ORIGINAL ARTICLE

Comparison of bond strength between

orthodontic brackets bonded with halogen and
plasma arc curing lights: An in-vitro and
in-vivo study
Michael D. Signorelli,a Elizabeth Kao,b Peter W. Ngan,c and Marcia A. Gladwind
Bitburg, Germany, and Morgantown, WVa

Introduction: This study assessed in-vitro shear bond strength and in-vivo survival rate of orthodontic
brackets bonded with either a halogen or a plasma arc light. Methods: Ninety extracted premolars were
divided into 6 groups of 15. Stainless steel brackets were bonded to the teeth by using either a halogen light
with a 20-second curing time or a plasma arc light with a 2-, 6-, or 10-second curing time. Brackets were
debonded either within 30 minutes of bonding or after thermocycling for 24 hours. Bond strengths were
tested on a testing machine at a crosshead speed of 1 mm/minute. The bracket failure interface was
measured with a modified adhesive remnant index score. Data were analyzed by using ANOVA and
Tukey-Kramer multiple comparison tests. For the in-vivo study, a split-arch design was used to determine the
bracket-failure rate and distribution in 25 patients. The patients were followed for a mean period of 1.1 years
(386 days). Survival analysis was carried out to compare the failure rates of the 2 techniques. Results: No
significant differences in bond strengths were found 30 minutes after bonding between the halogen light (13.6 ⫾
3.8 MPa) and the plasma arc light with 2-, 6-, or 10-second curing times (9.6 ⫾ 2.9, 14.2 ⫾ 4.6, 16.0 ⫾ 3.0
MPa, respectively). Similar bond strengths were also found between the halogen light with a 20-second (16.1 ⫾
3.6 MPa) curing time and plasma arc light with 6 seconds (18.2 ⫾ 4.6 MPa) of curing time after 24 hours of
thermocycling. For the in-vivo study, no significant difference was found in bracket failure rates between the
2 light sources (4.9% in both groups). No significant differences were found between ARI scores for the
halogen light and the plasma arc light at either 30 minutes or 24 hours after debonding. Conclusions: These
results indicate that the plasma arc light with a 6-second curing time can produce similar bond strength and
bracket-failure rates as the halogen light that requires a longer curing time. (Am J Orthod Dentofacial Orthop
2006;129:277-82)

