Search Results (19)

Objectives: The aim of the present systematic review and meta-analysis is to compare bracket adhesion failure rates between resin-modified glass ionomer cement (RMGIC) and conventional resin adhesives (CRA) during fixed orthodontic treatment (OT), based on evidence from randomized controlled trials (RCTs). Methods: The research question is “Is there a difference in bracket adhesion failure rates between RMGIC and CRA?” The study was performed in accordance with the PRISMA guidelines. A comprehensive literature search was performed across multiple databases without time or language restrictions through February 2026. Keywords were used in different combinations using Boolean operators. Hand searching was performed and disagreements were resolved via discussion. The risk of bias (RoB) and certainty of evidence (CoE) were assessed using the Cochrane risk of bias tool and Grading of Recommendations Assessment, Development and Evaluation approach, respectively. Quantitative data synthesis was conducted using a random-effects model to calculate pooled odds ratios and 95% confidence intervals. Results: Seven RCTs met the inclusion criteria. Bracket failure rates ranged from 5.95% to 15.0% for RMGIC and 3.4% to 25.0% for CRA. The pooled meta-analysis revealed no statistically significant difference in bracket failure between the two adhesive types (OR = 1.00; 95% CI: 0.60 to 1.67), although substantial statistical heterogeneity was observed (I² = 69.0%, p = 0.0065). One included trial demonstrated significantly improved retention for RMGIC when combined with a specific enamel deproteinization conditioning step prior to bonding. Three studies had a low RoB and the remaining were judged as having “some concerns”. The overall CoE was low. Conclusions: Based on the currently available randomized evidence, no statistically significant difference in bracket adhesion failure rates was observed between RMGIC and CRA during fixed OT. However, given the low CoE, substantial heterogeneity among studies, and relatively short follow-up periods, these findings should be interpreted with caution. Further well-designed randomized controlled trials with longer follow-up are needed to provide more definitive conclusions. Full article

Surface hardness is a fundamental parameter influencing wear resistance, durability, and the interaction of occlusal ramps with opposing enamel during orthodontic treatment. Five commercially available materials (Harmonize, Leone F3172-01, Transbond™ XT, Band and Build LC, and Ultra Band-Lok) and one experimental material (Composite RK-F10) were evaluated for bite ramps. Twelve standardized specimens (n = 2 per material) were prepared using EVA molds and polymerized according to manufacturers’ instructions or internal protocols. Vickers microhardness (HV) was measured following ASTM E384-16 using a 500 g load, 20 s dwell time, and ten indentations per specimen. Load dependence was assessed (25–2000 g). Surface morphology was analyzed by SEM, and cytotoxicity of eluates was evaluated on dental pulp stem cells (DPSCs) and monocyte/macrophage cell lines using CCK-8 assays (ISO 7405, ISO 10993). Significant differences in hardness were observed among materials (p < 0.05). Harmonize (64.5 ± 1.6 HV), Band and Build LC (64.4 ± 1.9 HV), and Ultra Band-Lok (64.1 ± 2.0 HV) showed the highest values, whereas Transbond™ XT exhibited the lowest value (53.7 ± 6.0 HV). Composite RK-F10 demonstrated intermediate hardness and good cytocompatibility. SEM analysis revealed differences in surface homogeneity and filler distribution. Overall, the materials exhibited distinct mechanical and biological profiles. The combined Vickers microhardness, short-term (24 h) cytotoxicity, and SEM data provide an integrated preliminary in vitro characterization of materials for bite ramps. The observed differences contribute to a comparative description of their physico-biological behavior. Full article

