Failure rate of brackets bonded with antimicrobial and fluoride-releasing, self-etching primer and the effect on prevention of enamel demineralization. An in vivo investigation into bond failure rates with a new self-etching primer system. An Investigation into the Use of a Single Component Self-etching Primer Adhesive System for Orthodontic Bonding: A Randomized Controlled Clinical Trial Effect of saliva contamination on bracket failure with a self-etching primer: a prospective controlled clinical trial. Effect of self-etching primers on bond strength--are they reliable? Six and 12 months' evaluation of a self-etching primer versus two-stage etch and prime for orthodontic bonding: a randomized clinical trial. A comparative assessment of the failure rate of molar tubes bonded with a self-etching primer and conventional acid-etching. A Randomized Clinical Trial Comparing ‘One-Step’ and ‘Two-Step’ Orthodontic Bonding Systems Clinical bond failure rates of adhesive precoated self-ligating brackets using a self-etching primer. Effects of etchant concentration and duration on the retention of orthodontic brackets: an in vivo study. A randomised clinical trial to investigate bond failure rates using a self-etching primer. Effect of fluoridated paste on the failure rate of precoated brackets bonded with self-etching primer: a prospective split-mouth study.
INTRODUCTION Our aim in this r and omized clinical trial was to compare the failure rates of orthodontic brackets by using 2 self-etching primers ( SEPs ) ( Transbond Plus [ 3 M Unitek , Seefeld , Germany ] and Clearfil Protect Bond [ Kuraray Medical , Okayama , Japan ] ) with a split-mouth design . Additionally , the effect of Clearfil Protect Bond was investigated regarding inhibition of plaque accumulation and demineralization . METHODS A total of 480 brackets were bonded in 24 patients with the SEPs .  The observation period was 12 months . One week after bonding and at every third recall , the plaque index and a visual rating of the enamel adjacent to the bracket were assessed at the lateral incisors and the first premolars . Additionally ,  DIAGNOdent  ( KaVo , Biberach , Germany ) values were measured . RESULTS Over the investigation time , 26 failures were recorded . Five occurred with the brackets bonded with Transbond Plus , and the rest with Clearfil Protect Bond ( P = 0.002 ) . The additionally observed parameters had no significant differences . CONCLUSIONS The failure rate with Clearfil Protect Bond was significantly higher . For our patients , who had adequate oral hygiene , there was no benefit with regard to plaque accumulation and prevention of demineralization with Clearfil Protect Bond Self-etching primers have recently been introduced to simplify the orthodontic bonding process . The aim of this study was to compare the effectiveness of such a product with conventional 2-stage etching and priming with 37 % o-phosphoric acid and a conventional unfilled primer .  Twenty consecutive patients having orthodontic bonds placed were selected to participate in this cross-mouth control study . Diagonally opposite quadrants were r and omly allocated to either the self-etching primer group or the conventional etching and priming group . A total of 364 teeth were bonded with a light-cured diacrylate adhesive ; bond failures were then monitored over 6 months . There were 20 bond failures ( 10.99 % ) in the self-etching primer group and 9 bond failures ( 4.95 % ) in the conventional etch and priming group over this period . The results were analyzed with the McNemar test and 95 % confidence interval . The difference between the failure proportions was -0.06 with an associated 95 % confidence interval of -0.121 to 0.001 . This study produced weak evidence to suggest that bond failures with a self-etching primer will be higher than those with conventional etching and priming . This increased likelihood of bond failure must be weighed against the time advantage of the self-etching primer when used at the initial bonding appointment Objective This study assessed the in vivo bond failure of the single component orthodontic self-etching primer system , Ideal 1 ( GAC Orthodontic Products ) and compared it with the conventional acid etching using a conventional 37 % o-phosphoric acid , rinsing and drying regimen when bonding stainless steel orthodontic brackets to enamel . Design Prospect i ve r and omized , controlled clinical trial . Setting Orthodontic Department , Bristol Dental School . Material and methods Twenty consecutive patients undergoing upper and lower fixed orthodontic treatment entered this cross-mouth control study . Diagonally opposite quadrants were r and omly allocated to either the self-etching primer group or the conventional etching group . A total of 339 teeth were bonded with Ideal 1 light-cured adhesive . Bond failures and locus of bond failure were then recorded at 1 , 6 and 12 months . Results Significantly more bond failures occurred at each of the 3 time intervals , 1 , 6 and 12 months , where the enamel was pretreated with the Ideal I self-etching primer , than when the enamel was treated with the conventional etchant , 37 % o-phosphoric acid . With the latter the cumulative bond failure rates were 3.0 , 5.3 and 14.8 % , respectively . With the self-etching primer the cumulative failure rates