title: Bond strength to surface enamel for different tooth types.
abstract: OBJECTIVE
  Fixed appliance therapy in orthodontics relies on the effective bonding of brackets to surface enamel. Bracket de-bonding during treatment is both inconvenient and costly to both dentist and patient. Factors which control the efficacy of the bond are not fully understood. For example, there has never been a study to determine the efficacy of bonding to different teeth in the dentition. The aim of this study was to investigate the possible differences in bond strength to acid etched enamel on the different teeth of the dentition.
  
  
  METHODS
  Two hundred and forty extracted sound human teeth were collected from white Caucasian subjects between the age of 10 and 22 years. Approximately 20 teeth of each tooth type were bonded using a standard acid etch technique with 'A company' stainless steel brackets using a light cured composite (Transbond, 3M Unitek). Shear bond strength (24 h) was measured using an Instron testing machine.
  
  
  RESULTS
  Tooth type was found to have a significant effect on bond strength (p<0.001). The greatest mean bond strength was found on the lower first molar teeth, and the lowest on the upper first molar teeth. In the upper arch, bond strength was greater on anterior teeth than posterior teeth (p<0.001). In the lower arch bond strength was weaker on anterior teeth than posterior teeth (p<0.001).
  
  
  CONCLUSIONS
  The results have profound implications for bond strength testing of dental composites to enamel as well as to the expectations of bond reliability in orthodontic therapy. The findings suggest that, in order to achieve meaningful comparisons, enamel bond strength measurements should be made using the same tooth type, or that appropriate stratification of groups of test teeth should be used. These findings may also explain, in part, variability in enamel bonding efficacy despite the best efforts of the dental practitioner.
authors.affiliation: Child Dental Health, Newcastle Dental School, Framlington Place, NE2 4BW, Newcastle upon Tyne, UK. r.s.hobson@ncl.ac.uk
authors.forename: R S
authors.initials: RS
authors.lastname: Hobson
authors.forename: J F
authors.initials: JF
authors.lastname: McCabe
authors.forename: S D
authors.initials: SD
authors.lastname: Hogg
mesh_terms: D000134:Acid Etching, Dental; D000180:Acrylic Resins / Q000737:chemistry; D000268:Adhesiveness; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D017438:Bisphenol A-Glycidyl Methacrylate / Q000737:chemistry; D002648:Child; D003481:Cuspid / Q000033:anatomy & histology; D001840:Dental Bonding; D003743:Dental Enamel / Q000648:ultrastructure*; D003799:Dental Stress Analysis / Q000295:instrumentation; D006801:Humans; D007180:Incisor / Q000033:anatomy & histology; D008334:Mandible; D008437:Maxilla; D008963:Molar / Q000033:anatomy & histology; D016910:Orthodontic Brackets; D019279:Resin Cements / Q000737:chemistry*; D013193:Stainless Steel; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D013314:Stress, Mechanical; D013499:Surface Properties; D013696:Temperature; D013997:Time Factors; D014070:Tooth / Q000033:anatomy & histology*; D014867:Water
chemical_list: D000180:Acrylic Resins; D019279:Resin Cements; D014867:Water; D013193:Stainless Steel; C065742:Transbond; D017438:Bisphenol A-Glycidyl Methacrylate