title: Tooth whitening effects on bracket bond strength in vivo.
abstract: OBJECTIVE
  To test the hypothesis that there is no difference between the bracket survival rate of brackets bonded to bleached and unbleached teeth.
  
  
  METHODS
  Thirty-eight patients who required comprehensive orthodontic treatment were included in the study. A split mouth technique was used with one arch exposed to in-office whitening gel containing 38% hydrogen peroxide for 30 minutes, while the unbleached arch served as the control. Patients were divided into two groups: Brackets bonded within 24 hours after bleaching and brackets bonded 2-3 weeks after bleaching. The bracket survival rate was computed using the log-rank test (Kaplan-Meier Analysis).
  
  
  RESULTS
  A significantly higher rate of bracket failure was found with bleached teeth (16.6%) compared with unbleached teeth (1.8%) after 180 days. Brackets bonded within 24 hours of bleaching resulted in significantly higher clinical failure (14.5%) compared with those bonded after 3 weeks (2.1%). Adhesive Remnant Index scores of failed brackets revealed that the majority of failure in bleached teeth occurred in the enamel/resin interface.
  
  
  CONCLUSIONS
  The hypothesis was rejected. Brackets bonded within 24 hours after bleaching have a significantly higher risk for bond failure. Orthodontic bonding should be delayed for 2-3 weeks if patients have a history of in-office bleaching with 38% hydrogen peroxide.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Mullins
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Kao
authors.forename: Chris A
authors.initials: CA
authors.lastname: Martin
authors.forename: Erdogan
authors.initials: E
authors.lastname: Gunel
authors.forename: Peter
authors.initials: P
authors.lastname: Ngan
mesh_terms: D000293:Adolescent; D002648:Child; D001840:Dental Bonding; D003743:Dental Enamel / Q000187:drug effects*; D003799:Dental Stress Analysis; D006801:Humans; D006861:Hydrogen Peroxide / Q000009:adverse effects; D053208:Kaplan-Meier Estimate; D016910:Orthodontic Brackets; D016877:Oxidants / Q000009:adverse effects; D019279:Resin Cements; D013997:Time Factors; D014073:Tooth Bleaching / Q000009:adverse effects*
chemical_list: D016877:Oxidants; D019279:Resin Cements; C477790:Transbond XT; D006861:Hydrogen Peroxide