Influence of surface conditioning on ceramic microstructure and bracket adhesion.

The objective of this study was to investigate the influence of different conditioning procedures on various ceramic microstructures and bracket adhesion. Ceramic specimens (feldspathic, leucite, leucite-free, and fluorapatite) were mechanically conditioned (n = 20 per ceramic type) with conventional hydrofluoric acid (5 per cent HF; 60/30 seconds), buffered hydrofluoric acid (9.6 per cent BHF; 60/30 seconds), or sandblasting (Al(2)O(3)/SiO(2) particles). Silane coupling agents were added for chemical conditioning before bracket bonding. Bracket adhesion was calculated with a shear test in a universal testing machine. The bracket-composite-ceramic interface was further evaluated using the adhesive remnant index (ARI). One specimen of each ceramic/conditioning combination was subjected to qualitative electron microscopy investigation. One-way analysis of variance followed by Tukey's honestly significant difference test were applied for inferential statistics. Conditioning with conventional 5 per cent HF or sandblasting resulted in significantly (P < 0.001) higher bond strengths (mean values: 34.11 and 32.86 MPa, respectively) than with 9.6 per cent BHF (mean value: 12.49 MPa). Etching time or sandblasting particles had no statistical (P > 0.001) influence on bond strength. Higher ARI scores were found in the conventional 5 per cent HF and sandblasted groups, when compared with the 9.6 per cent BHF group. Microscopic examination of the conditioned ceramic surfaces showed that leucite and leucite-free ceramics differed most with respect to their surface roughness, though without an influence on shear bond strength (SBS; P < 0.001). Bracket adhesion was mostly influenced by the conditioning procedure itself. Sandblasted ceramic surfaces showed sufficient conditioning and bracket adhesion; however, the increased bracket adhesion was associated with a risk of ceramic surface damage.