This study investigated the effectiveness of acid etching and bond strength in an orthodontic bonding system in accordance with various time periods after 1.23% acidulated phosphate fluoride (APF) gel applications.
Materials and methods
APF gel was applied on the enamel surface of bovine teeth, which were assigned to group F0. The tooth specimens were then immersed in distilled water for 1 (F1), 7 (F7), 14 (F14), 21 (F21) and 28 (F28) days. A group without fluoride pretreatment was a control group. All groups were etched with 35% phosphoric acid and evaluated using a surface hardness tester and scanning electron microscope (SEM). A shear bond strength (SBS) test was performed using a universal testing machine, and the bond failure modes were also examined.
After the 1.23% APF gel treatment, the hardness of the acid-etched enamel surface decreased as the immersion period increased. SEM images of the test groups showed etched patterns similar to control group as the immersion period increased. The SBS increased with increasing immersion period, whereas group F21 was not significantly different from the control group. Relatively high adhesive remnant index scores were identified as the ageing period increased.
The present study indicated that in order to obtain suitable bond strength, it is recommended to use an acid etching-based bonding system for the fixation of orthodontic appliances on the enamel surface 21 days after the use of APF gel.
Fluoride pre-treatment interferes with the acid etching effects on enamel, causing a reduction in the bond strength with orthodontic brackets.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Tufekci E, Dixon JS, Gunsolley JC, Lindauer SJ (2011) Prevalence of white spot lesions during orthodontic treatment with fixed appliances. Angle Orthod 81(2):206–210. https://doi.org/10.2319/051710-262.1
Enaia M, Bock N, Ruf S (2011) White-spot lesions during multibracket appliance treatment: a challenge for clinical excellence. Am J Orthod Dentofac Orthop 140(1):e17–e24. https://doi.org/10.1016/j.ajodo.2010.12.016
Stecksen-Blicks C, Renfors G, Oscarson ND, Bergstrand F, Twetman S (2007) Caries-preventive effectiveness of a fluoride varnish: a randomized controlled trial in adolescents with fixed orthodontic appliances. Caries Res 41(6):455–459. https://doi.org/10.1159/000107932
Richter AE, Arruda AO, Peters MC, Sohn W (2011) Incidence of caries lesions among patients treated with comprehensive orthodontics. Am J Orthod Dentofac Orthop 139(5):657–664. https://doi.org/10.1016/j.ajodo.2009.06.037
Featherstone JD (2004) The continuum of dental caries--evidence for a dynamic disease process. J Dent Res 83 Spec No C:C39–C42. https://doi.org/10.1177/154405910408301s08
Wang WN, Sheen DH (1991) The effect of pretreatment with fluoride on the tensile strength of orthodontic bonding. Angle Orthod 61(1):31–34 https://www.angle.org/doi/10.1043/0003-3219(1991)061%3C0031:TEOPWF%3E2.0.CO;2
Gao SS, Zhang S, Mei ML, Lo EC, Chu CH (2016) Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a systematic review. BMC Oral Health 16(12):1–9. https://doi.org/10.1186/s12903-016-0171-6
Rolla G, Saxegaard E (1990) Critical evaluation of the composition and use of topical fluorides, with emphasis on the role of calcium fluoride in caries inhibition. J Dent Res 69 Spec No:780-785–discussion 820-783. https://doi.org/10.1177/00220345900690S150
Ahn SJ, Lee SJ, Lee DY, Lim BS (2011) Effects of different fluoride recharging protocols on fluoride ion release from various orthodontic adhesives. J Dent 39(3):196–201. https://doi.org/10.1016/j.jdent.2010.12.003
Geiger AM, Gorelick L, Gwinnett AJ, Benson BJ (1992) Reducing white spot lesions in orthodontic populations with fluoride rinsing. Am J Orthod Dentofac Orthop 101(5):403–407. https://doi.org/10.1016/0889-5406(92)70112-n
Attin R, Stawarczyk B, Kecik D, Knosel M, Wiechmann D, Attin T (2012) Shear bond strength of brackets to demineralize enamel after different pretreatment methods. Angle Orthod 82(1):56–61. https://doi.org/10.2319/012311-48.1
Al-Kawari HM, Al-Jobair AM (2014) Effect of different preventive agents on bracket shear bond strength: in vitro study. BMC Oral Health 14(28):1–6. https://doi.org/10.1186/1472-6831-14-28
Du M, Cheng N, Tai B, Jiang H, Li J, Bian Z (2012) Randomized controlled trial on fluoride varnish application for treatment of white spot lesion after fixed orthodontic treatment. Clin Oral Investig 16(2):463–468. https://doi.org/10.1007/s00784-011-0520-4