T
he acid-etch technique has been widely used in
orthodontics to directly bond attachments to
enamel surfaces. For years, self-cured resin was
the only type of adhesive available. This resin begins to
polymerize upon mixing, and working time is limited.
It has been shown that the bond strength of the resin is
weakened when air is incorporated during mixing or
when the pastes are incompletely mixed.1
Buonocore2 introduced the first photosensitive
a
US Air Force, Bitburg, Germany.
b
Professor, Department of Restorative Dentistry, School of Dentistry, West
Virginia University, Morgantown.
c
Professor and chair, Department of Orthodontics, School of Dentistry, West
Virginia University, Morgantown.
d
Professor, Division of Dental Hygiene, School of Dentistry, West Virginia
University, Morgantown.
Reprint requests to: Dr Peter Ngan, West Virginia University, School of
Dentistry, 1076 Health Science Center North, PO Box 9480, Morgantown, WV
26506; e-mail, pngan@hsc.wvu.edu.
Submitted, March 2004; revised and accepted, July 2004.
0889-5406/$32.00
Copyright © 2006 by the American Association of Orthodontists.
doi:10.1016/j.ajodo.2004.07.043
light-cured resin in 1970. The greatest advantage of a
light-cured system is longer working time before poly-
merization begins. Visible light curing (VLC) was
introduced about 1980.3 Polymerization of VLC resins
is based on the presence of a photo initiator, cam-
phorquinone, which is sensitive to light in the 470-nm
wavelength spectrum.4,5 Most VLC units have a broad
wavelength width between 400 and 520 nm, with a
light intensity commonly about 400 mW/cm2. The
curing time for bonded metal brackets with conven-
tional VLC units is variable. For example, the manu-
facturer of Transbond XT (3M Unitek, Monrovia,
Calif) recommends a 20-second cure, but Oesterle et al6
and Wang and Meng7 independently found stronger
bond strengths with a 40-second cure.
Various methods have been introduced to enhance
the polymerization of bonding agents. In the late 1980s,
argon lasers were introduced with curing times of only
10 seconds for filled resins and 5 seconds for unfilled
resins. The argon laser operates in a wavelength range
277
278 Signorelli et al
of 454 to 496 nm of the visible light spectrum, with an
intensity that approaches 800 mW/cm2.8 In-vitro stud-
ies have shown that the bond strengths were compara-
ble to those of VLC units.9-11
More recently, the plasma arc light has been used
for rapid curing of restorative materials.12 This system
has a filter that narrows the spectrum of visible light to
a band centered on the 470 nm wavelength for activa-
tion of camphorquinone while producing a high light
intensity of 1200 mW/cm2. This enables the curing
time to be significantly shortened.12 A high-energy,
high-pressure ionized gas in the presence of an electric
current is used to create a light source strong enough to
increase the polymerization rate of composite resins
and resin-modified glass ionomers.13 The use of such
light-curing units has been recently reported for orth-
odontic purposes with a recommended cure time of 2
seconds per bracket in 1 study12 and 3 seconds per
bracket in another.14
The objectives of this study were to compare (1) the
in-vitro shear bond strength and the in-vivo survival
rate and distribution of brackets bonded with plasma
arc light or halogen light, and (2) the in-vitro and
in-vivo bracket-failure interface for the 2 curing-light
systems.
MATERIAL AND METHODS
In-vitro bond strength study
Two different light units for curing orthodontic
bracket adhesive were compared: a plasma arc light-
curing system (OrthoLite, 3M Unitek, Monrovia,
Calif) and a conventional halogen light-curing sys-
tem (Ortholux XT, 3M Unitek). The OrthoLite pro-
duces a light intensity of approximately 2000 mW/cm2,
and the Ortholux XT produces approximately 400
mW/cm2.13 Both curing units produce wavelengths
between 400 and 500 nm. The plasma arc light has an
8-mm diameter light guide, and the halogen light has a
7-mm light guide.
Ninety freshly extracted human premolars were
collected. The criteria for selection included noncarious
and nonrestored buccal surfaces with no visible cracks
from the extraction forceps. The teeth were not exposed
to pretreatment chemical agents such as hydrogen
peroxide or bleach. They were cleansed of tissue and
debris, steam-autoclaved for 45 minutes in liquid cycle
at 250°F, and stored in 0.1% thymol. Steam steriliza-
tion at a low temperature reduces bacteria contamina-
tion; this process has been shown not to affect the
enamel surface or the bond strength.15 The teeth were
then embedded in epoxy resin (Buehler, Lake Bluff,
Ill), and a dental surveyor was used to align the facial
surface of each tooth so that it was perpendicular with
American Journal of Orthodontics and Dentofacial Orthopedics
February 2006
the bottom of the stainless steel mounting ring. This
oriented the bonding surface to be parallel to the force
applied during the shear strength test. The mounted teeth
were kept moist in a humidor while the epoxy resin
polymerized and then stored in water until bonding.
Before bonding, the teeth were randomly divided
into 6 groups, each containing 15 teeth. Group I:
brackets were cured with a halogen light for 20 seconds
(10 seconds mesial and 10 seconds distal) and
debonded within 30 minutes. Group II: bracketes were
cured with a halogen light for 20 seconds, thermo-
cycled for 24 hours (approximately 580 cycles with a
1-minute dwell time each in 5°C and 55°C), and
debonded. Group III: brackets were cured with a
plasma arc light for 2 seconds (1 second mesial and 1
second distal) and debonded within 30 minutes. Group
IV: brackets were cured with a plasma arc light for 6
seconds (3 seconds mesial and 3 seconds distal) and
debonded within 30 minutes. Group V: brackets were
cured with a plasma arc light for 6 seconds, thermo-
cycled for 24 hours, and debonded. Group VI: brackets
were cured with a plasma arc light for 10 seconds and
debonded within 30 minutes.
The bonding surface of each tooth was pumiced for
10 seconds and rinsed for 10 seconds with distilled
water. The enamel surface was conditioned with 37%
phosphoric acid gel for 30 seconds and rinsed with
distilled water. The surface was thoroughly dried, and a
thin layer of Transbond XT sealant (3M Unitek) was
