ZİRKONYUM YÜZEYLERE FARKLI YÜZEY PÜRÜZLENDİRME TEKNİKLERİ SONRASI YAPIŞTIRILAN SERAMİK BRAKETLERİN BAĞLANMA DAYANIMLARININ KARŞILAŞTIRMALI OLARAK İNCELENMESİ: İN-VİTRO ÇALIŞMA

Abstract

Amaç: Monolitik zirkonyum yüzeylere, estetik beklentileri karşılamak amacıyla sık tercih edilen seramik braketlerin bağlanma dayanımını inceleyen çalışmalara az rastlanmaktadır. Bu çalışmanın amacı farklı pürüzlendirme yöntemleri uygulanmış zirkonyum yüzeylere yapıştırılan seramik braketlerin bağlanma dayanımını ölçmek ve kopma bölgelerini Artık adeziv indeksi (Adhesive Remnant Index: ARI) skorlaması ile değerlendirmektir.
Gereç ve Yöntem: 40 adet zirkonyum blok 4 eşit gruba ayrılarak hidroflorik asit (HF), alüminyum oksit (Al2O3) ile kumlama, Er-YAG lazer ve Nd-YAG lazer ile yüzey pürüzlendirme işlemleri yapılmış ve tüm seramik braketler yüzeylere yapıştırılmıştır. Universal test cihazıyla braketlerin yüzeylere bağlanma dayanımları Megapaskal (Mpa) cinsinden kaydedilmiştir. Sıyırma testi sonrası zirkonyum yüzeylerdeki kopma bölgeleri optik mikroskopta x20 büyütme altında yüzeyler incelenmiştir.
Bulgular: Yapılan değerlendirme sonucunda sırasıyla bağlanma dayanımı ortalama değerleri 4,56±1,99 MPa, 6,88±2.04 MPa, 7,43±1,47 MPa, 5,66±2,31 MPa ile en düşük HF grubu, en yüksek ise Er-YAG grubu olmuş- tur. Er-YAG grubunda ölçülen değerin HF grubuna göre istatistiksel olarak anlamlı şekilde daha yüksek olduğu görülmüştür (p<0.05). ARI skorları incelendiğinde Er-YAG grubunda örneklerin %40’ında tüm artık kompozitin porselen yüzeyinde kaldığı (ARI skoru 1) görülmüştür.
Sonuç: Ortodonti kliniğinde kullanılan HF ile pürüzlendirme yöntemi son- rası braketlerin zirkonyum yüzeylere bağlanma dayanımı yetersiz bulunmuştur. Zirkonyum yüzeylere Er-YAG lazer ile pürüzlendirme yönteminin seramik braketlerde daha fazla bağlanma dayanımı sağladığı gösterilmiştir.

Keywords

• monolitik zirkonyum
• seramik braket
• bağlanma dayanımı
• yüzey pürüzlendirme
• lazer

SHEAR BOND STRENGTH OF CERAMIC BRACKETS BONDED TO ZIRKONIUM SURFACES AFTER DIFFERENT SURFACE PREPERATION TECHNIQUES: AN IN VITRO STUDY

Abstract

Objective: There are few studies examining the shear bond strength (SBS) of ceramic brackets (which are frequently chosen to meet aesthetic expectations), on monolithic zirconium surfaces. The aim of this study is to measure the SBS of ceramic brackets adhered to the zirconium surfaces, to which different surface roughening methods have been applied and to evaluate the rupture areas with ARI scoring.
Materials and method: 40 zirconium blocks were divided into 4 equal groups and surface roughening processes performed with hydrofluoric acid (HF), sandblasting with aluminum-oxide (Al2O3), Er-YAG and Nd-YAG laser. All ceramic brackets were adhered to the surfaces. The SBS values of the brackets to surfaces were recorded in MPa with a universal test machine. For ARI scoring, the surfaces were examined under x20 magnification with optical microscope.
Results: the mean SBS values were 4.599±1.989, 6.879±2.037, 7.429±1.468, 5.665±2.308 MPa respectively, with the lowest being the HF group and the highest being the Er-YAG group. It was observed that the measured value in the Er-YAG group was statistically higher than the HF group. When Adhesive Remnant Index (ARI) scores were examined, it was observed that in 40% of the samples in the Er-YAG group, all residual composite remained on the zirconium.
Conclusion: the SBS of the HF method, which is frequently used in orthodontic clinics, to zirconium was found insufficient. It has been shown that surface roughening of zirconium with Er-YAG laser provides more SBS with ceramic brackets.

Keywords

• monolithic zirconium
• ceramic bracket
• bond strength
• surface roughening
• laser

References

1. 1. Blatz MB, Sadan A, Kern M. Resin-ceramic bonding: a review of the literature. J Prosthet Dent 2003;89(3):268-74. google scholar
2. 2. Karan S, Büyükyilmaz T, Toroğlu MS. Orthodontic bonding to several ceramic surfaces: Are there acceptable alternatives to conventional methods? Am J Orthod Dentofac Orthop 2007;132(2):14. doi:10.1016/j.ajodo.2006.12.006 google scholar
3. 3. Poosti M, Jahanbin A, Mahdavi P, Mehrnoush S. Porcelain conditioning with Nd: YAG and Er:YAG laser for bracket bonding in orthodontics. Lasers Med Sci 2012;27(2):321-4. google scholar
4. 4. Ajlouni R, Bishara SE, Oonsombat C, Denehy GE. Evaluation of modifying the bonding protocol of a new acid-etch primer on the shear bond strength of orthodontic brackets. Angle Orthod 2004;74(3):410-3. google scholar
5. 5. Barbosa VLT, Almeida MA, Chevitarese O, Keith O. Direct bonding to porcelain. Am J Orthod Dentofac Orthop 1995;107(2):159-64. google scholar
6. 6. Bourke BM, Rock WP. Factors affecting the shear bond strength of orthodontic brackets to porcelain. Br J Orthod 1999;26(4):285-90. google scholar
7. 7. Thurmond JW, Barkmeier WW, Wilwerding TM. Effect of porcelain surface treatments on bond strengths of composite resin bonded to porcelain. J Prosthet Dent 1994;72(4):355-9. google scholar
8. 8. Wang WN, Meng CL, Tarng TH. Bond strength: a comparison between chemical coated and mechanical interlock bases of ceramic and metal brackets. Am J Orthod Dentofac Orthop 1997;111(4):374-81. google scholar