were 29.4 , 56.5 and 72.4 % . Conclusion The study found that enamel pre-treatment with the Ideal 1 self-etching primer system prior to orthodontic bonding results in an unacceptably high bond failure rate when compared with conventional enamel acid etching INTRODUCTION The aim of this study was to evaluate in vivo the effect of saliva contamination at different stages of the bonding procedure on the bond failure rate and the adhesive remaining on teeth after debonding brackets bonded with a hydrophilic self-etching primer ( Transbond Plus self-etching primer [ TSEP ] , 3 M Unitek , Monrovia , Calif ) . METHODS This was a prospect i ve controlled clinical trial . The sample consisted of 46 patients with similar treatment plans and mechanotherapies . Stainless steel brackets ( n = 531 ) were bonded with TSEP . The patients were divided into 2 groups : contamination with saliva before TSEP application and contamination with saliva after TSEP application . In both groups , saliva was applied in a split-mouth design . Diagonally opposite quadrants were allocated to either the contaminated group ( contamination before [ 153 teeth ] or after [ 115 teeth ] TSEP application ) or to the uncontaminated control group ( 263 teeth ) . Recording of failed brackets involved only first-time failures , and the observation period was a minimum of 6 months . RESULTS The chi-squared test showed no significant differences ( P = 0.11 ) in bracket failures between the groups . Kaplan-Meier survival analysis detected no significant differences in the survival rates between the 3 groups ( P = 0.51 ) . Most bond failures occurred during the first 3 months . In all 3 groups , the adhesive remaining on teeth after debonding tended to be less than half . CONCLUSIONS These findings suggest that saliva contamination before or after application of self-etching primer does not increase the clinical risk of bond failure Currently introduced self-etching primers combine conditioning and priming agents into a single product . The purpose of this study was to determine the effects of using three self-etching primers on the shear bond strength ( SBS ) of orthodontic brackets and on the bracket/adhesive failure mode . Brackets were bonded to extracted human teeth according to one of four protocol s. In the control group , teeth were etched with 37 % phosphoric acid . In the experimental groups , the enamel was conditioned with three different self-etching primers , Clearfil SE Bond ( CSE ) , Etch & Prime 3.0 ( EP3 ) , or Transbond Plus ( TBP ) , as suggested by the manufacturer . The brackets were then bonded with Transbond XT in all groups . The present in vitro findings indicate that conditioning with TBP before bonding orthodontic brackets to the enamel surface result ed in a significantly ( P < or = .001 ) higher SBS ( mean , 16.0 + /- 4.5 MPa ) than that found in CSE , EP3 , and the control ( acid-etched [ AE ] ) groups . CSE produced bond strength values ( mean 11.5 + /- 3.3 MPa ) that are statistically comparable to those produced by acid etching ( mean 13.1 + /- 3.1 MPa ) . The use of EP3 for enamel conditioning result ed in the lowest mean SBS value ( mean 9.9 + /- 4.0 MPa ) . A comparison of the adhesive remnant index scores indicated that there was more residual adhesive remaining on the teeth that were treated with conventional acid etching than in the CSE and EP3 groups . In the TBP group , the failure sites were similar to those of the AE group but different from those of the CSE group The aim of the study was to compare the mean clinical chair-side time required for bracket bonding and the mean bond failure rate at 6 and 12 months of stainless steel brackets with a micro-etched base bonded with a light-cured composite using a self-etching primer ( SEP ) or a two-stage etch and prime system .  Fifty-one subjects who required upper and /or lower pre-adjusted edgewise fixed appliances were recruited in a single centre r and omized clinical trial . The trial was a single-blind design , involving a within-patient comparison of the two bonding systems with each patient r and omly allocated the two bonding systems for each side of the mouth ( all teeth except molars ) . The two bonding techniques used were st and ardized throughout the trial and all bracket bonding was performed by a single operator . Bonding time was recorded using a digital timer . The bond failure rate of a strictly paired sample was recorded at 6 and 12 months for each patient . The mean bracket bonding time per patient with the SEP was significantly less than that with the two-stage bonding system ( mean difference 24.9 seconds ; 95 per cent confidence interval 22.1 - 27.7 seconds ; paired t-test P < 0.001 ) . The overall bond failure rates at 6 and 12 months with the SEP were 0.8 and 1.6 per cent , respectively , and for the two-stage etch and prime 1.1 and 3.1 per cent , respectively . At 6 months , the mean bond failure rate per patient with the SEP was 0.81 per cent and with the two-stage bonding system 0.96 per cent ( P = 0.87 ; Wilcoxon signed rank test ) . At 12 months , the mean bond failure rate with the SEP per patient was 1.54 per cent and with the two-stage bonding system 2.78 per cent ( P = 0.33 ; Wilcoxon signed rank test ) . The mean bracket bonding time with the SEP per patient was significantly shorter