Orthodontic Attachment Adhesion to Ceramic Surfaces

Abstract

Ceramic materials are constantly evolving, achieving good functionality and aesthetics. Bonding to ceramics may be difficult because of high toxicity procedures and risk of surface damage. The review aims to answer several research questions: Is there a golden standard for bonding to ceramic? Are there adhesives or types of photopolymerization lamps that produce a higher bond strength on certain types of ceramics rather than others? Articles focusing on the bonding process of orthodontic attachments to ceramic surfaces searched in Pubmed, Medline and Embase, published between 1990 and 2018 were revised. Exclusions concerned bonding to non-ceramic surfaces, bonding to ceramic surfaces that are not destined for orthodontics or laser usage. Forty-nine articles that matched the inclusion criteria were researched. The following categories of original research articles were compared and discussed: metallic brackets bonding to ceramic surfaces, ceramic brackets to ceramic surfaces, bonding to new types of ceramics, such as zirconia, lithium disilicate, different photopolymerisation devices used on bonding to ceramics. Some types of adhesive may achieve minimal bond strength (6-8 MPa) even on glazed ceramic. Ceramic surface preparation may be done by sandblasting or hydrofluoric acid (60s application and 9.6%) with generally similar results. Studies rarely show any statistical difference and there are reduced number of samples in most studies. Ceramic brackets show better adhesion to ceramic surfaces and the same bonding protocol is advised. A higher bond strength may lead to ceramic surface. Few studies focus on newer types of ceramics; additional research is necessary. There is no clear evidence that a certain type of photopolymerization device produces higher shear bond strength values.

Bonding of Clear Aligner Composite Attachments to Ceramic Materials: An In Vitro Study

“…Since ceramics are now used frequently in prosthodontics to meet patient aesthetic demands, orthodontists must choose proper methods of bonding to these materials to achieve optimum outcomes [26]. Ceramic materials are versatile and continuously evolving, making it possible to achieve the desired aesthetic results.…”

Can a Self-etching Primer be Effective in Bonding Aligner Attachments to Different Types of Ceramics?

“…The application of 9.6% HFA etching for 60 s was recommended for orthodontic attachment adhesion to ceramic surfaces in a recent review. 25 Asiry et al 26 reported that conventional pretreatment produced higher SBS values for LD ceramics than self-etching primer. This difference could be due to the acid remnants in the deep porosities of the non-neutralized ceramic surfaces.…”

“… 30 Therefore, it was necessary to assess the ceramic surfaces after detachment because of the risk of surface damage with or without remnant adhesives caused by high bond strength. 25 In this case, the RARI was developed and used for evaluation and scoring.…”

Orthodontic bonding to silicate ceramics: impact of different pretreatment methods on shear bond strength between ceramic restorations and ceramic brackets

“…In general, in the present study SBS values were remarkably high (median: 33.6 MPa). This might be explained by the fact that ceramic brackets were bonded to ceramic surfaces [ 59 ]. Al-Hity et al found significant higher tensile bond strength values for ceramic brackets bonded to glass ceramic in comparison to metal brackets [ 2 ].…”