Kim MJ, Lim BS, Chang WG, Lee YK, Rhee SH, Yang HC (2005) Phosphoric acid incorporated with acidulated phosphate fluoride gel etchant effects on bracket bonding. Angle Orthod 75(4):678–684 https://www.angle.org/doi/full/10.1043/0003-3219%282005%2975%5B678%3APAIWAP%5D2.0.CO%3B2?=
Ren YF, Zhao Q, Malmstrom H, Barnes V, Xu T (2009) Assessing fluoride treatment and resistance of dental enamel to soft drink erosion in vitro: applications of focus variation 3D scanning microscopy and stylus profilometry. J Dent 37(3):167–176. https://doi.org/10.1016/j.jdent.2008.09.008
Kilian M, Larsen MJ, Fejerskov O, Thylstrup A (1979) Effects of fluoride on the initial colonization of teeth in vivo. Caries Res 13(6):319–329. https://doi.org/10.1159/000260422
Bryant S, Retief DH, Bradley EL Jr, Denys FR (1985) The effect of topical fluoride treatment on enamel fluoride uptake and the tensile bond strength of an orthodontic bonding resin. Am J Orthod 87(4):294–302. https://doi.org/10.1016/0002-9416(85)90004-1
Cossellu G, Lanteri V, Butera A, Laffi N, Merlini A, Farronato G (2017) Timing considerations on the shear bond strength of orthodontic brackets after topical fluoride varnish applications. J Orthod Sci 6(1):11–15. https://doi.org/10.4103/2278-0203.197392
Øgaard B, Rølla G, Arends J (1988) Orthodontic appliances and enamel demineralization: part 1. Lesion development. Am J Orthod Dentofac Orthop 94(1):68–73. https://doi.org/10.1016/0889-5406(88)90453-2
Reynolds E, Cai F, Cochrane N, Shen P, Walker G, Morgan M, Reynolds C (2008) Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res 87(4):344–348. https://doi.org/10.1177/154405910808700420
Ten Cate JM (1999) Current concepts on the theories of the mechanism of action of fluoride. Acta Odontol Scand 57(6):325–329. https://doi.org/10.1080/000163599428562
Ogaard B (2001) CaF(2) formation: cariostatic properties and factors of enhancing the effect. Caries Res 35:40–44. https://doi.org/10.1159/000049109
Adanir N, Turkkahraman H, Gungor AY (2007) Effects of fluorosis and bleaching on shear bond strengths of orthodontic brackets. Eur J Dent 1(4):230–235. https://doi.org/10.1055/s-0039-1698344
Gungor AY, Turkkahraman H, Adanir N, Alkis H (2009) Effects of fluorosis and self etching primers on shear bond strengths of orthodontic brackets. Eur J Dent 3(3):173–177. https://doi.org/10.1055/s-0039-1697428
Silva-Benitez EL, Zavala-Alonso V, Martinez-Castanon GA, Loyola-Rodriguez JP, Patino-Marin N, Ortega-Pedrajo I, Garcia-Godoy F (2013) Shear bond strength evaluation of bonded molar tubes on fluorotic molars. Angle Orthod 83(1):152–157. https://doi.org/10.2319/030812-203.1
Kimura T, Dunn WJ, Taloumis LJ (2004) Effect of fluoride varnish on the in vitro bond strength of orthodontic brackets using a self-etching primer system. Am J Orthod Dentofac Orthop 125(3):351–356. https://doi.org/10.1016/j.ajodo.2003.04.007
Ortiz-Ruiz AJ, Munoz-Gomez IJ, Perez-Pardo A, German-Cecilia C, Martinez-Beneyto Y, Vicente A (2018) Influence of fluoride varnish on shear bond strength of a universal adhesive on intact and demineralized enamel. Odontology 106(4):460–468. https://doi.org/10.1007/s10266-018-0363-4
Endo T, Ishida R, Komatsuzaki A, Sanpei S, Tanaka S, Sekimoto T (2014) Effects of long-term repeated topical fluoride applications and adhesion promoter on shear bond strengths of orthodontic brackets. Eur J Dent 8(4):431–436. https://doi.org/10.4103/1305-7456.143609
Cartwright H, Lindahl R, Bawden J (1968) Clinical findings on the effectiveness of stannous fluoride and acid phosphate fluoride as caries reducing agents in children. J Dent Child 35(1):36–40
Horowitz HS (1969) Effect on dental caries of topically applied acidulated phosphate-fluoride: results after two years. J Am Dent Assoc 78(3):568–572. https://doi.org/10.14219/jada.archive.1969.0116
Wellock W, Brudevold F (1963) A study of acidulated fluoride solutions—II: the caries inhibiting effect of single annual topical applications of an acidic fluoride and phosphate solution. A two year experience. Arch Oral Biol 8(2):179–182. https://doi.org/10.1016/0003-9969(63)90054-2
Zachrisson BU (1975) Fluoride application procedures in orthodontic practice, current concepts. The Angle Orthod 45(1):72–81 https://www.angle.org/doi/10.1043/0003-3219(1975)045%3C0072:FAPIOP%3E2.0.CO;2
Yang YK, Seok SH, Lee YM, Yang HC, Lim BS Effects of pre- and post-fluoride treatments on the shear bond strength of dental bracket. Kor J Dent Mater 41(2014):197–207. https://doi.org/10.14815/kjdm.2014.41.3.197
