A COMPARISON OF BOND STRENGTHS BETWEEN LIGHT CURED COMPOSITE RESINS AND CHEMICALLY CURED COMPOSITE RESINS IN THE BONDING OF ORTHODONTIC ATTACHMENTS R. SIMS TOMPKINS, D.M.D. MEDICAL UNIVERSITY OF SOUTH CAROLINA SCHOOL OF DENTAL MEDICINE CHARLESTON, SOUTH CAROLINA 1986 A Thesis Submitted to the Faculty of the Department of Orofaciai Growth and Development in Partial Pulfillment of the Requirements for a Masters of Science Degree in Oral Biology ‘TEMPLE UNIVERSITY SCHOOL OF DENTISTRY PHILADELPHIA, PENNSYLVANIA MARCH 1989 Larry D. Love, D.D.S. Kourosh Zarrinnia, D.M.D.,M.S. ch AdvisorsMATERIALS AND METHODS PREPARATION Ninety noncarious premolars were extracted and stored in tap water. These teeth were then divided into six equal groups, with fifteen teeth in each group. (One group for each of the sample materials to be tested.) Each tooth was washed and then polished with a rubber cup using pumice mixed with distilled water. after rinsing and drying the tooth, an etching solution of 37% phosphoric acid was applied to the enamel surface of each tooth using disposable minisponge applicators with a dabbing action. The solution was allowed to remain in contact with the enamel for a period of sixty seconds, then thoroughly rinsed with water and the surface air dried. A standard Ormco Ormesh .018 x .025 siamese bracket with zero torque and zero angulation was then bonded utilizing the corresponding bonding agent according to the manufacturer's directions. (Table I) BONDING The six groups of orthodontic resins that were tested consisted of two chemically-cured resins and four Light-ABSTRACT The purpose of this investigation was to determine the bond strength values of several light-activate orthodontic bonding adhesives and show their effectiveness for use by comparison with accepted chemically-activated materials. Ninety extracted bicuspids were prepared for bonding and divided ramdomly into six equal groups (fifteen in each group) consisting of four light-cured resins and two chemically-cured resins. ‘The light-cured resins consisted of two macrofilled materials and two microfilled materials while the chemically-cured resins consisted of one macrofilled material and one microfilled material. after orthodontic brackets were bonded to the teeth with the corresponding materials, they were placed in acrylic bases for stabilization. The bracket-tooth-base apparatus was then placed ina Materials Testing Machine to determine the bond strength values of each sample. The results indicate that the light-activated orthodontic bonding adhesives compare favorably with the traditional chemically-activated materials. These materials have a command set which allows the operator ample time to accurately place orthodontic attachments; thereby progressing orthodontic bonding by one more step.cured resins. Because of their different methods of curing, these two classes of materials had slightly different bonding instructions, and will be discussed separately. CHEMICALLY-CURED RESINS As stated, the self-cured adhesives comprised two of the six groups of resins that were tested, and the directions for preparation were identical for each sample. First, a bonding agent was mixed and applied to the etched tooth surface. Next, the adhesive pastes were thoroughly mixed and placed on the solid-backed, mesh surface of the metal orthodontic bracket. The bracket was then seated on the etched tooth surface, and the excess was removed with a scaler from the periphery of the base. The bracket was allowed to set undisturbed for ten minutes before being placed in the acrylic base. LIGHT-CURED RESINS The light-cured resins comprised the remaining four of the six sample groups that were tested, and the directions for preparation varied. Group 3 (Transbond), Group 4 (Light Bond), and Group 5 (Heliosit orthodontic) were applied in an identical manner, with the exception of Group 5 which did not utilize a bonding agent. A light- cured bonding agent (single liquid) was applied to theetched tooth surface while the light-cured paste (single paste) was placed on the mesh surface of the bracket. The bracket was then seated on the tooth, and the excess removed with a scaler. The resin was cured with the Ortholux Visible Light Polymerization Unit (Unitek Corporation) in the following manner. The light was placed at a forty-five degree angle to the tooth surface and the bracket base at the gingival aspect of the tooth crown, and the resin was cured for ten seconds. The light source was then moved to the mesial, occlusal, and distal aspects of the bracket-tooth interface, and each area was cured for ten seconds, for a total cure time of forty seconds. Group 6 (Orthobond) was prepared in a slightly different manner. A bonding agent was wiped on the bracket base and the etched tooth surface. Next, the Orthobond powder and the light-cured resin were mixed to a consistency of cold honey. The mixed material was then applied to the bracket base and seated on the tooth surface. The excess was removed with a scaler, and the material was cured in a similar manner to the other groups, except the cure time was fifteen seconds for each side of the bracket base for a total of sixty seconds. STABILIZATION After the resin had been cured, each tooth had itsxoot removed and the crown was placed into an acrylic base embedding the lingual cusp and allowing the facial surface of the buccal cusp with its attached bracket to be exposed. (Removal of the root was necessary so that it would not interfere with the chisel attached to the Material Testing Systems machine.) Preparation of the acrylic base in which the tooth was embedded was found to be a critical factor. It was important to secure the tooth in such a way that the buccal surface was parallel to the front surface of the acrylic block to ensure a force parallel to the enamel-bracket interface. In order to obtain this relationship, as modified dental surveyor was used to hold the bracketed tooth. A -018 x .025 stainless steel wire was attached perpendicular to the dental surveyor's arm, with the flat part of the rectangular wire vertical to the floor. This size wire was used since it is the same size as the slot on the orthodontic brackets; thus, there is a tight fit between the two assuring an accurate and precise placement. The wire was engaged into the bracket on the tooth and ligated with a2 .012 stainless steel ligature. The bracketed tooth was then ready to be lowered into the acrylic base.(Figure 1) The acrylic base was made using a plastic cylinder (30mm x 30mm) as a form. The plastic cylinder was cut into one inch lengths for the ninety samples. The formwas then held perpendicular to the floor by a stabilizing device. A mixture of orthodontic acrylic was then mixed and poured into the form, The tooth was then lowered into the top of the cylinder and the acrylic was allowed to flow just to the edges of the buccal cusp for retention purposes. (Figures 283) After a sufficient setting time, the base with the embedded tooth was stored in water until it was time to be tested. The bond strengths of the adhesives were tested twenty-four hours after bonding using the Materials Testing Systems machine.(Figure 4) The machine was calibrated and a chisel was attached perpendicular to the crosshead of the MIS machine.(Figure 5) The acrylic base with the attached bracket was placed into the holding device. The attached vertical chisel was positioned at the base of the bracket and lowered at a rate of one millimeter per minute.