ONLINE ONLY ARTICLE

Effect of bracket base conditioning

Andreas Faltermeiera and Michael Behrb
Regensburg, Germany

Introduction: The aim of this study was to compare the effect of a silicoating system, the influence of
sandblasting, and the effect of a silane-coupling agent after sandblasting on the shear bond strength of stainless
steel foil-mesh brackets. To simulate the oral environment, all specimens were thermocycled (6000 times at 5°C
and 55°C) in a mastication device before testing. Methods: Four bracket groups were tested: group 1
consisted of 20 metal brackets that were sandblasted on the base; group 2 contained 20 brackets that were
sandblasted, and a silane-coupling agent was applied; in group 3, the surface of the base of 20 metal
brackets was treated by using a tribochemical system; and group 4 was the control group. The brackets were
bonded with a light-curing adhesive to extracted third molars, and the shear bond strength and the adhesive
remnant index score were determined. The brackets of group 1 were reconditioned after debonding with
sandblasting and tested again (group 5). Results: Sandblasting and tribochemical treatment of brackets
improved the shear bond strength of stainless steel brackets. Combined sandblasting and silane-coupling
treatment offers no benefit of increased in-vitro strength. Conclusions: The bond of resins to tribochemically
silicoated stainless steel brackets seems to be sufficient to strengthen the bond between the adhesive and
the metal bracket. This treatment is mainly indicated for low-compliance patients or teeth that are difficult to
bond. (Am J Orthod Dentofacial Orthop 2009;135:12.e1-12.e5)

T
he material most commonly used for brackets is between bracket and resin. Sandblasting can generate a
stainless steel. Nevertheless, many efforts have microretentive topography and increase the surface
been made to improve their esthetic appearance, area.9,10 This method uses a high-speed stream of
such as making them smaller or making them from aluminium oxide particles to remove unfavorable con-
ceramic and plastic. However, metal brackets perform taminants and oxides.7
closer to the ideal than their nonmetal counterparts. Today, not only mechanical retention between
Various types of steel, including American Iron and metal and resin is possible, but also a chemical link
Steel Institute types 303, 304, 304L, 316, 316L, and between alloy and adhesive can be achieved. Flame-
317 are used for orthodontic brackets.1,2 Most orth- pyrolytic or tribochemical systems can cover the alloy
odontic brackets are made from type 304L, which surface with a coat of silicate.11 In addition, a silane-
contains 18% to 20% chromium and 8% to 10% nickel, coupling agent is necessary; it bonds to the silicated
with small amounts of manganese, silicon, and carbon.3 alloy surface and the polymer.12,13 A chemical link
Direct bonding of orthodontic brackets to enamel is between metal and resin can attained by this procedure,
state of the art in orthodontics. Since the basic investi- which keeps away water from the bonding surface.
gations of Buonocore4 in etching tooth surfaces with For that reason, the question arises whether silicoat-
phosphoric acid, satisfactory bonding between enamel ing can improve the bond between stainless steel
and adhesive is achievable.5,6 There are still problems brackets and a light-curing adhesive. Our aim in this
with retention loss between the bond of the bracket and study was to compare the effect of a silicoating system
the resin. For that reason, most brackets offer mechan- (Rocatec, 3M Espe, Seefeld, Germany), the effect of
ical retention— eg, a foil-mesh structure on the base of sandblasting, and the influence of a silane-coupling
the bracket. In addition, sandblasting the brackets7 or a agent after sandblasting on the shear bond strength
laser-structured base8 are methods to improve the bond (SBS) of stainless steel foil-mesh brackets. The effects
of these conditioning methods were compared with
From the University of Regensburg, Medical Center, Regensburg, Germany. untreated foil-mesh brackets. To simulate the oral
a
Assistant professor, Department of Orthodontics. environment, all specimens were thermocycled (6000
b
Assistant professor, Department of Prosthetic Dentistry. times at 5°C and 55°C) in a mastication device before
Reprint requests to: Andreas Faltermeier, Department of Orthodontics, Univer-
sity Clinics, Franz-Josef-Strauss-Allee 11, D-93042, Regensburg, Germany; testing.
e-mail, Andreas.Faltermeier@klinik.uni-regensburg.de. Frequently, orthodontists are faced with the prob-
Submitted, December 2006; revised and accepted, March 2007. lem of debonded or inaccurately positioned brackets.
0889-5406/$36.00
Copyright © 2009 by the American Association of Orthodontists. Therefore, another concern of this study was to inves-
doi:10.1016/j.ajodo.2007.03.034 tigate the influence of bracket reconditioning on the
12.e1
12.e2 Faltermeier and Behr American Journal of Orthodontics and Dentofacial Orthopedics
January 2009

