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      Effect of different intracoronal bleaching methods on shear bond strength of ceramic brackets bonded to bleached enamel: An in-vitro study

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          Abstract

          OBJECTIVE:

          To investigate the effect of different intracoronal bleaching methods on the shear bond strength and site of failure of ceramic brackets.

          MATERIALS AND METHODS:

          Sixty freshly extracted human maxillary incisors were randomly divided into four groups ( n = 15). Endodontic access cavity was prepared and root canals were filled, root fillings were removed 2mm apical to the cementoenamel junction, and a 2-mmthick layer of glass ionomer cement base was applied. Group 1 served as the control. Intracoronal bleaching was performed with 35% carbamide peroxide in group 2, sodium perborate in group 3, and 37.5% hydrogen peroxide in group 4. The teeth were immersed in artificial saliva for 4 weeks before bracket bonding. Ceramic brackets were bonded with composite resin and cured with LED light. After bonding, the shear bond strength of the brackets was tested with a universal testing machine. The site of bond failure was determined by modified ARI (Adhesive Remnant Index).

          RESULTS:

          The highest value of shear bond strength was measured in control group (18.67 ± 1.59 MPa), which was statistically significant from groups 2,3, and 4. There was no significant difference between groups 2 and 4. The lowest shear bond strength was measured in group 3. ARI scores were not significant from each other.

          CONCLUSIONS:

          Intracoronal bleaching significantly affected the shear bond strength of ceramic brackets even after 4 weeks of bleaching. Bleaching with sodium perborate affects shear bond strength more adversely than does bleaching with other agents like hydrogen peroxide and carbamide peroxide.

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          Most cited references22

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          The effect of a vital bleaching technique on enamel surface morphology and the bonding of composite resin to enamel.

          This study examined the effect of a nightguard vital bleaching procedure on enamel surface morphology and the shear bond strength of a composite resin luting cement to enamel. Extracted human teeth were bleached for 1 week using a vital bleaching product. Control teeth were brushed with a fluoride toothpaste and processed similarly to the bleached teeth, however the bleaching product was substituted with artificial saliva in the night guards. Teeth were stored in artificial saliva for 24 h, 1, 6 or 12 weeks and then examined for any surface changes using light and scanning electron microscopy. The effect of etching surfaces with 37% phosphoric acid was examined at the scanning electron microscope level. The shear bond strength of composite resin luting cement to both buccal and lingual surfaces of bleached and control teeth was determined. Light microscopy investigation suggested the bleaching process resulted in a loss of mineral from enamel which was evident 24 h after bleaching and was sustained following 12 weeks storage in artificial saliva. Scanning electron microscopy showed a definite change in the surface texture of the bleached enamel surface. Acid etching of the bleached enamel surface produced loss of prismatic form and the enamel appeared overetched. The mean shear bond strength between composite resin luting cement and etched enamel tended to be lower for bleached enamel surfaces, however no significant difference in shear bond strength was noted between control and experimental groups. The results of this study suggest that bleaching resulted in changes to the surface and subsurface layers of enamel. Although surface changes were observed in the etched enamel, the shear bond strength of composite resin luting cement to etched bleached enamel appeared to be clinically acceptable.
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            Effects of three concentrations of carbamide peroxide on the structure of enamel.

            Carbamide peroxide bleaching agents have raised important questions on their potential adverse effects on the structure of enamel. The purpose of this study was to examine the effects of three carbamide peroxide bleaching agents in different concentrations (10, 16 and 35%) on the structure of enamel. Forty enamel slabs prepared from human third molars were divided equally among four groups. The specimens in the first and second group were subjected to 10% or 16% carbamide peroxide for 8 h per day for 6 weeks. Thirty-five percent carbamide peroxide was applied to the third group for 30 min a day for a 4 day period according to the manufacturers recommendation. The fourth group served as the control and was kept in artificial saliva during the test period. At the completion of the treatment, all the specimens were examined by infrared absorbtion spectroscopy and X-ray diffraction analysis. The results revealed that 10% or 16% carbamide peroxide did not seem to effect the structure of enamel, whereas 35% carbamide did affect the structure. The use of lower concentrations of carbamide peroxide (10-16%) is recommended over higher concentrations (35%) to avoid changes to the enamel.
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              Can previously bleached teeth be bonded safely?

              The purpose of our study was to determine the effect of a 35% hydrogen peroxide bleaching agent on the shear bond strength of metallic orthodontic brackets. Sixty premolars were randomly divided into 3 groups of 20 each. Teeth in group A were etched with 37% phosphoric acid before bonding metallic premolar brackets. Teeth in the other 2 groups were bleached with a 35% hydrogen peroxide in-office bleaching agent according to the manufacturer's recommendations. Twenty bleached teeth (group B) were bonded immediately, and the other 20 (group C) were stored in artificial saliva for 30 days before bonding. Shear bond strength of these brackets was measured on a universal testing machine and recorded in MPa. Adhesive remnant index (ARI) scores were determined after the brackets failed. Data were analyzed with analysis of variance (ANOVA) and chi-square tests. The shear bond strength values of groups A, B, and C were 12.9 +/- 3.4, 12.0 +/- 4.6, and 14.8 +/- 4.0 MPa, respectively. Results of ANOVA showed no statistically significant differences in shear bond strengths between groups (P >.05). ARI scores were significantly different in all groups. The unbleached group's failures were primarily at the bracket/adhesive interface, whereas the bleached groups either showed cohesive failures within the adhesive or failed at the adhesive/enamel interface. The results of this study suggest that office bleaching with hydrogen peroxide does not adversely affect the bond strengths of brackets bonded immediately after bleaching or 30 days after bleaching, even though bleaching can result in differences in the failure site.
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                Author and article information

                Journal
                J Orthod Sci
                J Orthod Sci
                JOS
                Journal of Orthodontic Science
                Medknow Publications & Media Pvt Ltd (India )
                2278-1897
                2278-0203
                Jul-Sep 2017
                : 6
                : 3
                : 86-90
                Affiliations
                [1] Department of Orthodontics and Dentofacial Orthopaedics, I.T.S Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
                Author notes
                Address for correspondence: Dr. Vikas Chauhan, A-139, Sector - 26 Noida, Gautam Budh Nagar, Uttar Pradesh - 201 301, India. E-mail: vikas205077@ 123456gmail.com
                Article
                JOS-6-86
                10.4103/jos.JOS_149_16
                5508408
                181a5416-8fe2-4f39-b8e9-ef445f623a19
                Copyright: © 2017 Journal of Orthodontic Science

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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                Categories
                Original Article

                ceramic brackets,enamel bonding,intracoronal bleaching,shear bond strength

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