Perbedaan Shear Bond Strength Bahan Adhesif Konvensional dengan Self-Etching Primer/Adhesive pada Bonding Breket Ortodonti Penelitian In Vitro

Abstract

The bonding of orthodontic brackets to enamel is a multistep process. Most orthodontists use a total etch conventional technique of etching tooth enamel with phosphoric acid, placing a primer on the etched, rinsed and dried surface, then bonding the bracket with an adhesive resin composite. To simplify bonding and decrease chair time, self-etching primer/adhesive has been introduced, that combines the etching, priming and resin bonding agent into a one step formulation. Based on the polymerization, material bonding can be divided into chemically-cured bonding material and light-cured bonding material. The aim of this in vitro study was to compare the shear bond strength of orthodontic brackets bonded to enamel with a conventional chemically-cured bonding material, conventional light-cured bonding material, and self-etching primer/adhesive material. Forty eight extracted human premolars were randomly divided into three groups of 16 each, and metal brackets were bonded according to the manufacturer’s instructions. In group I (control), the 37% phosphoric acid was used with chemically-cured Advantage No-Mix Direct Bond Adhesive. In group II, the Scotchbond 35% phosphoric acid plus Transbond XT primer was used with Transbond XT light-cured resin. In group III, Transbond Plus Self-Etching Primer was used with Transbond XT light-cured resin. Shear bond strength testing was performed with a Torsee Electronic System Universal Testing Machine. One-way ANOVA showed a statistically significant (P<0,01) difference between groups. Group II had the highest mean shear bond strength (7,76 ± 1,17 MPa), followed by group I (6,94 ± 1,52 MPa) and group III (4,16 ± 0,86 MPa). Significantly higher mean shear bond strength was seen in group I than group III, and in group II than group III (P<0,01). There was no statistically significant difference between group I and group II (P=0,151). The Transbond XT conventional light-cured material and Advantage No-Mix Direct Bond Adhesive showed better adhesion results than Transbond Plus Self-Etching Primer.

Perlekatan breket ortodonti ke permukaan enamel merupakan suatu proses yang terdiri dari beberapa tahapan. Kebanyakan ortodontis menggunakan teknik konvensional total etch melalui tahap etsa asam fosfor pada permukaan enamel, pencucian, pengeringan, pengolesan primer dan penempatan breket dengan bahan resin komposit. Untuk simplikasi dan mengurangi waktu kerja, diperkenalkan bahan adhesif self-etching primer/adhesive yang menggabungkan etsa asam, primer dan agen bonding dalam satu kemasan. Berdasarkan polimerisasi, bahan adhesif dibagi dua yaitu secara chemically-cured dan light-cured. Tujuan penelitian in vitro ini untuk membandingkan shear bond strength perlekatan breket ke permukaan enamel gigi dari bahan adhesif konvensional yang chemically-cured dan light-cured serta self-etching primer/adhesive. Gigi premolar manusia yang telah diekstraksi sebanyak 48 dibagi secara random menjadi tiga kelompok dengan masing-masing kelompok 16 gigi, dan breket metal dilekatkan ke permukaan enamel sesuai instruksi pabrik. Kelompok I (kelompok kontrol) menggunakan Advantage 37% asam fosfor dan Advantage No-Mix Direct Bond Adhesive. Kelompok II memakai Scotchbond 35% asam fosfor, Transbond XT primer dan Transbond XT Adhesive Paste. Kelompok III memakai Transbond Plus Self-Etching Primer dan Transbond XT Adhesive Paste. Uji shear bond strength dilakukan dengan alat Torsee Electronic System Universal Testing Machine. Uji ANOVA menunjukkan adanya perbedaan yang sangat signifikan diantara ketiga kelompok (P<0,01). Kelompok II memiliki nilai rerata shear bond strength tertinggi (7,76 ± 1,17 MPa), diikuti kelompok I (6,94 ± 1,52 MPa) dan kelompok III (4,16 ± 0,86 MPa). Nilai rerata shear bond strength signifikan lebih tinggi pada kelompok I dibandingkan kelompok III dan kelompok II dibandingkan kelompok III (P<0,01). Tidak ada perbedaan yang signifikan antara kelompok I dan kelompok II (P=0,151). Bahan adhesif konvensional light-cured Transbond XT dan Advantage No-Mix Direct Bond Adhesive menunjukkan hasil perlekatan yang lebih baik dibandingkan dengan bahan adhesif Transbond Plus Self-Etching Primer.