applied. APC precoated maxillary premolar brackets
(3M Unitek) with a bracket base area of 11.35 mm2
were used. Each bracket was placed on the tooth, and
an explorer was used to seat the brackets with a
constant force by 1 operator (M.D.S.). Excess adhesive
was removed, and the bracket adhesive was light-cured
with the designated curing unit and the curing time
indicated by group assignment. Each curing unit was
tested and calibrated according to the manufacturer’s
instructions to ensure that maximum intensity output
was obtained.16 The plasma light was calibrated by
inserting the curing tip fully into the calibration port
and then depressing the hand switch. The halogen light
was calibrated by placing the fiber-optic probe directly
on top of the built-in sensor until the light indicated that
the probe intensity was adequate. For groups, I, III, IV,
and VI, testing was completed within 30 minutes of
bonding. For groups II and V, testing was completed 24
hours after the thermocycling. between 5°C ⫾ 2°C in a
refrigerated circulating bath (Lindberg/Blue, Asheville,
NC) and 55°C ⫾ 2°C in a heated water bath for
approximately 580 cycles.
Debonding forces in Newtons were determined by
using a testing machine (Instron, Canton, Mass) with a
American Journal of Orthodontics and Dentofacial Orthopedics
Volume 129, Number 2
crosshead speed of 1 mm/minute. The stainless steel
rings were mounted on a base jig that could be adjusted
on X and Y axes to ensure that the applied force was
parallel to the long axis of the tooth. The alignment was
further checked against a vertically mounted ruler. The
teeth were immersed in water throughout the debonding
procedure with the force applied at the bracket-tooth
interface. The force was applied by placing the looped
end of an 0.018-in stainless steel wire, attached supe-
riorly to the load cell of the testing machine, under the
gingival bracket wings. The force was then applied at a
crosshead speed of 1 mm/minute. The bond strengths in
MPa were calculated based on the bracket base area.
After debonding, adhesive left on the bracket base was
examined with an optical microscope by 1 investigator
(M.D.S.) at 10 times magnification to determine the
bracket-failure interface. A modified adhesive remnant
index (ARI) was used to evaluate the adhesive remain-
ing on a bracket after debonding (Table 1).17,18 To
determine intrarater reliability, 10 specimens were
included in an error study to measure the ARI 2 weeks
apart. The coefficient of reliability was found to be
0.92.
In-vivo bracket-survival study
The in-vivo study included 25 patients (11 male, 14
female) from the School of Dentistry Orthodontic
Clinic at West Virginia University. Criteria for patient
selection included intact permanent dentition, no decal-
cification on teeth, and treatment requiring comprehen-
sive orthodontic treatment with fixed appliances. No
preference was placed on type of malocclusion or
whether extractions were indicated. Precoated APC
brackets were bonded to 445 teeth, and 222 were cured
with the plasma arc light and 223 with the halogen
light. The adhesive applied to the precoated brackets
contained the same ingredients as found in the Trans-
bond XT adhesive. A split-arch technique was used to
equate any variability between the right and left quad-
rants. Force of mastication and hygiene effectiveness
can vary from the left side to the right side, and these
variables could affect bracket failure. The patients were
alternately assigned to 1 of 2 groups. In group I, the
brackets for the maxillary left and mandibular right
quadrants were bonded with the plasma arc light curing
unit. The contralateral sides were bonded with a con-
ventional halogen light curing unit. In group II, the
pattern was reversed. The same bonding procedures
were used as in the in-vitro study. For plasma arc
curing, a 6-second exposure time (3 seconds mesial and
3 seconds distal) was used. For halogen curing, a
20-second exposure time (10 seconds mesial 10 sec-
onds distal) was used. The date and quadrant of bracket
Signorelli et al 279
Table I. Modified ARI scores
Score Definition
0 No adhesive left on bracket
1 Less than 25% of adhesive left on bracket
2 25% of adhesive left on bracket
3 50% of adhesive left on bracket
4 75% of adhesive left on bracket
5 100% of adhesive left on bracket
failures were recorded. The failed brackets were col-
lected to determine the bracket-failure interface.
Data analysis
For the in-vitro study, significant differences in
shear bond strength (MPa) and ARI scores between test
groups were determined by using ANOVA and Tukey-
Kramer multiple comparison tests. Level of signifi-
cance was preset at P ⬍ .05. The bracket-survival rate
was computed with the Kaplan-Meier product-limit
survival estimates.
RESULTS
In vitro bond strength study
The shear bond strengths for brackets bonded with
the 2 types of curing lights and varied curing times are
shown in Table II. Significant differences in the shear
bond strength were found among the 6 test groups (P ⬍
.0001). The Tukey-Kramer test showed that, among the
four 30-minute test groups, no significant differences
were found between brackets bonded with the plasma
arc light with curing times of 2, 6, or 10 seconds (9.6 ⫾
2.9, 14.2 ⫾ 4.6, 16.0 ⫾ 3.0 MPa, respectively) and the
halogen light control group with a curing time of 20
seconds (13.6 ⫾ 3.8 MPa). For the samples with 24
hours of thermocycling, no significant differences were
found between the brackets bonded with the plasma arc
light for 6 seconds (18.2 ⫾ 4.6 MPa) and the halogen
light control group with a curing time of 20 seconds
(16.1 ⫾ 3.6 MPa).
Among the plasma arc groups tested 30 minutes
after bonding, those with curing times of 6 and 10
seconds (14.2 ⫾ 4.6 MPa, 16.0 ⫾ 3.0 MPa, respec-
tively) were found to have significantly higher mean
bond strengths than the 2-second curing group (9.6 ⫾ 2.9
MPa). The plasma light with 6 seconds curing time had
the highest mean shear bond strength of 18.2 ⫾ 4.6 MPa
when debonded after 24 hours. This was significantly
higher than groups I and III.
In-vitro bracket-failure interface
The ARI scores of adhesive remaining on the
bracket after debonding for the 6 groups are shown in
Table III.
280 Signorelli et al American Journal of Orthodontics and Dentofacial Orthopedics
February 2006

