A Comparative Assessment of the Bonding Characteristics of Three-Dimensional Custom-Printed Polycrystalline Alumina Brackets and Conventional Brackets

Abstract

Objective: The objective was to compare the shear bond strength (SBS) and the adhesive remnant index (ARI) amongst six orthodontic bracket groups. Materials and Methods: Three-dimensional printed polycrystalline alumina brackets (3DBs), ceramic brackets (CBs), and metal brackets (MBs), divided into six groups, were bonded to bovine incisors using different bonding procedures. The SBSs were obtained using a universal testing machine, and the ARIs were assessed with a stereomicroscope. The statistical analyses included one-way analysis of variance (ANOVA) for SBS differences and Fisher’s exact test to show ARI differences amongst the groups (p < 0.05). Results: No significant differences (p > 0.05) were measured amongst the SBSs of the 3DB groups (12.3 MPa, 12.6 MPa, 12.3 MPa, 11.0 MPa, respectively). The latter four groups generally had significantly lower SBSs (p < 0.001) than the conventional bracket groups, CB and MB (16.9 MPa and 19.3 MPa, respectively). Also, there was no significant difference in SBSs for the CB and MB groups (p > 0.05). A high ARI for CBs and MBs (2) indicated that more than 50% of the adhesive remained on the enamel surface. The four 3DB groups had no residual adhesive or less than 50% adhesive on the enamel surface after debonding (ARI scores 0 and 1). A significant difference in ARI levels existed across the types of brackets (p < 0.05). Conclusion: Three-dimensional printed polycrystalline alumina brackets exhibited adequate SBS values for successful bonding. However, the values were lower compared to those for conventional ceramic and metal brackets. The majority of the adhesive remnant for the 3D-printed brackets was mainly located on the bracket base.