In vitro evaluation of direct and indirect effects of sonic and ultrasonic instrumentations on the shear bond strength of orthodontic brackets

Abstract

Objective: Sonic and ultrasonic instrumentations generate vibrations that may influence debonding characteristics. The objective of this in vitro study was to assess the direct and indirect effects of sonic and ultrasonic periodontal instrumentations on the shear bond strength (SBS) and the adhesive remnant index (ARI) scores of metallic orthodontic brackets. Methods: Metallic brackets were bonded to 75 extracted mandibular central incisors that were embedded in acrylic resin. Instrumentations around the bracket base performed with ultrasonic (UltrasonicB group, n=15) and sonic (SonicB group, n=15) scalers were used to evaluate the direct effects on the SBS of brackets. Lingual surface instrumentations with ultrasonic (UltrasonicL group, n=15) and sonic (SonicL group, n=15) scalers were performed to assess the indirect effects. The control group (n=15) did not have any treatment. Instrumentations were performed for 30 s with 0° scaler tip angulations with settings recommended by manufacturers. The SBS of the brackets tested with a universal testing machine and ARI scores were recorded. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Results: The mean SBS of the control group was significantly higher than that of the UltrasonicB and SonicB groups (p=0.008). The UltrasonicL and SonicL group instrumentations also decreased the SBS, although the difference was statistically insignificant. UltrasonicB instrumentations caused significantly higher frequency of ARI scores than the control group. Conclusion: The decrease of the SBS of metallic brackets indicates the influence of ultrasonic and sonic instrumentations on the breakage behavior at the bracket-resin interface. Instrumentations around the bracket base should be conducted with caution to decrease the bond failure risk of metallic brackets.