The purpose of the current study was to develop a bonding method that can achieve clinically acceptable bond strength values while leaving a minimum amount of adhesive on the tooth surface during the debonding process. One hundred teeth were randomly assigned into groups. Five different enamel surface preparation protocols were tested (N = 20, each): Conventional acid etch, standard SEP, SEP applied with a light brush stroke (altered SEP 1), SEP applied directly to the composite of pre-coated bracket (altered SEP 2), and Primer Only groups. Brackets were debonded using an Instron universal testing machine (Instron, Canton, MA) in shear mode and the mean shear bond strength values were calculated. In addition, enamel surfaces were examined under light microscope to determine the location of failure using ARI. The Primer Only group had significantly lower mean shear strength (0.14 MPa, P0.05). With respect to ARI values, there was a significant difference among these four groups. 85% of samples in the altered SEP 2 group had 10% or less composite resin left on their surfaces. This group had also a mean shear bond strength value of 11.43 MPa, significantly above the minimal strength needed for orthodontic attachment bonding, and the lowest ARI values overall. Therefore, application of SEP directly to the composite resin of the pre-coated brackets may be an ideal bonding method by providing adequate bond strength and leaving a minimum amount of composite resin on the tooth surface during debonding. It should be kept in mind that future in-vivo studies would be needed to confirm the findings obtained from the current in-vitro study.

This body of research investigated the bonding efficiency of self-etching primer adhesives to enamel and dentine with various surface characteristics. A series of preliminary experiments was carried out to determine the effect of operator experience, dentine tubule orientation, bond strength test method and resin composite material used on bond strengths. The results of the preliminary tests concluded that it is essential to develop skills in material handling and the test methods used; 2-step self-etching primer adhesives exhibit higher but more variable microshear bond strengths (µSBS) than ‘all-in-one’ adhesives on dentine at different depths and tubule orientations; fracture toughness and bond strength test results suggest that the fracture toughness of a resin composite may not be of significant influence on microtensile and µSBS tests outcomes for nano-filled hybrid materials. / An investigation of the bonding ability of self-etching primer adhesives under various tooth preparation conditions was carried out. Enamel and dentine specimens were prepared from human teeth and finished with various rotary cutting instruments and the erbium, chromium:yttrium, scandium, gallium, garnet laser. Specimens were bonded with two 2-step self-etching primer adhesives and two ‘all-in-one’ adhesives with a resin composite. The results showed that one of the 2-step adhesives exhibited higher but more variable µSBS than the ‘all-in-one’ adhesives and a silorane-based self-etching primer adhesive system to enamel and dentine. / The relationship between enamel microhardness and µSBS was evaluated. Enamel specimens were prepared and finished with one half of the surface tested for hardness using the Vickers test. The other half of the enamel surface was bonded using either a 2-step self-etching primer adhesive or an ‘all-in-one’ adhesive and a hybrid resin composite. Mean Vickers hardness numbers and µSBS for each enamel surface were calculated. Analysis using Pearson’s parametric test for regression analysis evaluated the correlation between Vickers hardness and µSBS. The results revealed a weak negative insignificant correlation between VHN and µSBS for the 2-step adhesive and no correlation for the ‘all-in-one’ adhesive. / The effect of conditioning and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on bonding to bleached and unbleached enamel was investigated. Four groups of enamel specimens: untreated control; bleaching with 16% carbamide peroxide gel for 90 min daily x 14 days; treated with CPP-ACP paste (Tooth Mousse, GC Corp., Japan) for 60 min daily x 7 days and bleached and CPP-ACP-treated were used. The specimens were divided into a further two groups and bonded with a total-etch adhesive or a 2-step self-etching primer adhesive. Specimens bonded with the self-etching primer adhesive were sub-divided into four conditioning subgroups before bonding: no conditioning; 30 – 40% phosphoric; 15% EDTA; 20% polyacrylic acid. Specimens were tested in shear mode until failure and analysed by 2-way ANOVA, one-way ANOVA and Tukey’s post-hoc test. The µSBS of the total-etch adhesive was not affected by enamel treatment. Bleaching reduced the µSBS of the self-etching primer adhesive but preconditioning with phosphoric acid and polyacrylic acid improved bond strengths after CPP-ACP application. Bond failure analysis revealed a predominance of adhesive failures after bleaching, but prior conditioning reduced the proportion of adhesive failures. Scanning electron microscopy (SEM) revealed that the interfacial morphology produced by the 2-step self-etching primer adhesive was independent of enamel treatment except after bleaching. Phosphoric acid etching was not inhibited by CPP-ACP treatment. Resin tag formation was observed with prior phosphoric acid and polyacrylic acid conditioning. / The effect of conditioning and CPP-ACP application on dentine bonding was also investigated. Dentine specimens with and without the smear layer were prepared and divided into a further two groups, CPP-ACP paste applied to one group for 60 min daily x 7 days and the other group was untreated. The two groups were divided into three subgroups for conditioning: no conditioning; 30 - 40% phosphoric acid; 20% polyacrylic acid. The dentine was bonded using a 2-step self-etching primer adhesive and an ‘all-in-one’ adhesive, and tested as previously described. Statistical analysis was carried out using one-way ANOVA and Tukey’s post-hoc test at α = 0.05. The results showed that the µSBS of both adhesives were not significantly affected on smear-covered dentine but was affected on smearless dentine. Conditioning did not improve bond strengths. Bond failure analysis showed more adhesive failures for the ‘all-in-one’ adhesive, particularly on smearless dentine and with prior polyacrylic acid conditioning. SEM revealed a similar morphology of the bonded interface for the 2-step self-etching primer adhesive regardless of conditioning; and areas of bond failures for the ‘all-in-one’ adhesive. / The 2-step self-etching primer adhesives exhibited higher bond strength and more regular bond integrity than the ‘all-in-one’ adhesives, as shown on the SEM observations. However, the ‘all-in-one’ adhesives exhibited less variability in bond strengths to tooth surface characteristics.