title: Comparison of fluoridated apatites with pure hydroxyapatite as potential biomimetic alternatives to enamel for laboratory-based bond strength studies.
abstract: OBJECTIVE
  To investigate whether fluoridated apatites have a shear bond strength which more closely equates to that of natural enamel than pure hydroxyapatite, making them potentially useful as biomimetic alternatives to natural enamel for ex vivo laboratory bonding studies.
  
  
  METHODS
  Discs of pure hydroxyapatite, pure fluorapatite and a 1:1 mixture of hydroxyapatite-fluorapatite were produced by cold uni-axial pressing. The discs were sintered at 1300 degrees C, embedded in epoxy resin, ground and polished. X-ray diffraction technique was used to analyse the purity of the apatites. Scanning electron microscopy was employed to investigate the etch patterns of the apatite specimens. Ninely-six upper left central incisor brackets were bonded to each of the three groups of discs. Shear bond strengths were determined by debonding the brackets using a loaded metal jig in an Instron Universal Testing Machine. The sites of bond failure were recorded using the Adhesive Remnant Index. One-way analysis of variance (ANOVA) and Bonferroni post-hoc comparisons were used to determine statistical differences between the mean shear bond strengths of the three specimen groups.
  
  
  RESULTS
  The mean shear bond strength of pure hydroxyapatite (20.44 MPa; SD: 8.03; 95% CI: 18.81, 22.07) was significantly higher than those of fluorapatite (13.13 MPa; SD: 6.76; 95% CI: 11.76, 14.50) and hydroxyapatitefluorapatite (13.62 MPa; SD: 7.03; 95% CI: 12.19, 15.04) (p < 0.001). There was no statistically significant difference in shear bond strengths between fluorapatite and hydroxyapatite-fluorapatite (p > 0.99), and both were below the normal range ascribed to enamel (15-20 MPa). More than 90 per cent of the fluorapatite and the hydroxyapatite-fluorapatite specimens demonstrated bond failure at the substrate-adhesive interface, while only one-third of the hydroxyapatite specimens exhibited bond failure at that interface.
  
  
  CONCLUSIONS
  Pure fluorapatite and hydroxyapatite-fluorapatite specimens offer no advantage over pure hydroxyapatite as a suitable artificial substrate for ex vivo bond strength testing.
authors.affiliation: Unit of Orthodontics, UCL Eastman Dental Institute for Oral Health Care Sciences, London, United Kingdom. s.jones@eastman.ucl.ac.uk
authors.forename: Steven P
authors.initials: SP
authors.lastname: Jones
authors.forename: Godwin C Y
authors.initials: GC
authors.lastname: Cheuk
authors.forename: George
authors.initials: G
authors.lastname: Georgiou
authors.forename: David R
authors.initials: DR
authors.lastname: Moles
mesh_terms: D001031:Apatites; D040761:Biomimetic Materials; D001840:Dental Bonding; D003743:Dental Enamel; D045662:Dental Etching; D003799:Dental Stress Analysis; D004338:Drug Combinations; D017886:Durapatite; D006801:Humans; D008422:Materials Testing; D016910:Orthodontic Brackets; D019279:Resin Cements; D033081:Shear Strength
chemical_list: D001031:Apatites; D004338:Drug Combinations; D019279:Resin Cements; C477790:Transbond XT; D017886:Durapatite; C025105:fluorapatite