Background/Objectives: Bond reliability is essential in orthodontic treatment, as temperature fluctuations in the oral environment can weaken adhesive interfaces and increase the risk of bracket failure. However, direct comparison of the long-term durability of commonly used orthodontic resin cements under thermocycling conditions is limited. Therefore, the present study aimed to evaluate and compare the shear bond strength (SBS) and failure modes of Transbond™ XT and Orthomite™ LC before and after thermal cycling (Tc). Methods: A total of 60 bovine enamel specimens were used in this study. Specimens were bonded with either Transbond XT or Orthomite LC under standardized conditions. SBS was measured at 24 h (Tc0) and after 5000 thermal cycles (Tc5000). Failure modes were classified as adhesive (A), enamel cohesive (B), or bracket cohesive (C) failure. Statistical analyses included the Mann–Whitney U test for SBS and Fisher’s exact test for failure mode distribution. Results: At Tc0, there was no significant difference in SBS between the two cements (p > 0.05). After Tc5000, Orthomite LC showed significantly higher SBS than Transbond XT (p = 0.00368). Failure mode analysis revealed that, after Tc, Transbond XT exhibited a higher incidence of adhesive failures (A), whereas Orthomite LC predominantly demonstrated bracket cohesive failures (C) (p = 0.00020). Conclusions: Orthomite LC demonstrated greater resistance to thermal cycling–induced bond degradation compared with Transbond XT, likely due to differences in resin monomer composition and interface stability. Full article

Introduction: Digital planning and evolution of technology is allowing dentistry to be more efficient in time than before. In orthodontics the main purpose is to obtain fewer patient visits and to reduce the bonding time. For that, indirect bonding planned with CAD-CAM softwares is used to obtain a shorter treatment period, in general, and less chair-time. This waste of chair-time should also be reduced in other fields of dentistry such as endodontics, surgery, prosthodontics, and aesthetics. Methods: A total of 504 teeth were embedded into epoxy resin models mounted as a dental arch. Customized lingual multibracket appliances were bonded by a current adhesion protocol. After that, they were debonded, the polishing of cement remnants was performed with three different burs and two drills. The polishing time of each group was recorded by an iPhone 14 chronometer. Results: Descriptive and comparative statistical analyses were performed with the different study groups. Statistical differences (p < 0.005) between diamond bur and tungsten carbide and white stone burs and turbine were obtained, with the first being the slowest of them. Discussion: Enamel roughness was widely studied in orthodontics polishing protocol as the main variable for protocols establishment. However, in lingual orthodontics, due the difficulty of the access to the enamel surfaces, the protocol is not clear and efficiency should be considered. It was observed that the tungsten carbide bur is the safest bur. It was also recommended that a two-step protocol of polishing by tungsten carbide bur be followed by polishers. Conclusions: A tungsten carbide bur mounted in a turbine was the most efficient protocol for polishing after lingual bracket debonding. Full article

Background: The aim of the present study was to assess the accuracy, repeatability and reproducibility of a novel digital technique to analyze the remaining cement after debonding lingual multibracket appliances and after polishing the remaining cement. Methods: Thirteen teeth were embedded in an epoxy resin simulating a dental arch and subsequently a digital impression was taken using an intraoral scanner; obtaining a standard tessellation language (STL1) digital file. Lingual multibracket appliances were bonded and debonded on the lingual surfaces of all teeth and another digital impression was made (STL2). Finally, the polishing procedure of the remaining cement was performed and a digital impression was taken (STL3). The teeth were individually segmented from the digital files and an alignment was performed between STL1 and STL2 and between STL1 and STL3 digital files using specific cephalometric 2D/3D software to assess the remaining cement after debonding and after polishing lingual multibracket appliances. The reproducibility and repeatability capacity of the measurement digital method was assessed using a Gage R&R statistical analysis. Results: The results were assessed by a statistical program and showed a statistically significant (p < 0.001) decrease in weight, thickness, and height of the cement remaining after polishing, with a mean decrease of 2.09 mm in width (X plane), 0.12 mm in thickness (Y plane), and 1.87 mm in height (Z plane). Conclusions: The use of novel digital diagnosis software is a repeatable, reproducible, and accurate measurement technique to analyze the remaining cement after debonding lingual multibracket appliances and after polishing the remaining cement. Practical Implications: The diagnosis cephalometric software evaluation of the polishing technique with different materials, burs or polishing sequences brings the research closer to the clinical field. This methodology allows the orthodontist to clinically measure the cement remnants after polishing without the need for teeth extraction and with current clinic objects such as intraoral scanning and orthodontic cephalometric software. This might give orthodontics more clearance in terms of better burs or protocols for polishing. Full article

