Pengaruh Penambahan Suspensi Enzim Papain pada Primer Adhesif Ortodonti terhadap Kekuatan Ikat Tarik

Abstract

Introduction: Bracket attachment failure constitutes a notable challenge in orthodontic practice, resulting in prolonged treatment durations and compromised clinical outcomes. A primary contributor to this phenomenon is the suboptimal bonding protocols of adhesive systems. Ideally, an adhesive should exhibit sufficient bonding strength to withstand masticatory forces and orthodontic movements while facilitating effortless removal without damaging the enamel or leaving excessive residual adhesive. The proteolytic enzyme papain has shown potential for enhancing the bond strength of orthodontic adhesives. Objective: This study aims to investigate the effects of papain enzyme incorporation in orthodontic adhesive primers on tensile bond strength (TBS) and residual adhesive on enamel.

Methods: Extracted maxillary premolar teeth were bonded with metal brackets, divided into three experimental groups: a control group (devoid of papain enzyme) and two groups integrating 15% papain enzyme within orthodontic adhesive primers at ratios of 50:50 and 25:75. Specimens were immersed in artificial saliva at 37°C for 24 hours before TBS assessments, adhesive remnant index (ARI) evaluation, and failure mode analysis utilizing scanning electron microscopy (SEM).

Results: A one-way ANOVA revealed significant differences in TBS (p < 0.05), with the highest values observed in the 25:75 ratio group. The ARI assessment indicated a score of 2 for 60% of brackets.

Conclusion: The integration of 15% papain enzyme into the orthodontic adhesive primer significantly enhanced the TBS, particularly in the 25:75 ratio group, resulting in mixed and cohesive failure modes that facilitated the removal of adhesive residues post-debonding.