Shear Bond Strength of Orthodontic Brackets on Intact and Demineralized Enamel After Application of Resin Infiltrant, Fluoride Varnish and Casein Phosphopeptide-amorphous Calcium Phosphate Remineralizing Agents: In-vitro Study

Objective: To evaluate the effects of remineralizing agents on the shear bond strength (SBS) of orthodontic brackets bonded to intact and demineralized enamel.

Material And Methods: In this in-vitro study, 160 human premolars were divided into 8 groups, including group 1 with intact enamel as the positive control, group 2 with demineralized enamel as the negative control, groups 3-5 treated with fluoride varnish, Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) and resin infiltrant on intact enamel, and groups 6-8 treated with the same agents on demineralized enamel. Brackets were bonded using the conventional method, and the samples were thermocycled. SBS of the brackets was measured using a universal testing machine, and the adhesive remnant index (ARI) was assessed. Data were analysed with one-way ANOVA and post hoc statistical test at the significance level of 0.05.

Results: SBS of the brackets in all groups with intact enamel was higher than that of their counterparts on demineralized enamel, which was only significantly different between groups 1 and 2 (P-value<0.001). SBS values of groups 7 and 8 were not significantly different from group 1 (P-value=1), yet the application of fluoride varnish on both intact (P-value=0.091) and demineralized enamel (P-value<0.001) created less SBS than in group 1.

Conclusions: All pre-treatment methods increased SBS of the brackets bonded to demineralized enamel, yet only the resin infiltrant and CPP-ACP produced SBS similar to that of intact enamel. Also, the use of fluoride varnish on intact enamel significantly reduced SBS.