Laurance-Young P, Bozec L, Gracia L, Rees G, Lippert F, Lynch RJ, Knowles JC (2011) A review of the structure of human and bovine dental hard tissues and their physicochemical behaviour in relation to erosive challenge and remineralisation. J Dent 39(4):266–272. https://doi.org/10.1016/j.jdent.2011.01.008
Field J, Waterhouse P, German M (2010) Quantifying and qualifying surface changes on dental hard tissues in vitro. J Dent 38(3):182–190. https://doi.org/10.1016/j.jdent.2010.01.002
Arends J, Ten Bosch J (1992) Demineralization and remineralization evaluation techniques. J Dent Res 71:924–928. https://doi.org/10.1177/002203459207100S27
Li N, Nikaido T, Alireza S, Takagaki T, Chen JH, Tagami J (2013) Phosphoric acid-etching promotes bond strength and formation of acid-base resistant zone on enamel. Oper Dent 38(1):82–90. https://doi.org/10.2341/11-422-L
Kim JH, Kwon OW, Kim HI, Kwon YH (2006) Acid resistance of erbium-doped yttrium aluminum garnet laser-treated and phosphoric acid-etched enamels. Angle Orthod 76(6):1052–1056. https://doi.org/10.2319/11405-398
Tomiyama K, Mukai Y, Teranaka T (2008) Acid resistance induced by a new orthodontic bonding system in vitro. Dent Mater J 27(4):590–597. https://doi.org/10.4012/dmj.27.590
Cuy JL, Mann AB, Livi KJ, Teaford MF, Weihs TP (2002) Nanoindentation mapping of the mechanical properties of human molar tooth enamel. Arch Oral Biol 47(4):281–291. https://doi.org/10.1016/S0003-9969(02)00006-7
Barbour ME, Parker DM, Allen GC, Jandt KD (2003) Human enamel dissolution in citric acid as a function of pH in the range 2.30< or =pH< or =6.30--a nanoindentation study. Eur J Oral Sci 111(3):258–262. https://doi.org/10.1034/j.1600-0722.2003.00039.x
Larsen MJ (1990) Chemical events during tooth dissolution. J Dent Res 69:575–580. https://doi.org/10.1177/00220345900690S114
Di Hipolito V, de Goes MF, Carrilho MR, Chan DC, Daronch M, Sinhoreti MA (2005) SEM evaluation of contemporary self-etching primers applied to ground and unground enamel. J Adhes Dent 7(3):203–211
Yeh ST, Wang HT, Liao HY, Su SL, Chang CC, Kao HC, Lee BS (2011) The roughness, microhardness, and surface analysis of nanocomposites after application of topical fluoride gels. Dent Mater 27(2):187–196. https://doi.org/10.1016/j.dental.2010.10.013
Scougall Vilchis RJ, Yamamoto S, Kitai N, Yamamoto K (2009) Shear bond strength of orthodontic brackets bonded with different self-etching adhesives. Am J Orthod Dentofac Orthop 136(3):425–430. https://doi.org/10.1016/j.ajodo.2007.08.024
Sheykholeslam Z, Buonocore MG, Gwinnett AJ (1972) Effect of fluorides on the bonding of resins to phosphoric acid-etched bovine enamel. Arch Oral Biol 17(7):1037–1045. https://doi.org/10.1016/0003-9969(72)90178-1
Tabrizi A, Cakirer B (2011) A comparative evaluation of casein phosphopeptide-amorphous calcium phosphate and fluoride on the shear bond strength of orthodontic brackets. Eur J Orthod 33(3):282–287. https://doi.org/10.1093/ejo/cjq062
Endo T, Ishida R, Komatsuzaki A, Sanpei S, Tanaka S, Sekimoto T (2014) Effects of long-term repeated topical fluoride applications and adhesion promoter on shear bond strengths of orthodontic brackets. Eur J Orthod 8(04):431–436. https://doi.org/10.4103/1305-7456.143609
Sinha PK, Nanda RS, Duncanson MG, Hosier MJ (1995) Bond strengths and remnant adhesive resin on debonding for orthodontic bonding techniques. Am J Orthod Dentofac Orthop 108(3):302–307. https://doi.org/10.1016/S0889-5406(95)70025-0
Vieira A, Ruben JL, Huysmans MC (2005) Effect of titanium tetrafluoride, amine fluoride and fluoride varnish on enamel erosion in vitro. Caries Res 39(5):371–379. https://doi.org/10.1159/000086843
Murakami C, Bönecker M, Corrêa MS, Mendes FM, Rodrigues CR (2009) Effect of fluoride varnish and gel on dental erosion in primary and permanent teeth. Arch Oral Biol 54(11):997–1001. https://doi.org/10.1016/j.archoralbio.2009.08.003
The work was supported by the Yonsei University College of Dentistry (6-2019-0021).
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent is not required.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Yang, SY., Jeong, I.J., Kim, KM. et al. Time-dependent effects after enamel fluoride application on an acid etching system in orthodontic bracket bonding. Clin Oral Invest 25, 497–505 (2021). https://doi.org/10.1007/s00784-020-03409-y
- Acid resistance
- Acidulated phosphate fluoride gel
- Enamel etching
- Shear bond strength
- Topical fluoride