Evaluation of the Effect of Phosphoric Acid or Er: YAG Laser on the Shear Bond Strength of Orthodontic Brackets to Enamel Surfaces Followed by 980-Laser Assisted Bleaching: An In Vitro Study

Introduction: The residual oxygen remained on tooth surface after bleaching may interfere with adhesion of brackets to enamel surface. This study aimed to evaluate the influence of phosphoric acid and Er: YAG laser as an etching technique on the shear bond strength (SBS) of orthodontic brackets to enamel surfaces after 980-laser-assisted bleaching. Method: A total of 84 human premolars were recruited in the present study. Samples were divided into 6 groups including conventional bleaching with conventional etching, conventional bleaching with Er: YAG laser etching, laser-assisted bleaching with conventional etching, and Laser-assisted bleaching with Er: YAG laser etching, without bleaching with traditional etching, and without bleaching+Er: YAG laser etching. Following thermocycling, the debonding of brackets was conducted using a universal testing machine. Scanning electron microscope (SEM) microscope evaluation and adhesive remnant index (ARI) scores were assessed. The comparison of SBS values between groups was carried out by means of a one-way analysis of variance, followed by post-hoc tests. Results: The non-bleaching with conventional etching group showed the highest SBS mean value (23.45±5.16 MPa), whereas the conventional bleaching with conventional etching group represented the lowest SBS mean value (8.8±3.83 MPa). In all groups, the most common type of failure was classified as either score 1 or score 2. No significant difference was observed in terms of SBS mean between the groups (P=0.165); however, the average SBS of bleached teeth was significantly lower, compared to the non-bleached group (P=0.000). Honeycomb structure and porosity were observed following Er: YAG laser etching on the tooth surface. Conclusion: Increased bond strength of brackets was observed in bleached teeth following Er: YAG laser etching. Therefore, if necessary, bond the brackets on the same day of bleaching will be done, the application of Er:YAG laser as etching technique will can be recommended.