Effects of surface conditioning on bond strength of metal brackets to all-ceramic surfaces.

The aim of this study was to determine the effectiveness of bonding brackets to ceramic restorations. Sixty feldspathic and 60 lithium disilicate ceramic specimens were randomly divided into six groups. Shear bond strength (SBS) and bond failure types were examined with six surface-conditioning methods: silane application to glazed surface, air particle abrasion (APA) with 25- and 50-microm aluminium trioxide (Al(2)O(3)), etching with 9.6 per cent hydrofluoric acid (HFA), and roughening with 40- and 63-microm diamond burs. Silane was applied to all roughened surfaces. Metal brackets were bonded with light cure composite, then stored in distilled water for 1 week and thermocycled (x500 at 5-55 degrees C for 30 seconds). The ceramic surfaces were examined with a stereomicroscope at a magnification of x10 to determine the amount of composite resin remaining using the adhesive remnant index. The lowest SBS values were obtained with HFA for feldspathic (5.39 MPa) and lithium disilicate (11.11 MPa) ceramics; these values were significantly different from those of the other groups. The highest SBS values were found with 63-microm diamond burs for feldspathic (26.38 MPa) and lithium disilicate (28.20 MPa) ceramics, and were not significantly different from 40-microm diamond burs for feldspathic and lithium disilicate ceramics (26.04 and 24.26 MPa, respectively). Roughening with 25- and 50-microm Al(2)O(3) particles showed modest SBS for lithium disilicate (22.60 and 26.15 MPa, respectively) and for feldspathic ceramics (17.90 and 14.66 MPa, respectively). Adhesive failures between the ceramic and composite resin were noted in all groups. Damage to the porcelain surfaces was not observed. The SBS values were above the optimal range, except for feldspathic ceramic treated with HFA and silane. With all surface-conditioning methods, lithium disilicate ceramic displayed higher SBS than feldspathic ceramic.