Table II. In-vitro mean shear/peel bond strength for test groups
Total curing Mean Minimum Maximum
Group Light source time Debond time MPa SD MPa MPa

I Ortholux XT 20 s 30 min 13.6a,b 3.8 8.7 21.5

II Ortholux XT 20 s TC 24 h 16.1b,c 3.6 11.9 23.2
III OrthoLite 2s 30 min 9.6a 2.9 5.0 13.5
IV OrthoLite 6s 30 min 14.2b,c 4.6 7.8 23.1
V OrthoLite 6s TC 24 h 18.2c 4.6 9.2 25.9
VI OrthoLite 10 s 30 min 16.0b,c 3.0 12.7 23.1

Superscript of same letter indicates groups that are not significantly different from each other.
TC, Thermocycled.

Table III. In vitro mean ARI score for test groups

Total curing Mean Minimum Maximum
Group Light source time Debond time ARI SD ARI ARI

I Ortholux XT 20 s 30 min 3.5a 1.2 0 5

II Ortholux XT 20 s TC 24 h 3.9b 1.3 0 5
III OrthoLite 2s 30 min 2.5a 1.7 0 5
IV OrthoLite 6s 30 min 3.2a 1.3 1 5
V OrthoLite 6s TC 24 h 4.6b 0.6 1 5
VI OrthoLite 10 s 30 min 3.3a 1.5 0 5

Superscript of same letter indicates groups that are not significantly different from each other.
TC, Thermocycled.

