Effect of Acid Surface Treatments on the Shear Bond Strength of Metal Bracket to Zirconia Ceramics

Abstract

The surface treatment of zirconia prior to bonding remains controversial and unclear. This study aimed to compare the shear bond strength (SBS) of metal brackets to zirconia under surface treatments with either 4% HF or 37% PA in both immediate loading (IML) and artificial aging by thermocycling (TMC). Methods: Eighty-four zirconia were randomly assigned to six groups based on the surface treatment and artificial aging by TMC: (1) No surface treatment (NT); (2) NT + TMC; (3) HF (4% HF for 2 min); (4) HF + TMC; (5) PA (37% PA for 2 min); and (6) PA + TMC. After bracket bonding, only the TMC groups were thermocycled for 5000 cycles. The SBS and adhesive remnant index (ARI) of all groups were analyzed (p < 0.01). Results: TMC significantly lowered the SBS more than the IML in all acid surface treatment groups (p < 0.01). The ARI score after TMC was significantly higher than the IML in all acid surface treatment groups (p < 0.001). No significant differences in the SBS values or ARI scores were observed among the surface treatments (p > 0.01). Conclusions: Two-minute simple etching methods, using either 4% HF or 37% PA, showed an insufficient SBS of metal orthodontic brackets to zirconia after TMC.