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INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com

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SIXTH GENERATION SELF-ETCHING PRIMERS

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The introduction of enamel etching in 1955 by BUONOCORE, gave a decisive new direction to the practice of orthodontics. Today, brackets are routinely bonded onto teeth.

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In the process of bonding orthodontic brackets to enamel, conventional adhesive system use three different agents 1. An enamel conditioner 2. A primer solution 3. And an adhesive resin

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A unique characteristic of some new bonding system is that these system combine the conditioning and priming agent into a single acidic primer solution www.indiandentalacademy.com


ALL-IN-ONE CONCEPT (PROMPT-L-POP) Introduced in April 1999: It consists of blister foil that contains 3 compartments 1. 2. 3.

Compartment 1 : containing methacrylated phosphoric esters,photoinitiaters,stabilizers. Compartment 2 :containing water, complex fluoride, stabilizers. Compartment 3 :containing micro brush.

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The blister is activated by squeezing compartment 1,there by releasing its content into compartment 2 and freshly mixed solution is released onto the micro brush into the compartment 3 by squeezing compartment 2. 1

2 3

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How does it work ?(prompt-L-pop): Prompt-l-pop when applied on enamel would dissolve the smear layer by rubbing it in for 15 seconds and at the same time etches the enamel surface. By air drying a very thin film of prompt-L-pop on top of enamel is formed which helps in micro retention of adhesive resin in combination with a chemical bond between this prompt-L-pop layer and the adhesive resin.

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ADVANTAGES : Prompt-L-pop takes only 3 steps until the adhesive resin is placed compared to 7 steps for a typical 5th generation adhesive material. 5th generation adhesive 1. Acid etch- 15 to 30 sec. 2. Rinse with water for 6th generation adhesive 10 sec. 1. Rubin 15 sec. 3. Air blot or blot dry. 2. Air dry- thin layer. 4. Apply primer. 3. Adhesive resin. 5. Air dry - thin layer. 6. Light cure for 10 sec. 7. Adhesive resin. www.indiandentalacademy.com


Orthodontists utilize the acid etch bonding technique as means of attaching brackets to the enamel surface.

Maintaining a sound, unblemished enamel surface after debonding orthodontic brackets is a primary concern to the clinician.

As a result, bond failure at the bracket –adhesive interface or within the adhesive is more desirable (safer) than bond failure at the adhesive-enamel interface, because enamel fracture and crazing have been reported at the time of bracket debonding,with ceramic brackets. www.indiandentalacademy.com


AIMS AND OBJECTIVES : ď Ž

To compare the effect of all-in-one adhesive and conventional adhesive system on the shear bond strength of orthodontic brackets.

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To determine the site of bond failure between enamel, adhesive and bracket base.

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MATERIALS : 1.

TEETH : In this study 20 extracted premolars which were extracted for orthodontic treatment were collected. All the collected teeth were cleaned of saliva and blood and stored in 0.1%thymol.

2.

BRACKETS : 20 Pre-adjusted stainless steel brackets ( Gemini,3M unitek, monrovia, USA ) www.indiandentalacademy.com


3.

BONDING ADHESIVE USED :  

Fifth generation bonding adhesive system. Sixth generation bonding adhesive system.

4.

LIGHT CURE UNIT.

5.

HOUNSFIELD UNIVERSAL TESTING MACHINE.

6.

STEREOMICROSCOPE.

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METHOD : ď Ž

The 20 premolars collected served as the sample for the study.

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These teeth were mounted along their long axis in acrylic blocks. The teeth were covered to the level of alveolar bone with acrylic.

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The buccal surface of all the teeth were cleaned and polished with pumice and rubber prophylactic cups for 10 seconds.

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The sample were randomly divided into 2 groups comprising of 10 teeth in each group.

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group 1 : bracket bonded using 5th generation bonding adhesive system

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group 2 : bracket bonded using 6th generation bonding adhesive system.

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Shear bond strength measurement : universal testing machine was used to test shear bond force. shear bond strengths was measured at a crosshead speed of 5 mm/min.

UNIVERSAL TESTING MACHINE

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Site of bond failure : after being debonded, the teeth and brackets were examined with a Stereo microscope at 10xmagnification.any adhesive that remained after bracket removal was assessed according to the modified adhesive remnant index(ARI) and scored with respect to the amount of resin material that adhered to the enamel surface.

OPTICAL STEREO www.indiandentalacademy.com MICROSCOPE


ARI scale: has a range of 1 to 5 1. 2. 3. 4. 5.

= all of the composite remained on the tooth. = more than 90% of the composite remained on the tooth. = more than 10% but less than 90% of the composite remained on the tooth. = less than 10% of the composite remained on the tooth. = No composite on the teeth.

STEREO MICROSCOPIC PICTURE OF TOOTH SURFACE TO www.indiandentalacademy.com DETERMINE ARI


Statistical analysis 

Continuous data are expressed as Range, Mean and Standard deviation.

Multiple groups are compared by ONE WAY ANOVA followed by student's t-test for group-wise comparison.

Chi-square test was used to compare the pattern of ARI scores between 2 groups.

A P-value of less than .05 was considered for statistical significance. www.indiandentalacademy.com


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RESULTS Shear bond strength ď Ž

The shear bond strength as recorded in kgf and converted into mpa.

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The difference in bond strength between the groups were assessed by one way ANOVA test pair wise multiple comparison between the groups is done by student's :t test

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One way ANOVA test revealed that group 1- (mean 11.4+_ .09) . group 2- (mean 08.03+_ 1.44)

Gp 2 exhibited less shear bond strength as compared to Gp1.

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GRAPH I COMPARISION OF SHEAR BOND STRENGTH BETWEEN 5TH AND 6TH (PROMPT-L-POP) GENERATION

Mean SBS (MPa)

11.4 12 10 8 6 4 2 0

8.0

5th Gen www.indiandentalacademy.com

6th Gen.


ARI Scores : ď Ž

Chi-square test was used to compare the pattern of ARI scores between 2 groups.

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There was a tendency to have less residual adhesive remaining on the tooth when 6th generation bonding agent was used (ARI score of 3 ).

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No.of cases

GRAPH ii COMPARISION OF ARI SCORES BETWEEN 5TH & 6TH GENERATIONS

20 18 16 14 12 10 8 6 4 2 0

1 2

1 3

7

9

Score 4 Score 3 Score 2

8

6

2 5th Gen

Score 5

1 6th Gen. www.indiandentalacademy.com

Score 1


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The direct bonding of brackets has revolutionized and improved the clinical practice of orthodontics.

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There is a need to improve on the bonding procedure by saving time and also minimizing enamel loss during bonding and debonding with out jeopardizing the ability to maintain a clinically useful bond strength.

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The use of the new self-etching primers for orthodontic purposes was thought to simplify the clinical handling of adhesive systems by combining the etching and the primer in one application.

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The newer generation of self-etch primer is compatible with composite adhesives and has adequate bond strength.

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The present finding indicate that the use of a cyanoacrylate adhesive to bond orthodontic brackets to enamel surface provided the clinically acceptable bond force levels suggested by Reynolds.

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6TH generation (prompt-l-pop) has less shear bond strength as compared to 5th generation but has clinically acceptable shear bond strength and it was found that it is of interest to note that there was a tendency to have less residual adhesive remaining on the tooth (ARI score of 3).

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