SBS by using sandblasting to remove the adhesive on Twenty-four hours after preparation, all samples
the base of the brackets. were thermocycled to simulate the moisture of saliva
and the temperature changes in the oral environment.
MATERIAL AND METHODS Therefore, all bracket groups were alternately flooded
Eighty recently extracted third molars were col- every 2 minutes with warm (55°C) and cold (5°C)
lected and stored in 0.5% chloramine-T. The teeth were distilled water for 6000 cycles in a mastication de-
examined with a magnifier (10 times) to ensure the vice.14
absence of caries, hypoplastic areas, and cracks. After The SBS was measured with a universal testing
removal of the roots, the crowns were embedded in machine (1446, Zwick, Ulm, Germany) at a crosshead
auto-polymerization acrylic resin so that the facial speed of 1 mm per minute–1. The embedded tooth and the
surface of each tooth was parallel to the base of the adhesively fixed bracket were positioned in the testing
polymer. After preparation, the specimens were stored machine so that the bracket slot was horizontal. A knife-
in 0.5% chloramine-T at 37°C for a week. The teeth edge shearing rod was used to deliver the shear force at
were cleaned with nonfluoridated pumice paste and the bracket base-enamel interface. All brackets were
rubber cups. Because 4 bracket groups had to be tested, tested to failure. The SBS was determined by using the
the teeth were randomly assigned to 4 groups of 20 formula ␴shear ⫽ Fmax/Abracket base surface (MPa).
teeth each. Group 1 consisted of 20 Ormesh brackets To study the influence of recycling artificially aged
(Ormco, Glendora, Calif) that were sandblasted on the brackets, the brackets of group 1, which were sand-
base with 120 ␮m aluminium oxide for 20 seconds at 2 blasted before bonding, were reconditioned with sand-
bar and cleaned in an ultrasonic device (Sonorex, AD blasting (120 ␮m aluminium oxide, 20 seconds, 2 bar)
Jensen, Zwolle, the Netherlands) before bonding. to remove the adhesive. After this, the recycled brack-
Group 2 had 20 Ormesh brackets that were treated as ets were cleaned in the ultrasonic device and again
described for group 1; additionally, a silane-coupling bonded as described before on the cleaned tooth sur-
agent (Espe Sil, 3M Espe) was applied to the sand- face. The SBS was determined again (group 5).
blasted base of the bracket. In group 3, the surfaces of Medians and standard deviations were calculated.
the base of 20 Ormesh brackets were treated by using To determine statistical differences, the Kruskal-Wallis
the Rocatec device. First, the area was blast cleaned for and Mann-Whitney U tests were used. The level of
10 seconds (pressure, 2.8 bar) with 110 ␮m of alumi- significance was set at ␣ ⫽ 0.05.
nium oxide (Rocatec Pre, 3M Espe). Then, a tribo- To compare the amount of adhesive on the
chemical coating was added by using Rocatec Plus (3M brackets, the adhesive remnant index (ARI) was
Espe) with a pressure of 2.8 bar for 13 seconds. The recorded (Table I).
distance between the base of the brackets and the blast
outlet was 10 mm. A silane-coupling agent (Espe Sil, RESULTS
3M Espe) was applied. Group 4, the control group, After sandblasting, a significant increase of SBS
included 20 new and untreated foil-mesh brackets. The was determined (P ⫽ 0.005) compared with the control
surface area of the Ormesh bracket bases was deter- group (Fig 1, Table II). The use of a silane-coupling
mined by measuring length and width and computing agent after sandblasting showed a significant (P ⫽
the mean area. The surface area of these brackets was 0.005, Table II) enhancement of SBS compared with
12.77 mm2. the untreated brackets (control group). However, the
The enamel surface of each tooth was etched with
20% phosphoric acid (Gluma Etch 20 Gel, Heraeus
Kulzer, Hanau, Germany) for 30 seconds, rinsed with Table I. Adhesive remnant index (ARI) scores of the
water for 20 seconds, and dried with an oil-free air bracket groups
source. An orthodontic resin-based light-activated ARI score 0 1 2 3
bonding system, Transbond XT (3M Espe) was used
according to the manufacturer’s instructions. All brack- Control group (untreated) 0 0 4 16
Sandblasted brackets 0 1 4 15
ets were placed centrally on the flat buccal surfaces of
Sandblasted and silane-treated brackets 0 1 3 16
the teeth. The excess resin was carefully removed from Tribochemically treated brackets 0 1 6 13
the tooth with a dental probe. The samples were then Sandblasted recycled brackets 0 1 3 16
light-cured with a light emitting diode curing device
ARI scores: 0, no composite remained on the enamel; 1, less than
(Ortholux LED, 3M Unitek, Monrovia, Calif) for 20 50% of the composite remained on the enamel; 2, more than 50% of
seconds. All brackets were bonded by the same opera- the composite remained on the enamel; 3, all composite remained on
tor (A.F.). the enamel.
American Journal of Orthodontics and Dentofacial Orthopedics Faltermeier and Behr 12.e3
Volume 135, Number 1

