Twelve-month Bracket Failure Rate with Amorphous Calcium Phosphate Bonding System

The aim of the study was to compare the survival rate of orthodontic brackets over a 12-month period using amorphous calcium phosphate (ACP) bonding system with a conventional adhesive (CA). In 30 patients with a mean age of 15 years 7 months, one operator bonded 138 brackets with a split-mouth design, using a resin-based CA and ACP-containing adhesive. The survival rate of the brackets was estimated by Kaplan-Meier analysis. Bracket survival distributions with respect to bonding procedure, dental arch, type of tooth (incisor, canine, and premolar), and patients' gender were compared using the log-rank test. The bond failure interface was determined using the Adhesive Remnant Index (ARI). The bond failure rates of the CA and ACP-containing adhesive were 2.67 and 3.8 per cent, respectively. There was no significant difference between the failure rates of ACP and CA-bonded systems (P > 0.05). Survival rates did not show significant differences between the upper and lower dental arches (P > 0.05). Lower survival rates were found for canine and premolar teeth than incisors (P < 0.05). Bond failure rates were higher for males than females (P < 0.05). There was a significant difference for ARI scores between the adhesive materials (P = 0.028); more of the ACP-based adhesive was left on the tooth at debond. ACP-containing adhesive can be effectively used to bond orthodontic brackets and can serve as a practicable alternative to the conventional bonding adhesives.