Shear bond strength evaluation of metallic brackets bonded to a CAD/CAM PMMA material compared to traditional prosthetic temporary materials: an in vitro study

Orthodontic treatment for adults is currently increasing, and therefore the need to bond brackets to restorations and temporary crowns. The use of CAD/CAM PMMA provisional restorations for orthodontic purposes have not yet been described, and there is currently insufficient information regarding the strength of bracket adhesion.

This study aimed at evaluating the effects of thermocycling (TC) and surface treatment on shear bond strength (SBS) of brackets to different provisional materials.

Forty specimens were made from each material [PMMA (Telio Lab), bis-acryl (Telio CS C&B), and PMMA CAD/CAM (Telio CAD)], sandpapered, and divided according to surface treatment (pumiced or sandblasted) and TC (half of the samples = 1,000 cycles, 5°C/55°C water baths) (n = 10/group). Stainless-steel brackets were bonded to the specimens (using Transbond XT), and SBS testing was performed. Data were analyzed by three-way ANOVA and LSD post-hoc tests (α = 0.05). Failure types were classified with adhesive remnant index (ARI) scores.

SBS values ranged from 1.5 to 14.9 MPa. Sandblasted bis-acryl and sandblasted auto-curing PMMA groups presented similar values (p> 0.05), higher than the CAD/CAM material (p< 0.05), with or without TC. When thermocycled, pumiced bis-acryl showed higher SBS than pumiced acrylic (p= 0.005) and CAD/CAM materials (p= 0.000), with statistical difference (p= 0.009). TC showed negative effect (p< 0.05) for sandblasted bis-acryl and pumiced acrylic groups. ARI predominant score was mostly zero (0) for CAD/CAM, 1 and 2 for bis-acryl, and 1 for acrylic groups.

In general, bis-acryl material showed the highest SBS values, followed by acrylic and CAD/CAM materials, which showed SBS values lower than an optimum strength for bonding brackets.