First insights on plasma orthodontics - Application of cold atmospheric pressure plasma to enhance the bond strength of orthodontic brackets

Abstract

Objective: The development of an ideal adhesive system has long been subject of research. Recent studies show that treatment with cold atmospheric pressure plasma (CAP) positively affects the bonding properties of enamel. Conditioning with CAP could therefore improve the mechanical and physical properties of bracket adhesives, e.g. Glass ionomer cement (GIC). Material and methods: Laser-structured brackets (Dentaurum, Ispringen) were bonded onto 60 bovine mandibular incisors using different orthodontic adhesives. For 20 specimens FujiOrthoLC (GC America Corp, Alsip, USA) was used according to manufacturer's instructions. Another 20 specimens received a 60 s CAP-treatment (kINPen med, Neoplas tool, Greifswald, Germany) before bracket bonding, of which 10 were re-moistened before applying FujiOrthoLC and 10 remained dry. Onto 20 specimens, brackets were bonded with the Composite Transbond XT (3M/Unitek, St. Paul, USA) following manufacturer's instructions. The shear bond strength of brackets on the teeth was determined with the universal testing machine Zwick BZ050/TH3A (Zwick, Ulm, Germany). Results: Brackets bonded with FujiOrthoLC in standard method, showed average shear bond strength of 5.58±0.46 MPa. Specimens treated with plasma showed clinically unacceptable adhesion values (re-moistened group: 2.79±0.38 MPa, dry group: 1.01±0.2 MPa). Bonding onto dried out teeth also led to spontaneous bracket losses (4 of 10 specimens). The composite group (Transbond XT) showed clinically acceptable adhesion values (7.9±1.03 MPa). Conclusions: Despite promising potential, surface conditioning with CAP could not improve the adhesive properties of GIC. By contrast, a decrease in shear bond strength was noticed after CAP treatment. Further investigations have to show whether it is possible to increase the retention values ​​of other orthodontic adhesives by CAP application and thus take advantage of positive characteristics and reduce side effects.