Impact on Bond Strength Between Ceramics and Resin Cement

This is a brief account of research pursued dissertation, The effectiveness of self-etching primer verse conventional acid etches primer, submitted to the university for the award of the degree. The objective of the dissertation was to add to information the existing literature on medical science, which basically focused on the importance of orthodontic bonding, by taking comparison the effectiveness of two bonding agents, that is the self-etching primer and the conventional etch and bond by nursing the incidence, time and sites of failure in bracket. The findings showed that only 2.51% of bracket debonded from the study, encompassing sixteen brackets from dawn from the self-etching primer cluster and seventeen from the conventional etch and bond cluster. The results of the study indicated that both SEP and CEP are correspondingly effective in retaining brackets, and that bracket failure usually happens within the following three months of treatment, with the premolars on the lower jaws being the commonest site for bracket failure and the incisors on the on the upper jaws recording the least incidences of bracket failure. This paper will, therefore, present the study and its findings from the individual standpoint.

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Introduction

Together with my classmates at the University, we were tasked to research and write a dissertation in the last semester. We had to select a research topic for this study moths earlier, however, given that I had essentially begun to put some groundwork for it, I was beginning to be doubtful.

I had settled on the effectiveness of SEP and CEP, given the allocated period and the needed effort to complete the dissertation, I wanted to have a feeling that the dissertation will not only be beneficial to me in attaining my degree but it will also have the possibility of serving a greater purpose. Consequently, had chosen on the topic significantly because of the potential effect that broken brackets and specifically SEP and CEP cause on the economically disenfranchised individuals, and therefore, I wanted to research and come up with a personal understanding of a key aspect to this. Throughout the study, I was hopeful about developing my personal understanding rather than the potential for any impact on any other person, a dream that seemed noble anyway.

After conducting some background reading, I conceived that the manner in which I was approaching the matter at hand could address the existing gap in the bracket failure. Importantly, many studies have focused on the bracket failure rate of SEP and CEP that gave varying findings. Some studies showed that self-etch primer possesses a meaningfully greater bond failure as compared to the conventional etch and prime system (Arash et al., 2017). Nevertheless, some researchers pointed the there was the insignificant difference between the self-etch and the conventional etching system for the bracket failure (Botton et al., 2016). Although I could understand the focus of these studies, I felt that focusing on the comparison between the two adhesives was of significant importance to try and close the research gap.

With the existence of the apparent research gap and the compelling urge to address it, I became hopeful about my plans. Nevertheless, I also felt some fear concerning the feasibility and the usefulness of the research, and in addition to my inexperience in encountering the bracket failures and the adhesives. However, after holding preliminary discussions with the experienced dentists, to advise me on the various aspects on the interview served to expose the degree of my ignorance in some areas and at the same time reassured me of a successful study. All the persons of interests in my study, whom I would perform the interviews, illustrated a point of interest in the subject of my dissertation which was a point in the right direction. Nevertheless, from these discussions, I discovered that not all the SEP brackets fail three weeks after medication as it is opined in many kinds of literature. This new finding challenged one of the unconscious presumptions I had harboured to the project and made me ponder whether more significant unknown presumptions might be waiting to unravel themselves. At this preliminary stage, I could only wait and observe what could pop up and carry the hope that, that would not occur.

Literature review

However, I tried to deeply and widely read on the earlier literature on the subject matter with the objective of gaining some understanding on the effectiveness of SEP and CEP. I found literature in the fields of clinical nursing and medical dentistry to be specifically instructive in this regard.

Research on the dental material, specifically in the bonding agent (Mirzakouchaki et al., 2016), gave an insight into the patient comfort and at the same time to simplify the treatment procedure. The significance of a bonding system that is constantly reliable, biocompatible, not affected by contamination of the saliva and most significantly easy to use, has led to the discovery of products that do not need the primary step of etching the enamel surface (Tribst et al., 2018).

This literature, assisted in dispelling some of the fears that I harboured concerning the legitimacy of my study, given that they seemed to build up an image congenial to my objectives. This was further reaffirmed by the statistics that for the better part appeared to confirm my presumptions regarding the effectiveness of SEP and CEP (Flores et al.,2015). For instance, from the study, it was statistically identified that thirty-three brackets were bound for both the adhesives, that is 17 for CEP and 16 for SEP, which illustrated that the bracket failure for both SEP and CEP was insignificant.

