Effects of remineralization procedures on shear bond strengths of brackets bonded to demineralized enamel surfaces with self-etch systems

Objective:  To compare the effects of different remineralization procedures on the surface roughness of teeth, shear bond strengths (SBSs), and Adhesive Remnant Index scores of self-etching primer (SEP) used to bond orthodontic brackets to previously treated demineralized enamel surfaces. Materials and Methods:  A total of 140 extracted human premolar teeth were randomly divided into seven equal groups. Group I was the control group. A demineralization procedure was performed in the other six groups. A remineralization procedure was performed before bonding by using casein phosphopeptide-amorphous calcium phosphate, fluoride, a microabrasion mixture (18% hydrochloric acid-fine pumice), a microabrasion agent, and resin infiltration in groups III to VII. Brackets were bonded using a self-etching primer/adhesive system. The specimens were tested for SBS. The roughness and morphology of the enamel surfaces were analyzed using profilometer and scanning electron microscopy. Data were analyzed with analysis of variance, Tukey, and G-tests at the α  =  .05 level. Results:  Significant differences were found in the SBS values among the seven groups (F  =  32.69, P  =  .003). The lowest SBS value was found in group II (2.62 ± 1.46 MPa). No significant differences were found between groups I, III, and VII, between groups III and IV, or between groups V and VI. The differences in the roughness values were statistically significant among the groups (P  =  .002). Conclusions:  Remineralization procedures restore the decreased SBS of orthodontic brackets and decrease surface roughness caused by enamel demineralization. SEPs provide clinically acceptable SBS values for bonding orthodontic brackets to previously treated demineralized enamel surfaces.