Bond Strengths of Brackets Bonded to Enamel Surfaces Conditioned with Femtosecond and Er:YAG Laser Systems

The aim of this study was to compare femtosecond and Er:YAG laser systems with regard to enamel demineralization and bracket bond strength. Human-extracted premolars were randomized to three groups (n = 17) depending on the conditioning treatment used for the buccal surfaces: 37 % orthophosphoric acid, Er:YAG laser etching (MSP mode 120 mJ, 10 Hz, 1.2 W), and femtosecond laser etching (0.4 W, 800 nm, 90 fs/pulse, 1 kHz). Metal brackets were bonded with Transbond XT to the conditioned surfaces and light cured for 20 s. The samples were thermocycled (5000 cycles, 5-55 °C) and subjected to shear bond strength (SBS) testing using a universal testing machine. Failure types were analyzed under an optical stereomicroscope and SEM. The adhesive remnant index (ARI) was evaluated to assess residual adhesive on the enamel surface. The results revealed no significant differences in SBS between the Er:YAG laser (7.2 ± 3.3 MPa) and acid etching groups (7.3 ± 2.7 MPa; p < 0.05), whereas a significant difference was observed between the femtosecond laser etching group (3.3 ± 1.2 MPa) and the other two groups (p < 0.01). ARI scores were significantly different among the three groups. The results of our study suggest that laser conditioning with an Er:YAG system results in successful etching, similar to that obtained with acid. The sole use of a femtosecond laser system may not provide an adequate bond strength at the bracket-enamel interface.