Increasing demand for adult orthodontic treatment using clear aligners has highlighted challenges in bonding clear aligner attachments to various restorations. Specifically, the bond strength of clear aligner attachments to glazed monolithic zirconia has not been extensively studied. This study aims to compare the shear bond strength (SBS) and mode of failure (MOF) of conventional bonding methods versus Superbond C&B (4-META/MMA-TBB resin cement) for clear aligner attachments on glazed monolithic zirconia. Fifty sintered and glazed zirconia samples were divided into five groups and attached with clear aligner attachments: Si (silane), B (bonding agent), SiB (bonding agent and silane), SU (Superbond C&B), and SiSU (silane and Superbond C&B). SBS and MOF of these samples were analyzed. Results indicated a significant difference in bond strength among the groups. SiSU exhibited the highest bond strength, followed by SU, while B had the lowest bond strength. SEM analysis revealed that SiSU and SU predominantly exhibited mixed failure, indicating high bond strength without affecting the glazed layers of the zirconia. In contrast, B exhibited only adhesive failure at the interface, resulting in insufficient bond strength for effective orthodontic treatment. In conclusion, using 4-META/MMA-TBB resin cement provides high bond strength for clear aligner attachments on glazed zirconia with minimal material damage during debonding. Full article

Polishing after the removal of brackets is the final step in orthodontic treatment. It is simple to perform, though some studies have reported that polishing causes damage to the enamel surface. An in vitro study was made of the influence of the buccal surface convexity of the tooth upon possible enamel loss when the remaining resin and adhesive are removed after bracket decementing using two different polishing modes: a tungsten carbide bur at low and high speeds. The convexity of the buccal surface was quantified in 30 incisors and 30 premolars. A stereoscopic microscope was used to obtain photographs of the profile of the crown, and Image J software was used to calculate convexity by dividing the length of a line from the cementoenamel junction to the incisal margin by another line from the mentioned junction to the maximum convexity of the buccal surface. Brackets were cemented on all the teeth and were decemented 24 h later. In both groups, the residual composite was removed with a tungsten carbide bur at a low speed in one-half of the teeth and at a high speed in the other half. The buccal surface of each tooth was then photographed again, and the convexity was calculated and compared against the baseline value. The difference between the two values were taken to represent the enamel loss. The convexity of the premolars was significantly greater than that of the incisors, but this did not result in greater enamel loss when the same polishing mode was used. However, the tungsten carbide bur at a high speed proved more aggressive, causing significantly greater enamel loss than when used at a low speed. Full article

Over the past several decades, orthodontic treatment has been increasingly sought out by adults, many of whom have undergone restorative dental procedures that cover enamel. Because the characteristics of restorative materials differ from those of enamel, typical bonding techniques do not yield excellent restoration–bracket bonding strengths. Plasma treatment is an emerging surface treatment that could potentially improve bonding properties. The purpose of this paper is to evaluate currently available studies assessing the effect of plasma treatment on the shear bond strength (SBS) and failure mode of resin cement/composite on the surface of ceramic materials. PubMed and Google Scholar databases were searched for relevant studies, which were categorized by restorative material and plasma treatment types that were evaluated. It was determined that cold atmospheric plasma (CAP) treatment using helium and H₂O gas was effective at raising the SBS of feldspathic porcelain to a bonding agent, while CAP treatment using helium gas might also be a potential treatment method for zirconia and other types of ceramics. More importantly, CAP treatment using helium has the potential for being carried out chairside due to its non-toxicity, low temperature, and short treatment time. However, because all the studies were conducted in vitro and not tested in an orthodontic setting, further research must be conducted to ascertain the effectiveness of specific plasma treatments in comparison to current orthodontic bonding treatments in vivo. Full article

