Air Abrasion as an Adjunct to Conventional Acid Etching in Orthodontic Bonding

Nandini S. , Hemalatha S. , Sanju K. Somiah

Journal of Dental Sciences and Research Vol. 2, Issue 2, Pages 1-5

M.Anoosha I MDS

 To obtain good bond strength enamel must be etched with 35 to 40% phosphoric acid for 15 to 60 seconds. Air abrasion technology makes use of a high speed stream of aluminium oxide particles propelled by air pressure. Other clinical applications include removal of composite from de-bonded brackets and increasing the retentiveness of stainless steel bands.

 Micro-etching is an effective method of cleaning brackets after accidental de-bonding. conventional bonding toxicity of acid to oral tissues the time taken for obtaining the desired dissolution Air abrasion typical tooth surface preparation time ranging from 0.5 to 3 seconds, without the additional step of rinsing.

Purpose of the study

To determine the mean shear debonding force of metal brackets following enamel preparation with acid etching alone or sandblasting or a combination of sandblasting and acid etching.

METHODOLOGY
80 freshly extracted premolar teeth for the orthodontic treatment, were collected and stored in distilled water. INCLUSION CRITERIA intact buccal and lingual enamel with no cracks no caries. The teeth were thoroughly cleaned of any soft tissue debris or blood and were stored immediately in distilled water at room temperature.

 The selected teeth were mounted in cold cure acrylic resin poured in metal rings The teeth were embedded in the acrylic horizontally

in such a way that the long axis of the tooth was

perpendicular to the central axis of metal ring and the palatal or lingual cusp and a part of the root surface was embedded in the acrylic for retention.

 The mounted teeth were randomly divided into four groups, consisting of 20 teeth each. Group I specimens -green colour acid etched with 37% phosphoric acid for 15seconds. Group II specimens -white colour- sandblasted with 50 micron aluminium oxide by a microetcher. Group III specimens - blue colour- enamel surface polished with pumice followed by acid etching with 37% phosphoric acid for 15 seconds. Group IV specimens -red colour- sandblasted with 50 micron aluminium oxide by a micro etcher followed by acid etching with 37% phosphoric acid for 15 seconds

Materials used
A no-mix chemically cured adhesive (Rely-a-Bond, Reliance Orthodontic Products, Inc.,Illinois, USA) MICROETCHER TM ERC (DANVILLEMATERIALS, SAN

RAMON, CA) -The intraoral sandblaster used in this

study was 0.022 inch slot stainless steel premolar PEA Roth brackets ( Gemini series, 3M Unitek).

A thin coating of the primer (Rely-a-Bond, Reliance Orthodontic Products) Orthodontic adhesive (Rely-a-Bond, Reliance Orthodontic Products, Inc., Illinois, USA), Remove the excess adhesive with a probe around the bonding of brackets. Each bracket was bonded to the middle third of each tooth. The bonding of all the brackets was performed by the same operator. After bonding, all the samples were stored in distilled water at room temperature for 48 hrs, before testing them for shear bond strength.

TESTING APPARATUS
An Instron Universal Testing Machine Model no. 4467, with 3000 Kg load cell, at a crosshead speed of 0.5mm/second was used to debond the brackets (Fig.3). For shear testing, the prepared metal ring was fixed to the aluminum jig, which in turn was secured in the lower jaw (crosshead), with the long axis of tooth and bracket base parallel to the direction of shear force applied.

 A loop was made using 23 gauge stainless steel wire and the ends of the wire were gripped in the upper jaw (cross head) and under the gingival tie wings by adjusting the cross head.

RESULTS
On comparing the mean shear bond strength Group I(acid etched group), Group II (sandblasted group), Group III (pumiced and acid etched) and Group IV (sandblasted and acid etched group) One-way ANOVA (Analysis of Variance) test there was a statistically significant difference between the four groups (p<0.05).

 The highest mean shear bond strength on debonding was found in Group IV (sandblasted and acid etched group), followed by Group III (pumiced and acid

etched group)and Group I (acid etched group) and

the lowest mean shear bond strength on debonding

was found in Group II (sandblasted group).

 There exists no statistically significant difference in the mean shear bond strength between Group I (acid etched group) and Group III (pumiced and acid etched).