than that of the two-stage bonding system ( P < 0.001 ) . The difference between the overall bond failure rate and the mean bond failure rate per patient for the two bonding systems was not statistically nor clinical ly significant at 6 and 12 months ( P = 1.00 and P = 0.125 , respectively ; McNemar 's test ) OBJECTIVES Comparative assessment of the failure rate of molar tubes bonded to first and second molars with a self-etching primer and conventional acid-etching . MATERIAL AND METHODS Four hundred forty-four molar tubes ( 246 first molar tubes and 198 second molar tubes ) were bonded , using a split-mouth design , on 62 patients ( 23 male , 39 female ; mean age 13.7 years ) with the 3 M Transbond Plus self-etching primer combined with Transbond XT paste ; or with conventional acid-etching , Orthosolo primer , and Enlight adhesive paste .  First-time failures were recorded over a period of 15 months . RESULTS Bond failure per adhesive system , arch ( maxilla-m and ible ) , quadrant ( left , right ) and tooth ( first or second molar ) were studied . Statistical analysis using logistic regression modeling ( alpha = .05 ) showed that the overall failure rate for the first and second molar tubes was 11 % ( 8 % with self-etching primer and 13 % with conventional acid-etching ) . No significant difference was found between the 2 bonding methods . Tooth location and type showed statistically significant associations . M and ibular tubes showed a 3:1 probability for failure compared to maxillary tubes . Right-sided tubes demonstrated 3 times more failures when compared to left-sided tubes , and second molar tubes showed a 3-fold increase in failure . CONCLUSION Molar tube bonding with self-etching primer shows similar success rates to conventional acid-etching , whereas the m and ibular right second molar presents the highest failure incidence Objective The primary objective of this prospect i ve clinical trial was to assess the clinical bond failure rates of orthodontic brackets bonded using a self-etching primer ( SEP ) , compared with brackets bonded using a conventional acid-etched technique with control adhesive ( Transbond ™ ) . A secondary aim was to investigate whether characteristics of the operator , patient or tooth bonded had any influence on bracket failure . Design Single-centre r and omized controlled clinical trial . Thirty-four patients were bonded , each being r and omly assigned to either the test or control adhesive . Setting NHS Hospital Orthodontic Department , Chester , UK . Subjects Orthodontic patients requiring fixed appliance treatment . Main outcome measures Bond failure . Main outcome results Failure rates over the initial 6-month period were 2.0 % ( Transbond ™ ) and 1.7 % ( SEP ) with no statistically significant difference between the two groups . Over the duration of the fixed appliance treatment , bond failure rates increased , but remained acceptable at 7.4 % ( TB ) and 7.0 % ( SEP ) , respectively . When operator , patient and tooth characteristics were analysed , only the bracket location was found to be significant . Maxillary brackets were more likely to fail than m and ibular brackets ( RR 0.47 % ; 95 % CI 0.22 , 1.03 ) . The failure rate for brackets in our study was low when compared with previous studies . Conclusions Both the acid-etched control and self-etching primer in combination with adhesive pre-coated brackets were successful for clinical bonding . Their combined failure rate was lower than that reported in similar trials OBJECTIVE To comparatively assess the failure rate of adhesive precoated ( APC ) self-ligating metal brackets bonded with two different enamel surface preparation techniques : self-etching primer ( SEP ) and conventional two-step etch and primer method ( CM ) . MATERIAL S AND METHODS Fifty-seven patients with complete permanent dentition were included in this study . A total of 1140 APC self-ligating brackets ( 3 M Unitek , Monrovia , Calif ) were bonded using a split-mouth design . For each patient , SEP ( Transbond Plus SEP , 3 M Unitek ) and CM ( 37 % phosphoric acid ) were used in alternate quadrants . All brackets were bonded by the same investigator after pumicing and rinsing of all of the teeth . The number , site , and date of first-time bracket failures were monitored throughout orthodontic treatment ( mean , 22 months ) . The survival rates of the brackets were estimated by Kaplan-Meier and log-rank tests ( P < .05 ) . The adhesive remnant index was used to determine the bond failure interface . RESULTS The bond failure rates were 2.97 % and 2.18 % for the CM and SEP , respectively . No statistically significant difference in failure rates was found between the groups . The bond failure sites were predominantly at the enamel-adhesive interface in both groups . CONCLUSION This long-term in vivo study showed that the combined use of SEP and the APC bracket system can be used effectively for bonding brackets after pumicing the enamel surfaces in clinical orthodontics Etching of enamel before the bonding of orthodontic attachments is usually done with a solution of 37 % H3PO4 for 60 seconds . The purpose of this study was to evaluate the effects of etchant concentration and duration on the clinical retention of bonded orthodontic attachments . Two r and omly selected groups of orthodontic patients