The association of the V-prep and a resin-modified glass ionomer cement (RMGIC) has shown to be a suitable alternative for the orthodontic bracket bonding procedure in vitro. The aim of this study was to evaluate over eighteen months the clinical bonding failure and survival rates of the conventional bonding technique using the Transbond XT (3M Unitek, Monrovia, CA, USA) and the RMGIC Fuji Ortho LC (GC Corporation, Tokyo, Japan) prepared with the V-prep. Therefore, one operator using the straight-wire technique bonded two hundred metallic brackets to upper and lower premolars of twenty-five patients requiring an orthodontic treatment. The randomized trial was a single-blind design in a split-mouth comparison. Each patient was randomly allocated one of the two bonding systems for each premolar on each side of the mouth. The bonding and rebonding techniques were standardized throughout the trial and bond failure was recorded each month for a period of eighteen months. The survival rates of the brackets were estimated by Kaplan–Meier and log-rank test (p < 0.05). A total of 200 orthodontic brackets were included in the study with a significant lower failure rate of 9.0% for the V-prep and RMGIC compared to 25.0% for the conventional bonding technique (p < 0.05). A higher survival rate was observed for the V-prep and RMGIC (16.36 months) over the conventional bonding technique (13.95 months) (p < 0.05). Lower premolar bonding failure was higher than upper premolar for both bonding techniques. The V-prep followed by RMGIC, with enamel surface protection abilities, can be used as an alternative bonding technique in an orthodontic treatment. Full article

Demineralized white lesions are a common problem when using orthodontic resin cement, which can be prevented with the addition of antibacterial substances. However, the addition of antibacterial substances such as zinc oxide alone may result in the deterioration of the resin cement’s functions. Halloysite nanotubes (HNTs) are known to be biocompatible without adversely affecting the mechanical properties of the material while having the ability to load different substances. The purpose of this study was to prepare orthodontic resin cement containing HNT fillers loaded with ZnO (ZnO/HNTs) and to investigate its mechanical, physical, chemical, and antibacterial properties. A group without filler was used as a control. Three groups containing 5 wt.% of HNTs, ZnO, and ZnO/HNTs were prepared. TEM and EDS measurements were carried out to confirm the morphological structure of the HNTs and the successful loading of ZnO onto the HNTs. The mechanical, physical, chemical, and antibacterial properties of the prepared orthodontic resin cement were considered. The ZnO group had high flexural strength and water absorption but a low depth of cure (p < 0.05). The ZnO/HNTs group showed the highest shear bond strength and film thickness (p < 0.05). In the antibacterial test, the ZnO/HNTs group resulted in a significant decrease in the biofilm’s metabolic activity compared to the other groups (p < 0.05). ZnO/HNTs did not affect cell viability. In addition, ZnO was cytotoxic at a concentration of 100% in the extract. The nanocomposite developed in this study exhibited antimicrobial activity against S. mutans while maintaining the mechanical, physical, and chemical properties of orthodontic resin cement. Therefore, it has the potential to be used as an orthodontic resin cement that can prevent DWLs. Full article

