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VOLUME 16 , ISSUE 1 ( January-June, 2024 ) > List of Articles

ORIGINAL RESEARCH

Influence of Microabrasion and Adhesion Promoters on Shear Bond Strength and Enamel Damage in Fluorosed Enamel: An In Vitro Evaluation

Devarasa G Murugeshappa, Dheeraj D Kalra

Keywords : Adhesion booster, Debonding, Elsenz™, Enamel cracks, Enamel fluorosis, GC Tooth Mousse, Microabrasion, Remineralization

Citation Information : Murugeshappa DG, Kalra DD. Influence of Microabrasion and Adhesion Promoters on Shear Bond Strength and Enamel Damage in Fluorosed Enamel: An In Vitro Evaluation. CODS J Dent 2024; 16 (1):3-8.

DOI: 10.5005/jp-journals-10063-0163

License: CC BY-NC 4.0

Published Online: 20-02-2025

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Introduction: Dental fluorosis, resulting from excessive fluoride intake during tooth development, causes significant alterations in enamel structure, including increased surface roughness and reduced hardness. These changes present challenges for orthodontic treatments, particularly in achieving reliable bracket bonding due to the hypermineralized, acid-resistant outer layer of fluorosed enamel. Objectives: (1) To assess and contrast the impact of microabrasion and an adhesion promoter on the shear bond strength (SBS) between orthodontic resin and fluorosed enamel; (2) To evaluate and compare the influence of microabrasion treatment and an adhesion promoter on enamel damage during bracket debonding. Methods: Forty permanent premolar teeth extracted for orthodontic reasons were included, comprising 30 fluorosed and 10 nonfluorosed teeth. The fluorosed teeth were divided into three groups: untreated (group II), treated with enamel microabrasion (group III), and treated with an adhesion promoter (group IV). A control group (group I) of nonfluorosed teeth was also included. Brackets were bonded using a standardized protocol, and the specimens underwent thermocycling. SBS was measured using a universal testing machine. Enamel damage was evaluated pre- and postdebonding using a stereomicroscope. Results: A marked increase in the number of enamel cracks after debonding was found in all four groups, with a statistically nonsignificant difference in enamel crack formation among the groups. Group IV (adhesion promoter) showed the greatest enamel damage, with 7 out of 10 teeth cracked, while group III (microabrasion) had moderate enamel damage, with 3 out of 10 teeth showing cracking following debonding, which was statistically highly significant (p > 0.05). Fluorosis reduced the mean SBS of orthodontic brackets to 12.37 MPa. However, the use of enhance locus ceruleus (LC) and enamel microabrasion increased the SBS in fluorosed teeth to 17.26 MPa and 16.7 MPa, respectively. Compared to group I (control), group II (untreated fluorosed) had a statistically significant decrease in SBS, whereas in comparison to group II, both groups III and IV showed a statistically significant increase in SBS (p < 0.05). Statistically significant differences were observed between groups for SBS values, with the highest in group I, followed by group IV, group III, and the lowest in group II. Significant differences were noted between groups I vs II (p < 0.05). Conclusion: Fluorosis substantially decreases the SBS of orthodontic brackets. Although adhesion promoters enhance the SBS of orthodontic brackets, they lead to a notable increase in enamel crack formation after bracket removal. Enamel microabrasion has the potential to enhance the bond strength of orthodontic brackets while reducing enamel damage after bracket removal.


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