ANOVA showed significant differences among the
6 test groups (P ⬍ .0016). No significant differences
were found between the halogen light control group
(3.5 ⫾ 1.2 MPa) and the plasma arc light groups tested
30 minutes after bonding (2.5 ⫾ 1.7 MPa). No signif-
icant difference was found between the halogen light
control group (3.9 ⫾ 1.3 MPa) and the plasma arc light
group tested 24 hours after bonding (4.6 ⫾ 0.6 MPa).
The Tukey-Kramer analysis showed significantly
higher ARI scores for group V compared with group
III (P ⬍ .05) and for group II compared with group
III (P ⬍ .05).
In-vivo bracket-survival distribution
The mean observation time at final data collection
was 386 days, or 1.1 years. Of 445 bonded teeth, 22
brackets failed, for a failure rate of 4.9%. Of the 22
failed brackets, 11 were cured with each light. The
chi-square analysis showed no significant difference
between the light source and the number of bracket
failures.
The bracket-survival distribution for the type of
curing unit was determined by the Kaplan-Meier prod-
uct-limit survival estimates analysis. It showed that the
mean durations of bracket failure were 189 days for the
plasma arc light group and 187 days for the halogen
light group. The ranges for the 11 failed brackets in
each group were 44 to 432 days for the plasma arc light
and 51 to 365 days for the halogen light group. No
pattern of bracket failure frequency with time was noted
among the 2 groups. A t test indicated no significant
differences between the 2 groups (P ⬍ .005).
Eight of the 11 failed brackets were collected from
the halogen light group, and 4 of the 11 were collected
from the plasma arc light group. The halogen arc light
group had a mean ARI score of 3.2, and the plasma arc
light group had a mean score of 3.0. The sample size of
the collected failed brackets was too small to justify
statistical analysis.
DISCUSSION
When evaluating the mean shear bond strengths of
the 4 groups tested 30 minutes after bonding, no
statistically significant differences were found between
the control group cured with the halogen light for 20
seconds and brackets bonded with the plasma arc light
with curing times of 2, 6, or 10 seconds. This agrees
with the findings of Oesterle et al,19 who found no
significant difference in bond strength among brackets
bonded with a plasma arc light with curing times of 3,
6, or 9 seconds and brackets bonded with a halogen
light with a 40-second curing time and all groups tested
at 30 minutes. Cacciafesta et al20 reported similar
findings with a light-cured glass ionomer 15 minutes
after bonding.
When evaluating the mean shear bond strengths
American Journal of Orthodontics and Dentofacial Orthopedics
Volume 129, Number 2
after 24 hours of thermocycling, no significant differ-
ence was found between brackets bonded with the
halogen light for 20 seconds and brackets bonded with
the plasma arc light for six seconds. This also agrees
with findings by Oesterle et al,19 Sfondrini et al,13 and
James et al.11 These results suggest that the plasma arc
light can be used to bond orthodontic brackets to the
enamel surface with a shorter curing time without a
significant decrease in shear bond strength. The faster
curing time saves chair time and might decrease the risk
of bond failure from moisture contamination.21
The degree of polymerization is directly related to
the amount of total energy that the resin absorbs, and
the total light energy is the intensity of the light times
the duration of the exposure. The 3M Unitek instruction
book16 lists the Ortholux XT as producing a light
intensity of approximately 400 mW/cm2; the OrthoLite
produces 5 times as much, approximately 2000 mW/cm2.
Greater total light energy results in increased fracture
toughness and greater flexural strength; these mean
greater bond strength.19
The manufacturer’s current recommended curing
time for the plasma arc light is 6 seconds: 3 seconds for
the mesial surface and 3 seconds for the distal surface
for metal brackets. A part of this investigation was to
determine whether a shorter curing time of 2 seconds
could produce the same bond strength. The results for
the 30-minute test groups showed that the shear bond
strengths produced by the plasma arc light with curing
times of 6 or 10 seconds were significantly higher than
with a curing time of 2 seconds.
Although the 2-second curing time with the plasma
arc light was significantly lower than the 6- and
10-second times, its mean shear bond strength of 9.6
MPa still exceeded the range of 6 to 8 MPa suggested
by Reynolds22 as clinically acceptable. Of the 15 teeth
that were cured for 2 seconds with the plasma arc light
and debonded within 30 minutes, 2 failed to reach 6
MPa. These findings suggest that more bond failures
can occur with a 2-second curing time, because most
orthodontists apply forces within 30 minutes of bond-
ing. A longer exposure time will allow for more
complete polymerization of the bracket adhesive and
improve bond strength. Both 6 and 10 seconds of
curing produced sufficient bond strengths for immedi-
ate loading of the bracket with orthodontic forces;
clinicians would gain no additional advantage by curing
longer. The results of this study indicate that bond
strength continues to increase after the initial polymer-
ization by the curing light.
The ARI enables the clinician to determine the
bracket-failure interface. A low score would be inter-
preted as a failure between the adhesive and bracket
Signorelli et al 281
interface, and a high score would indicate a failure at
the adhesive enamel interface. The highest mean score
(4.6) was for the plasma arc light group with a 6-second
curing time tested 24 hours after bonding. Because over
75% of the adhesive remained on the bracket base, this
would make residual adhesive removal easier for the
clinician.
In the in-vivo investigation, the bracket survival
rate distribution for the 2 curing systems was deter-
mined by using the Kaplan-Meier product limit survival
estimates from the time of bracket placement to final
data collection. This method enables the clinician to
evaluate the performance of the bonded brackets over
the entire test period instead of just at final data
collection. Our results showed no significant differ-
ences in either failure rate or time of failure. The failure
rate of 4.9% with both curing lights over the 1.1-year
observation period is acceptable and concurs with the
findings of other investigators.14,23-25 These clinical
findings further support the in-vitro findings that there
is no significant decrease in bond strength between the
plasma arc light and the halogen light groups. Sunna
and Rock23 found that 60% of the bond failures
occurred within the first 6 months, or 180 days; this
agrees with the mean duration of bracket failures with
the halogen light (187 days) and the plasma arc light
group (189 days).
Because some patients did not reutrn failed brackets
to clinicians, they were too few to justify a bracket-
failure interface data analysis. Of the brackets collected
and scored, the clinical impression was that there is no
difference in the amount of adhesive remaining on the
enamel surface after bracket failure or debonding.
CONCLUSIONS
Brackets bonded with the plasma arc light for 6
seconds were found to produce similar bond strength
compared with the halogen light with a 20-second
curing time. No significant differences were found in
the site of bracket failure interface between the halogen
and plasma arc curing lights. A longer than the recom-
mended curing time (10 seconds) with the plasma arc
light does not produce statistically significant higher
mean bond strengths; the 2-second cure time showed
significantly lower strength, although it was still within
the clinically acceptable range. There is no statistically
significant difference in the survival rate or time of
bracket failure between the plasma arc light and the
halogen light. Using the plasma arc light can save chair
time without increasing the bracket-failure rate.
282 Signorelli et al American Journal of Orthodontics and Dentofacial Orthopedics
February 2006

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