Table III.
SBS median values and standard deviations of
the bracket groups
Group Treatment SBS (MPa)

1 Sandblasted new brackets 7.43 ⫾ 0.62

2 Sandblasted and silane-treated brackets 7.42 ⫾ 0.66
3 Tribochemically treated brackets 7.72 ⫾ 0.88
4 Control (untreated new brackets) 5.86 ⫾ 0.60
5 Sandblasted recycled brackets 7.15 ⫾ 0.57

Fig 1. SBS (in MPa) of the bracket groups.

Table II.Statistical analysis (P values from Kruskal-

Wallis and Mann-Whitney U tests) of SBS and ARI
scores compared with the control group
Bracket surface modification SBS ARI

Sandblasted brackets 0.005 NS

Sandblasted and silane-treated brackets 0.005 NS
Tribochemically treated brackets 0.005 NS

NS, Not significant (level of significance, P ⫽ 0.05). Fig 2. SBS (in MPa) of brackets before and after
No significant difference (P ⬎0.05) between modified bracket groups sandblasting and recycling.
was measured.

silane-coupling agent after sandblasting did not change DISCUSSION

the SBS significantly when compared with the sand- In orthodontic literature, bonding brackets to
blasted brackets (without the silane-coupling agent). enamel is well documented.4,8,15-19 Nevertheless, the
The highest SBS median values (7.72 ⫾ 0.88 MPa) influence of silicoating and silane treatment of stainless
were measured after tribochemical treatment of the steel brackets compared with sandblasting has not been
brackets (Table III). The SBS enhancement after the sufficiently investigated. Atsü et al20 described higher
tribochemical process was significant (P ⫽ 0.005) bond strengths in both metal and ceramic brackets after
compared with the control group (Fig 1), but not silica coating followed by silanization. Newman et al21
significant if compared with sandblasting treatment of examined the effect of adhesion promoters on the bond
the brackets (with and without the silane-coupling strength of metal brackets. They described the in-
agent). creased bond strength of 80-gauge metal mesh brackets
The ARI showed no statistical difference (P ⬎0.05) after applying the promoters. However, they used only
between the test groups (Table II). Nevertheless, a trend a self- adhesive, and the accelerated aging process was
for improved adhesion between bracket base and resin only 1500 thermocycles. We used the light-cured ad-
of the tribochemically treated brackets was noticed hesive Transbond XT, and the accelerated aging pro-
after the ARI results (Table I). cess was 6000 thermocycles (5°C and 55°C) in a
After recycling the used brackets with sandblasting, mastication device.
no statistical difference between the SBS and the ARI In-vitro studies of SBS testing often have the
scores was determined compared with the originally problem that, in the oral environment, saliva penetrates
sandblasted brackets (Fig 2). between the surfaces of bracket and resin; this is
12.e4 Faltermeier and Behr American Journal of Orthodontics and Dentofacial Orthopedics
January 2009

