||Comparison of bonding and friction behavior among self-ligating ceramic brackets: an in vitro study
||Institute of Oral Medicine
ceramic self-ligating bracket
shear bond strength
adhesive remnant index (ARI)
resistance to sliding
矯正中的牙齒移動有兩個要素：矯正器於牙齒上有良好的黏著力，以及牙齒隨著弓線順暢移動。為了有良好的黏著力，廠商逐漸開發出不同的底座設計以提供足夠的機械性滯留。另外，在治療中的牙齒移動，矯正器與弓線會有摩擦力的產生。之前已有許多有關自鎖金屬矯正器的摩擦力研究被發表，近年來自鎖陶瓷矯正器蓬勃發展，而陶瓷矯正器的表面特性又與金屬矯正器不同。而且，現今較少比較性研究針對自鎖陶瓷矯正器。故本實驗的目的是想要評估：底座設計對不同品牌矯正器的剪力方向黏著強度之影響，及比較其在不同條件下的摩擦力。本實驗分為兩大部分，黏著實驗及摩擦力實驗。五組矯正器(含3種自鎖陶瓷矯正器：ClippyC, GeniusCrystal及DamonClear2；傳統陶瓷矯正器：ClarityAdvanced；自鎖金屬矯正器：Damon3MX)在黏著實驗中，以牛牙取代人牙；並測試五組底座不同的矯正器的黏著力，每組包含12個矯正器。以電子顯微鏡觀察底座設計，另在矯正器脫落後，分析其切面並比較其黏膠殘留指數。在摩擦力實驗中，研究一些比較因子的影響，包含兩種弓線粗細 (.014銅鎳鈦線, .016X .022 鎳鈦線)及三種角度(0°, 5°, 10°)。每種矯正器/弓線/角度組合皆測試五次，共有30組設定，故總共運行150次。而實驗結果指出，DamonClear2矯正器的剪切黏著力最大，且與其他4組在統計上有顯著差異；至於黏膠殘留指數，則是ClarityAdvanced矯正器最大，而DamonClear2矯正器最小。在摩擦力研究，角度為0°到5°時，摩擦力無顯著差異；但角度為5°到10°時，大部分的組合摩擦力皆有顯著差異。ClarityAdvanced矯正器比自鎖矯正器有更大的摩擦力，但在方線轉10°時，各組矯正器摩擦力則無顯著差異。本研究結論為DamonClear2矯正器的剪切黏著力最大，傳統矯正器比自鎖矯正器有更大的摩擦力，而在方線轉10°時除外。
Orthodontic tooth movement depends on adequate bond strength between brackets and the tooth surface and smooth tooth sliding along the archwire. For optimal mechanical retention, various base designs have been produced by manufacturers, for which good bond strength has been claimed. Without mechanical retention, a frictional force is generated between brackets and the archwire during sliding. The friction forces of metal self-ligating brackets have been previously studied. Recently, ceramic self-ligating brackets that have surface characteristics different from those of metal brackets have been proposed. Furthermore, studies have compared ceramic self-ligating brackets. The aims of this study were to evaluate the effect of the base design of various self-ligating ceramic brackets on shear bond strength and to compare friction forces among brackets under various circumstances. The present study is divided into two parts: a shear bond strength test and a friction behavior test. In the shear bond strength test, bovine teeth were used as a substitute for human teeth. Five groups of brackets (three ceramic self-ligating brackets: ClippyC, GeniusCrystal, and DamonClear2; one conventional self-ligating bracket: ClarityAdvanced; one metal self-ligating bracket: Damon3MX) were used and debonded with 12 brackets in each group. The base designs were observed using scanning electron microscopy. The interfaces after debonding were analyzed and the adhesive remnant index (ARI) scores were compared. In the friction test, five kinds of bracket were tested under various circumstances. Several parameters were investigated, including two wire sizes (0.014" Cu-NiTi and 0.016" × 0.022" NiTi) and three angulations (0°, 5°, and 10°). Each bracket/wire/angulation combination was tested five times in 30 settings. A total of 150 runs were performed. The results show that DamonClear2 had the highest bond strength among the 5 brackets, with significant differences found. ClarityAdvanced and DamonClear2 had the highest and lowest ARI scores, respectively. In the friction behavior test, there was no significant difference in friction force between angulations of 0° and 5°, but there was a significant difference between angulations of 5° and 10° for the same brackets. ClarityAdvanced had the largest frictional force, but there was no significant difference in frictional force for 0.016" × 0.022" NiTi with an angulation of 10°. It is found that DamonClear2 had the highest bond strength and that the conventional bracket generally had a larger frictional force than that of the self-ligating bracket, except for 0.016" × 0.022" NiTi with an angulation of 10°.
List of Tables ix
List of Figures x
Chapter 1 Introduction 1
1.1 General background 1
1.2 Literature review 2
1.2.1 Shear bond strength test 2
1.2.2 In vitro versus in vivo bonding studies 3
1.2.3 Optimum bond strength in orthodontics 3
1.2.4 Adhesive remnant index 4
1.2.5 Friction in orthodontic sliding 4
1.2.6 Critical contact angle 5
1.2.7 Review of self-ligating brackets 8
1.2.8 Review of ceramic brackets 10
1.3 Motivation 12
1.4 Objective 12
Chapter 2 Materials and Methods 13
2.1 Experimental flow chart 13
2.2 Materials 14
2.2.1 Brackets 14
2.2.2 Adhesives 16
2.2.3 Archwires 17
2.3 Methods 18
2.3.1 Shear bond strength test 18
2.3.2 Friction behavior test 21
2.3.3 SEM observation of brackets, slots, and wires 25
2.3.4 EDS analysis of bracket composition 25
2.3.5 Statistical analysis 26
Chapter 3 Results 27
3.1 Shear bond test 27
3.1.1 Bond strength test 27
3.1.2 Adhesive remnant index 29
3.1.3 Statistical analysis 32
3.2 Friction behavior test 33
3.2.1 Friction behavior 33
.220.127.116.11 Archwire: 0.014" 27 °C Cu-NiTi 33
.18.104.22.168 Archwire: 0.016" × 0.022" NiTi 36
3.2.2 Statistical analysis 40
.22.214.171.124 Bracket type as parameter 40
.126.96.36.199 Angulation as parameter 41
3.2.3 SEM observation 44
.188.8.131.52 Bracket design 44
.184.108.40.206 Tooth surfaces after debonding test 48
.220.127.116.11 Bracket slot before friction test 53
.18.104.22.168 Bracket slot after friction test 58
.22.214.171.124 Wires after friction test 63
3.3 EDS analysis of bracket composition 69
Chapter 4 Discussion 72
4.1 Effect of parameters on bond strength 72
4.1.1 Substrate 73
4.1.2 Base design 75
4.1.3 Bracket material 76
4.1.4 Enamel damage after bracket debonding 78
4.2 Effect of parameters on friction behavior 79
4.2.1 Materials 80
4.2.2 Critical contact angle 82
4.2.3 SEM observation 84
4.3 Limitations of study 85
Chapter 5 Conclusions 86
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