Group

Comparison Mean p

Difference SD

Group I

Group II Group III Group IV

3.146 .1574 -.076 .1574 -1.104 .1574

.000 .998 .000

Group II

Group III Group IV Group IV

-3.223 .1574 -4.251 .1574 -1.028 .1574

.000

Group III

.000

MEAN

S.D

MIN

MAX

P VALUE

Group I

20

10.1510

.4704

9.46

11.15

273.438

.000

Group II

20

7.0045

.3537

6.48

8.03

Group III 20

10.2275

.5874

9.29

11.62

Group IV 20

11.2555

.5472

10.64

12.62

Discussion
The micro etcher, the most commonly used micro sandblaster has recently been approved by the FDA for intra oral use. The dental chair-side model includes a contra-angle nozzle and rear-mounted abrasive jars containing the aluminium oxide powder.

The tubing is connected to a compressed air source in

the operatory.

 Marc E.Olsen, et al compared the traditional acid-etch technique with the air-abrasion surface preparation technique, using two different sizes of abrading particles. The results indicated that there was a significant difference in the shear bond strengths among the acid etched group (10.4 2.8 MPa), the 50 micron group (2.3 1.0 MPa) and the 90 micron group (3.6 2.2 MPa) (p=0.0001).

 The shear bond strength observed in group I (acid etched group) was 12.49 2.85 MPa and in group III (air abraded and acid etched group) was 12.59

2.68MPa.
Both groups had statistically better shear bond strengths when compared to group II (air abraded group) (0.29 0.56 MPa; p<0.05).

 Karen R. et al.[7] compared four methods of enamel preparations before orthodontic bonding. Sandblasting without acid etching produced lower bond strengths than sandblasting followed by acid etching. The greatest debonding force was achieved by sandblasting before acid etching, even though this was not statistically significant when compared with the other groups, which were also acid etched.

 The difference between present study and these studies could be due to The bond material used Bracket base area Time for which air abrasion was carried out Particle size of aluminium oxide used

The effect of enamel air abrasion on the retention of bonded metallic orthodontic brackets AJO-DO 2003
The purpose of this study was to compare the conventional acidetch technique with an air abrasion surface preparation technique. Eighty freshly extracted noncarious human premolar teeth were randomly divided into the following 4 groups: (1) acid etched with 37% phosphoric acid for 15 seconds (Express Dental Products, Toronto, Canada), (2) sandblasted with 50 aluminum oxide by a microetcher (Danville Engineering Inc, Danville, Calif), (3) polished with pumice followed by acid etched with 37% phosphoric acid for 15 seconds, (4) sandblasted with 50 aluminum oxide by a microetcher followed by acid etched with 37% phosphoric acid for 15 seconds. All the groups had stainless steel brackets (Dentaurum, Standard Edgewise) bonded to the buccal surface of each tooth with no-mix adhesive (Express Dental Products, Toronto, Canada).

 the only sandblasted group was 38.05 9.93 N; the only acid-etched group was 62.72 11.44 N; the group that was polished with pumice followed by acid etched was 69.78 14.87 N; and the group that was sandblasted followed by acid etched was 89.31 13.34 N. The sandblasting followed by acid etching group had significantly higher bond strength values when compared to the other 3 groups. This study showed that sandblasting should be followed by acid etching to produce enamel surfaces with comparable bond strength.

The air-abrasion technique versus the conventional acid-etching technique: A quantification of surface enamel loss and a comparison of shear bond strength
(Am J Orthod Dentofacial Orthop 2000;117:2

To quantify the surface enamel loss that results when an airabrasive technique is used and to compare the shear bond strength of different prebonding and bonding methods. 2 enamel-conditioning methods: acid etching with 37% phosphoric acid; and sandblasting with 50 m aluminum oxide particles under different conditions.

A profilometer was used

The results - the enamel loss associated with sandblasting is

equal to or smaller than that resulting from acid etching.

 The effectiveness of different prebonding and bonding techniques evaluated by means of shear bond strength

measurements.
For bonding, 1 resin and 1 glass ionomer cement were evaluated; For prebonding, a sandblaster, 2 different polyacrylic acids and phosphoric acid were tested.

The results showed that the bond strength of the sandblasted

groups was significantly lower than that of the etching groups.