By reading this literature, I acquired contradicting views on the effectiveness of SEP in comparison with CEP. This made question my own motivations, however, it proved difficult to pin any literature down with absolute certainty, I strived as much as I could not color any response from the interviewee with my individual ideas.

Methodology

Accordingly, in an effort to grant some level of participant-led responses and at the same time compensate for my inadequate experience in research, I settled on semi-structured interviews. After revising my demographic questionnaire and skeleton interview scripts a number of times and performing several practices runs with my friends and classmates, I was ready to partake my interviews. However, I had been in contact with a number of dental patients, though a significant aid came from the dentists who offered to introduce me to the potential participants and at the same time offered me private rooms in their clinics to conduct the interviews. During this period, I chose not to provide incentives given the ethical concerns and therefore, only depended on the respondents' generosity.

The interview process basically went down extremely smoothly, however, there was a steep learning curve. Significantly, I also relaxed a bit with every interview during which I acquired extra experience and got nearer to completing the study. Nevertheless, I also comprehended that the initial insight about sleeping was not the only thing I had missed. Despite my concerns to devoid from exoticizing any person, and to ensure a blank slate until something was written on it, by the close of the interview on day one, I appreciated that I had comprehended a significant distinction between the SEP and CEP.

Findings

Importantly, I had been paying attention to the Research Methods lesions and as such my research questions were not binding to any foregoing resolution. Nevertheless, the realization of this presumption and the accompanying fallacy felt to me like a revelation of sorts. It appeared too obvious and at the same time stubborn, the elusive presumption that had meant that there existed some ideas in my primary conception of research that were totally not related to the reality.

Nevertheless, there were a number of nuanced findings that became of interest. Despite the fact that a majority of the participants appeared relatively nonchalant that, if they wanted to, they could use the CEP adhesive, some of the participants never highlighted any difficulty with either of the adhesives. This was significantly unsurprising given that the backgrounds and the circumstances surrounding many participants would offer limited information about the two adhesives.

Conclusion

While it is certainly wrong to trivialize the effectiveness of the two adhesives, it is also significant not envisage an absolute dichotomy between the SEP adhesive and the CEP adhesive. This study set out to lay emphasis on the comparison of the effectiveness between the two adhesives by taking into consideration the degree of level bracket failure.

Nevertheless, some participants did not have difficulties with either of the adhesives; these difficulties were predominantly liked to the degree of bracket failure for either of the adhesives. Past experiences were also viewed to affect the perception which some participants had on the adhesives.

Finally, in the majority of the instances, the major differences arising from the SEP and CEP were minor rather than significant. This observation supported the fact that there is an insignificant distinction in the level of effectiveness between the two adhesives.

References

Arash, V., Naghipour, F., Ravadgar, M., Karkhah, A. and Barati, M.S., 2017. The shear bond strength of ceramic and metallic orthodontic brackets bonded with self-etching primer and conventional bonding adhesives. Electronic physician, 9(1), p.3584.

Botton, G., Morgental, C.S., Scherer, M.M., Lenzi, T.L., Montagner, A.F. and Rocha, R.D.O., 2016. Are selfetch adhesive systems effective in the retention of occlusal sealants? A systematic review and metaanalysis. International journal of paediatric dentistry, 26(6), pp.402-411.

Flores, T., Mayoral, J.R., Giner, L. and Puigdollers, A., 2015. Comparison of enamel-bracket bond strength using direct-and indirect-bonding techniques with a self-etching ion releasing S-PRG filler. Dental materials journal, 34(1), pp.41-47.

Mirzakouchaki, B., Shirazi, S., Sharghi, R., Shirazi, S., Moghimi, M. and Shahrbaf, S., 2016. Shear bond strength and debonding characteristics of metal and ceramic brackets bonded with conventional acid-etch and self-etch primer systems: An in-vivo study. Journal of clinical and experimental dentistry, 8(1), p.e38.

Tribst, J.P.M., Anami, L.C., Ozcan, M., Bottino, M.A., Melo, R.M. and Saavedra, G.S.F.A., 2018. Self-etching Primers vs Acid Conditioning: Impact on Bond Strength Between Ceramics and Resin Cement. Operative dentistry.