Effects of Antioxidants on the Shear Bond Strength of Orthodontic Brackets Bonded to Bleached Human Teeth: An In Vitro Study

Abstract

Aim: The aim of this study was to evaluate the effects of different concentrations of sodium ascorbate (SA), green tea (GT), and chamomile (CM) on the shear bond strength (SBS) of metal orthodontic brackets bonded to teeth bleached with 40% hydrogen peroxide (HP).

Materials and methods: Ninety-four sound premolars were divided into eight groups: group I (control + no bleaching), group II (bleaching + immediate bonding), group III (bleaching + 10% SA), group IV (bleaching + 35% SA), group V (bleaching + 0.5% GT), group VI (bleaching + 1% GT), group VII (bleaching + 0.5% CM), and group VIII (bleaching + 1% CM). In groups III-VIII, teeth were treated with the antioxidants for 10 minutes after bleaching with 40% HP, but before bonding. All the specimens were bonded with the resilience adhesive, and the SBS was tested with a universal testing machine (Instron 5965). The cross-head speed to break the bond was 1 mm/minute. The adhesive remnant index (ARI) was tested under 50× magnification. One-way analysis of variance, Tukey's post hoc, and Chi-squared tests were used for analysis (p ≤ 0.05).

Results: The differences in SBS among the eight tested groups were highly significant (p < 0.001). Comparison of the eight groups using Tukey's post hoc test revealed significantly lower SBS (p < 0.001) in test groups II, III, IV, and VIII than in group I. Adhesive remnant index scores showed significant intergroup differences (p = 0.005). Most groups had a failure score of 1 (<50% of the bonding material adhering to the tooth), whereas groups II and VIII showed a failure score of 0 (no material adhering to the tooth).

Conclusion: Bond strength can be enhanced by using 0.5% or 1% GT or 0.5% CM to allow bracket bonding immediately after bleaching.

Clinical significance: The use of antioxidants would allow clinicians to bleach teeth before orthodontic treatment without delaying bonding.

Keywords: Bleaching; Chamomile extract; Green tea; Metal orthodontic bracket; Shear bond strength Sodium ascorbate..