(Figure 6) A record of the force required to break the bonded bracket from the premolar was traced by a ink penon astrip chart. For each tooth tested, the force value was recorded, tabulated, and analyzed statistically for mean and standard deviation values. A two-way analysis of variance test was applied to the groups to determine whether any statistical significance existed among the recorded values.TABLE I GROUP BONDING MATERIAL z CONCISE (UNITEK) 2 DYNA-BOND IT (UNTTER) 3 TRANSBOND (UNTTER) 4 LIGHT-BOND (RELIANCE) cs HELIOSIT-ORTHO (VIVADENT) 6 ORTHO-BOND (DENMAT) ACTIVATION CHEMICALLY CURED CHEMICALLY LIGHT LIGHT CURED LIGHT LIGHTTABLE IT RESULTS (CHEMICALLY-CURED RESINS) GROUP 1 {CONCISE GROUP 2 (DYNABOND. SAMPLE VALUE (ibs) SAMPLE VALUE (lbs) 1 18.25 1 19.00 2 19.00 2 19.00 3 19.25 3 19.50 4 23.00 4 22.25 5 23.00 5 25.00 6 26.00 6 27.25 7 27.75 7 27.50 8 29.00 8 30.25 9 30.00 9 35.00 10 30.50 10 35.50 ii 32.00 1 36.00 12 39.25 12 37.50 13 40.50 13 40.25 14 40.75 14 40.75 15 45.50 15 45.50 MEAN 29.58 MEAN 30.68 S.D. 8.36 8.D. 8.38 RANGE 27.25 RANGE 26.50 Max. 45.50 Max. 45.50 Min. 18.25 Min. 19.00TABLE IIT RESULTS (LIGHT-CURED RESINS) GROUP 3 (‘TRANSBOND) GROUP 4 (LIGHT-BOND SAMPLE VALUE (lbs) SAMPLE VALUE (lbs) Z 15.75 1 30.25 2 16.00 2 31.50 3 16.25 3 34.00 4 16.50 4 35.25 5 20.25 5 36.50 6 22.50 6 38.00 7 23.25 me 39.25 8 29.00 8 41.25 9 29.75 9 42.00 10 37.00 10 42.50 la 38.00 i 45.00 12 39.25 12 45.75 13 39.75 13 46.00 14 44.00 14 47.50 15 45.50 15 47.75 MEAN 28.85 MEAN 40.17 S.D. 10.58 S.D. 5.56 RANGE 29.75 RANGE 17.50 Max. 45.50 Max. 47.75 Min. 15.75 Min. 30.25TABLE IV RESULTS (LIGHT-CURED RESINS) GROUP 5 (HELIOSIT-ORTHO) GROUP § {ORTHOBOND) SAMPLE VALUE (ibs) SAMPLE VALUE (ibs) ad 32.25 1 23.50 z 32.75 2 25.75 3 35.50 3 27.25 4 36.00 4 27.75 5 36.50 a 28.75 6 37.25 6 30.00 7 37.75 7 32.00 8 38.50 8 33.00 * 39.00 9 35.25 10 39.00 io 40.00 il 40.25 11 40.75 12 41.25 12 41.00 13 41.50 13 41.00 14 41.50 14 41.25 15 42.06 15 43.00 MEAN 38.07 MEAN 34.02 S.D. 2.87 S.D. 6.46 RANGE 9.75 RANGE 19.50 Max. 42.00 Max. 43.00 Min. 32.25 Min. 23.50CATEGORY 1 RESIN Transbond (L-Ma) Concise (C-Ma) Dynabond (C-Mi) Orthobond (L-Mi) VALUE 28.85 29.58 30.68 34.02 CATEGORY 2 RESIN VALUE Heliosit-ortho (LMi) 38.07 Light Bond (L-Ma) 40.17 = Chemically-cured, macrofilled = Chemically-cured, microfilled nt-cured, macrofilled i= Light-cured, microfilledRESULTS The data was analyzed by a two-way analysis of variance test, with the mean bond strengths and standard deviations for the bond testing shown in Tables II, III, and Iv. The bond strength for composite resin 1 ranged from 18.25 pounds to 45.50 pounds, with a mean bond strength value of 29.58 pounds per bracket. The bond strength for composite resin 2 ranged from 19.00 pounds to 45.50 pounds, with a mean bond strength value of 30.68 pounds per bracket. The bond strength for composite resin 3 ranged from 15.75 pounds to 45.50 pounds, with a mean bond strength value of 28.85 pounds per bracket. The bond strength for composite resin 4 ranged from 30.25 pounds to 47.75 pounds, with a mean bond strength value of 40.17 pounds per bracket. The bond strength for composite resin 5 ranged from 32.25 pounds to 42.00 pounds, with a mean bond strength value of 38.07 pounds per bracket. The bond strength for composite resin 6 ranged from 23.50 pounds to 43.00 pounds, with a mean bond strength value of 34.02 pounds per bracket.Light Bond had significantly (p<0.05) higher bond strengths than any of the other composite resins used. Heliosit-Orthodontic had the second highest bond strengths which were also significantly different (p<0.05) from the chemically-cured materials. The values of the remaining two groups of light-cured adhesives differed slightly, and these materials were grouped together in a non-significant category. (See Table V)