Objective: The purpose of this study was to evaluate the cervical marginal fit of porcelain laminate veneer (PLV) restorations made from two different types of CAD/CAM ceramic laminates: CEREC C PC and E.max (LD). Materials and Methods: This in-vitro experiment used a total of 32 human maxillary first premolars that were clean and free of any cracks or caries, extracted for orthodontic purposes. The samples were divided in a random way into two study groups: A and B (n = 16). Each sample was mounted on a dental surveyor and a silicon impression was made to create a silicone index for each tooth in both groups. Standardized preparation was carried out for all the samples by using preparation bur kit for the ceramic veneer system. Subsequently, digital impressions were made for all the samples by using Trios 3 shape intraoral camera (Sirona Dental Systems). The design of veneer restorations was made using Sirona inLab CAD SW 16.1 with CEREC inLab MC XL (Dentsply, Sirona Dental Systems, Bensheim, Germany). The veneer restorations were cemented using 3M RelyX veneer resin cement (3M ESPE, Seefeld, Germany) and the samples kept in distilled water for two weeks at 37 °C. All the specimens were subjected to thermocycling in a water bath with temperature varying between 5 °C and 55 °C for 500 cycles. The cervical marginal fit of veneers was evaluated by a digital microscope after sectioning the embedded teeth in acrylic resin. Results: The lowest mean of cervical marginal gap was recorded for Group A (91.59431 ± 1.626069) which was restored with CEREC CAD/CAM veneers, while the highest mean value of the gap was recorded for Group B (106.48863 ± 2.506684) which was restored with IPS E.max CAD. The t-test showed that the type of porcelain veneer restoration had a highly significant effect on the cervical marginal fit (p ≤ 0.01). Conclusions: CEREC CAD/CAM veneers showed smaller cervical marginal gaps, indicating a better fit compared to the IPS E.max CAD. Full article

Hybrid bioactive composite resins combine the benefits of glass ionomer cements with composite resins. Its self-adhesiveness is achieved through functional polyacrylic acids and carboxylic groups, hybridizing the smear layer and establishing ionic interactions between calcium and dentin. These materials are defined as having good aesthetics, moisture tolerance, durability, simplicity in technique and handling and are able to maintain a low microfiltration rate while releasing calcium, phosphate and fluorine. The aim of the present study was to evaluate microleakage in restorations using Surefill One™ bioactive resin. The null hypothesis is that this type of resin does not obtain a lower microleakage rate when compared to other materials. An in vitro study was carried out using thirty-six premolars and molars extracted for orthodontic reasons. Identical preparations were thus performed in all of them (Class V with 4 mm mesio-distal, 3 mm occluso-gingival and 3 mm in depth) and divided into different experimental groups: one positive control, one negative control and two tests with bioactive composite resin and conventional composite resin (Surefill One™ and Spectra™ ST HV, respectively). Through quantitative techniques using nuclear medicine, it was possible to evaluate microleakage through the use of a radioactive isotope, technetium. Radioactivity emitted by the specimens was detected by a gamma camera. The different groups were compared using the Kruskal–Wallis test and the Games–Howell test for multiple comparisons. The results of the experimental study point to statistically significant differences between the test groups (p = 0.002) with increased microleakage in the bioactive composite resin group. Based on the present microleakage study, it was possible to conclude that the bioactive composite resin (Surefill One™) does not reduce the microleakage rate when compared to a conventional nanohybrid composite resin (Spectra™ ST HV). However, Surefill One™ can be used in temporary restorations, primary teeth and in cases of tissue remineralization, thus avoiding more invasive procedures. Full article

