Clinical Significance of Bis-GMA and HEMA Orthodontic Resins Bonding to Enamel and Ceramic Materials

The advancement of new ceramic materials for dental crowns has prompted the need for improved methods of bonding orthodontic brackets to these surfaces. Currently, lithium-disilicate is the primary material being used for anterior crowns, while zirconia is the primary material being used in the posterior. The purpose of this study was to compare the shear bond strength of HEMA (Assure® Universal Bonding Resin) and bis-GMA (Assure® PLUS All Surface Bonding Resin) orthodontic bonding resins on enamel, lithium-disilicate, and zirconia materials. Two groups were formed, with three tested surfaces per group (n = 20). The categories included premolars, zirconia rods, and lithium-disilicate rods. Group 1 was treated with Assure, and group 2 was treated with Assure PLUS. Zirconia rods (1 cm x 1 cm x 4 cm) were used to represent zirconia crowns, and IPS e.max CAD rods (1 cm x 1 cm x 2 cm) were used to represent lithium-disilicate crowns. Assure and Assure PLUS bonding agents were applied according to the manufacturer's specifications, and standard edgewise universal premolar brackets were secured using Light Bond™ paste without fluoride. After 24 hours the brackets were sheared with a universal testing machine (Instron® 5566A) and the results were recorded. Data were analyzed using a combination of ANOVA and Tukey tests. A P value of less than .05 was considered statistically significant. Although group 1 and group 2 gave statistically equivalent results, the authors found that the ease of use when applying the group 2 bonding agent made it a safer, superior product within the confines of this study. It did not require a 4-minute hydrofluoric acid-etch and needed half the curing time of the group 1 agent when bonding to ceramic materials.