9. 9. Lemke K, Xu X, Hagan JL, Armbruster PC, Ballard RW. Bond strengths and debonding characteristics of two types of polycrystalline ceramic brackets. Aust Orthod J 2010;26(2):134-40. google scholar
10. 10. Smith GA, Mcİnnes-Ledoux P, Ledoux WR, Weinberg R. Orthodontic bonding to porcelain—bond strength and refinishing. Am J Orthod Dentofac Orthop 1988;94(3):245-52. google scholar
11. 11. Schmage P, Nergiz İ, Herrmann W, Özcan M. İnfluence of various surface-conditioning methods on the bond strength of metal brackets to ceramic surfaces. Am J Orthod Dentofac Orthop 2003;123(5):540-6. google scholar
12. 12. Zachrisson YO, Zachrisson BU, Büyükyilmaz T. Surface preparation for orthodontic bonding to porcelain. Am J Orthod Dentofacial Orthop 1996;109(4):420-30. google scholar
13. 13. Erdur EA, Basciftci FA. Effect of Ti:sapphire laser on shear bond strength of orthodontic brackets to ceramic surfaces. Lasers Surg Med 2015;47(6):512-9. google scholar
14. 14. Bishara SE, Trulove TS. Comparisons of different debonding techniques for ceramic brackets: An in vitro study: Part İİ. Findings and clinical implications. Am J Orthod Dentofac Orthop 1990;98(3):263-73. google scholar
15. 15. Ramakrishnaiah R, Alkheraif AA, Divakar DD, Matinlinna JP, Vallittu PK. The effect of hydrofluoric acid etching duration on the surface micromorphology, roughness, and wettability of dental ceramics. İnt J Mol Sci 2016;17(6):822. google scholar
16. 16. Ho GW, Matinlinna JP. İnsights on ceramics as dental materials. Part İ: ceramic material types in dentistry. Silicon 2011;3(3):109-15. google scholar
17. 17. Grewal Bach GK, Torrealba Y, Lagravere MO. Orthodontic bonding to porcelain: a systematic review. Angle Orthod 2014;84(3):555-60. google scholar
18. 18. Yucel MT, Aykent F, Akman S, Yondem İ. Effect of surface treatment methods on the shear bond strength between resin cement and all-ceramic core materials. J Non Cryst Solids 2012;358(5):925-30. google scholar
19. 19. Kurt I, Çehreli ZC, Özçırpıcı AA, Şar Ç. Biomechanical evaluation between orthodontic attachment and three different materials after various surface treatments: A three-dimensional optical profilometry analysis. Angle Orthod 2019;89(5):742-50. google scholar
20. 20. Özcan M. The use of chairside silica coating for different dental applications: a clinical report. J Prosthet Dent 2002;87(5):469-72. google scholar
21. 21. Ju GY, Lim BS, Moon W, Park SY, Oh S, Chung SH. Primer-treated ceramic bracket increases shear bond strength on dental zirconia surface. Materials (Basel) 2020;13(18):4106. google scholar
22. 22. Yi YA, Ahn JS, Park YJ, vd. The effect of sandblasting and different primers on shear bond strength between yttria-tetragonal zirconia polycrystal ceramic and a self-adhesive resin cement. Oper Dent 2015;40(1):63-71. google scholar
23. 23. Kocadereli I, Canay S, Akca K. Tensile bond strength of ceramic orthodontic brackets bonded to porcelain surfaces. Am J Orthod Dentofac Orthop 2001;119(6):617-20. google scholar
24. 24. Blakey R, Mah J. Effects of surface conditioning on the shear bond strength of orthodontic brackets bonded to temporary polycarbonate crowns. Am J Orthod Dentofac Orthop 2010;138(1):72-8. google scholar
25. 25. Weiner GP. Laser dentistry practice management. Dent Clin 2004;48(4):1105-26. google scholar
26. 26. Stabholz A, Zeltser R, Sela M, vd. The use of lasers in dentistry: principles of operation and clinical applications. Compend Contin Educ Dent 2003;24(12):935-48. google scholar
27. 27. Dederich DN, Bushick RD. Lasers in dentistry: separating science from hype. J Am Dent Assoc 2004;135(2):204-12. google scholar
28. 28. Yassaei S, Aghili H, KhanPayeh E. Comparison of shear bond strength of rebonded brackets with four methods of adhesive removal. Lasers Med Sci 2014;29(5):1563-8. google scholar
29. 29. Mokhtarpur H, Nafisifard M, Dadgar S, Etemadi A, Chiniforush N, Sobouti F. Shear Bond Strength of the Metal Bracket to Zirconium Ceramic Restoration Treated by the Nd: YAG Laser and Other Methods: An In Vitro Microscopic Study. J Lasers Med Sci 2020;11(4):411-6. google scholar
30. 30. Cetik S, Ha TH, Sitri L, Duterme H, Pham V, Atash R. Comparison of Shear Strength of Metal and Ceramic Orthodontic Brackets Cemented to Zirconia Depending on Surface Treatment: An in Vitro Study. Eur J Dent 2019;13(2):150-5. google scholar