The present research is focused on three different classes of orthodontic cements: resin composites (e.g., BracePaste); resin-modified glass ionomer RMGIC (e.g., Fuji Ortho) and resin cement (e.g., Transbond). Their mechanical properties such as compressive strength, diametral tensile strength and flexural strength were correlated with the samples’ microstructures, liquid absorption, and solubility in liquid. The results show that the best compressive (100 MPa) and flexural strength (75 Mpa) was obtained by BracePaste and the best diametral tensile strength was obtained by Transbond (230 MPa). The lowestvalues were obtained by Fuji Ortho RMGIC. The elastic modulus is relatively high around 14 GPa for BracePaste, and Fuji Ortho and Transbond have only 7 GPa. The samples were also subjected to artificial saliva and tested in different acidic environments such as Coca-Cola and Red Bull. Their absorption and solubility were investigated at different times ranging from 1 day to 21 days. Fuji Ortho presents the highest liquid absorption followed by Transbond, the artificial saliva has the best absorption and Red Bull has the lowest absorption. The best resistance to the liquids was obtained by BracePaste in all environments. Coca-Cola presents values four times greater than the ones observed for artificial saliva. Solubility tests show that BracePaste is more soluble in artificial saliva, and Fuji Ortho and Transbond are more soluble in Red Bull and Coca-Cola. Scanning electron microscopy (SEM) images evidenced a compact structure for BracePaste in all environments sustaining the lower liquid absorption values. Fuji Ortho and Transbond present a fissure network allowing the liquid to carry out in-depth penetration of materials. SEM observations are in good agreement with the atomic force microscopy (AFM) results. The surface roughness decreases with the acidity increasing for BracePaste meanwhile it increases with the acidity for Fuji Ortho and Transbond. In conclusion: BracePaste is recommended for long-term orthodontic treatment for patients who regularly consume acidic beverages, Fuji Ortho is recommended for short-term orthodontic treatment for patients who regularly consume acidic beverages and Transbond is recommended for orthodontic treatment over an average time period for patients who do not regularly consume acidic beverages. Full article

Nanoparticles based on metal and metallic oxides have become a novel trend for dental applications. Metal nanoparticles are commonly used in dentistry for their exclusive shape-dependent properties, including their variable nano-sizes and forms, unique distribution, and large surface-area-to-volume ratio. These properties enhance the bio-physio-chemical functionalization, antimicrobial activity, and biocompatibility of the nanoparticles. Copper is an earth-abundant inexpensive metal, and its nanoparticle synthesis is cost effective. Copper nanoparticles readily intermix and bind with other metals, ceramics, and polymers, and they exhibit physiochemical stability in the compounds. Hence, copper nanoparticles are among the commonly used metal nanoparticles in dentistry. Copper nanoparticles have been used to enhance the physical and chemical properties of various dental materials, such as dental amalgam, restorative cements, adhesives, resins, endodontic-irrigation solutions, obturation materials, dental implants, and orthodontic archwires and brackets. The objective of this review is to provide an overview of copper nanoparticles and their applications in dentistry. Full article

(1) Background: The amino acid arginine is now receiving great attention due to its potential anti-caries benefits. The purpose of this in vitro study was to evaluate the shear bond strength (SBS), ultimate tensile strength (UTS), and antimicrobial potential (CFU) of two arginine-containing orthodontic resin cements. (2) Methods: Forty bovine incisors were separated into four groups (n = 10): Orthocem, Orthocem + arginine (2.5 wt%), Transbond XT, and Transbond XT + arginine (2.5 wt%). The brackets were fixed to the flat surface of the enamel, and after 24 h the SBS was evaluated using the universal testing machine (Instron). For the UTS test, hourglass samples (n = 10) were made and tested in a mini-testing machine (OM-100, Odeme). For the antibacterial test (colony forming unit-CFU), six cement discs from each group were made and exposed to Streptococcus mutans UA159 biofilm for 7 days. The microbiological experiment was performed by serial and triplicate dilutions. The data from each test were statistically analyzed using a two-way ANOVA, followed by Tukey’s test (α = 0.05). (3) Results: The enamel SBS mean values of Transbond XT were statistically higher than those of Orthocem, both with and without arginine (p = 0.02033). There was no significant difference in the SBS mean values between the orthodontic resin cements, either with or without arginine (p = 0.29869). The UTS of the Transbond XT was statistically higher than the Orthocem, but the addition of arginine at 2.5 wt% did not influence the UTS for either resin cement. The Orthocem + arginine orthodontic resin cement was able to significantly reduce S. mutans growth, but no difference was observed for the Transbond XT (p = 0.03439). (4) Conclusion: The incorporation of arginine to commercial orthodontic resin cements may be an efficient preventive strategy to reduce bacterial growth without compromising their adhesive and mechanical properties. Full article