Influence of various surface-conditioning methods on the bond strength of metal brackets to ceramic surfaces.

With the increase in adult orthodontic treatment comes the need to find a reliable method for bonding orthodontic brackets onto metal or ceramic crowns and fixed partial dentures. In this study, shear bond strength and surface roughness tests were used to examine the effect of 4 different surface conditioning methods: fine diamond bur, sandblasting, 5% hydrofluoric acid, and silica coating for bonding metal brackets to ceramic surfaces of feldspathic porcelain. Sandblasting and hydrofluoric acid were further tested after silane application. A total of 120 ceramic disc samples were produced, and 50 were used for surface roughness measurements. The glazed ceramic surfaces were used as controls. Metal brackets were bonded to the ceramic substrates with a self-curing composite. The samples were stored in 0.9% NaCl solution for 24 hours and then thermocycled (5000 times, 5 degrees C to 55 degrees C, 30 seconds). Shear bond tests were performed with a universal testing device, and the results were statistically analyzed. Chemical surface conditioning with either hydrofluoric acid (4.3 microm) or silicatization (4.4 microm) resulted in significantly lower surface roughness than mechanical conditioning (9.3 microm, diamond bur; 9.7 microm, sandblasting) (P <.001). The surface roughness values reflect the mean peak-and-valley distances. The bond strengths of the brackets bonded to the ceramic surfaces treated by hydrofluoric acid with and without silane (12.2 and 14.7 MPa, respectively), silicatization (14.9 MPa), and sandblasting with silane (15.8 MPa) were significantly higher (P <.001) than those treated by mechanical roughening with fine diamond burs (1.6 MPa) or sandblasting (2.8 MPa). The highest bond strength values were obtained with sandblasting and silicatization with silane or hydrofluoric acid without silane; these fulfilled the required threshold. The use of silane after hydrofluoric acid etching did not increase the bond strength. Diamond roughening and sandblasting showed the highest surface roughness; they can damage the ceramic surface. Acid etching gave acceptable results for clinical use, but the health risks should be considered. The silicatization technique has the potential to replace the other methods; yet cohesive failures were observed in the ceramic during removal of the brackets.