One-Step Surface-Treatment Reagent (35% 3-O-Ethyl-l-ascorbic Acid Plus 50% Citric Acid Solution) Restores the Shear Bond Strength of Metal Brackets Bonded to Bleached Human Enamel: An In Vitro Study

Abstract

This study investigates how a new substance, composed of ethyl ascorbic acid and citric acid, affects the shear bond strength (SBS) of metal brackets when bonded to bleached teeth. Forty maxillary premolar teeth were used and randomly placed into four groups (n = 10): the control group did not undergo bleaching; the remaining groups underwent bleached using 35% hydrogen peroxide. In group A, 37% phosphoric acid was applied after bleaching. In group B, 10% sodium ascorbate was used for ten minutes before 37% phosphoric acid. In group C, 35%3-O-ethyl-l-ascorbic acid plus 50% citric acid solution (35EA/50CA) was applied for 5 min. The subgroups were bonded immediately after bleaching. The SBS was determined with a universal testing machine and analyzed using one-way ANOVA and then Tukey's HSD tests. Adhesive remnant index (ARI) scores were determined with a stereomicroscope and analyzed with a chi-squared test. The significance level was 0.05. Group C demonstrated significantly higher SBS values than group A (p < 0.001), but was not significantly different than the control group or group C (p > 0.05). The ARI scores were significantly different among the groups (p < 0.001). In conclusion, enamel surface treatment using 35EA/50CA improved the reduced SBS to an acceptable clinical level and reduced the clinical chair time.

Keywords: antioxidant; bleaching; brackets; ethyl ascorbic acid; shear bond strength.

Figure 1

The bonding index was created by attaching two upper premolar brackets to the opposing rims of a PVC pipe so that the universal machine’s blade and bracket margin were parallel.