difficult to simulate. Therefore, in-vitro studies in a dry significantly the SBS compared with the untreated
environment are seldom comparable with clinical con- control group.
ditions. In this study, an artificial oral environment with The ARI scores might be of interest to clinicians.
a mastication device was chosen to simulate moisture Even though no statistical differences between test
and temperature changes in the oral cavity. The tem- groups were found, a trend was obvious: adhesive
perature in the mastication test chamber varied between resins seem to remain more frequently on silicoated
5°C and 55°C for 6000 cycles. Our results are fairly bracket bases. The explanation for this finding is that
difficult to compare with other in-vitro investigations, a silicoated and silane-treated stainless steel surface
because most studies about the SBS of brackets used might improve the bond to the adhesive resin;
dry conditions and disregarded the influence of water therefore, after debonding, less resin remains on the
penetration into the bracket, resin, and tooth interface. tooth.
The influence of combined sandblasting and silane- In our investigation, we used only 1 type of cement
coupling treatment on the bond strength of plastic (Transbond XT) to guarantee that any variations of SBS
brackets was discussed by Guan et al.9 They concluded and ARI scores were attributable to the surface modi-
that combined sandblasting and silane-coupling treat- fication methods. The use of Transbond XT, a highly
ment increased the bond strength of plastic brackets. filled resin cement, is well established in orthodontics.
The reason for their findings could be that, after The SBS of orthodontic brackets depends on several
sandblasting, a higher level of inorganic glass fillers variables: bracket material, surface structure of the
with silicon dioxide were exposed on the surface. brackets, type of adhesive, and enamel quality. Perhaps
Therefore, the bond between resin and glass fillers more distinctive improvements of the SBS of brackets
could be strengthened by using a silane-coupling agent. and the ARI could be made if a lower filled or unfilled
Silane-coupling agents were applied in dentistry for
adhesive had been used, because a more liquid cement
bonding organic materials to ceramic materials or for
could better penetrate the grooves and undercuts of the
strengthening the bond between metal and resin after a
various surface-modification methods.
tribochemical or flame-pyrolytic process. A silane-
In accordance with our results, Sharma-Sayal et al16
coupling agent can connect silicon dioxide groups on
stated that sandblasted brackets are reliable when re-
activated metal or ceramic surfaces with an adhesive
used, and, if damage to the bracket base from sand-
consisting of a methyl-methacrylate or a 2,2-bis[p-(3-
blasting is minimal, the SBS is not compromised.
methacryloxy-2-hydroxypropoxy)phenyl]propane sys-
Huang et al1 compared the ions released from recycled
tem because of its bipolar structure. In our study, no
and new brackets and found that recycled brackets
statistical difference between bond strength of brackets
sandblasted without the silane-coupling agent and with released greater amounts of ions— eg, nickel and iron.
silane treatment could be found. Nevertheless, the bond Cacciafesta et al22 investigated the bond failures of
strength of brackets after Rocatec (tribochemical) treat- recycled vs new stainless steel brackets in a clinical
ment showed a slight improvement compared with study. They found no statistical difference between the
sandblasted (with or without the silane-coupling agent) total bond failure rates of recycled and new brackets.
brackets. An explanation for these findings might be The in-vitro findings of our study confirm their results.
that tribochemical systems cover the alloy surface with Even though bracket recycling is popular, the clinician
a coat of silicate. A silane-coupling agent can connect must be satisfied with clinical performance, and there
the silicated alloy surface with the resin because of its can be no infection risk between patients.23 However,
bipolar structure. This procedure offers a chemical link the clinician must determine whether it is cost effective
between metal and polymer that keeps water from the to reuse brackets, because it takes more chair-side time
bonding surface.11 Sandblasting treatment only seems to clean and recycle them.16
unable to activate the metal surface as required by the It is a common belief that clinically adequate bond
silane-coupling agent, because the silicoating process is strength for a stainless steel bracket to enamel should
missing. Therefore, no enhancement of bond strength be 6 to 8 MPa.17,24,25 Even though bond strength
between bracket and adhesive could be determined increased distinctly after silicoating and sandblasting
after the use of a silane-coupling agent on the surface treatment compared with the untreated control group in
after sandblasting compared with only sandblasted our study, median SBS values did not exceed 8 MPa.
bracket surfaces. However, all modified surfaces of the Thus, it can be concluded that these surface modifica-
brackets (sandblasted with or without the silane-cou- tions raise the SBS significantly and in a clinically
pling agent and tribochemical treatment) improved acceptable way.
American Journal of Orthodontics and Dentofacial Orthopedics Faltermeier and Behr 12.e5
Volume 135, Number 1

CONCLUSIONS 11. Behr M, Rosentritt M, Bettermann K, Handel G. Influence of

electron beam irradiation on the alloy-to-resin bond strength. Eur
Sandblasting and tribochemical treatment of stain- J Oral Sci 2005;113:429-35.
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sandblasting and silane-coupling treatment offers no dures and thermocycling on the shear bond strength of resin-
metal bonding systems. J Prosthet Dent 2003;90:184-9.
benefit of increased in-vitro strength. Bonding resins to
13. Hansson O, Moberg LE. Evaluation of three silicoating methods
tribochemically silicoated stainless steel brackets for resin-bonded prostheses. Scand J Dent Res 1993;101:243-51.
seems to be sufficient for strengthening the bond 14. Rosentritt M, Leibrock A, Lang R, Behr M, Scharnagl P, Handel
between the adhesive and the metal bracket. This G. Apparatur zur simulation des kauorgans (Regensburger
treatment is mainly indicated for low-compliance pa- kausimulator). Materialprüfung 1997;39:77-80.
15. Soderquist SA, Drummond JL, Evans CA. Bond strength eval-
tients or teeth that are difficult to bond. uation of ceramic and stainless steel bracket bases subjected to
cyclic tensile loading. Am J Orthod Dentofacial Orthop 2006;
129:175-80.
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