Acid Etching and Bond

Strength

Prepared By:
Mahmoud Kanan Mohsin
BDS
MSc Candidate in Orthodontics
Acid Etching

Etching of dental surface with an acid to

remove the smear layer and open enamel
tubules, increase retention of resin
sealant, and promote mechanical
retention.
Development
A concept of etching enamel surfaces
with phosphoric acid, first proposed by
Buonocore in1955 to increase the bond
strength between the composite resin and
etched enamel.
Mechanism of Action
The irregular enamel surface created by
dissolving hydroxyapatite crystals permits
penetration of the fluid adhesive
components and this penetration provides
micromechanical retention. Acid etching
of enamel appears to improve retention by
selectively eroding certain hydroxyapatite
formations and facilitating penetration by
the development of resin tags.
Enamel Etching

Dentin Etching
Types of Acid Etching
According to Silverstone et al there are 5 types of acid
etching pattern:
1. Type 1: preferential dissolution of prism cores,
resulting in honey comb like appearance.
2. Type II: preferential dissolution of prism
peripheries, giving cobblestone like appearance.
3. Type III: a mixture of type I and II pattern.
4. Type VI: pitted enamel surfaces as well as
structures that look like unfinished puzzle, maps or
networks.
5. Type V: flat, smooth surface
Acid etching removes approximately 10 µm of
enamel surface and creates a morphologically
porous layer (5 µm to 50 µm deep).
 The low-viscosity fluid resin contacts the
surface and is attracted to the interior of these
microporosities created by capillary attraction.
Resin tags are formed into microporosities of
conditioned enamel that after adequate
polymerization, provide a resistant, long-
lasting bond by micromechanical interlocking
with this tissue.
Effects of Important Variables on Bond Strength

Differences among Teeth

 Differences in bond strength are generally not
observed among different teeth. Likewise, no
differences in bond strength are observed
between lingual and buccal surfaces.
Effects of Fluoride
Teeth with a higher concentration of fluoride
are more resistant to acid etching than normal
teeth and may require an extended etching
time.
Bond strengths to a group of severely and
moderately fluorotic teeth, were about 40 %
lower than bond strengths to normal teeth,
Group of mildly to moderately fluorotic teeth
from young adults showed similar bond
strengths when compared to normal teeth.
Type and Concentration of Acid
In restorative dentistry the highest possible
bond strength to tooth structure is desirable.
 In contrast, the orthodontic bond strength
must be sufficient to retain the brackets but
low enough to allow easy clean-up of
adhesive when the case is completed and the
brackets are removed.
Factors which are affecting acid etching of
enamel include:
1. Type of the acid
2. Concentration of the acid
3. The time of etching.
 Etching with 10 % or 37 % phosphoric acid
produces the highest bond strengths to enamel.
 The use of 10 % maleic acid for etching results in a
lower bond strength
 No etching yields a very low bond strength.
 No differences in bond strengths are observed when
enamel is etched with phosphoric acid ranging in
concentration from 2 % to 37 %.
Duration of Etching
No differences in bond strength are detected
between 15-second and 60-second etching
with 37 % phosphoric acid; however, shorter
etching times cause less enamel damage on
debonding.
Decreasing etching time between 30 and 10
seconds does not affect bond strength(11
Mpa) or location of failure site
Whereas etching for 0 or 5 seconds reduces
bond strength (less than 3 MPa) significantly
Etching vs. Not Etching
Resin composite does not bond well to unetched
enamel
However, hybrid ionomer orthodontic cements
have bond strengths to moist, unetched enamel
ranging from 8 to 25 MPa.
Hybrid ionomer orthodontic cements presently
bond better to moist, unetched enamel than to
sandblasted metal brackets. Once their bond
strength to metal brackets is improved, these
cements could be used in a non-acid-etching
bonding technique.
Comparison of relative properties of cements and
adhesives used for orthodontic bonding and
banding