participated in the study . In both groups , teeth in contralateral quadrants , excluding the molar teeth , were bonded . In the first group , 158 teeth were etched with a solution of 37 % H3PO4 for 60 seconds , and 155 teeth were etched with 37 % H3PO4 for 15 seconds . In the second group , 196 teeth were etched with 37 % H3PO4 and 196 teeth with 15 % H3PO4 , both for 60 seconds . Conventional edgewise mechanotherapy was used in both groups of patients . After 24 months of treatment , in the first group , 8 brackets were dislodged when etched with 37 % H3PO4 for 60 seconds and 9 when etched with 37 % H3PO4 for 15 seconds . In the second group , 6 brackets were dislodged when etched with 37 % H3PO4 for 60 seconds and 13 were dislodged when etched with 15 % H3PO4 for 60 seconds . Reducing the etching time of 37 % H3PO4 from 60 seconds to 15 seconds or reducing the acid concentration from 37 % to 15 % H3PO4 applied for 60 seconds had no significantly different effect on the retention of bonded orthodontic attachments . The results suggest that the reduction of etchant concentration and the duration of etching in orthodontic bonding should be considered This clinical trial evaluated , over a 12-month period , the performance of brackets bonded to teeth etched and primed with Transbond Plus Self-Etching Primer ( SEP ) when compared with a conventional separate two-step etch and primer system .  Thirty-nine r and omly selected patients requiring fixed appliance therapy were entered into the study . R and om allocation of each etching system , along with a ' split-mouth cross-quadrant ' design was used . A total of 661 brackets were placed by two operators . The failure and survival rates of the brackets were determined for age and gender of the patients , each etching system , operator , mode of failure , tooth position in the dental arch , and number of manipulations prior to curing the adhesive . Statistical analysis showed that SEP had a significantly higher bond failure rate ( 11.2 per cent ) than the conventional etch and primer system ( 3.9 per cent ) at the P = 0.001 level . Cox 's proportional hazards regression showed the conventional etch and primer system to have a 60 per cent reduced chance of bracket failure over a 12-month observation period , while males had a 2.4 times increased risk compared with females . The predominant mode of failure was at the composite enamel interface for the SEP , while for the conventional etch and primer system , it was within the composite adhesive . No statistically significant differences were found for the failure rate with respect to the age of the patient , operator , tooth location , or the number of manipulations of the bracket . This in vivo study showed that brackets bonded using SEP had an increased clinical bond failure rate compared with the conventional , separate , etch and prime system INTRODUCTION The aim of this prospect i ve r and omized clinical trial was to determine the effect of using fluori date d paste ( Dentsply , York , Pa ) compared with plain pumice ( Ortho Technology , Tampa , Fla ) on the clinical bond failure rates of precoated brackets bonded with self-etching primer . METHODS A split-mouth technique was used . The teeth in the maxillary right and m and ibular left quadrants were prepared with a fluori date d paste only , and the teeth in the maxillary left and m and ibular right quadrants were prepared with plain pumice before bonding the precoated brackets . A total of 627 brackets in 34 orthodontic patients ( 20 female , 14 male ) were included in this study ; 315 brackets were bonded after pumice treatment , and 312 were bonded after paste treatment . The patients were followed for 6 months to determine the rates of bracket failure . RESULTS The overall failure rate was 8 % . The failure rates for pumice and paste were 4.8 % and 11.2 % , respectively . The McNemar test showed a statistically significant difference between the 2 groups . Based on tooth type , the failure rate of the maxillary canine and the m and ibular central incisor brackets were significantly different for paste and pumice . There was also a difference in the survival rates of the brackets in both groups . CONCLUSIONS Preparation of the enamel surface with fluori date d paste before bonding with self-etching primer is not recommended . However , the use of plain pumice is recommended , even if it is time-consuming
There was insufficient evidence to assess the effect of bonding modality on demineralization rates .
CONCLUSIONS There is weak evidence indicating higher odds of failure with self-etch primer than acid etch over 12 months in orthodontic patients , and there is strong evidence that a self-etch primer is likely to result in a modest time savings ( 8 minutes for full bonding ) compared with acid etch
INTRODUCTION The use of self-etch primers has increased steadily because of their time savings and greater simplicity ; however , overall benefits and potential disadvantages and harms have not been assessed systematic ally .
In this study , we review ed r and omized controlled trials to assess the risk of attachment failure , bonding time , and demineralization adjacent to attachments between 1-stage ( self-etch ) and 2-stage ( acid etch ) bonding in orthodontic patients over a minimum follow-up period of 12 months .