In vitro Assessment of Influence of Various Bleaching Protocols on the Strength of Ceramic Orthodontic Brackets bonded to Bleached Tooth Surface: A Comparative Study.

INTRODUCTION: Esthetics is one of the common issues because of which patients consult dental orthodontic treatment. Two ways of tooth bleaching are available these days, which includes in-office bleach and home bleach. Various bleaching protocols are available these days for treating the tooth surfaces. Hence, we planned the present study for investigating the impact of various intracoronal bleaching protocols on shear bond strength of ceramic brackets bonded to tooth surface after bleaching.

MATERIALS AND METHODS: The present study included assessment of 100 extracted maxillary central incisors with the integrated buccal surface. A resin block was made and individual teeth were embedded in each block. Root canal therapy procedure was performed in all the teeth, after which 2 mm short of tooth apex up to the level of cementoenamel junction, removal of the root canal filling was done. All the samples were broadly divided into four study groups with 25 samples in each group. Bleaching procedure was carried in all the samples intracoronally followed by testing of shear bond strength using universal force testing machine. Following the modified adhesive remnant index (AI), assessment of remaining adhesive on the brackets was done. All the results were compiled and analyzed by Statistical Package for the Social Sciences (SPSS) software version 17.0.

RESULTS: In the control group, mean shear bond strength was found to be 17.9 MPa. While comparing the carbamide peroxide (CP) group with sodium perborate study group, we observed a statistically significant difference. Nonsignificant results were obtained while comparing the shear bond strength in between sodium perborate group and hydrogen peroxide (HP) group.

CONCLUSION: Intracoronal bleaching does affect the shear bond strength of ceramic brackets. Sodium perborate bleaching influences shear bond strength more strongly than other bleaching agents such as CP and HP.

CLINICAL SIGNIFICANCE: In patients undergoing orthodontic treatment, HP is a preferred agent where bleaching has to be followed by orthodontic bonding to the tooth surface.