Reviews
|November 26, 2013
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Summary

This review found low-quality evidence that is insufficient to determine if self-etching primers (SEPs) or conventional etchants are better for bonding orthodontic appliances. More high-quality studies are needed to compare etching techniques and materials for improved clinical outcomes.

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Area of Science:

  • Orthodontics
  • Dental Materials Science
  • Biomaterials

Background:

  • Acid etching is a standard orthodontic procedure for bonding brackets to enamel, with various etchants and techniques developed since the 1960s.
  • Despite extensive research, a definitive consensus on the clinical efficacy of different dental etchants and etching techniques remains elusive.
  • This systematic review addresses the need for clarity on the comparative effectiveness of various orthodontic bonding preparation methods.

Purpose of the Study:

  • To systematically compare the clinical effects of different dental etchants and etching techniques used for bonding fixed orthodontic appliances.
  • To evaluate the available evidence on bond failure rates, decalcification, participant satisfaction, and cost-effectiveness associated with various etching protocols.
  • To identify gaps in the research and guide future high-quality randomized controlled trials in orthodontic bonding.

Main Methods:

  • A comprehensive search of multiple electronic databases (Cochrane, MEDLINE, EMBASE, etc.) up to March 2013 was conducted.
  • Randomized controlled trials (RCTs) comparing different etching materials or techniques for bonding orthodontic brackets were included.
  • Data extraction and risk of bias assessment were performed independently by two reviewers, with disagreements resolved by discussion.

Main Results:

  • Thirteen RCTs involving 417 participants and 7184 teeth/brackets were included, with most studies assessed as having a high risk of bias.
  • Low-quality evidence from five studies was insufficient to determine a difference in bond failure rates between self-etching primers (SEPs) and conventional etchants (RR 1.14, 95% CI 0.75 to 1.73).
  • Data were insufficient to assess outcomes like decalcification, participant satisfaction, cost-effectiveness, or compare different SEPs or etching parameters.

Conclusions:

  • Current low-quality evidence does not support conclusions on the superiority of SEPs versus conventional etching systems for orthodontic bonding.
  • Significant data gaps exist regarding decalcification, patient-reported outcomes, cost-effectiveness, and comparisons of specific etching materials, concentrations, or times.
  • Further well-designed RCTs are crucial to provide robust evidence for clinical decision-making in orthodontic bracket bonding.