Cement / Adhesive Bond Strength to Bond Strength to Metal

Enamel Brackets

Resin composite High Medium – high

Hybrid ionomer Medium – high Low-medium

Use of Pumice with or without Fluoride
Pumice is used to clean the enamel
surface before acid etching and bonding.
However, bond strength appears to be
unaffected whether pumice is used or not.
 Use of a fluoridated pumice or paste with
varying fluoride concentrations also does
NOT affect bond strength or location of
bond failures.
Iatrogenic Effects of Etching
1. Fracture and cracking of enamel upon
debonding.
2. Increased surface porosity - possible staining.
3. Loss of acquired fluoride in outer 10 µm of
enamel surface.
4. Loss of enamel during etching about 10 ±20
µm of enamel.
5. Resin tags retained in enamel - possible
discoloration of resin.
6. Rougher surface if over-etched.
Crystal-Growing Solutions
 A proposed alternative to etching enamel for retention of an
adhesive is to grow crystals on the enamel surface, this
technique is called crystal bonding.
 Potential advantages of crystal bonding include:

1. Easier debonding
2. Less residual adhesive left on the tooth
3. Less damage to enamel.
 Crystal bonding involves application to enamel of a poly
(acrylic acid) solution containing sulfate ions, which causes
growth of calcium sulfate dihydrate crystals on the enamel
surface. These crystals in turn retain the adhesive.
 Since crystal bonding produces bond strengths of 60±80 %
of the bond strength obtained with acid etching, it is not yet
considered a practical technique.
Acidic Primers(Self Etching Primer)
Another alternative to etching enamel
with phosphoric acid is to use an acidic
primer of the type used to bond restorative
composites to enamel and dentin.
Although these primers are expensive,
comparable bond strengths are found.
Air Abrasion
Air abrasion, also referred to as micro-
etching, is a technique in which particles of
aluminum oxide are propelled against the
surface of enamel by high air pressure,
causing abrasion of the surface.
Bond strengths to air-abraded enamel are
only about 50 % of those to acid-etched
enamel.
Air abrasion could be an alternative to
pumicing the teeth before etching.
Laser Etching
The application of laser energy to an enamel
surface causes localized melting and ablation.
Removal of enamel (etching) results primarily
from the micro-explosion of entrapped water
in the enamel and some melting of the
hydroxyapatite crystals.
Laser etching of enamel by a neodymium-
yttrium-aluminum garnet (Nd:YAG) laser
typically produces lower bond strengths than
does acid etching.
Moisture-Resistant Primers
An alternative to bonding to dry enamel is to
apply a moisture-resistant primer to etched
enamel that has been contaminated with moisture
or saliva.
This type of primer is a hydrophilic methacrylate
monomer that will wet enamel contaminated with
saliva or moisture.
The bond strength of a resin composite adhesive
applied to enamel primed with the moisture-
resistant primer is similar to that of resin
composite adhesive applied to etched, dry enamel.
Chlorhexidine
Chlorhexidine can be applied on the teeth and over
orthodontic appliances during treatment to reduce
bacterial colonization.
Bond strength is not affected if the chlorhexidine is
applied after bonding has been completed or as a
prophylactic paste on enamel before etching.
Bond strength is reduced if the chlorhexidine is
applied as a layer on etched enamel or on the
sealant before the adhesive is applied.
A chlorhexidine-containing primer did not
significantly affect bond strength.
Bleaching
Teeth recently have significantly lower
bond strengths to resin composites.
The bleach produces oxygen, which
inhibits free radical polymerization of
resin composites.
Research has shown that orthodontic
brackets can be placed after use of
carbamide peroxide bleaching with no
adverse effect on bond strength.
Thanks for Attending
References
1. http://www.angle.org/doi/pdf/10.2319/12
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2. http://www.forp.usp.br/bdj/Bdj9(1)/t019
1/t0191.html
3. http://www.angle.org/doi/pdf/10.2319/12
0605-426R.1
4. http://www.danielathys.com.br/downloa
ds/enamel_acid_etching_-_a_review.pdf
5. http://www.jaypeejournals.com/eJournal
s/ShowText.aspx?ID=3128&Type=FRE
E&TYP=TOP&IN=_eJournals/images/J